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The SAFe-T upper endoscopy tool:a web-based application for the point-of-care evaluation of gastroenterology fellow performance in upper endoscopy

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Gastroenterology Report 2020年第6期8卷 431-436,I0001,I0002页

作者： Navin L.Kumar Guillaume Kugener kelly e.hathorn Molly L.Perencevich Kunal Jajoo John R.Saltzman Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalBostonMAUSA Harvard Medical School BostonMAUSA Massachusetts Institute of Technology CambridgeMAUSA

Background:Attending assessment is a critical part of endoscopic education for gastroenterology *** aim of this study was to develop and validate a concise,web-based assessment tool to evaluate real-time fellow performance in upper ***:We developed the Skill Assessment in Fellow endoscopy Training(SAFe-T)upper endoscopy tool to capture both summative and formative feedback in a concise,five-part *** tool mirrors the previously validated SAFe-T colonoscopy tool and is administered electronically via a web-based *** evaluated the tool in a prospective study of 15 gastroenterology fellows(5 fellows each from Years 1–3 of training)over the 2018–2019 academic *** independent reviewer evaluated a subset of these procedures and completed both the SAFe-T and Assessment of Competency in endoscopy(ACe)upper endoscopy forms for reliability ***:Twenty faculty completed 413 SAFe-T evaluations of the 15 fellows in the *** mean SAFe-T overall score differentiated each sequential fellow year of training,with first-year cases having lower performance than second-year cases(3.31 vs 4.25,Pecond-year cases having lower performance than third-year cases(4.25 vs 4.56,Pe mean SAFe-T overall score decreased with increasing case-complexity score,with straightforward compared with average cases(3.98 vs 3.39,Perage compared with challenging cases(3.39 vs 2.84,P=0.042).In dual-observed procedures,the SAFe-T tool showed excellent inter-rater reliability with a Kappa agreement statistic of 0.815(P=0.001).The SAFe-T overall score also highly correlated with the ACe upper endoscopy overall hands-on score(r=0.76,P=0.011).Conclusions:We developed and validated the SAFe-T upper endoscopy tool—a concise and web-based means of assessing real-time gastroenterology fellow performance in upper endoscopy.

关键词： endoscopy education assessment tool fellowship trainee

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Role of gastroesophageal reflux disease in lung transplantation

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World Journal of Transplantation 2017年第2期7卷 103-116页

作者： kelly e hathorn Walter W Chan Wai-Kit Lo Division of Internal Medicine Brigham and Women’s Hospita Wai-Kit Lo Division of Gastroenterology Hepatology and Endoscopy Brigham and Women’s Hospital Harvard Medical School

Lung transplantation is one of the highest risk solid organ transplant modalities. Recent studies have demonstrated a relationship between gastroesophageal reflux disease(GeRD) and lung transplant outcomes, including acute and chronic rejection. The aim of this review is to discuss the pathophysiology, evaluation, and management of GeRD in lung transplantation, as informed by the most recent publications in the field. The pathophysiology of reflux-induced lung injury includes the effects of aspiration and local immunomodulation in the development of pulmonary decline and histologic rejection, as reflective of allograft injury. Modalities of reflux and esophageal assessment, including ambulatory p H testing, impedance, and esophageal manometry, are discussed, as well as timing of these evaluations relative to transplantation. Finally, antireflux treatments are reviewed, including medical acid suppression and surgical fundoplication, as well as the safety, efficacy, and timing of such treatments relative to transplantation. Our review of the data supports an association between GeRD and allograft injury, encouraging a strategy of early diagnosis and aggressive reflux management in lung transplant recipients to improve transplant outcomes. Further studies are needed to explore additional objective measures of reflux and aspiration, better compare medical and surgical antireflux treatment options, extend followup times to capture longer-term clinical outcomes, and investigate newer interventions including minimally invasive surgery and advanced endoscopic techniques.

关键词： Lung transplant Reflux Aspiration Rejection Bronchiolitis obliterans syndrome Fundoplication

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Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects

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World Journal of Gastrointestinal endoscopy 2019年第5期11卷 329-344页

作者： Diogo Turiani Hourneaux de Moura Bruna Furia Buzetti Hourneaux de Moura Michael A Manfredi kelly e hathorn Ahmad N Bazarbashi Igor Braga Ribeiro eduardo Guimaraes Hourneaux de Moura Christopher C Thompson Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s Hospital-Harvard Medical School Department of endoscopy of Clinics Hospital of Sao Paulo University esophageal and Airway Atresia Treatment Center Boston Children's Hospital-Harvard Medical School

A gastrointestinal(GI) transmural defect is defined as total rupture of the GI wall,and these defects can be divided into three categories: perforations,leaks,and fistulas. Surgical management of these defects is usually challenging and may be associated with high morbidity and mortality rates. Recently,several novel endoscopic techniques have been developed,and endoscopy has become a firstline approach for therapy of these conditions. The use of endoscopic vacuum therapy(eVT) is increasing with favorable results. This technique involves endoscopic placement of a sponge connected to a nasogastric tube into the defect cavity or lumen. This promotes healing via five mechanisms,including macrodeformation,microdeformation,changes in perfusion,exudate control,and bacterial clearance,which is similar to the mechanisms in which skin wounds are treated with commonly employed wound vacuums. eVT can be used in the upper GI tract,small bowel,biliopancreatic regions,and lower GI tract,with variable success rates and a satisfactory safety profile. In this article,we review and discuss the mechanism of action,materials,techniques,efficacy,and safety of eVT in the management of patients with GI transmural defects.

关键词： Gastrointestinal endoscopy endoscopic vacuum therapy Negative pressure therapy Fistula Leak Perforation Defect

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Homeward bound:canopy cover and species identity influence non-breeding season homing success and speed in forest birds

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Avian Research 2021年第2期12卷 173-180页

作者： Jin Bai Chelsea A.Weitekamp kelly Frye Kathryn e.Sieving Wildlife ecology and Conservation University of FloridaGainesvilleFLUSA Forest Resources and Conservation University of FloridaGainesvilleFLUSA

Background:efficient and safe movement is fundamental for wild birds to thrive in their *** arboreal forest animals,especially birds,canopy cover has a large impact on birds’daily movements and is a crucial component of conservation strategies seeking to retain avian population in disturbed or urban ***:We translocated woodland bird species utilizing different forest strata during two non-breeding seasons in Gainesville,FL,*** used linear model and generalized linear model to examine the effects of canopy cover and species identity on homing success and ***:Among our study species of Tufted Titmouse(Baeolophus bicolor),Carolina Chickadee(Poecile carolinensis),and Northern Cardinal(Cardinalis cardinalis),we found that Carolina Chickadees and Tufted Titmice were more likely to return than Northern *** birds that successfully returned,homing speed is significantly affected by forest canopy cover and species identity(titmice had higher homing speed than cardinals).Birds return much faster in landscape with higher canopy ***:This study presented evidence of species identity’s effect on homing success and speed in common feeder bird species in Southeast US and provided further evidence that bird movements in the suburban land cover are constrained by low canopy cover.

关键词： Forest bird movement Forest canopy cover Homing behaviour Non-breeding season Site fidelity

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Deciphering the role of hedgehog signaling in pancreatic cancer

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The Journal of Biomedical Research 2016年第5期30卷 353-360页

作者： Dongsheng Gu kelly e Schlotman Jingwu Xie Wells Center for Pediatric Research Division of Hematology and OncologyDepartment of PediatricsIndiana University Simon Cancer CenterIndiana University

Pancreatic cancer, mostly pancreatic ductal adenocarcinoma （PDAC）, is a leading cause of cancer-related death in the US, with a dismal median survival of 6 months. Thus, there is an urgent unmet need to identify ways to diagnose and to treat this deadly cancer. Although a number of genetic changes have been identified in pancreatic cancer, their mechanisms of action in tumor development, progression and metastasis are not completely understood. Hedgehog signaling, which plays a major role in embryonic development and stem cell regulation, is known to be activated in pancreatic cancer; however, specific inhibitors targeting the smoothened molecule failed to improve the condition of pancreatic cancer patients in clinical trials. Furthermore, results regarding the role of Hh signaling in pancreatic cancer are controversial with some reporting tumor promoting activities whereas others tumor suppressive actions. In this review, we will summarize what we know about hedgehog signaling in pancreatic cancer, and try to explain the contradicting roles of hedgehog signaling as well as the reason（s） behind the failed clinical trials. In addition to the canonical hedgehog signaling, we will also discuss several non-canonical hedgehog signaling mechanisms.

关键词： hedgehog pancreatic cancer Glil non-canonical signaling cancer metastasis

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Can active late-type stars contribute to the Galactic lithium abundance?

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Research in Astronomy and Astrophysics 2020年第7期20卷 127-133页

作者： Darnell e.kelly Damian J.Christian Mihalis Mathioudakis Darko Jevremovi′c Department of Physics and Astronomy California State UniversityNorthridgeCA 91330-8268USA Astrophysics Research Centre School of Mathematics and PhysicsQueen’s University BelfastBelfast BT71NNUK Astronomical Observatory Volgina 711060 BelgradeSerbia

Lithium abundances in our Galaxy and especially 6 Li abundances provide important constraints on our understanding of Big Bang Nucleosynthesis(BBNS),stellar evolution and the creation of light elements by cosmic rays in the ISM.~6 Li has been detected in energetic solar events,one chromospherically active binary and several dwarf halo *** our work on active late-type stars with high lithium abundances,we expand our study to consider if the flare origin of lithium created by spallation can contribute significantly to the Galactic abundance of *** previously derived ~6 Li/~7 Li=0.030 ± 0.010 for active K dwarf GJ 117 using VLT UVeS *** find^6 Li/~7 Li ratios of 0.02 and 0.10 for two other stars in our sample,GJ 182 and eUVe J1145-55.3 A,*** that these later type,active stars have significant flare rates and stellar winds,we have estimated the contribution of these stars to the Galactic lithium *** that K and M stars comprise over 84% of our Galaxy and that many of these can have significant stellar winds,we conclude that spallation in stellar flares can contribute 1% and up to 5% of the Galactic lithium abundance.

关键词： stars:abundances stars:activity Galaxy:abundances

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Phase-selective graphene oxide membranes for advanced microfluidic flow control

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Microsystems & Nanoengineering 2016年第1期2卷 256-262页

作者： Jennifer Gaughran David Boyle James Murphy Robert kelly Jens Ducrée School of Physical Sciences Dublin City UniversityDublin 9Ireland Biomedical Diagnostics Institute Dublin City UniversityDublin 9Ireland

For the first time,we harness the unique phase-selectivity of chip-integrated graphene oxide(GO)membranes to significantly enhance flow control on centrifugal microfluidic *** this paper,we present novel processes for the assembly of these GO membranes into polymeric microfluidic systems and demonstrate that multilayer GO membranes allow the passage of water while blocking pressurized air and organic solutions.

关键词： centrifugal microfluidics flow control graphene oxide membranes solvent selectivity

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INVeSTIGATION OF THe ATRP OF n-BUTYL MeTHACRYLATe USING THe Cu(I)/N,N,N',N",N"-PeNTAMeTHYLDIeTHYLeNeTRIAMINe CATALYST SYSTeM

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Chinese Journal of Polymer Science 2004年第2期22卷 195-204页

作者： kelly A. Davis Krzysztof Matyjaszewski Center for Macromolecular engineering Department of Chemistry Carnegie Mellon University 4400 Fifth Ave.Pittsburgh Pennsylvania 15213 USACenter for Macromolecular Engineering Department of Chemistry Carnegie Mellon University 4400 Fifth Ave.Pittsburgh Pennsylvania 15213 USA

The polymerization of n-butyl methacrylate was investigated using the Atom Transfer Radical Polymerization technique with CuBr and CuCl/N,N,N',N',N'-pentamethyldiethylenetriamine catalytic systems. Various combinations of catalyst systems and initiators were utilized in order to optimize the polymerization conditions and to obtain well-defined polymers (i.e. controlled molecular weights and low polydispersities). It has been found that the optimal initiator for this system is a chlorine-based initiator, when the catalyst used is a salt in conjunction with the N,N,N',N',N'- pentamethyldiethylenetriamine ligand. Bromine-based initiators tend to result in large amounts of initial termination, leading to polymers with less than ideal chain end functionality, even if CuCl is used as the species to invoke the halogen exchange. Additionally, the effects of the polymerization temperature, species and the initiator structure were determined.

关键词： ATRP Atom transfer radical polymerization Controlled/living radical polymerization Butyl methacrylate Pentamethyldiethylenetriamine

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A review of experimental design in forensic taphonomy:moving towards forensic realism

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Forensic Sciences Research 2020年第4期5卷 249-259页

作者： kelly L.Miles Devin A.Finaughty Victoria e.Gibbon Department of Biology University of New BrunswickFrederictonNBCanada School of Anthropology and Conservation University of KentCanterburyUK Department of Human Biology University of Cape TownCape TownWCSouth Africa

Forensic taphonomy as a discipline requires standardization to satisfy Daubert criteria for sci-entific data to be admissible in *** response,there has been a shift towards quantifica-tion of methodology and estimating the postmortem *** these advances,there are still biases and limitations within the discipline not explicitly addressed in the early stages of experimental design nor in final published *** this article,unresolved debates with respect to the conductance and reporting of forensic taphonomic research are reviewed,beginning with the nature of experimental cadavers,human or animal analogues and their body size,and second,the forensic realism of experimental setups,specifically with respect to caging,clothing and number of ***,albeit imperfect,are a good model to gain a general idea of the trends that may be seen in humans in subsequent validation studies in facilities where human donors are *** date,there is no consen-sus among taphonomists on the extent of the effect that body mass has on decomposition *** research is required with both human cadavers and non-human analogues that builds on our current knowledge of forensic taphonomy to answer these nagging *** will enable the discipline to make the reliable assumption that pigs and donor decomposition data can be applied to homicide cases.A suite of experimental design aspects is suggested to ensure systematic and standardized data collection across differ-ent biogeoclimatic circumstances to identify and quantify the effects of potential confounding *** studies in multiple,varied biogeographic circumstances with standardized protocols,equipment and carrion will facilitate independent global validation of *** factors are reviewed to show the need for adjustments in experimental design to ensure relevance and applicability of data within locally realistic forensic *** initiation of a global decomposition data

关键词： Forensic sciences forensic taphonomy decomposition Daubert standard exclusion cages clothed pigs carrion biomass scavenging

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Methodology for the estimation of expansive cement borehole pressure

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International Journal of Mining Science and Technology 2023年第1期33卷 73-81页

作者： kelly-Meriam Habib Isaac Vennes Hani S.Mitri Department of Mining and Materials engineering McGill UniversityMontreal H3A 0E8Canada

This work is part of a multi-phase project which aims to develop a sound methodology for rock fragmen-tation in underground mines using expansive *** specifically,it is the first phase of the project which focuses on laboratory tests to investigate the mechanical performance of expansive cement,also known as soundless chemical demolition agents(SCDA).This paper reports the results of laboratory tests conducted on instrumented thick-walled cylinders filled with expansive *** pressure evo-lution and temperature variation with time are first examined for different borehole *** clas-sical analytical method for expansive pressure estimation is validated with direct pressure measurement using high-capacity pressure sensor,and an empirical model is obtained.A new methodology based on iterative procedure is developed using axisymmetric finite element modelling and test results to derive the modulus of elasticity of the expansive cement at peak *** results of this study show that the expansive pressure increases with borehole diameter when the rigidity of the steel cylinder is constant reaching 83 MPa for a 38.1 mm *** is also shown that the expansive pressure decreases signif-icantly with increased cylinder rigidity for the same borehole *** newly developed methodol-ogy revealed that the modulus of elasticity of expansive cement at peak pressure is estimated at 8.2 GPa.A discussion on the extension of the findings of this work to hard rock mining applications is presented.

关键词： Rock fragmentation Soundless chemicaldemolitionagents expansive cement

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