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A comparison of laparoscopic to open pancreaticoduodenectomy for pancreatic adenocarcinoma by propensity score matching analysis

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Laparoscopic, Endoscopic, and Robotic Surgery 2024年第4期7卷 141-146页

作者： mount j. mount B. Poruk K. Tice M. Stauffer j.A. Department of Surgery Mayo Clinic Jacksonville FL United States Medical Education Heritage College of Osteopathic Medicine Ohio University Athens OH United States Medical Education The University of Toledo College of Medicine and Life Sciences Toledo OH United States

Obj.ctive: In previous studies, laparoscopic pancreaticoduodenectomy (LPD) has demonstrated safety and potential benefits over open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma (PDAC). After performing both LPD and OPD procedures interchangeably in routine practice for a decade, the outcomes of LPD versus OPD for PDAC were analyzed and compared at a single institution. Our primary aim was to compare features of LPD and OPD in PDAC patients so that the suitable surgical approach may be chosen for each individual. Methods: From j.nuary 2010 through December 2020, all patients undergoing pancreaticoduodenectomy (PD) were identified, and information was collected prospectively. At a single institution, PD was performed on 589 patients, of whom 347 were OPD patients and 242 were LPD patients. After excluding those who underwent pancreatectomy for indications other than PDAC, total pancreatectomy, maj.r vascular or concomitant organ resection, there were 237 patients (OPD = 157, LPD = 80). Then propensity score matching was completed to analyze 77 OPD patients versus 77 LPD patients to create a similar group of patients who underwent either LPD or OPD for PDAC. A comparison of perioperative data and 90-day outcomes with subsequent statistical analysis was performed. Results: Operative time (491 min vs. 281 min, p j.ang University

关键词： Laparoscopy Pancreatic ductal adenocarcinoma Pancreatic fistula Pancreaticoduodenectomy Whipple

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Why Don’t We Adequately Identify and Manage Adverse Drug Reactions despite Having the Needed Information?

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Health 2024年第2期16卷 148-159页

作者： Mark j. Kupersmith Karl Kieburtz Department of Neurology Ophthalmology and Neurosurgery Icahn School of Medicine at Mount Sinai New York NY USA SafeTherapeutics LLC New York NY USA Clintrex Research Corporation Sarasota FL USA

Importance/Obj.ctive: Adverse Drug Reactions (ADRs) are unavoidable, but recognizing and addressing ADRs early can improve wellness and prevent permanent inj.ry. We suggest that available medical information and digital/electronic methods could be used to manage this maj.r healthcare problem for individual patients in real time. Methods: We searched the available digital applications and three literature databases using the medical subj.ct heading terms, adverse drug reaction reporting systems or management, filtered by clinical trial or systemic reviews, to detect publications with data about ADR identification and management approaches. We reviewed the reports that had abstract or summary data or proposed or implemented methods or systems with potential to identify or manage ADRs in clinical settings. Results: The vast maj.rity of the 481 reports used retrospectively collected data for groups of patients or were limited to surveying one population group or class of medication. The reports showed potential and definite associations of ADRs for specific drugs and problems, mostly, but not exclusively, for patients in hospitals and nursing homes. No reports described complete methods to collect comprehensive data on ADRs for individual patients in a healthcare system. The digital applications have ADR information, but all are too cumbersome or incomplete for use in active clinical settings. Several studies suggested that providing information about potential ADRs to clinicians can reduce these problems. Conclusion and Relevance: Although investigators and government agencies agree with the need, there is no comprehensive ADR management program in current use. Informing the patient’s healthcare practitioners of potential ADRs at the point of service has the potential for reduction of these complications, which should improve healthcare and reduce unneeded costs.

关键词： Adverse Drug Reaction Medication Side Effect Identification Medication Complication Medication Safety

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术前子宫内膜活检为高分化肿瘤的子宫内膜癌患者的手术分期、最终分级和存活情况

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世界核心医学期刊文摘（妇产科学分册） 2006年第2期2卷 43-44页

作者： EltabbakhG.H. Shamonki j. mount S.L. 马超 Lake Champlain Gynecologic Oncology 364 Dorset Street South Burlington VT 05403 United States

Obj.ctive. The purpose of our study was to assess the surgical stage, final grade, and survival of women with endometrial carcinoma whose preoperative endometrial biopsy showed well-differentiated (FIGO grade 1) carcinoma. Materials and methods. A retrospective study was conducted including all women treated at the University of Vermont between 1992 and 2004 whose preoperative endometrial biopsy was reviewed by the staff at the Pathology Department and diagnosed as FIGO grade 1 adenocarcinoma and who received peritoneal washings, total abdominal (or laparoscopic) hysterectomy, bilateral salpingo-oophorectomy,and pelvic ±para-aortic lymphadenectomy as part of their surgery. Results. One hundred eighty-two patients (age: 32-91, median: 60) were enrolled. All patients had total hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, and bilateral pelvic lymphadenectomy. Fifteen (8.2%) patients had para-aortic lymphadenectomy. There were no operative mortalities. Fourteen patients (7.7%)had maj.r operative or postoperative complications. There was disagreement between the pre-and postoperative grade in 30%of the study group. The surgical stages were: IA: 55 (30.2%), IB: 61 (33.5%), IC: 26 (14.3%), IIA: 9 (4.9%), IIB: 8 (4.4%), IIIA: 10 (5.5%), IIIB: 2 (1.1%), IIIC: 8 (4.4%), and IV: 3 (1.6%). Postoperatively, 131 (72%) patients received no additional treatment, 47 (25.8%) received radiation therapy, 3 (1.6%) received chemotherapy, and 1 (0.5%) received Megace. During a median follow-up period of 6 years, 8 (4.4%) patients had recurrence and 6 (3.2%) died from their disease. The 5year disease-free and overall survival was 95.2%and 96.4%, respectively. Conclusions. Approximately 30%of women with endometrial carcinoma whose preoperative endometrial biopsy shows grade 1 tumors have grade 2 or 3 in the hysterectomy specimen and 12.6%have advanced surgical stage (stage III and IV) disease. Women with preoperative endometrial biopsy showing grade 1 tumors who under

关键词：手术分期子宫内膜活检高分化肿瘤存活情况盆腔淋巴结全子宫切除术醋酸甲地孕酮腔镜子宫切除

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杀螟松原油、乳油及可湿性粉剂气相色谱法测定的协作研究

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世界农药 1986年第4期 44-49页

作者： D. L. mount j. W. Miles 王一麟美国佐治亚州亚特兰大疾病控制中心美国佐治亚州亚特兰大疾病控制中心传染病中心寄生虫病分部传染病中心寄生虫病分部

为了采用气相色谱法(GO)测定原油及制剂中的杀螟松,曾对多种柱填充材料和内标物进行过评价,以便确定最佳的色谱系统。杀螟松及其最相关的异构体,O,O-二甲基O-(4-甲基-3-硝基苯基)硫代磷酸酯,在OV-210和六环聚苯醚(PPE-6R)填充的柱上能... 详细信息

为了采用气相色谱法(GO)测定原油及制剂中的杀螟松,曾对多种柱填充材料和内标物进行过评价,以便确定最佳的色谱系统。杀螟松及其最相关的异构体,O,O-二甲基O-(4-甲基-3-硝基苯基)硫代磷酸酯,在OV-210和六环聚苯醚(PPE-6R)填充的柱上能得到分离。在小范围的协作试验中曾选用以PPE-6R柱,并以萤蒽为内标的GC系统作为分离杀螟松的方法,随后此法又在有二十一位协作者参加的全面协作试验中采用。向每位协作者提供了杀螟松原油、乳油及可湿性粉剂的成对试样。成对杀螟松原油、乳油及可湿性粉剂试样的变异系数(CV)分别为1.02,1.11及1.01。同时还提供了替换法所得的数据,替换法采用OV-210柱,癸二酸二丁酯为内标。本法已被采纳为初审的公定方法(Official First Action)。

关键词：杀螟松内标标的异构体协作试验可湿性粉剂农药剂型原油石油气相色谱法协作研究乳油

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Oil-bearing fluid inclusions from the Palaeoproterozoic:A review of biogeochemical results from time-capsules >2.0 Ga old

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Science China Earth Sciences 2009年第1期52卷 1-11页

作者： Simon C. GEORGE Adriana DUTKIEWICZ Herbert VOLK j.hn RIDLEY David j. MOSSMAN Roger BUICK Department of Earth and Planetary Sciences Macquarie University School of Geosciences University of Sydney CSIRO Petroleum Department of Geosciences Colorado State University Department of Geography Mount Allison University Department of Earth and Space Sciences & Astrobiology Program University of Washington

The observation of oil inclusions trapped prior to 2.0 Ga in Palaeoproterozoic rocks and the ability to obtain detailed molecular geochemical information from them provide a robust way for understanding the early biog... 详细信息

关键词： Palaeoproterozoic fluid inclusion oil biomarker blank

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Land Quality Assessment and Monitoring:The Next Challenge for Soil Science

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Pedosphere 2003年第1期13卷 1-10页

作者： H.ESWARAN j.KIMBLE U.S.DepartmentofAgriculture NaturalResourcesConservationServicePOBox2890WashingtonDC20013（USA） U.S.DepartmentofAgriculture NaturalResourcesConservationServicePOBox2890Washington

Sustainable land management (SLM) is the key to harmonizing environmental and ecological concernsof society with the economic realities of producing adequate food and fiber of high quality and ensuring abasic minimal quality of life. The aim of SLM is to maintain the integrity of the biophysical land resourcebase, but it can only be realized if land users understand the impacts of land management options on theirlands but also on other off-site areas and can optimize the socioeconomic and environmental benefits of theirchoice. To facilitate this, the contribution of soil survey organizations would be through the assessment andmonitoring of land quality. Land quality is a measure of the ability of land to perform specific functions and isderived by an integration of soil survey information with other environmental, and if necessary, socioeconomicinformation. The desired reliability influences the operational scale of the assessment. Such an assessmentwould assist in: 1) locating homologous areas for research sites or for transferring technologies; 2) providingthe geographic basis for systems analysis (e.g. by modeling); 3) serving as a basis for local, national andglobal resource assessment and monitoring; 4) providing an ecosystem context for land use, assessments oftemporal and spatial variability, and impact of human interventions; 5) serving as a framework for moredetailed assessment for all levels of interest; and 6) evaluating global issues such as food security, impacts ofclimate change, biodiversity monitoring, and addressing *** on an evaluation of the progress made in soil resource inventories and considering the demandsof the environment focused world, the paper considers the need for countries to mount such a program. Theauthors believe that this is the next demand of soil science and that we can fulfill our social contract byperiodically providing such information on the state of a nation's land resource.

关键词： degradation land quality monitoring of soils sustainable landmanagement

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Comparing children＇s Homo sapiens and chimpanzees＇ Pan troglodytes quantity j.dgments of sequentially presented sets of items

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Current Zoology 2011年第4期57卷 419-420,421-428页

作者： Michael j. BERAN j.lie S. j.HNSON-PYNN Christopher READY Language Research Center Georgia State University Atlanta GA 30302 USA Department of Psychology Berry College Mount Berry GA 30149 USA

We presented a quantity j.dgment task that involved comparing two sequentially presented sets of items to preschoolers and chimpanzees using nearly identical procedures that excluded verbal instructions to children. Trial difficulty in this task reflected the ratio difference between sets of discrete items where larger ratios （e.g., 0.80 as from comparing 4 to 5） were more difficult than smaller ones （e.g., 0.50 as from comparing 4 to 8）. Children also completed verbal-based tasks probing the relationskip between counting proficiency and performance on the quantity j.dgment task of sequentially presented identical sized items. Both species＇ performance was best when ratios between comparison sets were small regardless of set size in all types of tasks. Generally, chimpanzees and older children performed better than younger children except at larger ratios. Children＇s counting proficiency was not related to success in choosing the larger of two quantities of identical-sized items. These results indicate that chimpanzees and children share an approximate number sense that is reflected through analog magnitude estimation when comparing quantities [Current Zoology 57 （4）： 419-428, 2011].

关键词： Numerical cognition Quantity j.dgments Children Chimpanzees Pan troglodytes

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Validation of Novel Completely Sealed Nasal Positive Airway Pressure Device: SuperNO2VA™EtCO2Measurement and Pressure Test Performance

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Open j.urnal of Anesthesiology 2020年第10期10卷 337-348页

作者： Michael j. Pedro Steven H. Cataldo Vyaire Medical Inc. Mettawa IL USA Caremount Medical PC Mount Kisco New York USA

Background: SuperNO2VA™ Et Nasal Mask (Vyaire Medical, Inc., United States) is a new nasal mask with an integrated sampling hood to capture exhaled gases and enable accurate measurements of end tidal carbon dioxide (EtCO2). The authors hypothesized that the SuperNO2VA Et design would measure EtCO2 more accurately than a predicate EtCO2 sampling line, the Smart CapnoLine® Plus, Adult/Intermediate CO2 Oral-Nasal Set (Medtronic, United States). Methods: A simulated patient setup enabled comparison of the accuracy of CO2 measurements within the SuperNO2VA Et and a predicate device for eight condition combinations of input CO

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Association between Exposure to Metals during Pregnancy,Childhood Gut Microbiome,and Risk of Intestinal Inflammation in Late Childhood

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Environment & Health 2024年第10期2卷 739-749页

作者： Vishal Midya Manasi Agrawal j.mil M.Lane Chris Gennings Leonid Tarassishin Libni A.Torres-Olascoaga j.seph Eggers j.ll K.Gregory Mellissa Picker Inga Peter j.remiah j.Faith Manish Arora Martha M.Tellez-Roj. Robert O.Wright j.an-Frederic Colombel Shoshannah Eggers Department of Environmental Medicine and Climate Science Icahn School of Medicine at Mount SinaiNew York 10029-6574New YorkUnited States Division of Gastroenterology Icahn School of Medicine at Mount SinaiNew York 10029-6574New YorkUnited States Center for Molecular Prediction of Inflammatory Bowel Disease(PREDICT) Department of Clinical MedicineAalborg UniversityCopenhagen 9220Denmark Department of Genetics and Genomic Sciences Icahn School of MedicineNew York 10029-6574New YorkUnited States Center for Research on Nutrition and Health National Institute of Public HealthCuernavaca 62508Mexico Department of Immunology and Immunotherapy Icahn School of Medicine at Mount SinaiNew York 10029-6574New YorkUnited States Department of Epidemiology University of Iowa College of Public HealthIowa City 52242 IowaUnited States Instructional Technology Group Icahn School of Medicine at Mount SinaiNew York 10029-6574New YorkUnited States

Alterations to the gut microbiome and exposure to metals during pregnancy have been suggested to impact inflammatory bowel ***,how prenatal exposure to metals eventually results in long-term effects on the gut microbiome,leading to subclinical intestinal inflammation,particularly during late childhood,has not been *** is also unknown whether such an interactive effect drives a specific subgroup of children toward elevated susceptibility to intestinal *** used an amalgamation of machine-learning techniques with a regression-based framework to explore if children with distinct sets of gut microbes and certain patterns of exposure to metals during pregnancy(metal−microbial clique signature)had a higher likelihood of intestinal inflammation,measured based on fecal calprotectin(FC)in late *** obtained samples from a well-characterized longitudinal birth cohort from Mexico City(n=108),*** the second and third trimesters of pregnancy,11 metals were measured in whole *** microbial abundances and FC were measured in stool samples from children 9−11 years of *** FC was defined as having FC above 100μg/g of *** identified subgroups of children in whom microbial and metal−microbial clique signatures were associated with elevated FC(false discovery rate(FDR)<0.05).In particular,we found two metal−microbial clique signatures significantly associated with elevated FC:(1)low cesium(Cs)and copper(Cu)in the third trimester and low relative abundance of Eubacterium ventriosum(OR[95%CI]:10.27[3.57,29.52],FDR<0.001)and(2)low Cu in the third trimester and high relative abundances of Roseburia inulinivorans and Ruminococcus torques(OR[95%CI]:7.21[1.81,28.77],FDR<0.05).This exploratory study demonstrates that children with specific gut microbes and specific exposure patterns to metals during pregnancy may have higher fecal calprotectin levels in late childhood,denoting an elevated risk of intestinal inflammation.

关键词： exposome metals machine learning microbiome environmental epidemiology intestinal inflammation

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Parkin and LRRK2/Dardarin Mutations in Early Onset Parkinson’s Disease in the Basque Country (Spain)

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j.urnal of Behavioral and Brain Science 2015年第3期5卷 101-108页

作者： j. F. Martí Massó j. Ruiz-Martínez C. Paisán-Ruiz A. Gorostidi A. Bergareche A. Lopez de Munain A. Alzualde j. Pérez-Tur Servicio Neurologia Hospital Donostia San Sebastián Spain Center for Biomedical Research in Neurodegenerative Diseases Network (CIBERNED) Spain Neurosciences Area Biodonostia Institute San Sebastián Spain Department of Neuroscience University of Basque Country UPV-EHU San Sebastián Spain Department of Genetics and Genomic Sciences Icahn School of Medicine at Mount Sinai New York USA Molecular Genetics Unit Instituto de Biomedicina de Valencia-CSIC Valencia Spain

We have performed a complete screening of the Parkin gene (PRKN2) and looked for ***2019Ser (G2019S) and ***1441Gly (R1441G) LRRK2/dardarin gene mutations in twenty seven patients with Parkinson’s disease (PD) with an age at onset younger than 50 years (EOPD), living in Gipuzkoa (Basque Country, Spain). Thirteen of them (48%) were PRKN2 mutation carriers. The c.255-256DelA mutation was the most frequent, followed by a deletion involving exons 3 and 4. A deletion involving exons 3 and 12 of the PRKN2 gene and R1441G LRRK2 mutation was found together in one PD patient. Four out of fourteen PRKN2 negative patients carried the p.G2019S mutation. Both PRKN2 mutation carriers and non-carriers presented frequently with family history (10 PRKN2 mutation carriers and 8 PRKN2 non-carriers);in fact, five patients without a known gene mutation had a first degree relative affected, suggesting another monogenic disease. PRKN2 carriers presented with a younger age at onset (36.7 vs. 41.7) and more benign disease progression. Indeed, those PD patients younger than forty who initially presented with unilateral tremor became shortly bilateral. Relatively, symmetric parkinsonism and slow disease progression carried more frequently PRKN2 mutations than patients with unilateral akinetic rigid parkinsonism and age at onset later than 40 years. As expected in a recessive disease, PRKN2 patients present more often with affected siblings and unaffected patients. The G2019S LRRK2 mutation, less prevalent than R1441G in our area, may be also a frequent cause of PD in EOPD (4 patients).

关键词： Parkin Early Onset Parkinsonism Parkinson’s Disease LRRK2 Dardarin

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