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African Americans are less likely to receive curative treatment for hepatocellular carcinoma

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World Journal of Hepatology 2018年第11期10卷 849-855页

作者： lindsay a sobotka Alice Hinton Lanla F Conteh Department of Internal Medicine The Ohio State University Wexner Medical Center Division of Biostatistics College of Public Health The Ohio State University Department of Gastroenterology and Hepatology The Ohio State Wexner Medical Center

AIM To determine if racial disparities continue to exist in the treatment of hepatocellular carcinoma(HCC).METHODS A retrospective database analysis using the Nationwide Inpatient Sample was performed including patients with a primary diagnosis of HCC. Univariate and multivariate analyses were utilized to determine racial disparities in liver decompensation, treatment, inpatient mortality, and metastatic *** A total of 62604 patients with HCC were included consisting of 32428 Caucasian, 9726 African-American, 8988 Hispanic, and 11462 patients of other races. Caucasian patients were more likely to undergo curative therapies of liver transplant(OR: 2.66, 95%CI: 1.92-3.68), resection(OR: 1.82, 95%CI: 1.48-2.23), and ablation(OR: 1.77, 95%CI: 1.36-2.30) than African-American patients. Hispanic patients were more likely to undergo transplant(OR: 2.18, 95%CI: 1.40-3.39) and ablation(OR: 1.46, 95%CI:1.05-2.03) than African-American patients. Patients of other races were more likely to receive a liver transplant(OR: 2.41, 95%CI: 1.62-3.61), resection(OR: 1.79 95%CI: 1.39-2.32), and ablation(OR: 2.03, 95%CI: 1.47-2.80) than African-American patients. There are no differences in the rates of transarterial chemoembolization between *** Racial disparities in HCC treatment exist despite emphasis to support equality in healthcare. African-American patients are less likely to undergo curative treatments for HCC.

关键词： Racial disparity Hepatocellular carcinoma Liver transplantation Resection Ablation

Accuracy of virtual chromoendoscopy in differentiating gastric antral vascular ectasia from portal hypertensive gastropathy:A proof of concept study

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World Journal of Hepatology 2021年第12期13卷 2168-2178页

作者： Ahmad M Al-Taee Mark P Cubillan Alice Hinton lindsay a sobotka Alex S Befeler Christine Y Hachem Hisham Hussan Division of Gastroenterology and Hepatology NYU Langone HealthNew YorkNY 10016United States Department of Internal Medicine Saint Louis UniversitySt LouisMO 63110United States Division of Biostatistics The Ohio State UniversityColumbusOH 43210United States Division of Gastroenterology Hepatologyand NutritionThe Ohio State UniversityColumbusOH 43210United States Division of Gastroenterology and Hepatology Saint Louis UniversitySt LouisMO 63110United States

BACKGROUND Accurate detection of gastric antral vascular ectasia(GAVE)is critical for proper management of cirrhosis-related gastrointestinal ***,endoscopic diagnosis of GAVE can be challenging when GAVE overlaps with severe portal hypertensive gastropathy(PHG).AIM To determine the added diagnostic value of virtual chromoendoscopy to high definition white light for real-time endoscopic diagnosis of GAVE and *** We developed an I-scan virtual chromoendoscopy criteria for diagnosis of GAVE and *** tested our criteria in a cross-sectional cohort of cirrhotic adults with GAVE and PHG when high-definition white light endoscopy(HDWLE)diagnosis was in *** then compared the accuracy of I-scan vs HDWLE alone to *** Twenty-three patients were included in this study(65.2%Caucasians and 60.9%males).Chronic hepatitis C was the predominant cause of cirrhosis(43.5%)and seven adults(30.4%)had confirmed GAVE on histology.I-scan had higher sensitivity(100%vs 85.7%)and specificity(75%vs 62.5%)in diagnosing GAVE compared to *** translates into a higher,albeit not statistically significant,accuracy of I-scan in detecting GAVE compared to HDWLE alone(82%vs 70%).I-scan was less likely to lead to an accurate diagnosis of GAVE in patients on dialysis(P<0.05)and in patients with elevated creatinine(P<0.05).Iscan had similar accuracy to HDWLE in detecting *** This pilot work supports that virtual chromoendoscopy may obviate the need for biopsies when the presence of GAVE is in *** studies are needed to assess the impact of virtual chromoendoscopy on success of endoscopic therapy for GAVE.

关键词： Portal hypertensive gastropathy Gastric antral vascular ectasia Virtual chromoendoscopy Endoscopy

Rare cause of dysphagia after esophageal variceal banding: A case report

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World Journal of Gastrointestinal Endoscopy 2019年第4期11卷 292-297页

作者： lindsay a sobotka Mitchell L Ramsey Michael Wellner Sean G Kelly Department of Gastroenterology Hepatology and Nutrition The Ohio State University Wexner Medical Center

BACKGROUND Esophageal varices are a result of progressive liver disease and portal hypertension. Treatment can be performed with band ligation versus nonselective beta blockers depending on the size of varices, ability to tolerate medications and history of variceal bleeding. Band ligation is an effective intervention with rare but serious complications including bleeding, ulcers and rarely obstruction. Few cases of esophageal obstruction and necrosis caused by banding have been reported, each with varied management from conservative treatment to band *** SUMMARY An 89 years old woman with a past medical history of nonalcoholic steatohepatitis cirrhosis presented to the hospital with an inability to swallow one day after screening esophagogastroduodenoscopy where band ligation of esophageal varices was performed for primary prophylaxis. The patient was not able to tolerate her oral secretions. Initial blood work revealed a Model of End Organ Liver Disease score of 7. She was treated with sublingual nitroglycerin for esophageal spasm, a known complication after esophageal banding. When she failed to improve, esophagogastroduodenoscopy was performed and revealed the mucosa surrounding the banded varix was necrosed and blocking the lumen of the esophagus. The band was purposefully dislodged, revealing distal ulceration and stricturing. Within 72 h after band removal, she was tolerating an oral diet. Endoscopy performed 2 wk later revealed an intrinsic stenosis,measuring 8 mm in diameter by 1 cm in length, which was *** Esophageal obstruction is a complication of variceal banding that should be considered in patients with inability to tolerate oral diet after banding.

关键词： Case report Esophageal varices Band ligation Esophageal necrosis Esophageal obstruction

Paracentesis in cirrhotics is associated with increased risk of 30-day readmission

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World Journal of Hepatology 2018年第6期10卷 425-432页

作者： lindsay a sobotka Rohan M Modi Akshay Vijayaraman A James Hanje Anthony J Michaels Lanla F Conteh Alice Hinton Ashraf El-Hinnawi Khalid Mumtaz Department of Internal Medicine the Ohio State University Wexner Medical Center Division of Gastroenterology Hepatology and Nutrition the Ohio State Wexner Medical Center Division of Biostatistics College of Public Health the Ohio State University Department of Surgery the Ohio State Wexner Medical Center

AIM To determine the readmission rate, its reasons, predictors, and cost of 30-d readmission in patients with cirrhosis and *** A retrospective analysis of the nationwide readmission database(NRD) was performed during the calendar year 2013. All adults cirrhotics with a diagnosis of ascites,spontaneous bacterial peritonitis, or hepatic encephalopathy were identified by ICD-9 codes. Multivariate analysis was performed to assess predictors of 30-d readmission and cost of *** Of the 59597 patients included in this study, 18319(31%) were readmitted within 30 d. Majority(58%) of readmissions were for liver related reasons. Paracentesis was performed in 29832(50%) patients on index admission. Independent predictors of 30-d readmission included age 3 Elixhauser comorbidity(OR: 1.13; CI: 1.05-1.22), nonalcoholic cirrhosis(OR: 1.16; CI: 1.10-1.23), paracentesis on index admission(OR: 1.28; CI: 1.21-1.36) and having hepatocellular carcinoma(OR: 1.21; CI: 1.05; 1.39). Cost of index admission was similar in patients readmitted and not readmitted(P-value: 0.34); however cost of care was significantly more on 30 d readmission($30959 ± 762) as compared to index admission($12403 ± 378), P-value: < *** Cirrhotic patients with ascites have a 33% chance of readmission within 30-d. Younger patients, with public insurance, nonalcoholic cirrhosis and increased comorbidity who underwent paracentesis are at increased risk of readmission. Risk factors for unplanned readmission should be targeted given these patients have higher healthcare utilization.

关键词： Cirrhosis Readmission rates Paracentesis Ascites

Cystic fibrosis patients on cystic fibrosis transmembrane conductance regulator modulators have a reduced incidence of cirrhosis

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World Journal of Hepatology 2022年第2期14卷 411-419页

作者： Mitchell L Ramsey Michael R Wellner Kyle Porter Stephen E Kirkby Susan S Li Luis F Lara Sean G Kelly A James Hanje lindsay a sobotka Department of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Gastroenterology Hepatology and NutritionThe Ohio State Wexner Medical CenterColumbusOH 43210United States Department of Biostatistics The Ohio State UniversityColumbusOH 43210United States Department of Pulmonary and Critical Care Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Gastroenterology Hepatology and NutritionThe Ohio State UniversityColumbusOH 43210United States

BACKGROUND Cystic fibrosis transmembrane conductance regulator(CFTR)modulators significantly improve pulmonary function in patients with cystic fibrosis(CF)but the effect on hepatobiliary outcomes remains *** hypothesized that CF patients on CFTR modulators would have a decreased incidence of cirrhosis compared to patients not on CFTR modulators or on *** To investigate the effect of CFTR modulators on the development of cirrhosis in patients with *** A retrospective analysis was performed using Truven MarketScan from January 2012 through December 2017 including all patients with a diagnosis of *** were excluded if they underwent a liver transplantation or if they had other etiologies of liver disease including viral hepatitis or alcohol *** were grouped by use of CFTR modulators,ursodiol,dual therapy,or no *** primary outcome was development of ***-Meier curves estimated the incidence of cirrhosis and log-rank tests compared incidence curves between treatment *** A total of 7201 patients were included,of which 955(12.6%)used a CFTR modulator,529(7.0%)used ursodiol,105(1.4%)used combination therapy,and 5612(74.3%)used neither *** incidence of cirrhosis was 0.1%at 1 year and 0.7%at 4 years in untreated patients,5.9%and 10.1%in the Ursodiol group,and 1.0%and 1.0%in patients who received both *** patient treated with CFTR modulators alone developed *** on CFTR modulators alone had lower cirrhosis incidence than untreated patients(P=0.05),patients on Ursodiol(P<0.001),and patients on dual therapy(P=0.003).The highest incidence of cirrhosis was found among patients treated with Ursodiol alone,compared to untreated patients(P<0.001)or patients on Ursodiol and CFTR modulators(P=0.01).CONCLUSION CFTR modulators are associated with a reduction in the incidence of cirrhosis compared to other therapies in patients with CF.

关键词： Cirrhosis Ursodiol Transmembrane Cystic fibrosis Market scan Cystic fibrosis related liver disease

Outcomes of inpatient cholecystectomy among adults with cystic fibrosis in the United States

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World Journal of Gastrointestinal Endoscopy 2021年第9期13卷 371-381页

作者： Mitchell L Ramsey lindsay a sobotka Somashekar G Krishna Alice Hinton Stephen E Kirkby Susan S Li Michael P Meara Darwin L Conwell Peter P Stanich Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Biostatistics The Ohio State University College of Public HealthColumbusOH 43210United States Division of Pulmonary and Critical Care Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of General Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of General and Gastrointestinal Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210United States

BACKGROUND Symptomatic biliary and gallbladder disorders are common in adults with cystic fibrosis(CF)and the prevalence may rise with increasing CF transmembrane conductance regulator modulator *** may be considered,but the outcomes of cholecystectomy are not well described among modern patients with *** To determine the risk profile of inpatient cholecystectomy in patients with *** The Nationwide Inpatient Sample was queried from 2002 until 2014 to investigate outcomes of cholecystectomy among hospitalized adults with CF compared to controls without CF.A propensity weighted sample was selected that closely matched patient demographics,patient’s individual comorbidities,and hospital *** propensity weighted sample was used to compare outcomes among patients who underwent laparoscopic *** outcomes of open and laparoscopic cholecystectomy were compared among adults with *** A total of 1239 inpatient cholecystectomies were performed in patients with CF,of which 78.6%were performed *** was<0.81%,similar to those without CF(P=0.719).In the propensity weighted analysis of laparoscopic cholecystectomy,there was no difference in mortality,or pulmonary or surgical complications between patients with CF and *** adjusting for significant covariates among patients with CF,open cholecystectomy was independently associated with a 4.8 d longer length of stay(P=0.018)and an$18449 increase in hospital costs(P=0.005)compared to laparoscopic *** Patients with CF have a very low mortality after cholecystectomy that is similar to the general *** patients with CF,laparoscopic approach reduces resource utilization and minimizes post-operative complications.

关键词： Laparoscopic cholecystectomy Nationwide Inpatient Sample Cystic fibrosis Mortality Length of stay Symptomatic biliary disorders

Cultivating potential:Harnessing plant stem cells for agricultural crop improvement

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Molecular Plant 2024年第1期17卷 50-74页

作者： Penelope lindsay Kyle W.Swentowsky David Jackson Cold Spring Harbor Laboratory Cold Spring HarborNY 11724USA National Key Laboratory of Crop Genetic Improvement Huazhong Agricultural UniversityWuhanHubei430070China

Meristems are stem cell-containing structures that produce all plant organs and are therefore important targets for crop *** regulators control the balance and rate of cell divisions within the *** these regulators impacts meristem architecture and,as a consequence,plant *** this review,we discuss genes involved in regulating the shoot apical meristem,inflorescence meristem,axillary meristem,root apical meristem,and vascular cambium in *** highlight several examples showing how crop breeders have manipulated developmental regulators to modify meristem growth and alter crop traits such as inflorescence size and branching *** transformation techniques are another innovation related to plant meristem research because they make crop genome engineering *** discuss recent advances on plant transformation made possible by studying genes controlling meristem ***,we conclude with discussions about how meristem research can contribute to crop improvement in the coming decades.

关键词： meristem crop improvement plant transformation plant breeding crop yield gene editing

Spatial distributions of soil nutrients affected by land use,topography and their interactions,in the Loess Plateau of China

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International Soil and Water Conservation Research 2024年第1期12卷 227-239页

作者： Wenxin Zhou Changjia Li Wenwu Zhao lindsay C.Stringer Bojie Fu State Key Laboratory of Earth Surface Processes and Resource Ecology Faculty of Geographical ScienceBeijing Normal UniversityBeijingChina Institute of Land Surface System and Sustainable Development Faculty of Geographical ScienceBeijing Normal UniversityBeijingChina Department of Environment and Geography University of YorkYorkUK York Environmental Sustainability Institute University of YorkYorkUK

Soil nutrient availability and their spatial distributions are strongly related to land use and landscape *** study aims to address the knowledge gap regarding the interaction between these factors and the underlying *** selected five land uses(grassland with Artemisia gmelinii,woodland with Robinia pseudoacacia,shrubland with Caragana korshinskii and Hippophae rhamnoides,and apple orchard with Malus pumila)and nine slope positions across hillslopes in the Loess Plateau,China,to investigate their combined effects on the contents and stocks of soil organic carbon(SOC),total nitrogen(TN)and total phosphorus(TP).Parametric and non-parametric statistical tests were conducted to determine the significant differences in the means or the medians of the soil nutrient *** showed that the SOC and TN contents of shrubland with Caragana korshinskii were statistically significantly greater than those of the grassland(p<0.05).SOC and TN contents generally decreased from the upper slope to the middle slope,and to the foot slope for the grassland,woodland and shrublands,and on the contrary,an increasing trend from the upper slope,to the middle slope,and to the foot slope was identified for the apple *** study highlights that land use,slope position and their interaction have significant effects on the spatial distributions of soil *** provides essential empirical evidence for the identification of the optimal vegetation type and slope positions in land management and vegetation restoration activities.

关键词： Soil organic carbon Total nitrogen Total phosphorus Slope position Vegetation restoration

“If Somebody Needed Help, I Went Over”: Social Capital and Therapeutic Communities of Older Adult Farmers in British Columbia Floods

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International Journal of Disaster Risk Science 2024年第2期15卷 290-301页

作者： Kyle Breen Siyu Ru Luna Vandeweghe Jenna Chiu lindsay Heyland Haorui Wu School of Social Work Dalhousie UniversityHalifaxNS B3H 1S2Canada

Older adults in disaster contexts are often thought of as a passive, vulnerable population that lacks agency and capacities to cope in the aftermath. However, it can be argued that older adults may have underrecognized strengths that can be utilized pre-, peri-, and post-disaster. One of these strengths is older adults' unique social capital that stems from long-standing connections with other members of their respective communities. Using data from in-depth, semistructured interviews with farmers in British Columbia 3–11 months after the 2021 floods, this research explored the experiences of older adult farmers' recovery. The farmers discussed how they leveraged their social capital to aid in their recovery efforts from the flood event. By using their bonding social capital, older adult farmers transformed their existing, deep-rooted connections into post-disaster assistance. This, in turn, generated the idea of the therapeutic community, helping community members cope in the aftermath. This research indicated the need to further examine how older adults in disaster settings can be viewed as assets with community knowledge and skills as opposed to solely as a vulnerable population.

关键词： British Columbia Flood disaster Older adults Qualitative research Social capital Therapeutic community