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Transanal total mesorectal excision:a valid option for rectal cancer?

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World journal of Gastroenterology 2015年第41期21卷 11700-11708页

作者： Nicolas C Buchs Gary A Nicholson Frederic Ris Neil J Mortensen Roel Hompes Department of Colorectal Surgery Churchill Hospital Oxford University Hospitals Division of Visceral Surgery Department of Surgery University Hospitals of Geneva Nuffield Department of Surgical Science University of Oxford John Radcliffe Hospital

Low anterior resection can be a challenging operation, especially in obese male patients and in particular after radiotherapy. Transanal total mesorectal excision(Ta TME) might offer technical advantages over laparoscopic or open approaches particularly for tumors in the distal third of the rectum. The aim of this article is to review the current experience with Ta TME. The limits and future developments are also explored. Although the experience with Ta TME is still limited, it might be a promising alternative to laparoscopic TME, especially for difficult cases where laparoscopy is too demanding. The preliminary data on complications and short-term oncological outcomes are good, but also emphasize the importance of careful patient selection. Finally, there is a need for large-scale trials focusing on long-term outcomes and oncological safety before widespread adoption can be recommended.

关键词： Transanal Bottom up Transanal minimally invasive s

Natural orifice transluminal endoscopic surgery and localized resection for colorectal neoplasia

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World journal of Gastrointestinal Surgery 2010年第6期2卷 199-202页

作者： Ronan A Cahill Neil J Mortensen Department of Colorectal Surgery John Radcliffe Hospital

Modern methods of surgical intervention have the potential to provide effective,definitive management of early stage colorectal neoplasia by truly minimally invasive means.Margin-free clearance of early colonic neoplasia from within the intestinal lumen can already now be effected by endoscopic submucosal dissection in the colon and transluminal endoscopic microsurgery(TEM) in the rectum.Natural orifice transluminal endoscopic surgery(NOTES) offers the potential for providing transmural,full thickness excision as TEM does but at sites in the colon proximal to the rectum.The next conceptual advance required to make this practice an effective reality lies in evolving surgical regional staging strategies to effectively partner localized resective approaches and allow their deployment as definitive curative therapy.As the most compelling modality for nodal status ascertainment in the absence of lymphatic basin excision for other malignant disease processes,it seems timely to reconsider sentinel node biopsy in cancer of the colon and rectum.Whether by this means or indeed any other,such an ability to confidently identify patients with node negative disease would allow nascent innovative techniques flourish as definitive management for confined(N0) T1 and T2 cancers and so allow the application of available advanced technology for clinical benefit.Conversely,the development of a specific clinical niche for NOTES(whether,as here,for full thickness localized colonic excision or nodal staging alone) would greatly benefit the evolution and incorporation of this surgical strategy into clinical care paradigms.

关键词： Natural orifice transluminal endoscopy Early stage colorectal neoplasia Colorectal cancer Minimal invasive surgery Laparoendoscopic surgery Endoscopy

Natural history of uncomplicated sigmoid diverticulitis

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World journal of Gastrointestinal Surgery 2015年第11期7卷 313-318页

作者： Nicolas C Buchs Neil J Mortensen Frederic Ris Philippe Morel Pascal Gervaz Department of Colorectal Surgery Oxford University Hospitals Division of Visceral and Transplantation Surgery Department of Surgery Faculty of Medicine University Hospitals of Geneva

While diverticular disease is extremely common, the natural history(NH) of its most frequent presentation(i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to populationbased or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode(and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence.

关键词： Diverticulitis Colon Cohort Recurrence Natural his

The role of digital technologies in supporting and improving fishery and aquaculture across the supply chain-Quo Vadis?

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Aquaculture and Fisheries 2023年第4期8卷 365-374页

作者： neil j.Rowan Bioscience Research Institute Technological University of the ShannonMidlands Midwest(TUS)AthloneN37 HD68Ireland Empower Eco^(™)Innovation Hub TUSAthloneN37 HD68Ireland CURAM Research Centre NUIGalwayH91 TK33Ireland

Fish constitute important high protein products to meet the demands of an increasing global population.However,the continued depletion of wild fish stocks is leading to increased strain on the aquaculture sector in terms of sustaining the supply of fish and seafood to global markets.Despite the fact that aquaculture is more diversified than other agriculture sectors,there are significant pressures on the industry to continue innovating in order to enable sustainability including increased fish production,improved appropriate selection of species,disease mitigation,reduced wastage,preventing environmental pollution and generating more employment globally.This viewpoint article addresses how digital transformation can help support and meet expansion needs of the fisheries/aquaculture industries that includes exploiting and harnessing ICT,IoT,Cloud-edge computing,AI,machine learning,immersive technologies and blockchain.Digital technologies are bringing significant operational benefits for global food chain,improving efficiencies and productivity,reducing waste,contamination and food fraud.The focus on digital technologies has recently evolved to Industry 5.0 where AI and robotics are coupled with the human mind in order to advance human-centric solutions.This viewpoint describes the role of Quadruple helix Hub(academic-industry-government and society)in delivering a convergent holistic approach to meeting the diversity of fishery industry needs by connecting and placing fisheries centrally in a defined ecosystem of stakeholders.This includes specialist training,testing technologies,providing access to finance and fostering disruption through aquaculture accelerator initiatives such as that provided by Hatch Blue.Connecting digital Innovation Hubs trans-regionally,nationally and internationally will also help mitigate against significant risks for the fisheries and aquaculture industry including climate change,global pandemics and conflicts that can jeopardize fish and seafood production and supply chains.There is

关键词： Digital transformation Sustainability End-to-end monitoring Food processing Disruptive innovation

Anorectal and Colonic Diseases 3

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快速转诊的大量增加改善了英国肠癌患者的预后吗?

2010年

作者： jean-Claude R. Givel neil mortensen Bruno Roche

来源：畅想之星图书光盘版（南... 评论

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英国医学杂志中文版 2021年第4期24卷 193-196页

作者： Michael Thompson Daniel’Leary Iona Heath Lynn Faulds Wood Brian Ellis Karen Flashman neil Smart john Nicholls neil mortensen Paul Finan Asha Senapati Robert Steele Peter Dawson james Hill Brendan Moran 白静雯(译) 张国君(校) Queen Alexandra Hospital PortsmouthUK London UK University of Exeter Medical School ExeterUK Imperial College LondonUK john Radcliffe Hospital OxfordUK St james′s University Hospital LeedsUK University of Dundee DundeeUK Manchester University ManchesterUK North Hampshire Hospital BasingstokeUK 厦门大学附属翔安医院肿瘤诊治中心

Michael Thompson及其同事认为,需要更精确的风险分层以确保及时诊断肠癌,同时避免不必要的检查。英国卫生部为了提高肠癌患者的生存率,制定了全科医生转诊指南和公众宣传活动的政策,这些政策增加了紧急转诊到医院的人数,还导致了并无... 详细信息

Michael Thompson及其同事认为,需要更精确的风险分层以确保及时诊断肠癌,同时避免不必要的检查。英国卫生部为了提高肠癌患者的生存率,制定了全科医生转诊指南和公众宣传活动的政策,这些政策增加了紧急转诊到医院的人数,还导致了并无明显临床获益的不必要肠镜检查和CT结肠造影。

关键词：肠癌患者全科医生肠镜检查公众宣传转诊风险分层及时诊断临床获益

Validity of long-term and short-term recall of occupational sitting time in Finnish and Chinese office workers

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journal of Sport and Health Science 2020年第4期9卷 345-351页

作者： Ying Gao neil j.Cronin Nina Nevala Taija Finni Neuromuscular Research Center Faculty of Sport and Health SciencesUniversity of Jyv€askyl€aJyv€askyl€a FI-40014Finland Finnish Institute of Occupational Health Helsinki FI-00250Finland

Background:As sedentary behavior is a global health issue,there is a need for methods of self-reported sitting assessment.The accuracy and reliability of these methods should also be tested in various populations and different cultural contexts.This study examined the validity of longterm and short-term recall of occupational sitting time in Finnish and Chinese subgroups.Methods:Two cohort groups of office-based workers(58.6%female,age range 2267 years)participated:a Finnish group(FIN,n=34)and a Chinese group(CHI,n=36).Long-term(past 3-month sitting)and short-term(daily sitting assessed on 5 consecutive days)single-item measures were used to assess self-reported occupational sitting time.Values from each participant were compared to objectively measured occupational sitting time assessed via thigh-mounted accelerometers,with Spearman’s rho(r)used to assess validity and the Bland-Altman method used to evaluate agreement.Coefficients of variation depicted day-to-day variability of time spent on sitting at work.Results:In the total study sample,the results showed that both long-term and short-term recall correlated with accelerometer-derived sitting time(r=0.532,95%confidence intervals(CI):0.3360.684,pjectively measured sitting time,self-reported occupational sitting time was 2.4%(95%CI:0.5%to 5.3%,p=0.091)and 2.2%(95%CI:0.7%3.6%,p=0.005)greater for long-term and short-term recall,respectively.The agreement level was within the range21.2%to 25.9%for long-term recall,and24.2%to 28.5%for short-term recall.During a 5-day work week,day-to-day variation of sitting time was 9.4%§11.4%according to short-term recall and 10.4%§8.4%according to accelerometry-derived occupational sitting time.Conclusion:Overall,both long-term and short-term self-reported instruments provide acceptable measures of occupational sitting time in an office-based workplace,but their utility at the individual level is limited due to large variability.

关键词： Accelerometry Daily recall Office workers Questionnaire Self-report Sitting time Validity

Acid-insoluble ash is a better indigestible marker than chromic oxide to measure apparent total tract digestibility in pigs

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Animal Nutrition 2021年第1期7卷 64-71页

作者： Susanto Prawirodigdo neil j.Gannon Brian j.Leury Frank R.Dunshea Faculty of Veterinary and Agricultural Sciences The University of MelbourneParkvilleVictoria3010Australia Balai Pengkajian Teknologi Pertanian Central java SemarangCentral Java50552Indonesia Biomin Singapore PO Box 2419ToowoombaQLD4350Australia Faculty of Biological Sciences The University of LeedsLeedsLS29JTUnited Kingdom

The aim of this study was to determine the apparent total tract digestibility(ATTD)of nutrients in cottonseed meal(CSM)and soybean meal(SBM)in simple carbohydrate and more complex wheat-based diets using 2 indigestible markers and total faecal collection.Twenty-five Large White×Landrace boars(57.8 kg)were randomly allocated to either a pure wheat diet,40%CSM or SBM in either a sugar-starch-(1∶1)or wheat-based diet for 18 d.Acid-insoluble ash(AIA)and chromic oxide(Cr2O3)were included in all diets as indigestible markers.Diets were offered(1,800 g/d per pig)in 3 meals/d from d 1 to 11 and 8 meals/d from d 12 to 17.On d 9,the pigs were moved to individual metabolism cages to allow total faecal collection.On d 18,the pigs were fed hourly for 8 h.After the 8th meal,pigs were anaesthetized and digesta sampled from the terminal ileum and rectum before lethal injection.There were no differences between ATTD of nitrogen(N)determined using AIA as a marker and measured by total faecal collection.On the other hand,the ATrD of N of diets containing CSM in sugar-starch-or wheat-based diets and the pure wheat diet determined using Cr2O3 as a marker was less(-3.11%,-4.46%and-6.59%;P

关键词： Organic matter Pig Wheat Cottonseed meal Soybean meal Digestibility Nitrogen

Typing of pancreatic cancer-associated fibroblasts identifies different subpopulations

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World journal of Gastroenterology 2018年第41期24卷 4663-4678页

作者： Michael Friberg Bruun Nielsen Michael Bau mortensen Sonke Detlefsen Department of Pathology Odense University HospitalDepartment of Clinical ResearchUniversity of Southern DenmarkOdense Pancreas Center(OPAC)Odense C 5000Denmark Department of Surgery HPB SectionOdense University HospitalDepartment of Clinical ResearchUniversity of Southern DenmarkOdense Pancreas Center(OPAC)Odense C 5000Denmark

AIM To determine whether it is possible to identify different immune phenotypic subpopulations of cancer-associated fibroblasts (CAFs) in pancreatic cancer (PC). METHODS We defined four different stromal compartments in surgical specimens with PC: The juxtatumoural, peripheral, lobular and septal stroma. Tissue microarrays were produced containing all pre-defined PC compartments, and the expression of 37 fibroblast (FB) and 8 extracellular matrix (ECM) markers was evaluated by immunohistochemistry, immunofluorescence (IF), double-IF, and/or in situ hybridization. The compartment-specific mean labelling score was determined for each marker using a four-tiered scoring system. DOG1 gene expression was examined byquantitative reverse transcription PCR (qPCR). RESULTS CD10, CD271, cytoglobin, DOG1, miR-21, nestin, and tenascin C exhibited significant differences in expression profiles between the juxtatumoural and peripheral compartments. The expression of CD10, cytoglobin, DOG1, nestin, and miR-21 was moderate/strong in juxtatumoural CAFs (j-CAFs) and barely perceptible/weak in peripheral CAFs (p-CAFs). The upregulation of DOG1 gene expression in PC compared to normal pancreas was verified by qPCR. Tenascin C expression was strong in the juxtatumoural ECM and barely perceptible/weak in the peripheral ECM. CD271 expression was barely perceptible in j-CAFs but moderate in the other compartments. Galectin-1 was stronger expressed in j-CAFs vs septal fibroblasts, PDGFRβ, tissue transglutaminase 2, and hyaluronic acid were stronger expressed in lobular fibroblasts vs p-CAFs, and plectin-1 was stronger expressed in j-CAFs vs l-FBs. The expression of the remaining 33 markers did not differ significantly when related to the quantity of CAFs/FBs or the amount of ECM in the respective compartments.CONCLUSION Different immune phenotypic CAF subpopulations can be identified in PC, using markers such as cytoglobin, CD271, and miR-21. Future studies should determine whether CAF subpopulations have different functional properties.

关键词： Pancreatic cancer Tumour stroma Cancerassociated fibroblasts Extracellular matrix Subtyping Immunohistochemistry