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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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Hepatocellular Ballooning is Due to Highly Pronounced Glycogenosis Potentially Associated with Steatosis and Metabolic Reprogramming

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 52-61页

作者： Silvia Ribback Kristin peters Mohd Yasser Jessica Prey Paula Wilhelmi Qin Su Frank Dombrowski peter Bannasch Institut für Pathologie Universitaetsmedizin GreifswaldGreifswaldGermany Cell Marque Millipore-SigmaRocklinCAUSA German Cancer Research Center(DKFZ) HeidelbergGermany

Background and Aims:Hepatocellular ballooning is a common finding in chronic liver disease,mainly characterized by rarefied cytoplasm that often contains Mallory-Denk bodies(MDB).Ballooning has mostly been attributed to degeneration but its striking resemblance to glycogenotic/steatotic changes characterizing preneoplastic hepatocellular lesions in animal models and chronic human liver diseases prompts the question whether ballooned hepatocytes(BH)are damaged cells on the path to death or rather viable cells,possibly involved in neoplastic ***:Using specimens from 96 cirrhotic human livers,BH characteristics were assessed for their glycogen/lipid stores,enzyme activities,and proto-oncogenic signaling cascades by enzyme-and immunohistochemical approaches with serial paraffin and cryostat ***:BH were present in 43.8%of cirrhotic *** pronounced excess glycogen storage of(glycogenosis)and/or lipids(steatosis)were characteristic,ground glass features and MDB were often *** glucose-6-phosphatase,increased glucose-6-phosphate dehydrogenase activity and altered immunoreactivity of enzymes involved in glycolysis,lipid metabolism,and cholesterol biosynthesis were ***,components of the insulin signaling cascade were upregulated along with insulin dependent glucose transporter glucose transporter 4 and the v-akt murine thymoma viral oncogene homolog/mammalian target of rapamycin signaling pathway associated with de novo ***:BH are hallmarked by particularly pronounced glycogenosis with facultative steatosis,many of their features being reminiscent of metabolic aberrations documented in preneoplastic hepatocellular lesions in experimental animals and chronic human liver ***,BH are not damaged entities facing death but rather viable cells featuring metabolic reprogramming,indicative of a preneoplastic nature.

关键词： Chronic liver disease Carbohydrate metabolism Insulin signaling Preneoplasia Metabolic reprogramming

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First results of turbulence investigation on Globus-M2 using radial correlation Doppler reflectometry

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Plasma Science and Technology 2024年第10期26卷 49-55页

作者： A.PONOMARENKO A.YASHIN v.GUSEv E.KISELEv G.KURSKIEv v.MINAEv Y.PETROv N.SAKHAROv P.SHCHEGOLEv E.TKACHENKO N.ZHILTSOv peter the Great St.petersburg Polytechnic University St.Petersburg 195251Russia Ioffe Institute St.Petersburg 194064Russia

The first results of investigation of the turbulence structure using Doppler backscattering(DBS)on the Globus-M2 tokamak are presented.A one-channel DBS system with a variable probing frequency within the 18–26 GHz range was installed to investigate the edge plasma at normalized minor radiiρ=0.9–*** correlation Doppler reflectometry was used to study the changes in turbulence eddies after the LH *** analysis was applied to the phase derivative of complex in-phase and quadrature(IQ)signals of the DBS diagnostic as it contains information about the poloidal plasma rotation *** L-mode,the radial correlation length L_(r)is estimated to be 3 cm and after transition to H-mode reduces to approximately 2 *** modelling in a linear local approximation using code GENE indicates that the instability with positive growth rate at the normalized minor radiusρ=0.75 in L-mode and H-mode on Globus-M2 was the ion temperature gradient(ITG)mode.

关键词： tokamak turbulence Doppler backscattering correlation reflectometry

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Highly Active Interfacial Sites in SFT-SnO_(2) Heterojunction Electrolyte for Enhanced Fuel Cell Performance via Engineered Energy Bands:Envisioned Theoretically and Experimentally

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Energy & Environmental Materials 2024年第3期7卷 384-397页

作者： Sajid Rauf Muhammad Bilal Hanif Faiz Wali Zuhra Tayyab Bin Zhu Naveed Mushtaq Yatao Yang Kashif Khan peter D.Lund Martin Motola Wei Xu College of Electronic and Information Engineering and State Key Laboratory of Radio frequency Heterogeneous Integration Shenzhen UniversityShenzhen 518000China Department of Inorganic Chemistry Faculty of Natural SciencesComenius University in BratislavaIlkovicova 684215BratislavaSlovakia College of Physics and Optoelectronic Engineering Shenzhen UniversityShenzhen 518060China School of Energy and Environment Southeast UniversityNo.2 Si Pai LouNanjing 210096China School of Materials and Energy University of Electronic Science and Technology of ChinaChengdu 611731China New Energy Technologies Group Department of Applied PhysicsAalto University School of ScienceP.O.Box 15100Fl-00076AaltoEspoo Finland

Extending the ionic conductivity is the pre-requisite of electrolytes in fuel cell technology for high-electrochemical *** this regard,the introduction of semiconductor-oxide materials and the approach of heterostructure formation by modulating energy bands to enhance ionic conduction acting as an electrolyte in fuel ***(n-type;SnO_(2))plays a key role by introducing into p-type SrFe_(0.2)Ti_(0.8)O_(3-δ)(SFT)semiconductor perovskite materials to construct p-n heterojunction for high ionic ***,two different composites of SFT and SnO_(2)are constructed by gluing p-and n-type SFT-SnO_(2),where the optimal composition of SFT-SnO_(2)(6∶4)heterostructure electrolyte-based fuel cell achieved excellent ionic conductivity 0.24 S cm^(-1)with power-output of 1004 mW cm^(-2)and high OCv 1.12 v at a low operational temperature of 500℃.The high power-output and significant ionic conductivity with durable operation of 54 h are accredited to SFT-SnO_(2)heterojunction formation including interfacial conduction assisted by a built-in electric field in fuel cell ***,the fuel conversion efficiency and considerable Faradaic efficiency reveal the compatibility of SFT-SnO_(2)heterostructure electrolyte and ruled-out short-circuiting ***,the first principle calculation provides sufficient information on structure optimization and energy-band structure modulation of SFT-SnO_(2).This strategy will provide new insight into semiconductor-based fuel cell technology to design novel electrolytes.

关键词： high ionic conductivity interfacial conduction modulated energy band structure p-n heterojunction semiconductors

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Storylines of family medicine Ⅱ:foundational building blocks—context,community and health

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Family Medicine and Community Health 2024年第S3期12卷 12-22页

作者： William B ventres Leslie A Stone Rupal Shah Tamala Carter Geoffrey M Gusoff Winston Liaw Bich-May Nguyen Joanna v Rachelson Mary Alice Scott Teresa L Schiff-Elfalan Seiji Yamada Robert C Like Kathleen Zoppi A peter Catinella Richard M Frankel Shailendra Prasad Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Bridge Lane Group Practice LondonUK Penn Center for Community Health Workers University of PennsylvaniaPhiladelphiaPennsylvaniaUSA National Clinician Scholars Program UCLA David Geffen School of MedicineLos AngelesCaliforniaUSA Health Systems and Population Health Sciences University of Houston Tilman J Fertitta Family College of MedicineHoustonTexasUSA Southern New Mexico Family Medicine Residency Program Las CrucesNew MexicoUSA New Mexico Primary Care Training Program Silver CityNew MexicoUSA Anthropology New Mexico State UniversityLas CrucesNew MexicoUSA Family Medicine and Community Health University of Hawai'i at Manoa John A Burns School of MedicineHonoluluHawaiiUSA Family Medicine and Community Health Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Family Medicine Indiana University School of MedicineIndianapolisIndianaUSA Family Medicine–Transmountain Texas Tech University Health Sciences CenterEl PasoTexasUSA Medicine Indiana University School of MedicineIndianapolisIndianaUSA Family Medicine and Community Health University of Minnesota Medical School-Twin Cities CampusMinneapolisMinnesotaUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅱ:foundational building blocks—context,community and health’,authors address the following themes:‘Context—grounding family medicine in time,place and being’,‘Recentring community’,‘Community-oriented primary care’,‘Embeddedness in practice’,‘The meaning of health’,‘Disease,illness and sickness—core concepts’,‘The biopsychosocial model’,‘The biopsychosocial approach’and‘Family medicine as social medicine.’May readers grasp new implications for medical education and practice in these essays.

关键词： thematic illustration dimensions

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Characteristics of Extreme Rainfall Events over Uganda during September to November Rainfall Season

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Journal of Geoscience and Environment Protection 2024年第3期12卷 131-152页

作者： Donnata Alupot Guirong Tan Kokou Romaric Posset peter Natiko Key Laboratory of Meteorological Disaster Ministry of Education (KLME)/Joint International Research Laboratory of Climate and Environment Change (ILCEC)/Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters (CIC-FEMD) Nanjing University of Information Science and Technology Nanjing China Climate Change Department Pan African University Institute for Water and Energy Sciences (Including Climate Change) C/O Univer-sité Abou Bekr Belkaid Tlemcen Campus Chetouane Tlemcen Algeria Directorate of Weather Forecasting Uganda National Meteorological Authority Port Bell Road Kampala Uganda

Understanding the characteristics of extreme rainfall is crucial for effective flood management planning, as it enables the incorporation of insights from past extreme rainfall patterns and their spatiotemporal distribution. This work investigated the changes in the frequency and pattern of extreme rainfall over Uganda, using daily datasets sourced from Climate Hazard Group InfraRed Precipitation with Station (CHIRPS-v2) for the period 1981 to 2022. The study utilized the extreme weather Indices provided by the Expert Team on Climate Change Detection and Indices (ETCCDI). Attention was directed towards September to November (SON) rainfall season with precise analysis of four indices (Rx1day, Rx5day, R95p, and R99p). The Sequential Mann-Kendall (SQMK) non-parametric test was applied to identify abrupt changes in SON extreme rainfall trends. Results showed that October consistently recorded the highest count of extreme rainfall days across all four indices. The long-term analysis revealed fluctuations in extreme rainfall events across years, with certain periods exhibiting heightened intensity. The analysis portrayed a shift in the decadal variations and region-specific distribution of extreme rainfall, with Eastern Uganda and areas around Lake victoria standing out compared to other regions. The findings further revealed an increase in extreme rainfall for all indices in the recent decade (2011-2022) with 2019/2020 standing out as the extreme years of SON for the study period. While trendlines suggested a slight increase in intense daily rainfall events, the SQMK tests revealed statistical significance in the trend of prolonged periods of intense daily rainfall. This study contributes to the understanding of the spatiotemporal variability and trends of extreme rainfall events over Uganda during the SON season, which is crucial for the assessment of climate change impacts and adaptation strategies. It provides valuable information for seasonal extreme rainfall forecas

关键词： CHIRPS variability Region-Specific Early Warning Climate Change

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Nonlinear Rydberg exciton-polaritons in Cu2O microcavities

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Light(Science & Applications) 2024年第4期13卷 619-627页

作者： Maxim Makhonin Anthonin Delphan Kok Wee Song Paul Walker Tommi Isoniemi peter Claronino Konstantinos Orfanakis Sai Kiran Rajendran Hamid Ohadi Julian Heckötter Marc Assmann Manfred Bayer Alexander Tartakovskii Maurice Skolnick Oleksandr Kyriienko Dmitry Krizhanovskii Department of Physics and Astronomy University of SheffieldSheffield S37RHUK. Department of Physics and Astronomy University of ExeterStocker RoadExeter EX44PYUK. SUPA School of Physics and AstronomyUniversity of St AndrewsSt Andrews KY169SSUK. Fakultät Physik TU DortmundAugust-Schmidt-Straße 444227 DortmundGermany

Rydberg excitons(analogues of Rydberg atoms in condensed matter systems)are highly excited bound electron-hole states with large Bohr *** interaction between them as well as exciton coupling to light may lead to strong optical nonlinearity,with applications in sensing and quantum information ***,we achieve strong effective photon–photon interactions(Kerr-like optical nonlinearity)via the Rydberg blockade phenomenon and the hybridisation of excitons and photons forming polaritons in a Cu2O-filled *** pulsed resonant excitation polariton resonance frequencies are renormalised due to the reduction of the photon-exciton coupling with increasing exciton *** analysis shows that the Rydberg blockade plays a major role in the experimentally observed scaling of the polariton nonlinearity coefficient as∝n4.4±1.8 for principal quantum numbers up to n=*** high principal quantum numbers studied in a polariton system for the first time are essential for realisation of high Rydberg optical nonlinearities,which paves the way towards quantum optical applications and fundamental studies of strongly correlated photonic(polaritonic)states in a solid state system.

关键词： density Rydberg polar

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volcanic Risk Perception and Coping Strategies from Mounts Cameroon and Nyiragongo Eruptions, Central Africa: A Comparative Analysis

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Journal of Geoscience and Environment Protection 2024年第6期12卷 161-189页

作者： Mabel N. Wantim Innocent Bradriyo Asong F. Zisuh Louis M. Balgawa Mero Yannah Katcho Karume Nde-Fon peter Bih Amban Nchini L. Wayih Emmanuel v. Yenshu Samuel N. Ayonghe Unit of Disaster Risk Management Department of Environmental Science University of Buea Buea Cameroon Observatoire volcanologique de Goma (OvG) Goma Democratic Republic of the Congo Institute of Geological and Mining Research (IRGM) Yaounde Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Social and Management Sciences University of Buea Buea Cameroon

Approximately 2,000,000 people are exposed to volcanic risks in communities situated at the flanks of Mounts Cameroon (MC) and Nyiragongo (MN) volcanoes in Central Africa. This study therefore sought to investigate risk perception from four previous eruptions of MC, namely the 1959, 1982, 1999, and 2000 eruptions;and two previous eruptions of MN: 1977 and 2002. The study was initiated with co-design workshops held with major stakeholders in the cities of Buea and Goma at the flanks of MC and MN, respectively, in 2017, to develop the research objectives for the study. A non-random questionnaire survey was later conducted within 14 and 15 communities in Buea and Goma respectively, on the effects, perceived risks, and coping strategies for the chosen eruptions. Three age groups (18 - 30, 31 - 45 and >45 years) and gender (male and female) were considered. The population at the flanks of both volcanoes cited scientific and indigenous factors to be responsible for eruptions from these volcanoes. At MC and MN, ≥45% of the sampled participants (with a higher female population) perceived that the sampled eruptions posed a very high risk to the population. In terms of the effects, the age group of 18 - 30 was the least knowledgeable. In terms of direct effect on persons, over 90% of participants at MC and MN attested that they were overcome by fear/panic. On measures to cope with any likely eruption, the following order was established at the flanks of both volcanoes: sensitization of population, use of religious (prayers) and of traditional/indigenous strategies. In terms of future coping strategies, while the males at MC maintained sensitization as the favourite option, 62% of the males at MN opted for traditional/indigenous strategies. The female population at both MC and MN showed a higher preference for religious strategies like prayers.

关键词： Risk Perception Mount Cameroon Mount Nyiragongo Indigenous Buea Goma

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Pain management in chronic pancreatitis

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World Journal of Gastroenterology 2008年第20期14卷 3137-3148页

作者： Cathia Gachago peter v Draganov University of Florida Department of Gastroenterology Hepatology and Nutrition1600 SW Archer Rd Room 602 Gainesville Florida 32610United States

Abdominal pain is a major clinical problem in patients with chronic pancreatitis. The cause of pain is usually multifactorial with a complex interplay of factors contributing to a varying degree to the pain in an individual patient and, therefore, a rigid standardized approach for pain control tends to lead to suboptimal results. Pain management usually proceeds in a stepwise approach beginning with general lifestyle recommendations. Low fat diet, alcohol and smoking cessation are encouraged. Analgesics alone are needed in almost all patients. Maneuvers aimed at suppression of pancreatic secretion are routinely tried. Patients with ongoing symptoms may be candidates for more invasive options such as endoscopic therapy, and resective or drainage surgery. The role of pain modifying agents (antidepressants, gabapentin, peregabalin), celiac plexus block, antioxidants, octreotide and total pancreatectomy with islet cell auto transplantation remains to be determined.

关键词： Chronic pancreatitis Pain Endoscopy Endoscopic ultrasound Pancreas

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Paraneoplastic dermatological manifestation of gastrointestinal malignancies

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World Journal of Gastroenterology 2009年第35期15卷 4372-4379页

作者： Lyubomir A Dourmishev peter v Draganov Dermatology and venereology Medical University Department of Gastroenterology Hepatology and NutritionUniversity of Florida

Numerous dermatological disorders have been associated with underlining malignancies of the gastrointestinal (GI)*** cutaneous manifestations might have an important diagnostic value if they are the sole expressions of otherwise asymptomatic *** recognition of some typical paraneoplastic dermatologic disorders can lead to the prompt diagnosis of the underlying malignancy,timely administration of therapy,and ultimately,better *** this review we discuss the most common paraneoplastic dermatological syndromes from the perspective of the practicing gastroenterologist. We also outline a comprehensive practical approach for the evaluation for occult malignancy in patients presenting with cutaneous findings potentially associated with GI cancers.

关键词： Paraneoplastic Dermatological Gastro-intestinal Cancer Malingnancy

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