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Stratification of outcomes for mucinous appendiceal adenocarcinoma with peritoneal metastasis by histological grade

World Journal of Gastrointestinal Oncology 2017年第9期9卷 354-362页

作者： Travis Edward Grotz Richard E Royal Paul F Mansfield michael james overman Gary N Mann Kristen Ashlee Robinson Karen A Beaty Safiea Rafeeq Auerlio Matamoros Michelle W Taggart Keith Francis Fournier Department of Surgical Oncology at the University of Texas MD Anderson Cancer Center Department of Medical Oncology at the University of Texas MD Anderson Cancer Center Department of Radiology at the University of Texas MD Anderson Cancer Center Department of Pathology at the University of Texas MD Anderson Cancer Center Department of SurgicalOncology at the University of Texas MD Anderson Cancer Center

AIM To investigate the importance of a three-tiered histologic grade on outcomes for patients with mucinous appendiceal adenocarcinoma(MAA).METHODS Two hundred and sixty-five patients with MAA undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were identified from a prospective database from 2004 through 2014. All pathology was reviewed by our gastrointestinal subspecialty pathologists and histological grade was classified as well-differentiated, moderately differentiated, and poorly differentiated. Survival analysis was performed using Cox proportional hazards *** There were 201(75.8%) well-, 45(16.9%) moderatelyand 19(7.2%) poorly-differentiated tumors. Histological grade significantly stratified the 5-year overall survival(OS), 94%, 71% and 30% respectively(P < 0.001) as well as the 5-year disease-free survival(DFS) 66%, 21% and 0%, respectively(P < 0.001). Independent predictors of DFS included tumor grade(HR = 1.78, 95%CI: 1.21-2.63, P = 0.008), lymph node involvement(HR = 0.33, 95%CI: 0.11-0.98, P < 0.02), previous surgical score(HR = 1.31, 95%CI: 1.1-1.65, P = 0.03) and peritoneal carcinomatosis index(PCI)(HR = 1.05, 95%CI: 1.02-1.08, P = 0.002). Independent predictors of OS include tumor grade(HR = 2.79, 95%CI: 1.26-6.21, P = 0.01), PCI(HR = 1.10, 95%CI: 1.03-1.16, P = 0.002), and complete cytoreduction(HR = 0.32, 95%CI: 0.11-0.92, P = 0.03). Tumor grade and PCI were the only independent predictors of both DFS and OS. Furthermore, histological grade and lymphovascular invasion stratified the risk of lymph node metastasis into a low(6%) and high(40%) risk groups. CONCLUSION Our data demonstrates that moderately differentiated MAA have a clinical behavior and outcome that is distinct from well-and poorly-differentiated MAA. The threetier grade classification provides improved prognostic stratification and should be incorporated into patient selection and treatment algorithms.

关键词： Hyperthermic intraperitoneal chemotherapy Pseudomyxoma peritonei Histology Grade Prognostic Outcomes

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Two-dimensional near-infrared photonic crystal fabrication by generation of void channels in solid resin

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Chinese Optics Letters 2003年第12期1卷 719-721页

作者： michael james Ventura Centre for Micro-Phtonics and the Centre for Ultrahigh-Highwidth Devices for Optical Systems School of Biophysical Sciences and Electrical Engineering Swinburne University of Technology PO Box 218 Hawthorn Victoria 3122 Australia

Two-dimensional (2D) triangular void channel photonic crystals with different lattice constants stacked in two different directions were fabricated by using femtosecond laser micro-explosion in solid polymer material. Fundamental and higher-order stop gaps were observed both in the infrared transmission and reflection spectra. There is an approximately linear relationship between the gap position and the lattice constant. The suppression of the fundamental gap is as high as 70% for 24-layer structures stacked in the T-M direction.

关键词： of as Two-dimensional near-infrared photonic crystal fabrication by generation of void channels in solid resin by that were for with

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Atmospheric Precursors of and Response to Anomalous Arctic Sea Ice in CMIP5 Models

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Advances in Atmospheric Sciences 2018年第1期35卷 27-37页

作者： michael KELLEHER james SCREEN College of Engineering Mathematics and Physical SciencesUniversity of Exeter

This study examines pre-industrial control simulations from CMIP5 climate models in an effort to better understand the complex relationships between Arctic sea ice and the stratosphere, and between Arctic sea ice and cold winter temperatures over Eurasia. We present normalized regressions of Arctic sea-ice area against several atmospheric variables at extended lead and lag times. Statistically significant regressions are found at leads and lags, suggesting both atmospheric precursors of, and responses to, low sea ice; but generally, the regressions are stronger when the atmosphere leads sea ice, including a weaker polar stratospheric vortex indicated by positive polar cap height anomalies. Significant positive midlatitude eddy heat flux anomalies are also found to precede low sea ice. We argue that low sea ice and raised polar cap height are both a response to this enhanced midlatitude eddy heat flux. The so-called "warm Arctic, cold continents" anomaly pattern is present one to two months before low sea ice, but is absent in the months following low sea ice, suggesting that the Eurasian cooling and low sea ice are driven by similar processes. Lastly, our results suggest a dependence on the geographic region of low sea ice, with low Barents–Kara Sea ice correlated with a weakened polar stratospheric vortex, whilst low Sea of Okhotsk ice is correlated with a strengthened polar vortex. Overall, the results support a notion that the sea ice, polar stratospheric vortex and Eurasian surface temperatures collectively respond to large-scale changes in tropospheric circulation.

关键词： sea ice–atmosphere coupling stratosphere–troposphere coupling atmospheric circulation Eurasian climate

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Occupational hand injuries:a current review of the prevalence and proposed prevention strategies for physical therapists and similar healthcare professionals

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Journal of Integrative Medicine 2018年第2期16卷 84-89页

作者： Giles Gyer Jimmy michael james Inklebarger The London College of Osteopathic Medicine 8-10 Boston PlaceLondon NWI 6QHUnited Kingdom

Hand injury is the second most common work-related musculoskeletal injury among physical therapists （PTs） and other manual therapy professionals such as osteopaths, physiotherapists, chiropractors, acupuncturists and massage therapists. However, the nature and extent of this problem have not been fully explored yet. Therefore, the objective of this study was to review the existing literature published on the prevalence, risk factors, consequences, and prevention of hand injuries among PTs and similar healthcare professionals. The lifetime prevalence of hand injuries was about 15%-46%, and the annual prevalence was reported as 5%-30%. Thumb injuries were found to be the most prevalent of all injuries, accounting more than 50% of all hand-related problems. The most significant risk factors for job-related hand injuries were performing manual therapy techniques, repetitive workloads, treating many patients per day, continued work while injured or hurt, weakness of the thumb muscles, thumb hypermobility, and instability at the thumb joints. Frs reported modifying treatment technique, taking time off on sick leave, seeking intervention, shifting the specialty area, and decreasing patient contact hours as the major consequences of these injuries. The authors recommend that PTs should develop specific preventive strategies and put more emphasis on the use of aids and equipment to reduce the risk of an unnecessary injury.

关键词： Occupational injuries Public health Physical therapists Occupational therapists Complementary therapies

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A Scalable Testing Framework for Location-Based Services

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Journal of Computer Science & Technology 2009年第2期24卷 386-404页

作者： Jiang Yu Andrew Tappenden james Miller michael Smith University of Alberta Edmonton T6G 2E1 Canada University of Calgary Calgary T2N 1N4 Canada

A novel testing framework for location based services is introduced. In particular, the paper showcases a novel architecture for such a framework. The implementation of the framework illustrates both the functionality and the feasibility of the framework proposed and the utility of the architecture. The new framework is evaluated through comparison to several other methodologies currently available for the testing of location-based applications. A case study is presented in which the testing framework was applied to a typical mobile service tracking system. It is concluded that the proposed testing framework achieves the best coverage of the entire location based service testing problem of the currently available methodologies; being equipped to test the widest array of application attributes and allowing for the automation of testing activities.

关键词： location based applications location-based services M-commerce software testing

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A case of phenibut withdrawal and treatment with baclofen

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World Journal of Emergency Medicine 2023年第4期14卷 338-340页

作者： michael Morris james Espinosa Alan Lucerna Robin Lahr Department of Emergency Medicine Rowan University SOM/Jefferson StratfordNJ 08084USA Emergency Medicine Residency Program Director Rowan University SOM/Jefferson StratfordNJ 08084USA

Phenibut(β-phenyl-γ-aminobutyric acid)is a psychoactive gamma-aminobutyric acid(GABA)analog marketed online as a nutritional and nootropic(cognition enhancing)*** consumption poses a high risk of potential *** from phenibut mimics benzodiazepine and alcohol withdrawal and can be dangerous.A number of approaches have been described for phenibut withdrawal,including protocols that include baclofen,but for inpatient and outpatient *** we describe a 30-year-old male who presented to an emergency department(ED)with insomnia,anxiety and palpitations after he stopped taking phenibut.

关键词： treatment withdrawal alcohol

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Effects of biomechanical parameters of spinal manipulation: A critical literature review

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Journal of Integrative Medicine 2022年第1期20卷 4-12页

作者： Giles Gyer Jimmy michael james Inklebarger Imtiaz Ibne Alam Department of Clinical Skills the London College of Osteopathic MedicineBoston PlaceLondon NW1United Kingdom Department of Pharmacy Stamford University BangladeshDhaka 1217Bangladesh

Spinal manipulation is a manual treatment technique that delivers a thrust,using specific biomechanical parameters to exert its therapeutic *** parameters have been shown to have a unique dose-response relationship with the physiological responses of the *** far,however,there has not been a unified approach to standardize these biomechanical *** fact,it is still undetermined how they affect the observed clinical outcomes of spinal *** study,therefore,reviewed the current body of literature to explore these dosage parameters and evaluate their significance,with respect to physiological and clinical *** the experimental studies reviewed herein,it is evident that the modulation of manipulation’s biomechanical parameters elicits transient physiological responses,including changes in neuronal activity,electromyographic responses,spinal stiffness,muscle spindle responses,paraspinal muscle activity,vertebral displacement,and segmental and intersegmental acceleration ***,to date,there have been few clinical trials that tested the therapeutic relevance of these *** addition,there were some inherent limitations in both human and animal models due to the use of mechanical devices to apply the *** studies evaluating the effects of varying biomechanical parameters of spinal manipulation should include clinicians to deliver the therapy in order to explore the true clinical significance of the dose-response relationship.

关键词： Spinal manipulation Biomechanical characteristics Biomechanical parameters Dosage Force-time profile

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Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation

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Journal of Integrative Medicine 2019年第5期17卷 328-337页

作者： Giles Gyer Jimmy michael james Inklebarger Jaya Shanker Tedla The London College o f Osteopathic Medicine London NW1 6QHUnited Kingdom Department of Medical Rehabilitation Sciences College of Applied Medical SciencesKing Khalid University3665 GuraigerAbhaSaudi Arabia

Spinal manipulation has been an effective intervention for the management of various musculoskeletal disorders. However,the mechanisms underlying the pain modulatory effects of spinal manipulation remain elusive. Although both biomechanical and neurophysiological phenomena have been thought to play a role in the observed clinical effects of spinal manipulation, a growing number of recent studies have indicated peripheral, spinal and supraspinal mechanisms of manipulation and suggested that the improved clinical outcomes are largely of neurophysiological origin. In this article, we reviewed the relevance of various neurophysiological theories with respect to the findings of mechanistic studies that demonstrated neural responses following spinal manipulation. This article also discussed whether these neural responses are associated with the possible neurophysiological mechanisms of spinal manipulation. The body of literature reviewed herein suggested some clear neurophysiological changes following spinal manipulation, which include neural plastic changes, alteration in motor neuron excitability,increase in cortical drive and many more. However, the clinical relevance of these changes in relation to the mechanisms that underlie the effectiveness of spinal manipulation is still unclear. In addition,there were some major methodological flaws in many of the reviewed studies. Future mechanistic studies should have an appropriate study design and methodology and should plan for a long-term follow-up in order to determine the clinical significance of the neural responses evoked following spinal manipulation.

关键词： Occupational injuries Public health Physical therapists Occupational therapists Complementary therapies

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Comprehensive Optimization-based Techno-economic Assessment of Hybrid Renewable Electricity-hydrogen Virtual Power Plants

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Journal of Modern Power Systems and Clean Energy 2023年第2期11卷 553-566页

作者： james Naughton Shariq Riaz michael Cantoni Xiao-Ping Zhang Pierluigi Mancarella University of Melbourne(UoM) Australia University of Birmingham(UoB) UK University of Manchester UK

Hydrogen is being considered as an important option to contribute to energy system ***,currently its production from renewables is expensive compared with the methods that utilize fossil *** paper proposes a comprehensive optimization-based techno-economic assessment of a hybrid renewable electricity-hydrogen virtual power plant(VPP)that boosts its business case by co-optimizing across multiple markets and contractual services to maximize its profits and eventually deliver hydrogen at a lower net ***,multiple possible investment options are *** studies of VPP placement in a renewable-rich,congested area of the Australian network and based on real market data and relevant sensitivities show that multi-market participation can significantly boost the business case for cleaner *** highlights the importance of value stacking for driving down the cost of cleaner *** to the participation in multiple markets,all VPP configurations considered are found to be economically viable for a hydrogen price of 3 AUD$/kg(2.25 USD$/kg),which has been identified as a threshold value for Australia to export hydrogen at a competitive ***,if the high price volatility that has been seen in gas prices in 2022(and by extension electricity prices)continues,the flexibility of hybrid VPPs will further improve their business cases.

关键词： Virtual power plant techno-economic assessment electrolyser flexibility hydrogen multi-energy system optimal power flow

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Intestinal lymphangiectasia in adults

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World Journal of Gastrointestinal Oncology 2011年第2期3卷 19-23页

作者： Hugh james Freeman michael Nimmo Department of Medicine (Gastroen-terology) University of British Columbia Department of Pathology University of British Columbia

Intestinal lymphangiectasia in the adult may be characterized as a disorder with dilated intestinal lacteals causing loss of lymph into the lumen of the small intestine and resultant hypoproteinemia, hypogamma-globulinemia, hypoalbuminemia and reduced number of circulating lymphocytes or lymphopenia. Most often, intestinal lymphangiectasia has been recorded in children, often in neonates, usually with other congenital abnormalities but initial def inition in adults including the elderly has become increasingly more common. Shared clinical features with the pediatric population such as bilateral lower limb edema, sometimes with lymphedema, pleural effusion and chylous ascites may occur but these reflect the severe end of the clinical spectrum. In some, diarrhea occurs with steatorrhea along with increased fecal loss of protein, reflected in increased fe- cal alpha-1-antitrypsin levels, while others may present with iron def iciency anemia, sometimes associated with occult small intestinal bleeding. Most lymphangiectasia in adults detected in recent years, however, appears to have few or no clinical features of malabsorption. Diagnosis remains dependent on endoscopic changes confirmed by small bowel biopsy showing histological evidence of intestinal lymphangiectasia. In some, video capsule endoscopy and enteroscopy have revealed moreextensive changes along the length of the small intes- tine. A critical diagnostic element in adults with lym- phangiectasia is the exclusion of entities (e.g. malignancies including lymphoma) that might lead to obstruction of the lymphatic system and "secondary" changes in the small bowel biopsy. In addition, occult infectious (e.g. Whipple's disease from Tropheryma whipplei) or in? am- matory disorders (e.g. Crohn's disease) may also present with profound changes in intestinal permeability and protein-losing enteropathy that also require exclusion. Conversely, rare B-cell type lymphomas have also been described even decades following ini

关键词： Intestinal lymphangiectasia Adults Submucosa

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