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Current position of ALPPS in the surgical landscape of CRLM treatment proposals

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World journal of Gastroenterology 2013年第39期19卷 6548-6554页

作者： Marcello Donati Gregor A Stavrou karl j oldhafer Department of General and Abdominal Surgery Asklepios Hospital Barmbek22291 HamburgGermany Department of Surgery General and Oncologic Surgery UnitVittorio-Emanuele University Hospital of Catania95122 CataniaItaly

The Authors summarize problems,criticisms but also advantages and indications regarding the recent surgical proposal of associating liver partition and portal vein ligation(PVL)for staged hepatectomy(ALPPS)for the surgical management of colorectal liver *** at published data,the technique,when compared with other traditional and well established methods such as PVL/portal vein embolisation(PVE),seems to give real advantages in terms of volumetric gain of future liver ***,major concerns are raised in the literature and some questions remain unanswered,preliminary experiences seem to be *** method has been adopted all over the world over the last 2 years,even if oncological long-term results remain unknown,and benefit for patients is *** prospective studies comparing traditional methods(PVE,PVL or classical 2 staged hepatectomy)with ALPPS are available to *** reinterpretations of the original method were also proposed in order to enhance feasability and increase safety of the *** data about morbidity and mortality are also *** real role of ALPPS is,to date,still to be *** clinical studies,even if,for ethical reasons,in well selected cohorts of patients,are expected to better define the indications for this new surgical strategy.

关键词： Portal ligation In situ split Liver resections Colorectal metastases Liver metastases

Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score:is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)?

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 52-66,I0007,I0008页

作者： Ivan Capobianco karl j.oldhafer Mohammed-Hossein Fard-Aghaie Ricardo Robles-Campos Roberto Brusadin Henrik Petrowsky Michael Linecker Arianeb Mehrabi Katrin Hoffmann jun Li Asmus Heumann Roberto Hernandez-Alejandro Mauro Enrique Tun-Abraham Elio jovine Matteo Serenari Bergthor Bjornsson Per Sandström Ruslan Alikhanov Mikhail Efanov Paolo Muiesan Andrea Schlegel Thomas M.van Gulik Pim B.Olthof Gregor Alexander Stavrou Lina Maria Serna-Higuita Alfred Königsrainer Silvio Nadalin Department of General Visceral and Transplant SurgeryUniversity Hospital TübingenTübingenGermany Department of General and Abdominal Surgery Asklepios Hospital BarmbekHamburgGermany Department of Surgery Virgen de la Arrixaca Clinic and University HospitalMurciaSpain Swiss HPB and Transplantation Center Department of SurgeryZurich University HospitalZurichSwitzerland Department of General Visceraland Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany General Visceral and Thoracic Surgery Department and ClinicHamburg-Eppendorf University Medical CenterHamburgGermany Division of Transplantation and Hepatobiliary Surgery University of RochesterRochesterNYUSA Division of HPB Surgery and Liver Transplantation Department of SurgeryLondon Health Sciences CentreLondonCanada General and Emergency Surgery Unit Azienda Ospedaliero-Universitaria di BolognaMaggiore HospitalBolognaItaly General Surgery and Transplantation Unit Azienda Ospedaliero-Universitaria di BolognaSant’Orsola-Malpighi HospitalBolognaItaly Department of Surgery in Linköping and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden Department of Hepatopancreatobiliary Surgery Moscow Clinical Scientific CenterMoscowRussia Liver Unit Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Surgery Amsterdam UMC(Location AMC)University of AmsterdamAmsterdamThe Netherlands Department of General Abdominal and Thoracic SurgerySurgical OncologySaarbruecken General HospitalSaarbrueckenGermany Department of Clinical Epidemiology and Applied Biometry University of TübingenTübingenGermany

Background:Preoperative patient selection in Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)is not always reliable with currently available scores,particularly in patients with primary liver *** study aims to(I)to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and(II)to create a score predicting 90-day mortality ***:Thirteen high-volume centers participated in this retrospective multicentric study.A risk analysis based on patient characteristics,underlying disease and procedure type was performed to identify risk factors and model the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score.A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index(CCI),the age-adjusted CCI(aCCI),the ALPPS risk score before Stage 1(ALPPS-RS1)and Stage 2(ALPPS-RS2).The model was internally validated applying ***:A total of 451 patients were *** was 14.4%.The CAPRA score is calculated based on the following formula:(0.1×age)−(2×BSA)+1(in the presence of primary liver tumor)+1(in the presence of severe cardiovascular disease)+2(in the presence of moderate or severe diabetes)+2(in the presence of renal disease)+2(if classic ALPPS is planned).The predictive ability was 0.837 for the CAPRA score,0.443 for CCI,0.519 for aCCI,0.693 for ALPPS-RS1 and 0.807 for *** 1,000 cycles of bootstrapping the C statistic was *** accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of ***:Comorbidities play an important role in ALPPS and should be carefully considered when planning the *** assessing the patient’s preoperative condition in relation to ALPPS,the CAPRA score has a very good ability to predict postoperative mortality.

关键词： Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS) comorbidity mortality prediction model patient selection

Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

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Health 2024年第2期16卷 148-159页

作者： Mark j. Kupersmith karl Kieburtz Department of Neurology Ophthalmology and Neurosurgery Icahn School of Medicine at Mount Sinai New York NY USA SafeTherapeutics LLC New York NY USA Clintrex Research Corporation Sarasota FL USA

Importance/Objective: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent injury. We suggest that available medical information and digital/electronic methods could be used to manage this major healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subject heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast majority of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

关键词： Adverse Drug Reaction Medication Side Effect Identification Medication Complication Medication Safety

Dynamic convergent shock compression initiated by return current in high-intensity laser-solid interactions

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Matter and Radiation at Extremes 2024年第4期9卷 40-53页

作者： Long Yang Martin Rehwald Thomas Kluge Alejandro LasoGarcia Toma Toncian karl Zeil Ulrich Schramm Thomas E.Cowan Lingen Huang Helmholtz-Zentrum Dresden-Rossendorf 01328 DresdenGermany Technische Universitat Dresden 01062 DresdenGermany

We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser *** particle-in-cell simulations and coupled hydrodynamic simulations reveal that the compression process is initiated by both magnetic pressure and surface ablation associated with a strong transient surface return current with density of the order of 10^(17) A/m^(2) and lifetime of 100 *** results show that the dominant compression mechanism is governed by the plasma β,i.e.,the ratio of thermal pressure to magnetic *** targets with small radius and low atomic number Z,the magnetic pressure is the dominant shock compression *** to a scaling law,as the target radius and Z increase,the surface ablation pressure becomes the main mechanism generating convergent ***,an indirect experimental indication of shocked hydrogen compression is provided by optical shadowgraphy measurements of the evolution of the plasma expansion *** results presented here provide a novel basis for the generation of extremely high pressures exceeding Gbar(100 TPa)to enable the investigation of high-pressure physics using femtosecond j-level laser pulses,offering an alternative to nanosecond kj-laser pulse-driven and pulsed power Z-pinch compression methods.

关键词： shock convergent return

Elucidating regulatory processes of intense physical activity by multi-omics analysis

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Military Medical Research 2024年第4期11卷 479-499页

作者： Ernesto S.Nakayasu Marina A.Gritsenko Young-Mo Kim jennifer E.Kyle Kelly G.Stratton Carrie D.Nicora Nathalie Munoz Kathleen M.Navarro Daniel Claborne Yuqian Gao karl K.Weitz Vanessa L.Paurus Kent j.Bloodsworth Kelsey A.Allen Lisa M.Bramer Fernando Montes Kathleen A.Clark Grant Tietje justin Teeguarden Kristin E.Burnum-johnson Biological Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Environmental and Molecular Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthWestern States DivisionDenverCO 80204USA Computational Analytics Division Pacific Northwest National LaboratoryRichlandWA 99352USA National Security Directorate Pacific Northwest National LaboratoryRichlandWA 99352USA Los Angeles County Fire Department Los AngelesCA 90063USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthRespiratory Health DivisionMorgantownWV 26505USA Environmental and Molecular Toxicology Oregon State UniversityCorvallisOR 97331USA

Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work ***:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise *** profiles ***-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics ***:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of *** blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy *** urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid *** saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory ***:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.

关键词： Multi-omics analysis Intense exercise Human performance Biofluids Metabolism Immunity

The relationship between relative growth rate and whole-plant C:N:P stoichiometry in plant seedlings grown under nutrient-enriched conditions

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journal of Plant Ecology 2011年第3期4卷 147-156页

作者： Youhong Peng karl j.Niklas Shucun Sun ECORES Lab Chengdu Institute of BiologyChinese Academy of Sciences9 Section 4 Renminnan RoadChengdu 610041China Department of Plant Biology Cornell UniversityIthacaNY 14850USA Department of Biology Nanjing UniversityNanjing 210093China

Aims Recent theories indicate that N is more in demand for plant growth than P;therefore,N concentration and N:C and N:P ratios are predicted to be positively correlated with relative growth rate(RGR)in plants under nutrient-enriched *** prediction was tested in this *** We examined the whole-plant concentrations of C,N and P and RGR,as well as the relationship between RGR and the concentrations and the ratios of N:C,P:C and N:P,for different harvest stages(the days after seed germination)of the seedlings of seven shrub species and four herbaceous species grown in N and P non-limiting *** relationships among plant size,nutrient concentrations and ratios were subsequently *** Findings RGR was positively correlated with N concentration and the ratios of N:PandN:C when the data were pooled for all species and for each shrub species,but not for individual herbaceous ***,the relationship between RGR and P concentration and P:C was not significantly correlated for either shrubs or *** variation of N among harvest stages and species was much greater than that of P,and the variation in N:P ratio was determined primarily by changes in N *** shrub species differed from the herbaceous species in their N and P concentrations,nutrient ratios and in intraspecific relationships between RGR and nutrient *** differences possibly reflect differences in the capacity for P storage and biomass allocation *** general,our data support recent theoretical predictions regarding the relationship between RGR and C:N:P stoichiometry,but they also show that species with different life forms differ in the relationships among RGR and C:N:P stoichimetries.

关键词： C:N:P stoichiometry RGR growth rate hypothesis life forms seedlings screening experiment

Life cycle and morphology of development stages of Physocephalus dromedarii (Nematoda: Spirocercidae)

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Asian Pacific journal of Tropical Biomedicine 2016年第10期6卷 825-829页

作者： Rolf karl Schuster Saritha Sivakumar jrg Kinne Central Veterinary Research Laboratory

Objective: To study the development of Physocephalus dromedarii(P. dromedarii) in the final ***: For this, 5 adult dromedaries were orally infected with third larval stages of P. dromedarii obtained from naturally infected scarab beetles(Scarabaeus cristatus). The camels were necropsied 14, 42, 70, 84 and 280 days after infection and their abomasi were examined for the presence of ***: Early 4th stage larva occurred already 2 weeks after infection. They were still in the sheet of the 3rd stage larva. Six weeks after infection, the nematodes became juvenile male and female adults measuring 9 and 10 mm, respectively. Their size doubled at 10 weeks post infection and patency was reached at 12 weeks. P. dromedarii was still present in the camel that was examined 40 weeks after ***: As a result of experimental infection of the natural host, the determined prepatent period of P. dromedarii equalled 12 weeks.

关键词： Physocephalus dromedarii Nematoda Life cycle Dromedary Abomasum

Vibrational Analysis of Oxygen Adsorption on Cs and CO Coadsorbate Precovered Ru(0001)Surface

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Chinese Physics Letters 1999年第6期16卷 428-430页

作者： HE Pei-mo karl jacobi Department of Physics Zhejiang UniversityHangzhou 310027 Fritz-Haber-Institut der Max-Planck-Gesellschaft Faradayweg 4-6D-14195 BerlinGermany

Vibrational analysis of oxygen adsorption on the Cs and CO coadsorbate precovered Ru(0001)surface was carried out by means of high-resolution electron energy loss *** submonolayer Cs coverages on Ru(0001)j an appropriate amount of CO adsorption leads to formation of(2x2)-Cs+2CO *** oxygen adsorption on this Cs and CO coadsorbate precovered surface results in a remarkable change of high-resolution electron energy loss *** loss peak of C-O stretch mode for 2x2 island species decreases in intensity,which is accompanied by appearance of new bands at about 87 and 240 *** results show that Cs adatoms and CO molecules are rearranged upon oxygen adsorption,and are correlated with coexistence of bare surface CO and a mixed phase of Cs,CO,and O.

关键词： spectroscopy. adsorption Adsorption

Induced pluripotent stem cells as suitable sensors for fibromyalgia and myalgic encephalomyelitis/chronic fatigue syndrome

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World journal of Stem Cells 2021年第8期13卷 1134-1150页

作者： María B Monzón-Nomdedeu karl j Morten Elisa Oltra School of Biotechnology Universidad Católica de Valencia San Vicente MártirValencia 46001Spain Nuffield Department of Women's and Reproductive Health The Women CentreUniversity of OxfordOxford OX39DUUnited Kingdom Department of Pathology Universidad Católica de Valencia San Vicente MártirValencia 46001Spain Centro de Investigación Traslacional San Alberto Magno Universidad Católica de Valencia San Vicente MártirValencia 46001Spain

BACKGROUND Fibromyalgia(FM)and myalgic encephalomyelitis/chronic fatigue syndrome(ME/CFS)are devastating metabolic neuroimmune diseases that are difficult to diagnose because of the presence of numerous symptoms and a lack of specific *** patient heterogeneity linked to patient subgroups and variation in disease severity,anomalies are found in the blood and plasma of these patients when compared with healthy control *** seeming specificity of these“plasma factors”,as recently reported by Ron Davis and his group at Stanford University,CA,United States,and observations by our group,have led to the proposal that induced pluripotent stem cells(iPSCs)may be used as metabolic sensors for FM and ME/CFS,a hypothesis that is the basis for this indepth *** To identify metabolic signatures in FM and/or ME/CFS supporting the existence of disease-associated plasma factors to be sensed by *** A PRISMA(Preferred Reported Items for Systematic Reviews and Meta-analysis)-based systematic review of the literature was used to select original studies evaluating the metabolite profiles of FM and ME/CFS body *** MeSH terms“metabolomic”or“metabolites”in combination with FM and ME/CFS disease terms were screened against the PubMed *** original studies applying omics technologies,published in English,were *** data obtained were tabulated according to the disease and type of body fluid *** across studies were searched and P-values reported by the original studies were gathered to document significant differences found in the disease *** Eighteen previous studies show that some metabolites are commonly altered in ME/CFS and FM body *** vitro cell-based assays have the potential to be developed as screening platforms,providing evidence for the existence of factors in patient body fluids capable of altering morphology,differentiation state and/or growth ***,they can be further develo

关键词： Myalgic encephalomyelitis/chronic fatigue syndrome Fibromyalgia Induced pluripotent stem cells Plasma factor Conditioned medium Sensor system