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Endoscopic ultrasound staging for early esophageal cancer: Are we denying patients neoadjuvant chemo-radiation?

World Journal of Gastroenterology 2017年第46期23卷 8193-8199页

作者： Carrie Luu marisa amaral Jason Klapman Cynthia Harris Khaldoun Almhanna Sarah Hoffe Jessica Frakes Jose M Pimiento Jacques P Fontaine Department of Thoracic Oncology H. Lee Moffitt Cancer Center and Research Institute Department of Gastrointestinal Oncology H. Lee Moffitt Cancer Center and Research Institute Department of Radiation Oncology H. Lee Moffitt Cancer Center and Research Institute

AIM To evaluate the accuracy of endoscopic ultrasound(EUS) in early esophageal cancer(EC) performed in a highvolume tertiary cancer center. METHODS A retrospective review of patients undergoing esophagectomy was performed and patients with c T1 N0 and c T2 N0 esophageal cancer by EUS were evaluated. Patient demographics, tumor characteristics, and treatment were reviewed. EUS staging was compared to surgical pathology to determine accuracy of EUS. Descriptive statistics was used to describe the cohort. Student's t test and Fisher's exact test or χ~2 test was used to compare variables. Logistic regression analysis was used to determine if clinical variables such as tumor location and tumor histology were associated with EUS *** Between 2000 and 2015, 139 patients with clinical stage Ⅰ or Ⅱ?A esophageal cancer undergoing esophagectomy were identified. There were 25(18%) female and 114(82%) male patients. The tumor location included the middle third of the esophagus in 11(8%) and lower third and gastroesophageal junction in 128(92%) patients. Ninety-three percent of patients had adenocarcinoma. Preoperative EUS matched the final surgical pathology in 73/139 patients for a concordance rate of 53%. Twenty-nine patients(21%) were under-staged by EUS; of those, 19(14%) had unrecognized nodal disease. Positron emission tomography(PET) was used in addition to EUS for clinical staging in 62/139 patients. Occult nodal disease was only found in 4 of 62 patients(6%) in whom both EUS and PET were negative for nodal involvement. CONCLUSION EUS is less accurate in early EC and endoscopic mucosal resection might be useful in certain settings. The addition of PET to EUS improves staging accuracy.

关键词： Esophageal cancer Endoscopic ultrasound Staging Early esophageal cancer Endoscopic mucosal resection

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Extreme Weather Disruptions and Emergency Preparedness Among Older Adults in Ohio: An Eight-County Assessment

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International Journal of Disaster Risk Science 2024年第2期15卷 213-225页

作者： Smitha Rao Fiona C.Doherty Anthony Traver marisa Sheldon Emma Sakulich Holly Dabelko‑Schoeny College of Social Work The Ohio State UniversityColumbusOH 43210USA Age Friendly Innovation Center College of Social WorkThe Ohio State UniversityColumbusOH 43210USA College of Public Health The Ohio State UniversityColumbusOH 43210USA

The disproportionate risks and impacts of climate change and extreme weather on older adults are increasingly evident. While especially true in disaster-prone areas, human-caused climate change introduces an element of uncertainty even in previously identified “safe” regions such as the Midwestern United States. Using a cumulative disadvantage and vulnerability-informed framework and descriptive statistics from multiple data sources, this article provides an overview of climate impacts, vulnerabilities, and county-level characteristics, focusing on older adults living in Central Ohio. A comparative multiple-case study methodology was used to triangulate regionally representative primary and secondary data sources to examine state and county-level measures of vulnerability, emergency preparedness, and disruptions caused by extreme weather among older adults across eight counties in Central Ohio. Seventy-eight percent of older adults in the sample reported being prepared for emergencies per Federal Emergency Management Agency guidelines. Older adults in Union County reported the highest rates of preparedness, while those in Fayette County reported the lowest. County-level rates of disruption of life activities by extreme weather ranged widely. Among the most rural in the region, Fayette County emerged as uniquely disadvantaged, with the lowest median income, the most vulnerable across multiple social vulnerability dimensions, and the most reported disruptions to life activities from extreme weather. County profiles offer a snapshot of existing vulnerabilities, socioeconomic conditions, special needs, preparedness, and current disruptions among older adults in the region and can inform resource mobilization across community and policy contexts.

关键词： Disaster preparedness Extreme weather Midwestern United States Older adults Regional assessment Social vulnerability

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Satellite-enabled enviromics to enhance crop improvement

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Molecular Plant 2024年第6期17卷 848-866页

作者： Rafael T.Resende Lee Hickey Cibele H.amaral Lucas L.Peixoto Gustavo E.Marcatti Yunbi Xu Universidade Federal de Goia´s(UFG) Agronomy DepartmentPlant Breeding SectorGoiania(GO)74690-900Brazil TheCROP a Precision-Breeding Startup:EnviromicsPhenomicsand GenomicsNo Zip-codeOperating VirtuallyGoiania(GO)and Sete Lagoas(MG)Brazil Queensland Alliance for Agriculture and Food Innovation The University of QueenslandBrisbaneQLDAustralia Earth Lab Cooperative Institute for Research in Environmental SciencesUniversity of Colorado BoulderBoulderCO 80303USA Environmental Data Science Innovation&Inclusion Lab Cooperative Institute for Research in Environmental SciencesUniversity of Colorado BoulderBoulderCO 80303USA Universidade Federal de Sa˜o Joa˜o del-Rei Forest Engineering DepartmentCampus Sete LagoasSete Lagoas(MG)35701-970Brazil Institute of Crop Sciences Chinese Academy of Agricultural SciencesBeijing 100081China Peking University Institute of Advanced Agricultural Sciences WeifangShandong 261325China BGI Bioverse Shenzhen 518083China

Enviromics refers to the characterization of micro-and macroenvironments based on large-scale environmental *** providing genotypic recommendations with predictive extrapolation at a site-specific level,enviromics could inform plant breeding decisions across varying conditions and anticipate productivity in a changing ***-based integration of statistics,envirotyping(i.e.,determining environmental factors),and remote sensing could help unravel the complex interplay of genetics,environment,and *** support this goal,exhaustive envirotyping to generate precise environmental profiles would significantly improve predictions of genotype performance and genetic gain in ***,informatics management platforms aggregate diverse environmental datasets obtained using optical,thermal,radar,and light detection and ranging(LiDAR)sensors that capture detailed information about vegetation,surface structure,and *** wealth of information,coupled with freely available climate data,fuels innovative enviromics *** enviromics holds immense potential for breeding,a few obstacles remain,such as the need for(1)integrative methodologies to systematically collect field data to scale and expand observations across the landscape with satellite data;(2)state-of-the-art AI models for data integration,simulation,and prediction;(3)cyberinfrastructure for processing big data across scales and providing seamless interfaces to deliver forecasts to stakeholders;and(4)collaboration and data sharing among farmers,breeders,physiologists,geoinformatics experts,and programmers across research *** these challenges is essential for leveraging the full potential of big data captured by satellites to transform 21st century agriculture and crop improvement through enviromics.

关键词： envirotyping precision breeding genotype-environment interactions remote sensing predictive models enviromic information

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Starch Orodispersible Film Loaded with Melatonin for Human Supplementation

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Journal of Renewable Materials 2024年第7期12卷 1343-1354页

作者： Fabio Tamanini Tatiane Zucchini de Souza Creusa Sayuri Tahara amaral Antônio JoséFelix Carvalho Eliane Trovatti Department of Health and Biological Sciences University of Araraquara(UNIARA)São Paulo14801-340Brazil Department of Materials Engineering São Carlos School of EngineeringUniversity of São PauloSão Paulo13563-120Brazil

An innovative pharmaceutical form for administering melatonin,based on starch orodispersibleﬁlm(ODF),was designed and *** composition of the ODF included starch as the polymer matrix,the active drug melatonin,and a ***,a natural hormone produced by the pineal gland in the brain,can be absorbed by passive diffusion across the mucous membrane,resulting in improved bioavailability when compared to conventional oral *** study shows a simple and efﬁcient method for preparing melatonin-loaded orodispersibleﬁlms with a physically stable and commercially viable matrix,suitable for use in the pharmaceutical ***ﬁlms were prepared by treating the starch with microwave irradiation,followed by plasticization with glycerol,melatonin loading and drying by solvent *** tests showed theﬁlms’robustness,with a modulus of approximately 97 MPa,indicating good handling *** uptake analysis showed fast water absorption,reaching about 150%within 2 min,indicating its fast oral disintegration *** tests in artiﬁcial saliva and dissolution studies indicated the release of the drug in min-utes,indicating the potential properties of theﬁlm for oral drug *** the best of our knowledge,there is no melatonin ODF based on starch described in the literature.

关键词： Starch orodispersibleﬁlm melatonin drug delivery

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Utility of Preoperative Positron Emission Tomography (PET) in Localizing Perforator Vessels of Anterolateral Thigh Free Flap

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 275-284页

作者： Alexandra McMillan Sameer A. Alvi Zaid Al-Qurayshi Zachary Fleishacker Nitin A. Pagedar marisa R. Buchakjian Department of Otolaryngology University of Iowa Hospitals and Clinics Iowa City IA USA Division of Otolaryngology-Head & Neck Surgery North Shore University Health System Evanston IL USA Pritzker School of Medicine The University of Chicago Chicago IL USA Holden Comprehensive Cancer Center University of Iowa Iowa City IA USA

Objectives: The anterolateral thigh (ALT) flap is often considered the workhorse in soft tissue reconstruction of head and neck defects secondary to trauma, infection, or tumor resection. Despite its many advantages, ALT flaps have been criticized due to variability in vasculature, which may result in inadequate or non-existent perforators. This retrospective study aims to investigate the utility and validity of positron emission tomography (PET) scan to identify the location and characteristics of perforators to the ALT flap. Methods: We performed a 10-year retrospective review of ALT flaps at our institution to identify patients with preoperative PET scans available for analysis. Three reviewers (attending physician, fellow, and resident) were asked to identify the number, location, and characteristics (myocutaneous versus septocutaneous) of ALT perforators on imaging, and reviewer agreement was assessed. Results were then compared to available operative data. Results: One hundred twenty-one patients were identified who underwent ALT free flap surgery. Thirty-eight preoperative PET scans were identified for review. At least one perforator was identified in 92.1% of scans. Agreement percentages regarding the number of perforators ranged from 53% - 61% whereas agreement regarding the location of a single perforator ranged from 79% - 90%. However, reviewers did not agree regarding the type of perforator, with agreement ranging from 34% - 53%. Poor agreement was observed when compared to intraoperative data, with the number of perforators ranging from 26% - 34% and the type of perforator 11% - 24%. These findings are likely due to insufficient data available in operative reports. Conclusion: Although initial studies suggest that PET scan shows promising evidence to support the capacity to preoperatively identify ALT perforators, future prospective studies are warranted to fully validate these findings.

关键词： Anterolateral Thigh Flaps Positron Emission Tomography Head and Neck Defects Perforator Mapping

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Analysing vaccine efficacy evaluated in phase 3 clinical trials carried out during outbreaks

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Infectious Disease Modelling 2024年第4期9卷 1027-1044页

作者： Francisco Antonio Bezerra Coutinho Marcos Amaku Fernanda Castro Boulos Jose Alfredo de Sousa Moreira Joao Italo DiasFranca Julio Antonio do amaral Eliana Nogueira Castro de Barros Claudio Jose Struchiner Esper Jorge Kallas Eduardo Massad School of Medicine University of Sao PauloBrazil Instituto Butantan Sao PauloBrazil School of Applied Mathematics Fundacao Getulio VargasRio de JaneiroBrazil

In this paper we examine several definitions of vaccine efficacy(VE)that we found in the literature,for diseases that express themselves in outbreaks,that is,when the force of infection grows in time,reaches a maximum and then *** fact that the disease occurs in outbreaks results in several problems that we *** propose a mathematical model that allows the calculation of VE for several *** trials usually needs a large number of volunteers that must be ***,all volunteers should be enrolled in approximately the same time,but this is generally impossible for logistic reasons and they are enrolled in a fashion that can be replaced by a continuous density function(for example,a Gaussian function).The outbreak can also be replaced by a continuous density function,and the use of these density functions simplifies the ***,for example Gaussian functions,one of the problems one can immediately notice is that the peak of the two curves do not occur at the same *** model allows us to conclude:First,the calculated vaccine efficacy decreases when the force of infection increases;Second,the calculated vaccine efficacy decreases when the gap between the peak in the force of infection and the peak in the enrollment rate increases;Third,different trial protocols can be simulated with this model;different vaccine efficacy definitions can be calculated and in our simulations,all result are approximately the *** final,and perhaps most important conclusion of our model,is that vaccine efficacy calculated during outbreaks must be carefully examined and the best way we can suggest to overcome this problem is to stratify the enrolled volunteer's in a cohort-by-cohort basis and do the survival analysis for each cohort,or apply the Cox proportional hazards model for each cohort.

关键词： Vaccine efficacy Clinical trials Mathematical models Simulations Covid-19

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Improving the health and treatment success rates of in vitro fertilization patients with traditional Chinese medicine:Need for more robust evidence and innovative approaches

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Journal of Integrative Medicine 2022年第3期20卷 187-192页

作者： marisa Casale School of Public Health University of the Western CapeRobert Sobukwe RoadBellville 7535South Africa

Maximising access to and the success of fertility treatments should be a priority for global reproductive health,as should overall patient *** demand for in vitro fertilization(IVF)and other assisted fertility treatments has increased over the past decade and is likely to further increase in years to ***,there is still considerable unmet demand for infertility support ***,the high emotional,physical and financial burden experienced by individuals undergoing IVF cycles can be a risk for their mental and physical health,which in turn can influence treatment continuation and the likelihood of IVF *** from various parts of the world show that most individuals undergoing IVF also use adjunct alternative medicines and procedures,the most common being traditional Chinese medicine(TCM).The complementary and synergistic role of TCM for individuals undergoing IVF is an area that merits further attention and research,both for its potential positive effects on IVF success rates and for its broader physical and mental health ***,much of the existing evidence is not sufficiently robust or consistent for findings to be adopted with *** commentary argues that much work must be done to understand the efficacy and clinical best practices for these integrated *** can be achieved in part by developing more robust and clinically relevant randomized controlled trial protocols,collecting and triangulating evidence through a variety of study designs and methods,and strengthening the collection and pooling of clinic-level data.

关键词： In vitro fertilization Traditional Chinese medicine Mental health Pregnancy rates

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Treatment and prevention of epilepsy in onchocerciasis-endemic areas is urgently needed

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Infectious Diseases of Poverty 2024年第1期13卷 85-89页

作者： Robert Colebunders Joseph Nelson Siewe Fodjo Olivia Kamoen Luis-Jorge amaral Amber Hadermann Chiara Trevisan Mark J.Taylor Julia Gauglitz Achim Hoerauf Yasuaki Sato Katja Polman Maria-Gloria Basanez Dan Bhwana Thomson Lakwo Gasim Abd-Elfarag Sebastien D.Pion Global Health Institute University of AntwerpAntwerpBelgium Department of Neurology Heilig Hart ZiekenhuisLierBelgium Department of Public Health Institute of Tropical MedicineAntwerpBelgium Liverpool School of Tropical Medicine LiverpoolUK Department of Computer Science University of AntwerpAntwerpBelgium Institute of Medical Microbiology Immunology and ParasitologyUniversity Hospital BonnBonnGermany German Center for Infection Research(DZIF) Partner Site Bonn-CologneBonnGermany School of Global Humanities and Social Sciences Nagasaki UniversityNagasakiJapan MRC Centre for Global Infectious Disease Analysis and London Centre for Neglected TropicalDisease Research Department of Infectious Disease EpidemiologySchool of Public HealthImperial College LondonLondonUK National Institute for Medical Research TangaTanzania Vector Control Division Ministry of HealthKampalaUganda School of Public Health University of JubaJubaSouth Sudan Access for Humanity JubaSouth Sudan French National Research Institute for Sustainable Development MontpellierFrance

Background There is increasing epidemiological evidence supporting the association between onchocerciasis and seizures, reinforcing the concept of onchocerciasis-associated epilepsy (OAE). The aim of this paper is to provide an update on the new knowledge about OAE and to propose recommendations to the World Health Organization how to address this public health *** text During the 2nd International Workshop on OAE held on 19-21 September, 2023, in Antwerp, Belgium, participants recognised OAE as a substantial yet neglected public health problem, particularly in areas of sub-Saharan Africa where onchocerciasis remains hyperendemic. Evidence from prospective population-based studies suggest that strengthening onchocerciasis elimination efforts leads to a significant reduction of OAE incidence. There is a need to validate an OAE case definition to estimate the burden of disease and identify onchocerciasis-endemic areas requiring intensification of onchocerciasis elimination programmes and integration of epilepsy care. It is expected that raising awareness about OAE will boost the population uptake of ivermectin. The implementation of a community-based epilepsy treatment programme offering free anti-seizure medications (ASMs) has shown high effectiveness in reducing the frequency of seizures and improving the overall quality of life of people with *** To reduce OAE burden, enhanced collaboration between onchocerciasis and mental health programmes at community, national, and international levels is required. Urgent efforts are needed to ensure the uninterrupted provision of free ASMs in onchocerciasis-endemic areas. Furthermore, OAE should be included in the quantification of the onchocerciasis disease burden.

关键词： Onchocerciasis Morbidity Burden of disease Prevention Ivermectin Epilepsy Nodding syndrome Treatment Children Policy

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Biosorption of mercury by Macrocystis pyrifera and Undaria pinnatifida:Influence of zinc,cadmium and nickel

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Journal of Environmental Sciences 2011年第11期23卷 1778-1786页

作者： Josefina Plaza marisa Viera Edgardo Donati Eric Guibal Centro de Investigacióny Desarrollo en Fermentaciones Industriales CINDEFI (CCT La Plata-CONICET UNLP)Facultad de Ciencias Exactas50 y 115(1900) La PlataArgentina Ecole des Mines d'Ale`s Laboratoire Ge'nie de l'Environnement Industriel6avenue de Clavie`resF-30319 Ale`s cedexFrance Ecole des Mines d‘Ale`s Laboratoire Ge'nie de l‘Environnement Industriel6avenue de Clavie`resF-30319 Ale`s cedexFrance

This study investigated the adsorption of Hg（Ⅱ） on Macrocystis pyrifera and Undaria pinnatifida in monometallic system in the presence of Zn（II）,Cd（Ⅱ） and Ni（II）.The two biosorbents reached the same maximum sorption capacity （q m = 0.8 mmol/g） for *** showed a greater affinity （given by the coefficient b of the Langmuir equation） for mercury compared to *** （4.4 versus 2.7 L/mmol）.Mercury uptake was significantly reduced （by more than 50%） in the presence of competitor heavy metals such as Zn（II）,Cd（II） and Ni（Ⅱ）.Samples analysis using an environmental scanning electron microscopy equipped with an energy dispersive X-ray microanalysis showed that mercury was heterogeneously adsorbed on the surface of both biomaterials,while the other heavy metals were homogeneous *** analysis of biosorbents by Fourier transform infrared spectrometry indicated that Hg（Ⅱ） binding occurred on S=O （sulfonate） and N-H （amine） functional groups.

关键词： mercury isotherm sorption M.pyrifera U.pinnatifida ESEM-EDX FT-IR spectrometry

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Evaluation of the effectiveness of horizontal subsurface flow constructed wetlands for different media

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Journal of Environmental Sciences 2010年第6期22卷 820-825页

作者： Antonio Albuquerque José Oliveira Sabrina Semitela Leonor amaral Department of Civil Engineering and Architecture and C-MADE University of Beira Interior Municipality of Penamacor Department of Sciences and Environmental Engineering Faculty of Sciences and TechnologyNew University of Lisbon

Two media bed （gravel and Filtralite NR） were tested in a mesocosm to evaluate the removal of organic matter （as chemical oxygen demand （COD））, ammonia （NH4-N）, nitrite, nitrate and solid matter （as total suspended solids （TSS）） for a synthetic wastewater （acetate-based） and a domestic wastewater. The use of Filtralite allowed average removal rates （6--16.8 g COD/（m^2·day）, 0.8-1.1 g NH4-N/（m^2·day） and 3.1 g TSS/（m^2·day）） and removal efficiencies （65%-93%, 57%-85% and 78% for COD, NH4-N and TSS, respectively）, higher than that observed in the experiments with gravel. The applied loads of COD, ammonia, nitrate and TSS seem to influence the respective removal rates but only for the treatment of domestic wastewater with nigher correlation coefficients for Filtralite. Regardless the type of media bed and the type of wastewater, nitrate was completely removed for nitrogen loading rates up to 1.3 g NO3-N/（m^2·day）. There was no evidence of the influence of nitrate loads on the removal of organic matter.

关键词： media bed constructed wetlands pollutants removal rates

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