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Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures

World Journal of Gastroenterology 2017年第16期23卷 2883-2890页

作者： Mohamed Mortagy neal mehta Mansour A Parsi Seiichiro Abe Tyler Stevens John J Vargo Yutaka Saito Amit Bhatt Department of Internal Medicine Homer Stryker MD School of MedicineWestern Michigan UniversityKalamazooMI 49008United States Department of Internal Medicine Medicine InstituteCleveland ClinicClevelandOH 44195United States Department of Gastroenterology and Hepatology Digestive Disease InstituteCleveland ClinicClevelandOH 44195United States Endoscopy Division National Cancer Center HospitalTokyo 104-0045Japan

Endoscopic submucosal dissection(ESD) is a wellestablished, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection(MAGESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's "second hand". Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology.

关键词： Endoscopic submucosal dissection Gastric cancer Magnetic anchor guidance Esophageal cancer Magnets Traction Natural orifice transluminal endoscopic surgery

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LIV-4:A novel model for predicting transplant-free survival in critically ill cirrhotics

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World Journal of Hepatology 2020年第6期12卷 298-311页

作者： Christina C Lindenmeyer Gianina Flocco Vedha Sanghi Rocio Lopez Ahyoung J Kim Fadi Niyazi neal A mehta Aanchal Kapoor William D Carey Eduardo Mireles-Cabodevila Carlos Romero-Marrero Department of Gastroenterology Hepatology and NutritionCleveland ClinicClevelandOH 44195United States Department of Internal Medicine Cleveland ClinicClevelandOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicClevelandOH 44106United States Department of Critical Care Medicine Cleveland ClinicClevelandOH 44195United States

BACKGROUND Critically ill patients with cirrhosis,particularly those with acute decompensation,have higher mortality rates in the intensive care unit(ICU)than patients without chronic liver *** of short-term mortality is important in order to identify patients at highest risk of *** of the currently available prognostic models have been widely accepted for use in cirrhotic patients in the ICU,perhaps due to complexity of calculation,or lack of universal variables readily available for these *** believe a survival model meeting these requirements can be developed,to guide therapeutic decision-making and contribute to cost-effective healthcare resource *** To identify markers that best identify likelihood of survival and to determine the performance of existing survival *** Consecutive cirrhotic patients admitted to a United States quaternary care center ICU between 2008-2014 were included and comprised the training *** data and clinical laboratory test collected on admission to ICU were *** under the curve receiver operator characteristics(AUROC)analysis was performed to assess the value of various scores in predicting inhospital mortality.A new predictive model,the LIV-4 score,was developed using logistic regression analysis and validated in a cohort of patients admitted to the same institution between *** Of 436 patients,119(27.3%)died in the *** multivariate analysis,a combination of the natural logarithm of the bilirubin,prothrombin time,white blood cell count,and mean arterial pressure was found to most accurately predict in-hospital *** from the regression coefficients of the independent variables,a novel model to predict inpatient mortality was developed(the LIV-4 score)and performed with an AUROC of 0.86,compared to the Model for End-Stage Liver Disease,Chronic Liver Failure-Sequential Organ Failure Assessment,and Royal Free Hospital Score,wh

关键词： Risk stratification Resource allocation Intensive care unit Acute-on-chronic liver failure Modeling Mortality

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SYNTHESIS OF NEW HIGH MOLECULAR WEIGHT AND REACTIVE LADDERLIKE POLYSILSESQUIOXANES

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Chinese Journal of Polymer Science 2000年第5期18卷 459-463页

作者： neal Tai-sheng Chung Institute of Materials Research and Engineering Singapore 117602 Singapore

Ladderlike polychloropropylsilsesquioxane (CP-T) was first synthesized by 'stepwise coupling polymerization'. The molecular weight of CP-T is as high as 1.7 x 10(5). It is a tough, elastic reactive ladderlike polymer and has good heat-resistant and adhesive properties. CP-T can further react with many nucleophilic reagents to generate new ladderlike reactive polysilsesquioxanes, which can be used as potential precursors in the synthesis of functional ladderlike polymers.

关键词： stepwise coupling polymerization reactive ladderlike polymer nucleophilic substitution

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Leadless pacemakers： a contemporary review

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Journal of Geriatric Cardiology 2018年第4期15卷 249-253页

作者： neal Bhatia Mikhael El-Chami Department of Medicine Division of Cardiology Section of Electrophysiology Emory University School of Medicine Atlanta USA

1 Introduction Over one million cardiac pacemakers are implanted every year worldwide,[11 of which approximately 200,000 are implanted in the United States alone.121 Combined with an aging population and increasing pacing indications, these numbers are expected to grow. Since the first pacemaker implantation in 1950s, cardiac pacemaker technology has rapidly advanced. Reduction in generator size, increased battery longevity, quality of pacemaker leads, algorithmic and rate responsive programming-all have revolutionized and transformed the implantation and management of transvenous cardiac pacemaker （TV-PPM）.

关键词： Leadless pacemakers Micra Nanostim Perforation

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Large non-pedunculated colorectal polyp management: The elephant in the room

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World Journal of Gastroenterology 2024年第25期30卷 3126-3131页

作者： Shirley X Jiang neal Shahidi Department of Medicine University of British ColumbiaVancouver V6Z 2K5BCCanada

Minimally invasive innovations have transformed *** to colorectal cancer(CRC),there has been a shift towards less invasive surgical techniques and use of endoscopic resection as an alternative for low risk T1 *** role of endoscopic resection is however much more extensive:It is now considered the first line management strategy for most large(≥20 mm)non-pedunculated colorectal polyps,the majority of which are *** is due to the well-established efficacy,safety,and cost-effectiveness of endoscopic techniques compared to *** endoscopic modalities now exist with distinct risk-benefit profiles and their outcomes are further improved by site-specific technical modifications,auxiliary techniques,and adverse event miti-gation *** capacity continues to evolve with emerging endoscopic techniques and expanding applications,particularly in the confines of a multi-disciplinary setting.

关键词： Cancer Colonoscopy Endoscopy Polyp Endoscopic mucosal resection Endoscopic submucosal dissection

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Geochronology and Significance of Granites Associated with Gold Deposits in the Jidong Area, China

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Acta Geologica Sinica(English Edition) 2000年第2期74卷 306-310页

作者： neal MCNAUGHTON David GROVES Department of Geology University of West Australia AustraliaDepartment of Geology University of West Australia Australia

The Jidong area is located on the north margin of the North China craton. It is a nucleus composed of the oldest rocks in China. Precambrian metarnorphic rocks with various Phanerozoic granitoids invaded are widespread. Gold deposits here have close spatial relations to granitoids. Some deposits occur within them and others in the outer zone of the contact belt of the intrusion, extending thousands of metres. There have been controversial views in regard to the relations of the deposits to the intrusions although traditional techniques have been used to date the intrusions. In order to solve such a problem, the SHRIMP technique was adopted to date the U-Pb ages of zircon collected from the Yuerya intrusion which hosts the large-sized Yuerya Au deposit and Qingshankou intrusion 2 km away from the Jinchangyu (larger-sized) Au deposit. Analysis shows that the ages of 175±1 Ma and 174±3 Ma for Yuerya intrusion and the age of 199±2 Ma for Qingshankou granite indicate the Early Yanshanian stage of the Mesozoic. The Yuerya intrusion also contains inherited zircon aged at about 2500 Ma, indicating that part of its source materials are Archaean metamorphic rocks. In addition to the SHRIMP data of this study, a great deal of data related to the alteration of Au deposits indicate the formation of the deposits at the Yanshanian stage of the Mesozoic, so the ore formation of Au deposits is inferred to relate to granitic intrusion.

关键词： SHRIMP geochronology granite Yanshanian East China

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Reflections on Studying Huang Di Nei Jing in the West

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Chinese Medicine and Culture 2024年第1期7卷 72-76页

作者： Edward neal Apricot Grove Educational Services Portland 97213the United States of America Xinglin Institute for Early East Asian Medicine Portland 97213the United States of America

Huang Di Nei Jing(《黄帝内经》The Yellow Emperor’s Inner Classic) has been the source text of Chinese medicine knowledge and innovation for over two thousand years. Despite this key relevance, many of its ideas and practices have proven difficult to understand and implement fully into clinical practice. Cultural and language differences can be compounded with these challenges but may also present new opportunities for advancement and insight when studied by researchers outside of the originating culture. This article introduces the method of Classical-Text Archaeology and delves into the author’s two-decade journey of researching this text, with a discussion on cultural differences and issues of medical scholarship.

关键词： Huang Di Nei Jing Chinese medicine Nei Jing nature-based medicine Classical text research Global health Medical anthropology Classical-Text Archaeology

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Aquatic community structure and stream habitat in a karst agricultural landscape

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Ecological Processes 2022年第1期11卷 155-170页

作者： neal D.Mundahl Erik D.Mundahl Department of Biology and Southeastern Minnesota Water Resources Center Winona State UniversityWinonaMN 55987USA Mundahl Nordic Services Glennallen/McCarthyP.O.Box MXYAlaska 99588USA

Background:Watersheds dominated by agriculture often have significant,negative impacts on local stream habitats and *** study examined stream biota and habitats within an entire stream in a karst agricultural landscape to determine if several decades of watershed conservation and management had reversed the severe degradation caused by poor land use and catastrophic soil erosion during the 1920s and ***:Fish communities and stream habitats were degraded at over half of the 22 stream sites examined,and benthic macroinvertebrate communities were mostly poor throughout the entire *** fish communities were associated with missing or narrow riparian buffers,high percent fine sediments,high embeddedness of coarse sub-strates,and homogeneous run *** communities were dominated by filter-feeding taxa and those adapted to life on or within fine *** sites with wide buffers and influenced by groundwater springs had higher fish community integrity and good to excellent instream ***:Our results suggest that wide riparian buffers and karstic springs may have allowed recovery of some stream reaches,but more extensive buffers and additional soil conservation practices in upland areas likely are necessary to protect most stream segments and their biota from on-going agricultural *** state stream buffer laws instituted after this study resulted in establishment of vegetated buffers at all study sites,which may lead to improved stream habitat and biotic communities in future *** invertebrate community improvement also may require translocation of sensitive taxa from nearby watersheds due to limited dispersal abilities of many species currently absent from the study *** frequency and intensity of storm events and flooding may hinder future recovery of stream habitats and biota.

关键词： Agricultural stream Fish Macroinvertebrates Stream habitats Karst

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Prevention of erectile dysfunction after radiotherapy for prostate cancer

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Asian Journal of Andrology 2014年第6期16卷 805-806页

作者： Izak Faiena neal Patel Allen D Seftel Division of Urology Rutgers Robert Wood JohnsonMedical School N J USA 2Division of Urology Cooper Medical School of Rowan University CamdenN J USA.

With increasing scrutiny of prostate cancer （PCa） diagnosis and treatment, much attention has been given to the morbidity caused by radical prostatectomy （RP） and/or radiotherapy （RT）. One of the most common side-effects of either treatment is erectile dysfunction （ED）.1 Approximately, 40% of patients will experience ED after RT for PCa. The post-RT ED causes significant patient dissatisfaction with cancer treatment as well as decrease in patient and partner psychosocial function,z To address this issue in patients undergoing RT, Pisansky et al.3 conducted a prospective, randomized, double-blinded, placebo-controlled trial to assess the efficacy of a phosphodiesterase enzyme-5 inhibitor （PDE5i）, tadalafil, as a preventive measure for patients undergoing RT for PCa and found no difference in erectile function between the control and treatment groups.

关键词： @@

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A Dual-Chaining Watermark Scheme for Data Integrity Protection in Internet of Things

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Computers, Materials & Continua 2019年第3期58卷 679-695页

作者： Baowei Wang Weiwen Kong Wei Li neal NXiong Jiangsu Engineering Centre of Network Monitoring Jiangsu Collaborative Innovation Center on Atmospheric Environment and Equipment TechnologySchool of Computer and SoftwareNanjing University of Information Science&TechnologyNanjing210044China Engineering Research Center of Electronic Information and Control from Fujian Provincial Education Department Fuzhou350108China Department of Mathematics and Computer Science Northeastern State UniversityOklahomaUSA.

Chaining watermark is an effective way to verify the integrity of streaming data in wireless network environment,especially in resource-constrained sensor networks,such as the perception layer of Internet of Things ***,in all existing single chaining watermark schemes,how to ensure the synchronization between the data sender and the receiver is still an unsolved *** the synchronization points are attacked by the adversary,existing data integrity authentication schemes are difficult to work properly,and the false negative rate might be up to 50 *** the additional fixed group delimiters not only increase the data size,but are also easily detected by *** this paper,we propose an effective dual-chaining watermark scheme,called DCW,for data integrity protection in smart campus IoT *** proposed DCW scheme has the following three characteristics:(1)In order to authenticate the integrity of the data,fragile watermarks are generated and embedded into the data in a chaining way using dynamic grouping;(2)Instead of additional fixed group delimiters,chained watermark delimiters are proposed to synchronize the both transmission sides in case of the synchronization points are tampered;(3)To achieve lossless integrity authentication,a reversible watermarking technique is *** experimental results and security analysis can prove that the proposed DCW scheme is able to effectively authenticate the integrity of the data with free distortion at low cost in our smart meteorological Internet of Things system.

关键词： Dual-chaining reversible watermark integrity authentication Internet of things.

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