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Diagnosis of hepatocellular carcinoma

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World Journal of Gastroenterology 2009年第11期15卷 1301-1314页

作者： Asmaa I Gomaa Shahid A Khan edward LS Leen Imam Waked simon D Taylor-Robinson Department of Hepatology and Gastroenterology Division of Medicine Imperial College London St Mary's Hospital Campus South Wharf Road London W2 1NY United Kingdom National Liver Institute Menoufi ya University Shebeen ElKom 32111 Egypt Imaging Sciences Department MRC Clinical Sciences Centre Imperial College London Hammersmith Hospital Campus Du Cane Road London W12 0HS United Kingdom

Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, particularly in parts of the developing world, and is increasing in incidence. This article reviews the current modalities employed for the diagnosis of HCC, including serum markers, radiological techniques and histological evaluation, and summarises international guidelines for the diagnostic approach to HCC.

关键词： Diagnosis Hepatocellular carcinoma Imaging Serum markers

Prediction modelling in the early detection of neonatal sepsis

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World Journal of Pediatrics 2022年第3期18卷 160-175页

作者： Puspita Sahu Elstin Anbu Raj Stanly Leslie edward simon Lewis Krishnananda Prabhu Mahadev Rao Vijayanarayana Kunhikatta Department of Pharmacy Practice Manipal College of Pharmaceutical SciencesManipal Academy of Higher Education(MAHE)Manipal 576104KarnatakaIndia Department of Paediatrics Kasturba Medical CollegeManipal Academy of Higher Education(MAHE)ManipalKarnatakaIndia 576104 Department of Biochemistry Kasturba Medical CollegeManipal Academy of Higher Education(MAHE)ManipalKarnatakaIndia 576104

Background Prediction modelling can greatly assist the health-care professionals in the management of diseases,thus sparking interest in neonatal sepsis *** main objective of the study was to provide a complete picture of performance of prediction models for early detection of neonatal *** PubMed,Scopus,CINAHL databases were searched and articles which used various prediction modelling measures for the early detection of neonatal sepsis were *** extraction was carried out based on Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies *** data consisted of objective,study design,patient characteristics,type of statistical model,predictors,outcome,sample size and *** model Risk of Bias Assessment Tool was applied to gauge the risk of bias of the *** An aggregate of ten studies were included in the review among which eight studies had applied logistic regression to build a prediction model,while the remaining two had applied artificial *** predictors like neonatal fever,birth weight,foetal morbidity and gender,cervicovaginitis and maternal age were identified for the early detection of neonatal ***,birth weight,endotracheal intubation,thyroid hypofunction and umbilical venous catheter were promising factors for predicting late-onset sepsis;while gestational age,intrapartum temperature and antibiotics treatment were utilised as budding prognosticators for early-onset sepsis *** Prediction modelling approaches were able to recognise promising maternal,neonatal and laboratory predictors in the rapid detection of early and late neonatal sepsis and thus,can be considered as a novel way for clinician decisionmaking towards the disease diagnosis if not used alone,in the years to come.

关键词： Neonatal sepsis Predictors Prediction modelling Systematic review Validation

Comparative analysis of thinning techniques in pine forests

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Journal of Forestry Research 2022年第4期33卷 1145-1156页

作者： Maame Esi Hammond Radek Pokorný simon Abugre Augustine Gyedu Department of Silviculture Faculty of Forestry and Wood TechnologyMendel University in BrnoZemědělská361300 BrnoCzech Republic Department of Forest Science School of Natural ResourcesUniversity of Energy and Natural ResourcesP.O.Box 214SunyaniGhana Forest Services Division(FSD) P.M.BKumasiGhana

Thinning is a necessary and complex forestry *** complexity increases due to theoretical disagreements,contradictory recommendations,and errors of modern practice,which require confirmation through longtime *** article presents a summary of experimental results from plantations established 20–30 years ago and explains concepts of the theory,methods,and regime of thinning in permanent sample plots of pine stands in Gatchinsky forest of the Leningrad *** research results allow for the clarification of growth patterns and age dynamics of pine stands subject to heavy,low thinning,as well as the results of applying the crown(high)thinning technique and a mixed treatment.A combined thinning and fertilization could improve wood quality and yield compared to conventional *** particular scientific importance is the analysis of change in tree diameter classes during growth and after *** research results allow for optimizing the treatment regime in pine plantations and reducing labor intensity by increasing the intensity of thinning and reducing the number of techniques.

关键词： Forest management practices Forest stand Selective thinning Silviculture

Percutaneous transhepatic cholangioscopy and lithotripsy in treating difficult biliary ductal stones: Two case reports

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World Journal of Gastrointestinal Endoscopy 2019年第4期11卷 298-307页

作者： edward Alabraba simon Travis Ian Beckingham Department of Hepato-Pancreato-Biliary Surgery Queen's Medical Centre Department of Radiology Queen’s Medical Centre

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) is preferred for managing biliary obstruction in patients with bilio-enteric anastomotic strictures(BEAS) and calculi. In patients whose duodenal anatomy is altered following upper gastrointestinal(UGI) tract surgery, ERCP is technically challenging because the biliary tree becomes difficult to access by per-oral *** endoscopic therapies like balloon-enteroscopy or rendevous-ERCP may be considered but are not always feasible. Biliary sepsis and comorbidities may also make these patients poor candidates for surgical management of their biliary *** SUMMARY We present two 70-year-old caucasian patients admitted as emergencies with obstructive cholangitis. Both patients had BEAS associated with calculi that were predominantly extrahepatic in Patient 1 and intrahepatic in Patient 2. Both patients were unsuitable for conventional ERCP due to surgically-altered UGl anatomy. Emergency biliary drainage was by percutaneous transhepatic cholangiography(PTC) in both cases and after 6-weeks' maturation, PTC tracts were dilated to perform percutaneous transhepatic cholangioscopy and lithotripsy(PTCSL) for duct clearance. BEAS were firstly dilated fluoroscopically,and then biliary stones were flushed into the small bowel or basket-retrieved under visualization provided by the percutaneously-inserted video cholangioscope. Lithotripsy was used to fragment impacted calculi, also under visualization by video cholangioscopy. Satisfactory duct clearance was achieved in Patient 1 after one PTCSL procedure, but Patient 2 required a further procedure to clear persisting intrahepatic calculi. Ultimately both patients had successful stone clearance confirmed by check *** PTCSL offers a pragmatic, feasible and safe method for biliary tract clearance when neither ERCP nor surgical exploration is suitable.

关键词： Percutaneous transhepatic cholangiography Video cholangioscopy Lithotripsy Biliary calculi Endoscopic retrograde cholangiopancreatography Case report Bilio-enteric anastomotic strictures

Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury

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Journal of Integrative Medicine 2020年第2期18卷 169-173页

作者： Louisa Sylvia Emerson West Allyson M.Blackburn Carina Gupta Eric Bui Tara Mahoney Geraldine Duncan edward C.Wright simon Lejeune Thomas J.Spencer Home Base:A Red Sox Foundation and Massachusetts General Hospital Program Massachusetts General HospitalCharlestownMA 02129USA Harvard Medical School BostonMA 02115USA Dauten Family Center for Bipolar Treatment Innovation Massachusetts General HospitalBostonMA 02114USA Equine Immersion ProgramsTM USA Pediatric Psychopharmacology and Adult ADHD Program Massachusetts General HospitalBostonMA 02114USA

Objective: Equine-assisted activities and therapies(EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder(PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury(TBI).Methods: A family member or support person could accompany veterans and participate in the *** hundred and six participants(veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program(IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic ***: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program’s ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76(standard deviation[SD] = 0.61) as reported by veterans and a mean score of 9.91(SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall ***: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.

关键词： Posttraumatic stress disorder Military personnel Traumatic brain injury Complementary and alternative medicine Equine-assisted therapy

Barriers to the Growth of Small and Medium Scale Construction Enterprises in Ghana

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Open Journal of Civil Engineering 2022年第1期12卷 38-55页

作者： simon Ofori Ametepey Emmanuel Yaw Frempong Jnr John edward Cobbina Department of Building Technology Koforidua Technical University Koforidua Ghana

The construction industry in most developing economies is dominated heavily by small and medium scale enterprises. These construction enterprises need to thrive in an extremely competitive business environment. Conversely, most of these small and medium scale construction enterprises (SMSCE) are fraught with a plethora of barriers that inhibit and threaten their growth and survival. This research sought to evaluate the critical barriers that affect the growth of SMSCEs in the Ghanaian Construction Industry. The quantitative research method was adopted using a structured questionnaire with variables that were identified through a comprehensive literature review. The survey questionnaire was administered to 400 respondents comprising 250 SMSCEs, 100 Local Authority Engineers, and 50 Consultants to elicit data based on the identified variables. The major findings established by the study as barriers to the growth of SMSCEs in Ghana are largely structured as financial/fiscal barriers, business development barriers, technical/technological barriers, corruption barriers, knowledge management barriers, project acquisition barriers. A guiding framework should be developed based on the barriers identified to aid the growth and survival of SMSCEs in Ghana.

关键词： Barriers Business Growth Business Survival Developing Countries Small and Medium Scale Enterprise SME

Strategies to tackle the challenges of external beam radiotherapy for liver tumors

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World Journal of Hepatology 2017年第14期9卷 645-656页

作者： Michael I Lock Jonathan Klein Hans T Chung Joseph M Herman edward Y Kim William Small Nina A Mayr simon S Lo Department of Radiation Oncology London Regional Cancer ProgramUniversity of Western Ontario Department of Radiation Oncology Odette Cancer CentreSunnybrook Health Sciences Centre Department of Radiation Oncology the University of Texas Department of Radiation Oncology University of Washington School of Medicine Department of Radiation Oncology Loyola University Medical Center

Primary and metastatic liver cancer is an increasingly common and difficult to control disease *** offers a non-invasive treatment alternative for these patients who often have few options and a poor ***,the anatomy and aggressiveness of liver cancer poses significant challenges such as accurate localization at simulation and treatment,management of motion and appropriate selection of dose *** article aims to review the options available and provide information for the practical implementation and/or improvement of liver cancer radiation programs within the context of stereotactic body radiotherapy and image-guided radiotherapy *** patient inclusion and exclusion criteria are presented given the significant toxicity found in certain sub-populations treated with ***,certain sub-populations,such as those with tumor thrombosis or those with larger lesions treated with transarterial chemoembolization,have been shown to have significant improvements in outcome with the addition of radiation and merit special *** a liver radiation programrequires three primary challenges to be addressed:(1) immobilization and motion management;(2) localization;and(3) dose regimen and constraint *** to deal with motion include simple internal target volume(ITV) expansions,non-gated ITV reduction strategies,breath hold methods,and surrogate marker methods to enable gating or *** of the tumor and organs-at-risk are addressed using contrast infusion techniques to take advantage of different normal liver and cancer vascular anatomy,imaging modalities,and margin ***,a dose response has been demonstrated and dose regimens appear to be converging.A more uniform approach to treatment in terms of technique,dose selection and patient selection will allow us to study liver radiation in larger and,hopefully,multicenter randomized studies.

关键词： Hepatocellular carcinoma Liver metastases 4DCT Image-guided radiotherapy Stereotactic body radiation therapy

Computational Intelligence Determines Effective Rationality

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International Journal of Automation and computing 2008年第1期5卷 63-66页

作者： edward P.K.Tsang Centre for Computational Finance and Economic Agents University of EssexColchester CO4 3SQUK

Rationality is a fundamental concept in economics. Most researchers will accept that human beings are not fully rational. Herbert simon suggested that we are ＂bounded rational＂. However, it is very difficult to quantify ＂bounded rationality＂, and therefore it is difficult to pinpoint its impact to all those economic theories that depend on the assumption of full rationality. Ariel Rubinstein proposed to model bounded rationality by explicitly specifying the decision makers＇ decision-making procedures. This paper takes a computational point of view to Rubinstein＇s approach. From a computational point of view, decision procedures can be encoded in algorithms and heuristics. We argue that, everything else being equal, the effective rationality of an agent is determined by its computational power - we refer to this as the computational intelligence determines effective rationality （CIDER） theory. This is not an attempt to propose a unifying definition of bounded rationality. It is merely a proposal of a computational point of view of bounded rationality. This way of interpreting bounded rationality enables us to （computationally） reason about economic systems when the full rationality assumption is relaxed.

关键词： Rationality bounded rationality computational intelligence economics computational intelligence determines effective rationality (CIDER) theory.

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学历是工作的敲门砖

疯狂英语（口语版） 2013年第2期 40-42页

作者： simon edward Smith

学历就像一块敲门砖，没有学历你连那扇工作的大门都进不去，因为企业招聘的时候通常首选的条件就是学历。而当我们工作越久，接触社会越久，越感觉到学历的重要性。具有高学历，你就具有更多机会获得物质上和精神上的财富。

关键词：学历砖企业招聘