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Resection of isolated liver oligometastatic disease in pancreatic ductal adenocarcinoma:Is there a survival benefit?A systematic review

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World Journal of Gastrointestinal Surgery 2023年第7期15卷 1512-1521页

作者： James m Halle-Smith Sarah powell-Brett Keith Roberts Nikolaos A Chatzizacharias Department of HPB and Liver Transplant Queen Elizabeth HospitalUniversity of BirminghamBirmingham B152GWUnited Kingdom

BACKGROUND Presence of liver metastatic disease in pancreatic ductal adenocarcinoma(PDAC),either synchronous or metachronous after pancreatic resection,is a terminal diagnosis that warrants management with palliative intent as per all international practice guidelines.However,there is an increasing interest on any potential value of surgical treatment of isolated oligometastatic disease in selected cases.AIm To present the published evidence on surgical management of PDAC liver metastases,synchronous and metachronous,and com.a.e the outcomes of these treatments to the current standard of care.mETHODS A systematic review was performed in line with the Preferred Reporting Items for Systematic Review and meta-Analyses guidelines to com.a.e the outcomes of both synchronous and metachronous liver metastases resection to standard care.RESULTS 356 studies were identified,31 studies underwent full-text review and of these 10 were suitable for inclusion.When synchronous resection of liver metastases was com.a.ed to standard care,most studies did not demonstrate a survival benefit with the exception of one study that utilised neoadjuvant treatment.However,resection of metachronous disease appeared to confer a survival advantage when com.a.ed to treatment with chemotherapy alone.CONCLUSION A survival benefit may exist in resection of selected cases of metachronous liver oligometastatic PDAC disease,after disease biology has been tested with time and systemic treatment.Any survival benefit is less clear in synchronous cases;however an approach with neoadjuvant treatment and consideration of resection in some selected cases may confer some benefit.Future studies should focus on pathways for selection of cases that may benefit from.a. aggressive approach.

关键词： Pancreas cancer Liver metastases Surgical resection Systematic review

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妇科手术同时进行脂膜切除术的远期效果

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世界核心医学期刊文摘（妇产科学分册） 2006年第10期2卷 44-45页

作者： Wright J.D. Rosenbush E.J. powell m.a. 朱磊 Division of Gynecologic Oncology Department of Obstetrics and Gynecology Washington University School of Medicine 4911 Barnes Hospital Plaza St. Louis MO 63110 United States

Objective.: While panniculectomy has been shown to be a useful technique in obese women undergoing gynecologic surgery, the long-term outcome of these patients has been poorly described. The goal of this study was to determine the long-term outcomes and patient satisfaction of women who underwent panniculectomy at the time of pelvic surgery. methods.: A retrospective review of patients who underwent panniculectomy at the time of pelvic surgery between 1996 and 2004 was performed. Postoperative complications and long-term trends in weight were evaluated. Patient satisfaction was assessed by telephone survey. Results.: Forty-two patients were identified. The m.a. EBL was 522 ml, the m.a. operating time was just over 4 h. Wound complications were noted in 36%of the subjects. Two weeks after the procedure, 86%of the women had a weight that was lower than their preoperative weight. Weight loss peaked 3 months postoperatively, 97%of the subjects had a net lower weight, with a m.a. loss of nearly 20 lb. Over the ensuing 2 years, weight loss gradually declined. After 2 years of follow-up, 62%of the women were below their preoperative body weights. The m.a. weight loss at 24 months was 7 lb. Overall patient satisfaction with the procedure was high. Eighty-six percent of the subjects responded that they would undergo the procedure again given their outcome. Conclusions.: Panniculectomy is well tolerated and associated with a high rate of patient satisfaction. Panniculectomy is a valuable component of gynecologic surgery in morbidly obese women.

关键词：脂膜切除术手术时间盆腔手术远期疗效平均失血量切口并发症术后并发症患者体重随访调查

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脂肪层切除术可以改善子宫内膜癌肥胖患者淋巴结的清除状况

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世界核心医学期刊文摘（妇产科学分册） 2005年第1期1卷 51-52页

作者： Wright J.D. powell m.a. Herzog T.J. 罗勇 Division of Gynecologi c Oncology Dept. of Obstetrics and Gynecology Washington Univ. Sch. of Med. 63 110 St.Louis MO United States

Objective.Panniculectomy has been used to facilitate pelvic surgery i n obese w omen. The goal of this study was to determine the effect of panniculectomy on st aging adequacy and lymph node yield in obese women with endometrial carcinoma un dergoing staging laparotomy. methods. A retrospective review of patients with endometrial neoplasms who underwent pann iculectomy at the time of hysterectomy was performed. For each subject, two cont rol patients were matched by body mass index (BmI). Results. Twenty-seven endom etrial cancer patients who underwent panniculectomy at the time of staging were identified. Panniculectomy was successfully performed in all 27 patients. While the m.a. number of pelvic nodes was statistically similar between the two groups (16.2 vs. 13.7)-(P = 0.199), the paraaortic node count was higher in patients who underwent panniculectomy (4.3 vs. 2.9) (P = 0.032). A paraaortic node dissec tion was not feasible in 3 (11.1%) of the panniculectomy patients and in 11 (20 .4%) of the controls (P = 0.365). There were no differences in intraoperative o r postoperative complications or in survival between the two groups. Conclusion. Among obese women with endometrial cancer, panniculectomy is well tolerated, fe asible, and associated with acceptable morbidity. While the clinical significanc e of an increased paraaortic node count is uncertain, our findings suggest that panniculectomy may enhance operative exposure and facilitate endometrial cancer staging.

关键词：脂肪层切除术盆腔淋巴结手术分期淋巴结清除盆腔手术手术视野术后并发症术后存活率无显著性差异

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卵巢癌患者临终前的资源消费:“太多“有多少?

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世界核心医学期刊文摘（妇产科学分册） 2006年第2期2卷 40-41页

作者： Lewin S.N. Buttin B.m. powell m.a. T.J. Herzog 马超 Division of Gynecologic Oncology Columbia University School of Physicians and Surgeons 161 Ft Washington Avenue New York NY 10032 United States

Objective. End-of-life (EOL) medical care consumes 10-12%of national health care expenditures and 27%of medicare dollars annually. Studies suggest that hospice services decrease EOL expenditures by 25-40%. The goal of this study was to com.a.e the total cost of hospital-based resources utilized in ovarian cancer patients during their last 60 days of life for those enrolled in hospice versus those not on hospice. methods. Study eligibility included patients who expired from ovarian cancer from 1999 to 2003. medical records were reviewed for demographic data as well as treatment, response and recurrence rates, histologic type, grade and stage. Billing records were analyzed for costs of inpatient and outpatients visits, including radiologic, laboratory and pharmacy charges. Total cost of hospital resources was com.a.ed between patients managed on hospice for >10 days (hospice group) versus methods: mann-Whitney U, Kruskal-Wallis and Student’s t tests. Overall survival was com.a.ed using Kaplan-meier statistics. Results. Of the 84 patients analyzed, 67 (79.8%) were in the non-hospice group and 17 (20.2%) were in the hospice group. Demographic, histologic and staging characteristics as well as platinum sensitivity were similar between the two groups before the last 60 days of life. m.a. number of chemotherapy cycles before the study period was also similar (20.4 and 21.0, respectively). However, during the study period, the m.a. total cost per patient in the non-hospice group was ＄59,319 versus ＄15,164 in the hospice group (P = 0.0001). A significant difference in cost was noted for m.a. inpatient days (＄6584 vs ＄1629, P = 0.0007), radiology (＄6063 vs ＄2343, P = 0.003), laboratory (＄12,281 vs ＄2026, P = 0.0004) and pharmacy charges (＄13,650 vs ＄4465, P = 0.0017) as well as for treating physician per patient (＄112,707 vs ＄34,677, P = 0.04). Overall survival for the two groups was the same. Conclusions. Our findings demonstrate that there is a significant cost difference

关键词：资源消费医疗记录医院成本医院资源检验科复发率人口数据存活数药剂科有显著性差异

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Post-COVID recovery and renewal through whole-of-society resilience in cities

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Journal of Safety Science and Resilience 2022年第3期3卷 222-228页

作者： Andrew G.mcClelland Roisin Jordan Szymon Parzniewski Duncan Shaw Nat O’Grady David powell Alliance manchester Business School University of ManchesterManchester M139PLUK Alliance manchester Business School Humanitarian&Conflict Response InstituteUniversity of ManchesterManchester M139PLUK Humanitarian&Conflict Response Institute University of ManchesterManchester M139PLUK

This paper explores and extends understanding of the role and significance of whole-of-society resilience pro-grammes that support cities when dealing with complex crises,like the COVID-19 pandemic.Highlighting the complexity of whole-of-society resilience as different actors locally shape it,we ask the question:How can collab-oration between formal and informal resilience practices help to enhance resilience across the‘whole-of-society’?We answer this question by reviewing the importance of whole-of-society resilience and its complexity in a city’s governance of the COVID-19 crisis.We argue that the necessity of renewing approaches to building lo-cal resilience capabilities across the whole-of-society requires synchronisation across and between formal and informal approaches-that is,“bottom-up”and governmental initiatives-to meet the diverse needs of com-munities.Secondly,we detail two recent practice-orientated initiatives that have taken a renewal approach to building resilience through the involvement of whole-of-society in planning recovery from COVID-19 using in-ternational standard ISO/TS 22393;and a new initiative called the National Consortium for Societal Resilience[UK+].Finally,we signpost a set of critical questions for whole-of-society resilience practice.

关键词： Whole-of-society resilience Crisis Recovery Renewal Cities,COVID-19

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Dynamic energy system modeling using hybrid physics-based and machinelearning encoder–decoder models

能源与人工智能(英文)

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能源与人工智能(英文) 2022年第3期9卷 128-138页

作者： Derek machalek Jake Tuttle Klas Andersson Kody m.powell Department of Chemical Engineering University of UtahSalt Lake CityUTUnited States of America Taber International LLCUnited States of America Department of Space Earthand EnvironmentUniversity of ChalmersGothenburgSweden Department of mechanical Engineering University of UtahSalt Lake CityUTUnited States of America

Three model configurations are presented for multi-step time series predictions of the heat absorbed by thewater and steam in a thermal power plant. The models predict over horizons of 2, 4, and 6 steps into thefuture, where each step is a 5-minute increment. The evaluated models are a pure machine learning model, anovel hybrid machine learning and physics-based model, and the hybrid model with an incomplete dataset. Thehybrid model deconstructs the machine learning into individual boiler heat absorption units: economizer, waterwall, superheater, and reheater. Each configuration uses a gated recurrent unit (GRU) or a GRU-based encoder–decoder as the deep learning architecture. m.a. squared error is used to evaluate the models com.a.ed totarget values. The encoder–decoder architecture is over 11% more accurate than the GRU only models. Thehybrid model with the incomplete dataset highlights the importance of the manipulated variables to the system.The hybrid model, com.a.ed to the pure machine learning model, is over 10% more accurate on averageover 20 iterations of each model. Automatic differentiation is applied to the hybrid model to perform.a.localsensitivity analysis to identify the most im.a.tful of the 72 manipulated variables on the heat absorbed in theboiler. The models and sensitivity analyses are used in a discussion about optimizing the thermal power plant.

关键词： Hybrid model Encoder-decoder Time series Automatic differentiation Thermal power plant

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A Ring-Reinforced Right Ventricle to Pulmonary Artery Conduit Is Associated with Better Regional mechanics after Stage I Norwood Operation

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Congenital Heart Disease 2022年第5期17卷 591-603页

作者： Benjamin Zielonka David m.Harrild Sunil J.Ghelani Eleni G.Elia Christopher W.Baird Andrew J.powell Rahul H.Rathod Department of Cardiology Boston Children’s HospitalBostonUSA Department of Pediatrics Harvard Medical SchoolBostonUSA Department of Cardiothoracic Surgery Boston Children’s HospitalBostonUSA Department of Surgery Harvard Medical SchoolBostonUSA

Background:The right ventricle to pulmonary artery conduit(RVPAC)may im.a.r right ventricular(RV)function in patients with functional single right ventricles.modification of the RVPAC using a ring-reinforced end with dunked insertion into the RV through a limited ventriculotomy may reduce the im.a.t on RV function.We com.a.ed RV segmental strain between patients with a traditional RVPAC and ring-reinforced RVPAC using feature tracking cardiovascular magnetic resonance(CmR)imaging.methods:Patients with CmR examinations after Stage I operation with RVPAC between 2000 and 2018 were reviewed.Ventricular mass,volumes,late gadolinium enhancement(LGE),and peak radial and circumferential strain of the 4 segments near the RVPAC insertion site were analyzed.Results:The study included 71 CmR examinations in 61 patients(30 traditional RVPAC,31 ring-reinforced RVPAC).Prior to Stage II,the ring-reinforced RVPAC group had better peak radial strain and circumferential strain in 1 of 4 segments proximal to the RVPAC insertion site com.a.ed to the traditional RVPAC group.Prior to Stage III operation,the ring-reinforced group had better peak radial and circumferential strain in 2 of 4 segments.LGE at the RVPAC insertion site was observed in 97%of patients before Stage II and 95%of patients before Stage III.RVPAC type and regional strain were not associated with transplant-free survival during a median follow-up of 6.3 years.Conclusions:Com.a.ed to a traditional RVPAC,the ring-reinforced RVPAC is associated with improved regional mechanics at the conduit insertion site.Further investigation of long-term outcomes after ring-reinforced RVPAC is warranted.

关键词： Single ventricle hypoplastic left heart syndrome cardiovascular magnetic resonance feature tracking

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Effect of salinity and acidity on bioleaching activity of mesophilic and extremely thermophilic bacteria

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中国有色金属学会会刊：英文版 2008年第3期18卷 714-721页

作者： H.DEVECI m.a.JORDAN N.powell I.ALP Department of mining Engineering Karadeniz Technical UniversityTrabzon 61080Turkey Camborne School of mines UECTremough CampusPenrynCornwallTR109EZUK

The effects of bacterial strain, salinity and pH on the bioleaching of a complex ore using mesophilic and extremely thermophilic bacteria were investigated and the statistical analysis of the results was performed using ERGUN’s test. The extreme thermophiles were shown to display superior kinetics of dissolution of zinc com.a.ed with the mesophiles as confirmed by the statistical analysis. Bioleaching performance of the extreme thermophiles is found to improve in response to the increase in acidity (pH from 2.0 to 1.0) whilst the activity of the mesophiles is adversely affected by decreasing pH. Statistical analysis of the bioleaching data indicates that the effect of pH is insignificant in the range of pH 1.0-1.2 for the extreme thermophiles and pH 1.4-2.0 for the mesophiles. Salinity is shown to have a suppressing effect on the mesophiles. However, the extreme thermophiles appear to be halophilic in character as they could operate efficiently under saline conditions (1%-4%Cl- (w/v)).

关键词：细菌生物浸取盐度 pH 硫化物

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PERSONS WITH DISABILITIES AND THEIR SEXUAL, REPRODUCTIVE, AND PARENTING RIGHTS： AN INTERNATIONAL AND COm.a.ATIVE ANALYSIS

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Frontiers of Law in China-Selected Publications from Chinese Universities 2016年第1期11卷 53-85页

作者： Robyn m. powell michael Ashley Stein Lurie Institute for Disability Policy Fellow Disability Law Attorney Ph.D student at Heller School for Social Policy and Management Brandeis University Waltham US. Executive Director Harvard Law School Project on Disability Extraordinary Professor University of Pretoria Faculty of Law Centre for Human Rights Visiting Professor at Harvard Law School Cambridge US.

Abstract Despite important gains in human rights, persons with disabilities -- and in particular women and girls with disabilities -- continue to experience significant inequalities in the areas of sexual, reproductive, and parenting rights. Persons with disabilities are sterilized at alarming rates; have decreased access to reproductive health care services and information; and experience denial of parenthood. Precipitating these inequities are substantial and instantiated stereotypes of persons with disabilities as either asexual or unable to engage in sexual or reproductive activities, and as incapable of performing parental duties. The article begins with an overview of sexual, reproductive, and parenting rights regarding persons with disabilities. Because most formal adjudications of these related rights have centered on the issue of sterilization, the article analyzes commonly presented rationales used to justify these procedures over time and across jurisdictions. Next, the article examines the Convention on the Rights of Persons with Disabilities and the attendant obligations of States Parties regarding rights to personal integrity, access to reproductive health care services and information, parenting, and the exercise of legal capacity. Finally, the article highlights fundamental and complex issues requiring future research and consideration.

关键词： disability Convention on the Rights of Persons with Disabilities human rights,parenting sexual and reproductive rights

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Arabidopsis ADC1 functions as an Nδ-acetylornithine decarboxylase

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Journal of Integrative Plant Biology 2020年第5期62卷 601-613页

作者： Yann-Ru Lou Sheaza Ahmed Jian Yan Adewale m.a.io Hannah m.powell Paul F.morris Georg Jander Boyce Thompson Institute for Plant Research IthacaNY 14853USA Department of Biological Sciences Bowling Green State UniversityBowling GreenOH 43403USA Key Laboratory of Agro-Environment in the Tropics Ministry of Agriculture and Rural AffairsSouth China Agricultural UniversityGuangzhou 510642China Department of Biochemistry and molecular Biology Michigan State UniversityEast LansingMI 48824USA Bayer Crop Science 700 Chesterfield Parkway WestChesterfieldMO 63017USA

Polyamines are small aliphatic amines found in almost all organisms,ranging from bacteria to plants and animals.In most plants,putrescine,the metabolic precursor for longer polyamines,such as spermidine and spermine,is produced from.a.ginine,with either agmatine or ornithine as intermediates.Here we show that Arabidopsis thaliana(Arabidopsis)arginine de-carboxylase 1(ADC1),one of the two known arginine decarboxylases in Arabidopsis,not only synthesizes agmatine from.a.ginine,but also converts N-acety.lornithine to N-acetylputrescine.Phylogenetic analyses indicate that duplication and neofunctionalization of ADC1 and NATA1,the enzymes that synthesize Nδ-acetylormithine in Arabidopsis,co-occur in a small number of related species in the Brassicaceae.Unlike ADC2,which is localized in the chloroplasts,ADC1 is in the endoplasmic reticulum together with NATA1,an indication that these two enzymes have access to the same substrate pool.Together,these results are con-sistent with a model whereby NATA1 and ADC1 to-gether provide a pathway for the synthesis of N-acetylputrescine in Arabidopsis.

关键词： Arabidopsis Phylogenetic Together

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