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Elderly patients over 80 years undergoing colorectal cancer resection: Development and validation of a predictive nomogram for survival

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 892-905页

作者： Aik Yong Chok Yun Zhao Hui Lionel Raphael Chen Ivan En-Howe Tan Desmond Han Wen Chew Yue Zhao marianne kit har au Emile John Kwong Wei Tan Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Group Finance Analytics Singapore Health ServicesSingapore 168582Singapore Group Finance Singapore Health ServicesSingapore 168582Singapore Singhealth Community Hospitals Singapore 168582Singapore

BACKGROUND Surgery remains the primary treatment for localized colorectal cancer(CRC).Improving surgical decision-making for elderly CRC patients necessitates an accurate predictive *** To build a nomogram to predict the overall survival of elderly patients over 80 years undergoing CRC *** Two hundred and ninety-five elderly CRC patients over 80 years undergoing surgery at Singapore General Hospital between 2018 and 2021 were identified from the American College of Surgeons–National Surgical Quality Improvement Program(ACS-NSQIP)*** variables were selected using univariate Cox regression,and clinical feature selection was performed by the least absolute shrinkage and selection operator regression.A nomogram for 1-and 3-year overall survival was constructed based on 60%of the study cohort and tested on the remaining 40%.The performance of the nomogram was evaluated using the concordance index(C-index),area under the receiver operating characteristic curve(auC),and calibration *** groups were stratified using the total risk points derived from the nomogram and the optimal cut-off *** curves were compared between the high-and low-risk *** Eight predictors:Age,Charlson comorbidity index,body mass index,serum albumin level,distant metastasis,emergency surgery,postoperative pneumonia,and postoperative myocardial infarction,were included in the *** auC values for the 1-year survival were 0.843 and 0.826 for the training and validation cohorts,*** auC values for the 3-year survival were 0.788 and 0.750 for the training and validation cohorts,respectively.C-index values of the training cohort(0.845)and validation cohort(0.793)suggested the excellent discriminative ability of the *** curves demonstrated a good consistency between the predictions and actual observations of overall survival in both training and validation cohorts.A significant difference in overall survival wa

关键词： Colorectal cancer Elderly Nomogram Overall survival Prognostic Risk stratification

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Acute hospital-community hospital care bundle for elderly orthopedic surgery patients:A propensity score-matched economic analysis

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World Journal of Orthopedics 2023年第4期14卷 231-239页

作者： Ivan En-Howe Tan Aik Yong Chok Yun Zhao Yonghui Chen Chee Hoe Koo Junjie Aw Mave Hean Teng Soh Chek Hun Foo Kwok Ann Ang Emile John Kwong Wei Tan Andrew Hwee Chye Tan marianne kit har au Group Finance Singapore Health ServicesSingapore 168582Singapore Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Post-Acute and Continuing Care Family MedicineOutram Community HospitalSingapore 168582Singapore Finance Singapore General HospitalSingapore 169608Singapore Department of Orthopedic Surgery Singapore General HospitalSingapore 169856Singapore Singhealth Community Hospital Singapore 168582Singapore

BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute *** Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative *** core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in *** To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic *** A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was *** measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)*** costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore *** Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both *** transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,Pharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.

关键词： Care bundle Community hospital Orthopedic surgery Cost-effectiveness Care transition Intervention

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ATP-dependent chromatin remodeling complex SWI/SNF in cardiogenesis and cardiac progenitor cell development

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Frontiers in Biology 2012年第3期7卷 202-211页

作者： Ienglam LEI Mai har SHAM Zhong WANG Cardiovascular Research Center Massachusetts General Hospital Boston MA 02114 USA harvard Stem Cell Institute 185 Cambridge Street Boston MA 02114 USA Department of Biochemistry Li Ka Shing Faculty of Medicine The University ofHong Kong Hong Kong China

The recent identification of cardiac progenitor cells （CPCs） provides a new paradigm for studying and treating heart disease. To realize the full potential of CPCs for therapeutic purposes, it is essential to understand the genetic and epigenetic mechanisms guiding CPC differentiation into cardiomyocytes, smooth muscle, or endothelial cells. ATP-dependent chromatin remodelers mediate one critical epigenetic mechanism. These large multiprotein complexes open up chromatin to modulate transcription factor access to DNA. SWI/SNF, one of the major types of chromatin remodelers, plays a key role in various aspects of development （de la Serna et al., 2006; Wu et al., 2009）, including heart development and disease （Lickert et al., 2004; Wang et al., 2004; Huang et al., 2008; Stankunas et al., 2008; Hang et al., 2010）. In this review, we describe the specific function of various SWI/SNF components in cardiogenesis and cardiac progenitor cell （CPC） self-renewal and differentiation. We envision that a detailed understanding of the SWI/SNF in heart development and CPC formation and differentiation will generate novel insights into epigenetic mechanisms that govern CPC differentiation and may have significant implications in understanding and treating heart disease.

关键词： ATP-dependent chromatin remodeling SWI/SNF cardiogenesis and cardiac progenitor cell

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LEAF COLOR SEGMENTATION AND POT VOLUME INFLUENCE ON THE CO_(2) ABSORPTION EFFICIENCY IN TWO COMMON GREEN-WALL PLANTS

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Journal of Green Building 2021年第3期16卷 3-12页

作者： har’el Agra Daphna Uni Rael Horwitz Tamir Klein Leon Blaustein The Kadas Green Roofs Ecology Center University of HaifaMt Carmel3498838Israel Department of Plant&Environmental Sciences Weizmann Institute of ScienceRehovot 76100Israel Institute of Evolution and Department of Evolutionary&Environmental Biology University of HaifaMt Carmel3498838Israel

Green walls can improve indoor air-quality by reducing concentrations of carbon dioxide(CO_(2))and other air *** study focused on the spider plant,Chlorophytum comosum,and devil’s ivy,Epipremnum aureum,both common green-wall plants that have been found to be efficient CO_(2) *** species have multiple variants with varying degrees of leaf green-white *** pho-tosynthesis depends on the concentration of leaf chlorophylls,we hypothesized that green variants are more efficient carbon absorbers than green-white *** addi-tion,we tested the hypothesis that the photosynthetic rate of plants is affected by pot volume,as suggested by previous *** used a portable gas exchange system to determine the rate of photosynthesis of the study *** evidence was found for better photosynthetic performance in the green ***-white variants of each *** fact,our results suggest the *** was observed that a spider plants assimilated carbon more efficiently when grown in a larger pot *** conclusion,our study shows that in terms of carbon assimilation,green-white variants of spider plants are the better choice for indoor green *** efficiency can be improved dramatically by increasing pot volume.

关键词： air quality carbon dioxide Chlorophytum comosum Epipremnum aureum indoor green wall photosynthesis

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Orchiopexy:one procedure,two diagnoses-different male infertility outcomes

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Asian Journal of Andrology 2024年第5期26卷 472-478页

作者： Nitza Heiman Newman Idan Farber Eitan Lunenfeld Atif Zeadna Iris har Vardi Zaki Assi Faculty of Health Sciences Ben Gurion University of the NegevBeer Sheva 84105Israel Department of Pediatric Surgery Soroka University Medical CenterBeer Sheva 84101Israel Adelson School of Medicine Ariel UniversityAriel 40700Israel IVF Unit Diviation of Obstetrics and GynecologySoroka University Medical CenterBeer Sheva 84010Israel

Infertility,affecting one in six couples,is often related to the male partner’s congenital and/or environmental conditions or complications *** retrospective study examines the link between orchiopexy for undescended testicles(UDT)and testicular torsion(TT)in childhood and adult fertility as assessed through sperm *** study involved the analysis of semen samples from 7743 patients collected at Soroka University Medical Center(Beer Sheva,Israel)between January 2009 and December *** were classified into two groups based on sperm concentration:those with concentrations below 5×10^(6)sperm per ml(AS group)and those above(MN group).Medical records and surgical histories were reviewed,categorizing orchiopexies by surgical *** 140 individuals who had undergone pediatric surgery,83(59.3%)were placed in the MN group and 57(40.7%)in the AS group.A higher likelihood of being in the MN group was observed in Jewish compared to Arab patients(75.9%vs 24.1%,P=0.006).In cases of childhood UDT,45(78.9%)patients exhibited sperm concentrations below 5×10^(6)sperm per ml(P<0.001),and 66(76.7%)had undergone unilateral and 18(20.9%)bilateral *** orchiopexy was significantly associated with lower sperm concentration,total motility,and progressive motility than unilateral cases(P=0.014,P=0.001,and P=0.031,respectively).Multivariate analysis identified UDT as a weak risk factor for low sperm concentration(odds ratio[OR]:2.712,P=0.078),with bilateral UDT further increasing this risk(OR:6.314,P=0.012).Jewish ethnicity and TT diagnosis were associated with a reduced risk of sperm concentrations below 5×10^(6)sperm per *** findings indicate that initial diagnosis,surgical approach,and ethnicity markedly influence male fertility outcomes following pediatric orchiopexy.

关键词： male infertility orchiopexy sperm analysis testicular torsion undescended testicle

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Applicability of public sector reform initiatives of the Yemeni government from the integrated TOE-DOI framework

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International Journal of Innovation Studies 2022年第4期6卷 286-302页

作者： Rami Salmeen Basloom Muslim har Sani Mohamad Sofiah Md auzair The Faculty of Economics and Management Universiti Kebangsaan MalaysiaBangi43600Malaysia Department of Accounting Kulliyyah of Economics and Management SciencesInternational Islamic University MalaysiaPO Box 1050728Kuala LumpurMalaysia

Effective resource allocation and accountability are critical for public services in countries facing a crisis,to ensure minimum inequality and even save *** innovation is introduced as public sector reform to improve the performance and accountability of public sector *** the said benefit,little has been done to study public administrative innovation in countries under *** study extends the literature by examining the attitude of civil service managers to the administrative innovation in the Yemeni government representing a country in crisis from an integrated perspective of technology-organization-environment(TOE)and diffusion of innovation(DOI)*** was collected from a survey of 200 civil service managers of the Yemeni central *** result shows that the attitude of managers to private sector management style is scored the highest representing the key tool of the public administrative *** the other hand,the downsizing elements were ranked the least significant as public sector reform *** explanatory model highlights the use of information technology,quality of human resources,and budget management orientation as significant factors for the applicability of public administrative innovation in the Yemeni central government.

关键词： Public administrative innovation Yemeni central government Technology-organization-environment Diffusion of innovation theory Country in crisis

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Peperomia pellucida(L.) Kunth and eye diseases: A review on phytochemistry, pharmacology and toxicology

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Journal of Integrative Medicine 2022年第4期20卷 292-304页

作者： Keat Lam Ho Phaik har Yong Chee Woon Wang Umah Rani Kuppusamy Chek Tung Ngo Festo Massawe Zhi Xiang Ng School of Biosciences Faculty of Science and EngineeringUniversity of Nottingham Malaysia43500 SelangorMalaysia School of Bioscience Faculty of MedicineBioscience and NursingMAHSA University42610 SelangorMalaysia Department of Biochemistry Faculty of MedicineBioscience and NursingMAHSA University42610 SelangorMalaysia Department of Biomedical Science Faculty of MedicineUniversity of Malaya50603 Kuala LumpurMalaysia Optimax Sunway Eye Specialist Centre Bandar Sunway46150 SelangorMalaysia

Peperomia pellucida(L.) Kunth is a medicinal plant used to manage inflammatory illnesses such as conjunctivitis, and gastrointestinal and respiratory tract disorders in tropical and subtropical ***, little is known about its pharmacological mechanism of action against eye diseases. This review aims to critically discuss the phytochemistry, pharmacology and toxicology of P. pellucida as well as its roles in the treatment of cataract, glaucoma and diabetic retinopathy. Recent developments in the uses of P. pellucida for healthcare and nutraceutical products by the pharmaceutical industry are also covered in this review. For this review, a literature search was performed with PubMed, ScienceDirect, SciFinder Scholar and Scopus databases, using relevant keywords. Among the various phytochemicals identified from P. pellucida, β-caryophyllene, carotol, dillapiole, ellagic acid, pellucidin A, phytol and vitexin exhibit strong pharmacological activities within the mitogen-activated protein kinase and nuclear factor-κB signalling pathways in inflammatory eye diseases. The antihypertensive, anti-inflammatory, antioxidant,antihyperglycemic and anti-angiogenic activities displayed by P. pellucida extracts in many in vitro,in vivo and clinical studies suggest its potential role in the management of inflammatory eye diseases.P. pellucida extract was non-toxic against normal cell lines but displayed mild toxicity in animal *** growing public interest in P. pellucida has inspired the nutraceutical and pharmaceutical industries to process the plant into health products. Although the potential pharmacological mechanisms against eye diseases have been summarized, further studies of the interactions among constituent phytochemicals from P. pellucida within various signalling pathways shall support the use of the plant as an alternative therapeutic source.

关键词： Peperomia pellucida Phytochemistry Pharmacology Toxicology Cataract Diabetic retinopathy Glaucoma

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Synthesis, spectral, 3D molecular modeling and antibacterial studies of dibutyltin (IV) Schiff base complexes derived from substituted isatin and amino acids

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Natural Science 2012年第3期4卷 170-178页

作者： har Lal Singh Jangbhadur Singh Department of Chemistry Faculty of Engineering & Technology Mody Institute of Technology and Science Sikar India

New dibutyltin(IV) complexes of Schiff base derived from 5-chloroindoline-2,3-dione, indoline- 2,3-dione with amino acids (tryptophan, alanine and valine) were synthesized and characterized by elemental analysis, IR, electronic spectra, conductance measurements, and biological activity. The analytical data showed that the Schiff base ligand acts as bidentate towards metal ions via the azomethine nitrogen and carboxylate oxygen by a stoichiometric reaction of M:L (1:2) to form metal complexes. NMR (1H, 13C and 119Sn) spectral data of the ligands and metal complex agree with proposed structures. The conductivity values between 14 - 27 ohm-1cm2mol-1 in DMF imply the presence of non-electrolyte species. 3D molecular modeling and analysis of bond lengths and bond angles have also been conducted for a representative compound, [Bu2Sn(L2)2], to substantiate the proposed structures. Antibacterial results indicate that the metal complexes are more active than the free ligands.

关键词： Schiff Base Isatins Amino Acids Dibutyltin (IV) Complexes Spectral Studies Antimicrobial Activity

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Accommodation of China's Industrial Heritage in Urban Conservation Practices (Ⅱ)

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China City Planning Review 2012年第1期21卷 14-19页

作者： Peter G. Rowe har Ye Kan Architecture and Urban Design and University Harvard University Graduate School of Design Harvard University

In recent years, the conservation of industrial heritage in China has gained increasing attention within the broader context of urban conservation practices. For both policy-makers and scholars, accommodating this industrial heritage will emerge as a pertinent issue for consideration as a growing number of industrial architectural legacies dating from the Republican and Maoist eras come under (re)development pressures. This paper thus traces the development of industrial heritage conservation practices in China and discusses several dilemmas intrinsic to this type of conservation, including issues of authenticity, representativeness, and distinction. Based on comparative case studies from China and other international precedents, this paper also seeks to illustrate the different approaches that could be pursued while still attaining a balance between competing interests and claims.

关键词： industrial heritage urban conservation adaptive reuse comparative international conservation practices

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颞动脉炎

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国外医学（耳鼻咽喉科学分册） 1989年第3期13卷 141-142页

作者： har-El G 常惠玉

颞动脉炎系指发生在颞动脉及头颈部中等大动脉的血栓性炎症,形成对各相应部位所在器官血供障碍引起的病变,耳及咽喉亦可受累,且易误诊。为此,本文重点对本病主要临床表现、诊断及治疗作一概要介绍。

关键词：颞动脉炎临床诊断

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