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Catastrophic gastrointestinal complication of systemic immunosuppression

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World Journal of Gastroenterology 2015年第8期21卷 2542-2545页

作者： lyn Alexandra smith Mitali Gangopadhyay Daniel R Gaya Gastroenterology Unit Glasgow Royal Infirmary Department of Pathology Southern General Hospital Glasgow

We present a case of acute upper gastrointestinal haemorrhage in a patient with systemic vasculitis immunosuppressed on cyclophosphamide and *** patient presented with a diffuse haemorrhagic oesophagitis and a non-specific *** taken from the oesophagus and duodenum demonstrated infection with herpes simplex virus(HSV)and cytomegalovirus(CMV)*** infection of the upper gastrointestinal tract is a recognised complication of immunosuppression and HSV is one of the most common *** on the other hand most commonly causes a colitis or less commonly *** enteritis is rare as is the synchronous infection with two viral agents in an immunocompromised patient having being described in a few case series *** infection of the gastrointestinal tract in immunocompromised patients should be treated with systemic anti-viral medication and consideration to withdrawal of the immunosuppressive therapy if possible and *** authors highlight the need for a high suspicion of viral infection in immunosuppressed patients presenting with upper gastrointestinal bleeding.

关键词： Immunosuppression Cytomegalovirus Gastrointestinal

Mediastinal node staging by positron emission tomographycomputed tomography and selective endoscopic ultrasound with fine needle aspiration for patients with upper gastrointestinal cancer:Results from a regional centre

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World Journal of Gastrointestinal Endoscopy 2018年第1期10卷 37-44页

作者： Chris Harrington lyn smith Jennifer Bisland Elisabet López González Neil Jamieson Stuart Paterson Adrian John Stanley Glasgow Royal Infirmary Glasgow G4 0ETUnited Kingdom Forth Valley Royal Hospital Larbert FK5 4WRUnited Kingdom Raigmore Hospital Inverness IV2 3UJUnited Kingdom Hospital Vega Baja Orihuela 03314Spain

AIM To investigate the impact of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) and positron emission tomography-computed tomography(PET-CT) in the nodal staging of upper gastrointestinal(GI) cancer in a tertiary referral *** We performed a retrospective review of prospectively recorded data held on all patients with a diagnosis of upper GI cancer made between January 2009 and December 2015. Only those patients who had both a PET-CT and EUS with FNA sampling of a mediastinal node distant from the primary tumour were included. Using a positive EUS-FNA result as the gold standard for lymph node involvement, the sensitivity, specificity, positive and negative predictive values(PPV and NPV) and accuracy of PET-CT in the staging of mediastinal lymph nodes were calculated. The impact on therapeutic strategy of adding EUS-FNA to PET-CT was *** One hundred and twenty one patients were included. Sixty nine patients had a diagnosis of oesophageal adenocarcinoma(Thirty one of whom were junctional), forty eight had oesophageal squamous cell carcinoma and four had gastric adenocarcinoma. The FNA results were inadequate in eleven cases and the PET-CT findings were indeterminate in two cases, therefore thirteen patients(10.7%) were excluded from further analysis. There was concordance between PET-CT and EUS-FNA findings in seventy one of the remaining one hundred and eight patients(65.7%). The sensitivity, specificity, PPV and NPV values of PET-CT were 92.5%, 50%, 52.1% and 91.9% respectively. There was discordance between PET-CT and EUS-FNA findings in thirty seven out of one hundred and eight patients(34.3%). MDT discussion led to a radical treatment pathway in twenty seven of these cases, after the final tumour stage was altered as a direct consequence of the EUS-FNA findings. Of these patients, fourteen(51.9%) experienced clinical remission of a median of nine months(range three to forty two months). CONCLUSION EUS-FNA leads to altered sta

关键词： Endoscopic ultrasound Oesophago-gastric cancer staging Oesophageal cancer Positron emission tomography-computed tomography Mediastinal nodes

Multiple sclerosis is at a checkpoint: advancing the program

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Neural Regeneration Research 2025年第3期20卷 811-812页

作者： Brandon C.smith Jessica L.Williams Department of Neurosciences Lerner Research InstituteCleveland ClinicClevelandOHUSA Department of Biological Geologicaland Environmental SciencesCleveland State UniversityClevelandOHUSA

Multiple sclerosis(MS) is a chronic inflammatory and demyelinating disease of the central nervous system(CNS). Patients with MS experience sensory and motor function loss due to myelin and/or axon damage perpetuated b... 详细信息

关键词： Hauser sclerosis damage

Polyethylene glycol has immunoprotective effects on sciatic allografts, but behavioral recovery and graft tolerance require neurorrhaphy and axonal fusion

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Neural Regeneration Research 2025年第4期20卷 1192-1206页

作者： Tyler A.smith Liwen Zhou Cameron L.Ghergherehchi Michelle Mikesh Cathy Z.Yang Haley O.Tucker JuliAnne Allgood Jared S.Bushman George D.Bittner Department of Molecular Biosciences University of Texas at AustinAustinTXUSA Department of Neuroscience University of Texas at AustinAustinTXUSA Division of Pharmaceutical Sciences University of WyomingLaramieWYUSA

Behavioral recovery using(viable)peripheral nerve allografts to repair ablation-type(segmental-loss)peripheral nerve injuries is delayed or poor due to slow and inaccurate axonal ***,such peripheral nerve allografts undergo immunological rejection by the host immune *** contrast,peripheral nerve injuries repaired by polyethylene glycol fusion of peripheral nerve allografts exhibit excellent behavioral recovery within weeks,reduced immune responses,and many axons do not undergo Wallerian *** relative contribution of neurorrhaphy and polyethylene glycol-fusion of axons versus the effects of polyethylene glycol per se was unknown prior to this *** hypothesized that polyethylene glycol might have some immune-protective effects,but polyethylene glycol-fusion was necessary to prevent Wallerian degeneration and functional/behavioral *** examined how polyethylene glycol solutions per se affect functional and behavioral recovery and peripheral nerve allograft morphological and immunological responses in the absence of polyethylene glycol-induced axonal ***-type sciatic nerve injuries in outbred Sprague–Dawley rats were repaired according to a modified protocol using the same solutions as polyethylene glycol-fused peripheral nerve allografts,but peripheral nerve allografts were loose-sutured(loose-sutured polyethylene glycol)with an intentional gap of 1–2 mm to prevent fusion by polyethylene glycol of peripheral nerve allograft axons with host *** to negative control peripheral nerve allografts not treated by polyethylene glycol and in contrast to polyethylene glycol-fused peripheral nerve allografts,animals with loose-sutured polyethylene glycol peripheral nerve allografts exhibited Wallerian degeneration for all axons and myelin degeneration by 7 days postoperatively and did not recover sciatic-mediated behavioral functions by 42 days *** morphological signs of rejection,such as col

关键词： allograft rejection axotomy macrophage myelin nerve repair polyethylene glycol(PEG) sciatic nerve T cell transplantation Wallerian degeneration

Chondroitinase ABC combined with Schwann cell transplantation enhances restoration of neural connection and functional recovery following acute and chronic spinal cord injury

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Neural Regeneration Research 2025年第5期20卷 1467-1482页

作者： Wenrui Qu Xiangbing Wu Wei Wu Ying Wang Yan Sun Lingxiao Deng Melissa Walker Chen Chen Heqiao Dai Qi Han Ying Ding Yongzhi Xia George smith Rui Li Nai-Kui Liu Xiao-Ming Xu Spinal Cord and Brain Injury Research Group Stark Neurosciences Research InstituteDepartment of Neurological SurgeryIndiana University School of MedicineIndianapolisINUSA Department of Hand Surgery the Second Hospital of Jilin UniversityChangchunJilin ProvinceChina Shriners Hospitals Pediatric Research Center Temple University School of MedicinePhiladelphiaPAUSA Department of Anatomy&Cell Biology Indiana University School of MedicineIndianapolisINUSA

Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal *** we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord *** report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal *** Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder ***,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord *** findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.

关键词： axonal regrowth bladder function chondroitinase ABC functional recovery glial scar lentivirus migration Schwann cell spinal cord injury transplantation

Analysis of hourly generation patterns at large coal-fired units and implications of transitioning from baseload to load-following electricity supplier

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Journal of Modern Power Systems and Clean Energy 2019年第3期7卷 468-474页

作者： Robert Kennedy smith U.S. Department of Energy Office of Fossil Energy

Several factors have led to the decline of electricity generation from coal over the past decade, and projections forecast high rates of growth for wind and solar technologies in coming years. This analysis uses hourly generation data from large coal-fired power stations to determine how operations have been modified in recent years and describes the implications of these changes for plant equipment and unit reliability. The data shows increasing variability in intraday generation output that affects nearly all of the units in the sample, but the magnitude of increase varies widely among plants. Outage patterns were examined as was the relationship between renewable energy growth in a region and the changes in coal plant operations. Aggregate direct and indirect costs associated with running coal plants as load-following units have not yet been quantified in large-scale studies on a sector-wide basis, largely due to differences in how specific equipment responds to output fluctuations. Due to findings from the hourly generation data analysis and the high degree of potential impact on coal plant equipment, the study suggests the development of a new modeling tool that will represent the costs of running coal-fired power plants at lower capacity factors.

关键词： Coal generation Emission intensity Baseload power Capacity factor

A new view of the local Universe

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Science China(Physics,Mechanics & Astronomy) 2024年第3期67卷 167-168页

作者： Lister Staveley-smith International Centre for Radio Astronomy Research(ICRAR) University of Western AustraliaCrawley WA 6009Australia ARC Centre of Excellence for All Sky Astrophysics(ASTRO 3D) Crawley WA 6009Australia

The distribution and kinematics of gas in and around dark matter halos, the formation of stellar populations from the gravitational collapse of gas clouds, and the interaction of stars and their remnants with interste... 详细信息

关键词： galaxies stars galactic

Inherent Complexities of a Multi-stakeholder Approach to Building Community Resilience

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International Journal of Disaster Risk Science 2020年第1期11卷 32-45页

作者： Josephine Adekola Denis Fischabcher-smith Moira Fischabcher-smith Finance Accounting and RiskGlasgow Caledonian UniversityGlasgow G40BAScotlandUK College of Social Sciences University of GlasgowGlasgow G128QQScotlandUK

Enhancing community resilience has increasingly involved national and regional governments adopting a multi-stakeholder approach because of the potential interagency benefits. This has led to questions about how best to involve stakeholder groups in translating community resilience policies into practice. This exploratory study contributes to this discussion by addressing two key areas that are fundamental in the concerted effort to build community resilience to natural hazards:(1) stakeholder understanding of community resilience as a concept;and(2) the difficulties associated with the processes of risk assessment and preparedness that stakeholders face locally in building community resilience. Data were collected through semistructured interviews with 25 practitioners and experts within Scotland’s resilience community, and were analyzed through an inductive approach to thematic analysis. These data show how the interpretation of community resilience differs across stakeholder groups. Analysis of the data reveals challenges around the nature of the risk assessment and its role in shaping risk perception and communication. Significant complications occur in communicating about low probability-high consequence events, perceived territoriality, competing risk prioritizations, and the challenges of managing hazards within a context of limited resources. The implications of these issues for policy and practice are also discussed.

关键词： Community disaster preparedness Community resilience Multi-stakeholder approach Natural hazards Risk assessment

Phylogenetic reconstruction of Chirita and allies (Gesneriaceae) with taxonomic treatments

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Journal of Systematics and Evolution 2011年第1期49卷 50-64页

作者： James F. smith Department of Biological Sciences Boise State University

Chirita D. Don, a large genus in the subfamily Cyrtandroideae of Gesneriaceae, has been the subject of much debate whether it is a natural group or not. In addition, the highly heterogeneous Chirita has also been very problematic with regard to delimitation and subdivision. Here we used the nrDNA internal transcribed spacer and cpDNA trnL-F for molecular phylogenetic analaysis, combined with morphological data. Our results suggest that Chirita is an artificial, polyphyletic genus. The most important character that defines Chirita, the dorso-ventrally oblique and bilamellar stigma, has evolved convergently in different clades of diandrous Cyrtandroideae. Chirita sensu stricto only includes the species of Chirita sect. Chirita, whereas Chirita sect. Microchirita is an independent clade located at the basal node of the phylogenetic tree. Chirita sect. Liebigia is closely related to Didymocarpus with an entire stigma unlike other species of Chirita. The species of Chirita sect. Gibbosaccus, Chiritopsis, Primulina, and Wentsaiboea form a monophyletic group that is sister to a strongly supported clade comprising four monotypic genera Paralagarosolen, Calcareoboea, Petrocodon, and Tengia. We further analyzed the morphological evolution of Chirita and identified a series of morphological synapomorphies for the monophyletic groups revealed herein, and thereby provide a taxonomic treatment in this study.

关键词： Chirita D. Don morphological evolution phylogenetic reconstruction polyphyly taxonomic treatment.