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Direct real-time PCR examination for Mycobacterium tuberculosis in respiratory samples can be cost effective

Health 2009年第2期1卷 63-66页

作者： Bryan Joseph Renton Patricia Denise Morrell Richard peter davidson Cooke peter david owen davies 不详

Aim: To assess whether the use of direct real- time polymerase chain reaction (PCR) on smear-positive sputa can be cost-effective, by speciating mycobacteria earlier than current methods and thereby preventing unnecessary screening tests as part of the contact tracing process. Methods: A retrospective study of all patients with smear-positive sputa in a Liverpool teach-ing hospital between 2004 and 2007. All the PCRs performed on these patients were re-viewed and compared them with their myco-bacterial culture results. Unit costs for PCR, chest X-ray (CXR), tuberculin skin test (TST), interferon-gamma (IFN-γ) and medical/nursing time were conservatively estimated at ￡50, ￡11, ￡10, ￡40 and ￡30 respectively. The total PCR costs were compared with the costs of unnec-essary follow up of patients, negative for My-cobacterium tuberculosis (MTB) by PCR, sub-sequently confirmed to be MTB culture nega-tive. Results: 203 smear-positive patients under-went direct PCR testing. 126 (62%) patients grew Mycobacterium tuberculosis (MTB), 74 (37%) had environmental mycobacterial infection (EMI) and 3 (1%) were culture negative. Of the 126 patients’ culture positive MTB patients, 123 were PCR positive and 3 PCR negative. Of the 77 pa-tients that were culture negative for MTB, 75 were PCR negative and 2 PCR positive The sensitivity, specificity, positive and negative predictive values for direct PCR versus MTB culture were 98%, 96%, 98% and 97% respec-tively. Total costs of all PCRs performed amounted to ￡10,150. The cost of contact pro-cedures for PCR-negative and MTB culture- negative index cases was estimated at ￡19,650. This equated to a total saving of ￡9,500 in contact tracing costs. Conclusions: Direct PCR examination testing of smear-positive patients can be cost-effective in areas where there is a high incidence of EMI.

关键词： Tuberculosis PCR and Cost Effective

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Direct real-time PCR examination for Mycobacterium tuberculosis in respiratory samples can be cost effective

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Health（健康） 2009年第2期

作者： Bryan Joseph Renton Patricia Denise Morrell Richard peter davidson Cooke peter david owen davies

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Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia: a population-based study

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Cancer Biology & Medicine 2024年第8期21卷 692-702页

作者： Md Mijanur Rahman Michael david david Goldsbury Karen Canfell Kou Kou Paramita Dasgupta peter Baade Xue Qin Yu The Daffodil Centre The University of SydneyA Joint Venture with Cancer Council NSWSydneyNSW 1340Australia School of Medicine and Dentistry Griffith UniversityGold CoastQLD 4222Australia Cancer Council Queensland BrisbaneQLD 4006Australia

Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy(LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status(SES).Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020. Flexible parametric survival models were fitted to estimate the LOLE by gender and area-level SES for 12 common ***: Of 422,680 people with cancer, 24% and 18% lived in the most and least disadvantaged areas, respectively. Patients from the most disadvantaged areas had a significantly greater average LOLE than patients from the least disadvantaged areas for cancers with high survival rates, including prostate [2.9 years(95% CI: 2.5±3.2 years) vs. 1.6 years(95% CI: 1.3±1.9 years)] and breast cancer [1.6 years(95% CI: 1.4±1.8 years) vs. 1.2 years(95% CI: 1.0±1.4 years)]. The highest average LOLE occurred in males residing in the most disadvantaged areas with pancreatic [16.5 years(95% CI: 16.1±16.8 years) vs. 16.2 years(95% CI: 15.7±16.7 years)] and liver cancer [15.5 years(95% CI: 15.0±16.0 years) vs. 14.7 years(95% CI: 14.0±15.5 years)]. Females residing in the least disadvantaged areas with thyroid cancer [0.9 years(95% CI: 0.4±1.4 years) vs. 0.6 years(95% CI: 0.2±1.0 years)] or melanoma [0.9 years(95% CI: 0.8±1.1 years) vs. 0.7 years(95% CI: 0.5±0.8 years)] had the lowest average ***: Patients from the most disadvantaged areas had the highest LOLE with SES-based differences greatest for patients diagnosed with cancer at an early stage or cancers with higher survival rates, suggesting the need to prioritise early detection and reduce treatment-related barriers and survivorship challenges to improve life expec

关键词： Cancer diagnosis life expectancy loss of life expectancy area-level socioeconomic status flexible parametric model

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Hepatic angiotensin-converting enzyme 2 expression in metabolic dysfunction-associated steatotic liver disease and in patients with fatal COVID-19

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World Journal of Gastroenterology 2024年第31期30卷 3705-3716页

作者： Angus K Jacobs Steven D Morley Kay Samuel Katie Morgan Lyndsey Boswell Timothy J Kendall david A Dorward Jonathan A Fallowfield peter C Hayes John N Plevris Hepatology Laboratory University of EdinburghEdinburgh EH164SBUnited Kingdom Scottish National Blood Transfusion Service Jack Copland CentreEdinburgh EH144BEUnited Kingdom Institute for Regeneration and Repair University of EdinburghEdinburgh EH164UUUnited Kingdom Edinburgh Pathology University of EdinburghEdinburgh EH164SBUnited Kingdom

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and *** injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated *** of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell *** To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe *** ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel *** ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct ***,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in ***2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD *** A

关键词： Metabolic dysfunction-associated steatotic liver disease Angiotensin-converting enzyme 2 Immunohistochemistry COVID-19 COVID-19-associated cholangiopathy

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Cost burden following esophagectomy:A single centre observational study

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2255-2269页

作者： Vered Buchholz Dong Kyu Lee david S Liu Ahmad Aly Stephen A Barnett Riley Hazard peter Le Benjamin Kioussis Vijayaragavan Muralidharan Laurence Weinberg Department of Surgery Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesiology and Pain Medicine Dongguk University Ilsan HospitalSeoul 14566GoyangSouth Korea Department of Surgery Austin HealthThe University of MelbourneMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HospitalHeidelberg 3084VictoriaAustralia Department of Critical Care The University of MelbourneMelbourne 3084VictoriaAustralia

BACKGROUND Cost analyses of patients undergoing esophagectomy is valuable for identifying modifiable expenditure drivers to target and curtail costs while improving the quality of *** aimed to define the cost-complication relationship after esophagectomy and delineate the incremental contributions to *** To assess the relationship between the hospital costs and potential cost drivers post esophagectomy and investigate the relationship between the cost-driving variables(predicting variables)and hospital costs(dependent variable).METHODS In this retrospective single center study,the severity of complications was graded using the Clavien-Dindo(CD)classification *** esophagectomy complications were categorized and defined according to consensus *** costing data included the in-hospital costs of the index admission and any unplanned admission within 30 postoperative *** used correlation analysis to assess the relationship between key clinical variables and hospital costs(in United States dollars)to identify cost drivers.A mediation model was used to investigate the relationship between these variables and hospital *** A total of 110 patients underwent primary esophageal *** median admission cost was $47822.7(interquartile range:35670.2-68214.0).The total effects on costs were $13593.9(95%CI:10187.1-17000.8,P<0.001)for each increase in CD severity grade,$4781(95%CI:3772.7-5789.3,P<0.001)for each increase in the number of complications,and $42552.2(95%CI:8309-76795.4,P=0.015)if a key esophagectomy complication *** esophagectomy complications drove the costs directly by $11415.7(95%CI:992.5-21838.9,P=0.032).CONCLUSION The severity and number of complications,and the development of key esophagectomy complications significantly contributed to total hospital *** institutional initiatives and strategies are needed to enhance patient outcomes and minimize costs.

关键词： Anesthesia Esophagectomy Complications Cancer Surgery

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The W3C Data Catalog Vocabulary,Version 2:Rationale,Design Principles,and Uptake

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Data Intelligence 2024年第2期6卷 457-487页

作者： Riccardo Albertoni david Browning Simon Cox Alejandra N.Gonzalez-Beltran Andrea Perego peter Winstanley Istituto di Matematica Applicata e Tecnologie Informatiche"Enrico Magenes" Consiglio Nazionale delle Ricerche(IMATI-CNR)GenoaItaly Independent Consultant United Kingdom LandandWater CSiROMelbourneAustralia Scientific Computing Rutherford Appleton LaboratoryScience and Technology Facilities CouncilHarwell Cam-pusOx110QXUnited Kingdom European Parliament Luxembourg Semantic Arts Fort CollinsCO80524USA

DCAT is an RDF vocabulary designed to facilitate interoperability between data catalogs published on the *** its first release in 2014 as a W3C Recommendation,DCAT has seen a wide adoption across communities and domains,particularly in conjunction with implementing the FAIR data principles(forfindable,accessible,interoperable and reusable data).These implementation experiences,besides demonstrating the fitness of DCAT to meet its intended purpose,helped identify existing issues and ***,over the last few years,additional requirements emerged in data catalogs,given the increasing practice of documenting not only datasets but also data services and *** paper illustrates the new version of DCAT,explaining the rationale behind its main revisions and extensions,based on the collected use cases and requirements,and outlines the issues yet to be addressed in future versions of DCAT.

关键词： Data Catalogs Interoperability Discoverability FAIR data

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Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2689-2701页

作者： Lewis A Hall Duncan Loader Santiago Gouveia Marta Burak James Halle-Smith peter Labib Moath Alarabiyat Ravi Marudanayagam Bobby V Dasari Keith J Roberts Syed S Raza Michail Papamichail david C Bartlett Robert P Sutcliffe Nikolaos A Chatzizacharias Department of Hepatopancreatobiliary Surgery and Liver Transplantation University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152TTUnited Kingdom College of Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Clinical Sciences University of BirminghamBirmingham B152TTUnited Kingdom

BACKGROUND The use of neoadjuvant therapy(NAT)in distal cholangiocarcinoma(dCCA)with regional arterial or extensive venous involvement,is not widely accepted and evidence is *** To synthesise evidence on NAT for dCCA and present the experience of a highvolume tertiary-centre managing dCCA with arterial *** A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received *** patients from 2017 to 2022 who were referred for NAT for dCCA at our centre were retrospectively collected from a prospectively maintained *** characteristics,NAT type,progression to surgery and oncological outcomes were *** Twelve studies were *** definition of“unresectable”locally advanced dCCA was *** studies reported outcomes for 9 patients who received NAT for dCCA with extensive vascular involvement.R0 resection rate ranged between 0 and 100%but without survival benefit in most *** studies considered either NAT in resectable dCCA or inclusive with extrahepatic *** presented case series includes 9 patients(median age 67,IQR 56-74 years,male:female 5:4)referred for NAT for borderline resectable or locally advanced *** patients progressed to surgery and 2 were *** patient died at 14 months with evidence of recurrence at 6 months and the other died at 51 months following recurrence 6 months *** Evidence for benefit of NAT is *** on criteria for uniform definition of resectability for dCCA is *** propose using the established National-Comprehensive-Cancer-Network®criteria for pancreatic ductal adenocarcinoma.

关键词： Cholangiocarcinoma Neoadjuvant therapy Arterial involvement Locally advanced Systematic review

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SIMAP500: A novel risk score to identify recipients at higher risk of hepatocellular carcinoma recurrence following liver transplantation

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World Journal of Transplantation 2024年第3期14卷 132-143页

作者： Amr Alnagar Nekisa Zakeri Konstantinos Koilias Rosemary E Faulkes Rachel Brown owen Cain M Thamara P R Perera Keith J Roberts Rebeca Sanabria-Mateos david C Bartlett Yuk Ting Ma Shivan Sivakumar Shishir Shetty Tahir Shah Bobby V M Dasari Department of HBP and Liver Transplantation Surgery Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom Centre for Liver Research Institute of Biomedical ResearchBirmingham B152TTUnited Kingdom Department of Hepatology Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom Department of Pathology University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Department of Oncology Queen Elizabeth HospitalUniversity Hospitals of BirminghamBirmingham B152GWUnited Kingdom

BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely *** stratification is vital with a long LT waiting time,as that could influence the recurrence despite strict listing *** This study aims to identify predictors of recurrence and develop a novel risk pre-diction score to forecast HCC recurrence following *** A retrospective review of LT for HCC recipients at University Hospitals Bir-mingham between July 2011 and February *** and multivariate analyses were performed to identify recurrence predictors,based on which the novel SIMAP500(satellite nodules,increase in size,microvascular invasion,AFP>500,poor differentiation)risk score was *** 234 LTs for HCC were performed with a median follow-up of 5.3 *** developed in 25 patients(10.7%).On univariate analyses,RETREAT score>3,α-fetoprotein(AFP)at listing 100-500 and>500,bridging,increased tumour size between imaging at the listing time and explant histology,increase in the size of viable tumour between listing and explant,presence of satellite nodules,micro-and macrovascular invasion on explant and poor differentiation of tumours were significantly associated with recurrence,based on which,the SIMAP500 risk score is *** SIMAP500 demonstrated an excellent predictive ability(c-index=0.803)and outper-formed the RETREAT score(c-index=0.73).SIMAP500 is indicative of the time to disease *** SIMAP500 risk score identifies the LT recipients at risk of HCC *** stratification allows patient-centric post-transplant surveillance *** validation of the score is recommended.

关键词： Liver transplantation Hepatocellular carcinoma Recurrence Survival

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Schwann cell Myc-interacting zinc-finger protein 1 without pox virus and zinc finger： epigenetic implications in a peripheral neuropathy

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Neural Regeneration Research 2018年第9期13卷 1534-1537页

作者： david Fuhrmann Hans-peter Elsaisser Department of Cytobiology and Cytopathobiology Philipps University of Marburg Marburg Germany

Functionality of adult peripheral nerves essentially relies on differentiation of Schwann cells during post- natal development, as well as fine-tuned re- and transdifferentiation in response to peripheral nerve injury. Epigenetic histone modifications play a major role during the differentiation of embryonic stem cells and diverse organ specific progenitor cells, yet only little is known about the epigenetic regulation of Schwa nn cells. Just recently, Fuhrmann et al. reported how the transcription factor Myc-interacting zinc-finger protein 1 （Mizl） might contribute to Schwann cell differentiation through repression of the histone de- methylase Kdm8. Here, we discuss the potential novel role of Mizl in Schwann cell differentiation and give a short overview about previously reported histone modifications underlying peripheral nerve develop- ment and response to injury.

关键词： Schwann celh differentiation peripheral nerve injury histone methylation epigenetics Mizl

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Quantifying geological uncertainty in metamorphic phase equilibria modelling;a Monte Carlo assessment and implications for tectonic interpretations

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Geoscience Frontiers 2016年第4期7卷 591-607页

作者： Richard M.Palin owen M.Weller david J.Waters Brendan Dyck Institute of Geosciences Johannes-Gutenberg University Mainz55128MainzGermany Geological Survey of Canada 601 Booth StreetOttawaONKIA OESCanada Department of Earth Sciences University of OxfordOxfordOX1 3ANUnited Kingdom

Pseudosection modelling is rapidly becoming an essential part of a petrologist＇s toolkit and often forms the basis of interpreting the tectonothermal evolution of a rock sample, outcrop, or geological region. Of the several factors that can affect the accuracy and precision of such calculated phase diagrams, ＂geological＂ uncertainty related to natural petrographic variation at the hand sample- and/or thin section-scale is rarely considered. Such uncertainty influences the sample＇s bulk composition, which is the primary control on its equilibrium phase relationships and thus the interpreted pressure-temper- ature （P-T） conditions of formation. Two case study examples--a garnet-cordierite granofels and a garnet-staurolite-kyanite schist--are used to compare the relative importance that geological uncer- tainty has on bulk compositions determined via （1） X-ray fluorescence （XRF） or （2） point counting techniques. We show that only minor mineralogical variation at the thin-section scale propagates through the phase equilibria modelling procedure and affects the absolute P-T conditions at which key assemblages are stable. Absolute displacements of equilibria can approach ＋l kbar for only a moderate degree of modal proportion uncertainty, thus being essentially similar to the magnitudes reported for analytical uncertainties in conventional thermobarometry. Bulk compositions determined from multiple thin sections of a heterogeneous garnet-staurolite-kyanite schist show a wide range in major-element oxides, owing to notable variation in mineral proportions. Pseudosections constructed for individual point count-derived bulks accurately reproduce this variability on a case-by-case basis, though averaged proportions do not correlate with those calculated at equivalent peak P-T conditions for a whole-rock XRF-derived bulk composition. The main discrepancies relate to varying proportions of matrix phases （primarily mica） relative to porphyroblasts （primarily staurolite and kyanit

关键词： Geological uncertainty Error Pseudosection Monte Carlo MnNCKFMASHTO

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