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Small duct primary sclerosing cholangitis: A discrete variant or a bridge to large duct disease, a practical review

World Journal of Hepatology 2022年第3期14卷 495-503页

作者： Christopher M Nguyen kevin T Kline Heather L Stevenson Kashif Khan Sreeram Parupudi Department of Internal Medicine The University of Texas Medical BranchGalvestonTX 77555United States Department of Gastroenterology and Hepatology The University of Texas Medical BranchGalvestonTX 77555United States Department of Pathology University of Texas Medical BranchGalvestonTX 77555United States

The natural history,associations with inflammatory bowel disease(IBD),and long-term outcomes of large duct primary sclerosing cholangitis(ldPSC)have been well *** duct primary sclerosing cholangitis(sdPSC)is a much less common and relatively more benign *** natural history of sdPSC has been difficult to characterize given the limited number of studies in the literature especially with regards to the subset of patients who progress to large duct *** has been unclear whether sdPSC represented a subset of ldPSC,an earlier staging of ldPSC,or a completely separate and distinct entity of its *** associations between sdPSC and IBD have been established with suspicion that concurrent sdPSC-IBD may be a key prognostic factor in determining which patients are at risk of progression to *** is known regarding the discrete circumstances that predisposes some patients with sdPSC to progress to *** has been suspected that progression to large biliary duct involvement subjects this subset of patients to potentially developing lifethreatening *** the authors conducted a thorough review of the published sdPSC literature using Pubmed searches and cross-referencing to compile all accessible studies regarding cohorts of sdPSC patients in order better characterize the subset of sdPSC patients who progress to ldPSC and the associated outcomes.

关键词： Small duct primary sclerosing cholangitis Inflammatory bowel disease Progression Primary sclerosing cholangitis Outcomes

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Cross-Linking of Sago Starch with Furan and Bismaleimide via the Diels-Alder Reaction

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Journal of Renewable Materials 2023年第12期11卷 4039-4060页

作者： Henky Muljana Ivana Hasjem Merianawati Sinatra Dicky Joshua Pesireron MichaelWilbert Puradisastra Ryan Hartono kevin Yovan Hermanto Tony Handoko Department of Chemical Engineering Parahyangan Catholic UniversityBandung40141Indonesia

This research paper describes the synthesis of thermo-reversible cross-linking of sago starch by grafting a furan pendant group(methyl 2-furoate)onto the starch backbone,followed by a Diels-Alder(DA)reaction of the furan functional group with 1,1′-(methylenedi-4,1-phenylene)bismaleimide(BM).The proof of principles was provided by FTIR and 1H-NMR *** relevant FTIR peaks are the carbonyl peak(υC=O sym)at 1721 cm^(−1);the two peaks appeared after DA cross-linking,i.e.,at 1510 cm^(−1)(corresponding toυCH=CH BM aromatic rings,stretching vibrations),and at 1173 cm^(−1)(assigned to cycloadduct(C-O-C,δDA ring))while the^(1)H-NMR result shows evidence for the presence of a furan ring in the starch matrices(in the range ofδ6.3-7.5 ppm).The crosslinked starch product is indeed thermally reversible,as is evident from the appearance of exothermal(DA,temperature range of 50℃-70℃)and endothermal(retro DA,temperature range of 125℃-150℃)transitions in the DSC *** paper not only proves the thermal reversibility but also demonstrates that the final product properties(chemical,morphology,and thermal stability)can be tuned by varying the annealing temperature,BM intake,and reaction time.

关键词： Diels-Alder starch biopolymers thermal-reversible cross-linking

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Leaf gas exchange characteristics,biomass partitioning,and water use efficiencies of two C4 African grasses under simulated drought

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Grassland Research 2023年第1期2卷 37-45页

作者： kevin Z.Mganga Jana Kuhla Andrea Carminati Johanna Pausch Mutez A.Ahmed Copernicus Institute of Sustainable Development Utrecht UniversityUtrechtthe Netherlands Department of Agricultural Sciences South Eastern Kenya UniversityKituiKenya Bayreuth Center of Ecology and Environmental Research(BayCEER) University of BayreuthBayreuthGermany Department of Environmental Systems Science ETH ZurichZürichSwitzerland Department of Land Air and Water ResourcesUniversity of California DavisDavisCaliforniaUSA

Background:Few studies have evaluated the effect of drought on the morphophysiological characteristics of African C_(4) *** investigated how drought affects leaf gas exchange characteristics,biomass partitioning,and water use efficiencies of Enteropogon macrostachyus and Cenchrus ***:The grasses were grown in a controlled environment under optimum conditions,that is,70%of the maximum water‐holding capacity(WHC)for the first 40 ***,half of the columns were maintained under optimum or drought conditions(30%of maximum WHC)for another 20 ***:Under optimum conditions,*** showed a significantly higher photosynthetic rate,stomatal conductance,and transpiration rate than *** decreased the photosynthetic rate,stomatal conductance and transpiration rate only in *** net photosynthetic rate,stomatal conductance,and leaf transpiration of *** did not differ significantly under optimum and drought *** showed an increase in its water use efficiencies under drought to a greater extent than ***:Our results demonstrate that *** is more sensitive to drought than *** decrease in the intercellular CO_(2) concentration and the increase in stomatal limitation with drought in *** and *** suggest that stomatal limitation plays the dominant role in photosynthesis of the studied African C_(4) grasses.

关键词： biomass fractions C_(4)grasses drought photosynthesis stomatal conductance transpiration

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Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women,especially young women,compared to men

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World Journal of Hepatology 2023年第2期15卷 282-288页

作者： John Patterson Campbell Vinay Jahagirdar Adel Muhanna kevin F Kennedy John H Helzberg Department of Internal Medicine Division of Gastroenterology and HepatologySaint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States Department of Internal Medicine Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States Division of Cardiology Saint Luke’s Health System of Kansas CityKansas CityMO 64111United States Department of Internal Medicine Division of Gastroenterology and HepatologyLiver Disease Management UnitSaint Luke’s Health System of Kansas City and the University of Missouri-Kansas CityKansas CityMO 64111United States

BACKGROUND Alcoholic liver disease(ALD)remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare *** is evidence of increased alcohol consumption during the coronavirus disease 2019(COVID-19)pandemic,and the effect of this on the already burdened health systems remains *** To assess the trends for ALD admissions during the COVID-19 pandemic,and compare it to a similar pre-pandemic *** This retrospective study analyzed all admissions at a tertiary health care system,which includes four regional *** admissions were identified by querying a multi-hospital health system’s electronic database using ICD-10 *** admissions were compared for two one-year periods;pre-COVID-19 from April 2019 to March 2020,and during-COVID-19 from April 2020 to March *** were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods,with stratification by age and *** increase or decrease in admissions from the Poisson regression model were reported as incident rate *** One thousand three hundred and seventy-eight admissions for ALD were included.80.7%were Caucasian,and 34.3%were *** increase in the number of admissions for ALD during the COVID-19 pandemic was *** women,a sharp rise(33%)was noted in those below the age of 50 years,and an increase of 22%in those above 50 *** men,an increase of 24%was seen for those below 50 years,and a 24%decrease in those above 50 *** The COVID-19 pandemic has had widespread implications,and an increase in ALD admissions is just one of ***,given that women are often prone to rapid progression of ALD,this finding has important preventive health implications.

关键词： Alcoholic liver disease COVID-19 Alcoholic hepatitis Alcoholic liver cirrhosis Alcoholism Pandemic Young women Alcohol-related disorders

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Congenital Absence of Pericardium:The Largest Systematic Review in the Field on 247 Worldwide Cases(1977-Now)

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Congenital Heart Disease 2023年第6期18卷 595-610页

作者： Pier Paolo Bassareo Aurelio Secinaro Paolo Ciliberti Massimo Chessa Marco Alfonso Perrone kevin Patrick Walsh Colin Joseph Mcmahon Mater Misericordiae University Hospital National Adult Congenital Heart Disease ServiceDublinD07 R2WYIreland Children’s Health Ireland Crumlin DublinIreland School of Medicine University College of DublinDublinIreland Advanced Cardiovascular Imaging Unit Bambino GesùChildren’s HospitalIRCCSRomeItaly Department of Cardiac Surgery CardiologyHeart and Lung Transplantation Bambino Gesu’Children’s HospitalIRCCSRomeItaly Adult Congenital Heart Disease UNIT Paediatric and Adult Congenital Heart CentreIRCCS-Policlinico San DonatoSan Donato MilaneseMilanItaly School of Medicine Vita Salute San Raffaele UniversityMilanItaly Division of Cardiology and CardioLab Department of Clinical Sciences and Translational MedicineUniversity of Rome Tor VergataRomeItaly

Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental *** can be subdivided into complete and partial(left or right-sided)*** of its infrequency,just case reports and a few case series have been released so *** paper represents the largest systematic review in the *** features(age at diagnosis,type,gender,clinical presentation,electrocardiography,imaging(ultrasounds,CT/MRI),concomitant cardiac defects,and outcome)were ***:The electronic database PubMed was investigated from its establishment up to July 15th,*** case reports and case series were *** studies,papers that were not in English,Spanish,and Italian,and those manuscripts not reporting at least seven of the nine analysed *** ruled *** analysed data were reported mostly in terms of ***:One hundred eighty studies were included encompassing 247 *** than half of reviewed CAP cases were in males(63.2%).The mean age at diagnosis was 31.8±19.3 years;a range of 32 weeks of gestation-81 years).23.5%of the patients did not report any *** most common clinical presentations were chest pain(35.2%)and dyspnoea(29.2%).The most commonly seen ECG changes were right axis deviation(28.7%)and right bundle branch block(23.9%).CAP was suspected or diagnosed by echocardiography in 20.1%of *** diagnosis was made by CT and/or MRI in 61.9%of *** was left-sided in 71.2%,complete in 23.1%,and right-sided in 5.7%.A concomitant congenital heart defect was found in 22.7%,especially in the form of atrial septal defect(6.5%)and patency of ductus arteriosus(2.8%).The pericardial repair was required in 12.9% of the incomplete forms of the *** did the complete form require surgical *** outcome appeared favourable in the vast majority of cases,with just 18 deaths(7.3%).Discussion:The main limitation of this syste

关键词： Congenital absence pericardium pericardial agenesis electrocardiography echocardiography computed tomography cardiac magnetic resonance imaging

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Nonopioid perioperative analgesia in head and neck cancer surgery:A systematic review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 107-117页

作者： Beatrice C.Go Cammille C.Go kevin Chorath Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Perelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics Division of NeonatologyUniversity of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Management of postoperative pain after head and neck cancer surgery is a complex issue,requiring a careful balance of analgesic properties and side *** objective of this review is to discuss the efficacy and safety of multimodal analgesia(MMA)for these ***:Pubmed,Cochrane,Embase,Scopus,and *** were systematically searched for all comparative studies of patients receiving MMA(nonsteroidal anti-inflammatory drugs(NSAIDs),acetaminophen,anticonvulsants,local anesthetics,and corticosteroids)for head and neck cancer *** primary outcome was additional postoperative opioid usage,and secondary outcomes included subjective pain scores,complications,adverse effects,and 30-day ***:A total of five studies representing 592 patients(MMA,n=275;non-MMA,n=317)met inclusion *** most commonly used agents were gabapentin,NSAIDs,and acetaminophen(n=221),NSAIDs(n=221),followed by corticosteroids(n=35),dextromethorphan(n=40),and local nerve block(n=19).Four studies described a significant decrease in overall postoperative narcotic usage with two studies reporting a significant decrease in hospital *** pain scores widely varied with two studies reporting reduced pain at postoperative day *** were no differences in surgical outcomes,medical complications,adverse effects,or 30-day mortality and readmission ***:MMA is an increasingly popular strategy that may reduce dependence on opioids for the treatment of postoperative pain.A variety of regimens and protocols are available for providers to utilize in the appropriate head and neck cancer patient.

关键词： analgesia head and neck neoplasm NSAID opioids pain management

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Lack of Evidence for Local Adaptation of the Endangered Karner Blue Butterfly to Its Sole Larval Hostplant—The Wild Lupine

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Advances in Entomology 2023年第3期11卷 172-187页

作者： kevin Handel Maria Gabriela Bidart Department of Biological Sciences Bowling Green State University Bowling Green OH USA

Local adaptation is an important process that drives the evolution of populations within species, and it can be generally expressed by the higher fitness of individuals raised in their native habitats versus in a foreign location. The influence of local adaptation is especially prominent in species that subsist in small and/or highly isolated populations. This study evaluated whether the federally endangered Karner blue butterfly, Lycaeides melissa samuelis (Lepidoptera: Lycaenidae) is locally adapted to its exclusive larval host plant, the wild lupine (Lupinus perennis). To test for local adaptation, individuals from a laboratory-raised colony were reared on wild lupine plants from populations belonging to either their native (Indiana) or a foreign (Michigan and Wisconsin) region. For this purpose, lupine plants from the different populations were grown in a common garden in growth chambers, and one Karner blue larva was placed on each plant. Fitness traits related to growth and development were recorded for each butterfly across populations. Days from hatching to pupation and eclosion showed gender-specific significant differences across wild lupine populations and plant genotypes (within populations). The percent survival of butterflies (from hatching to eclosion) also differed among plants from different populations. These results indicate that wild lupine sources can affect some developmental traits of Karner blue butterflies. However, growth-related traits, such as pupal and adult weight of individuals reared in plants from native populations did not differ from those of foreign regions. The apparent absence of local adaptation to wild lupine suggests that, at least, some individuals of this species could be translocated from native populations to foreign reintroduction sites without experiencing decreased fitness levels. However, future studies including more populations across the geographical range of this butterfly are recommended to evaluate other environ

关键词： Local Adaptation Karner Blue Butterfly Wild Lupine Butterfly Fitness-Related Responses Plant Genotypic Effects

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Empirical Estimates of Global Climate Sensitivity:An Assessment of Strategies Using a Coupled GCM

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Advances in Atmospheric Sciences 2008年第3期25卷 339-347页

作者：朱伟军 kevin HAMILTON KLME Nanjing University of Information Science & Technology International Pacific Research Center University of Hawaii at ManoaHonolulu 96822USA

A control integration with the normal solar constant and one with it increased by 2.5% in the National Center for Atmospheric Research （NCAR） coupled atmosphere-ocean Climate System Model were conducted to see how well the actual realized global warming could be predicted just by analysis of the control results. This is a test, within a model context, of proposals that have been advanced to use knowledge of the present day climate to make ＂empirical＂ estimates of global climate sensitivity. The scaling of the top-of-the-atmosphere infrared flux and the planetary albedo as functions of surface temperature was inferred by examining four different temporal and geographical variations of the control simulations. Each of these inferences greatly overestimates the climate sensitivity of the model, largely because of the behavior of the cloud albedo. In each inference the control results suggest that cloudiness and albedo decrease with increasing surface temperature. However, the experiment with the increased solar constant actually has higher albedo and more cloudiness at most latitudes. The increased albedo is a strong negative feedback, and this helps account for the rather weak sensitivity of the climate in the NCAR model. To the extent that these model results apply to the real world, they suggest empirical evaluation of the scaling of global-mean radiative properties with surface temperature in the present day climate provides little useful guidance for estimates of the actual climate sensitivity to global changes.

关键词： climate sensitivity empirical estimates coupled GCM surface temperature

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Enhanced recovery after surgery protocols for outpatient operations in otolaryngology:Review of literature

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 96-106页

作者： kevin Chorath Sara Hobday Neeraj V.Suresh Beatrice Go Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics University of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Enhanced recovery after surgery(ERAS)protocols are patient-centered,evidence-based pathways designed to reduce complications,promote recovery,and improve outcomes following *** protocols have been successfully applied for the management of head and neck cancer,but relatively few studies have investigated the applicability of these pathways for other outpatient procedures in *** goal was to perform a systematic review of available evidence reporting the utility of ERAS protocols for the management of patients undergoing outpatient otolaryngology ***:A systematic literature review was conducted using MEDLINE,EMBASE,SCOPUS,and gray *** identified studies that evaluated ERAS protocols among patients undergoing otologic,laryngeal,nasal/sinus,pediatric,and general otolaryngology *** assessed the outcomes and ERAS components across protocols as well as the study design and ***:A total of eight studies fulfilled the inclusion criteria and were included in the *** of procedures evaluated with ERAS protocols included tonsillectomy and adenoidectomy,functional endoscopic sinus surgery,tympanoplasty and mastoidectomy,and septoplasty.A reduction in postoperative length of stay and hospital costs was reported in two and three studies,*** studies between ERAS and control groups showed persistent improvement in pre-and postoperative anxiety and pain levels,without an increase in postoperative complications and readmission ***:A limited number of studies discuss implementation of ERAS protocols for outpatient operations in *** clinical pathways appear promising for these procedures as they may reduce length of stay,decrease costs,and improve pain and anxiety postoperatively.

关键词： enhanced recovery after surgery otolaryngology outpatient surgery patient safety PSQI

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Tensionless contact of a finite beam:Concentrated load inside and outside the contact zone

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Acta Mechanica Sinica 2013年第6期29卷 836-839页

作者： Yin Zhang kevin D.Murphy State Key Laboratory of Nonlinear Mechanics Institute of MechanicsChinese Academy of Sciences Department of Mechanical Engineering University of ConnecticutStorrsCT 06268USA

For a finite beam with a nonzero gap distance, an asymmetric concentrated load can be either inside or outside of the contact zone. A new governing equation is given for the case of a concentrated load outside the contact zone. By numerically solving the left-side and right-side contact lengths of the beam, a criterion is established to determine whether the concentrated load is inside or outside the contact zone. A more general approach on the tensionless contact of a beam is thus presented.

关键词： Tensionless contact Lift-off Beam

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