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Outcomes of endoscopic submucosal dissection in cirrhotic patients: First American cohort

World Journal of Hepatology 2024年第5期16卷 784-790页

作者： robert luke pecha Fares Ayoub Ankur Patel Abdullah Muftah Michael W Wright Mai A Khalaf Mohamed O Othman Department of Gastroenterology and Hepatology UC DavisSacramentoCA 95817United States Department of Gastroenterology and Hepatology Baylor College of MedicineHoustonTX 77030United States Internal Medicine Baylor College of MedicineHoustonTX 77030United States Department of Gastroenterology and Hepatology University of Texas Medical Branch at GalvestonGalvestonTX 77550United States Medical School Baylor College of MedicineHoustonTX 77030United States Department of Tropical Medicine Tanta UniversityTanta 31527Egypt

BACKGROUND Among patients with cirrhosis and pre-malignant or early malignant mucosal lesions,surgical intervention carries a much higher bleeding *** such lesions are discovered,endoscopic submucosal dissection(ESD)may offer curative therapy with lower risks than surgery and improved outcomes compared to traditional endoscopic *** To evaluate the outcomes of ESD in patients with *** Patients with cirrhosis undergoing ESD between July 2015 and August 2022 were retrospectively matched in 1:2 fashion to controls based on lesion location,size,and anticoagulation *** outcomes were compared between *** A total of 64 Lesions from 59 patients were included(16 cirrhosis,43 control).There were no differences in patient or lesion characteristics between *** bloc and curative resection was achieved in 84.21%,78.94%of the cirrhosis group and 88.89%,68.89%of controls,respectively,with no significant *** patients had significantly higher rates of intra-procedural coagulation grasper use for control of bleeding(47.37%vs 20%;P=0.02).There were otherwise no significant differences in adverse event *** the 29 patients with follow up,we found higher rates of recurrence in the cirrhosis group compared to controls(40%vs 5.26%;P=0.019),however this effect did not persist on multivariable analysis controlling for known *** ESD may be safe and effective in patients with *** procedure related outcomes were not significantly different between ***-procedural bleeding requiring use of the coagulation grasper use was expectedly higher in the cirrhosis group given the known effects of liver disease on hemostasis.

关键词： Endoscopic aubmucosal dissection Cirrhosis Advanced polypectomy Intraprocedural bleeding Colon cancer

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Outcomes of central hepatectomy versus extended hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 249-254页

作者： Jenny Chan luke Bradshaw Nezor Houli Laurence Weinberg Marcos V Perini Michael Fink Vijayaragavan Muralidharan Graham Starkey robert Jones Bao Zhong Wang Christopher Christophi Mehrdad Nikfarjam Department of Surgery University of Melbourne Austin Health Heidelberg Melbourne Victoria Australia Department of Surgery University of Melbourne Northern Health Epping Victoria Australia Department of Anaesthesia University of Melbourne Austin Health Heidelberg Melbourne Victoria Australia

Background: Central hepatectomy(CH) is more difficult than extended hepatectomy(EH) and is associated with greater morbidity. In this modern era of liver management with aims to prevent posthepatectomy liver failure(PHLF), there is a need to assess outcomes of CH as a parenchyma-sparing procedure for centrally located liver tumors. Methods: A total of 178 major liver resections performed by specialist surgeons from two Australian tertiary institutions between June 2009 and March 2017 were reviewed. Eleven patients had CH and 24 had EH over this study period. Indications and perioperative outcomes were compared between the groups. Results: The main indication for performing CH was colorectal liver metastases. There was no perioperative mortality in the CH group and four(16.7%) in the EH group( P = 0.285). No group differences were found in median operative time [CH vs. EH: 450 min(290–840) vs. 523 min(310–860), P = 0.328], intraoperative blood loss [850 mL(40 0–150 0) vs. 650 mL(10 0–20 0 0), P = 0.746] or patients requiring intraoperative blood transfusion [1(9.1%) vs. 7(30.4%), P = 0.227]. There was a trend towards fewer hepatectomyspecific complications in the CH group [3(27.3%) vs. 13(54.2%), P = 0.167], including PHLF(CH vs. EH: 0 vs. 29.2%, P = 0.072). Median length of stay was similar between groups [CH vs. EH: 9 days(5–23) vs. 12 days(4–85), P = 0.244]. Conclusions: CH has equivalent postoperative outcomes to EH. There is a trend towards fewer hepatectomy-specific complications, including PHLF. In appropriate patients, CH may be considered as a safe parenchyma-sparing alternative to EH.

关键词： Central hepatectomy Mesohepatectomy Central bisectionectomy Central bisegmentectomy Extended hepatectomy

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Avian evolution and speciation in the Southeast Asian tropics

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Current Zoology 2015年第5期61卷 898-900页

作者： A. Townsend PETERSON robert G. MOYLE Fumin LEI luke C. CAMPILLO Peter A. HOSNER luke B. KLICKA Haw C. LIM Arpad S. NYARI Yanhua QU Sushma REDDY Frederick H. SHELDON FashengZOU Biodiversity Institute University of Kansas Lawrence KS 66045 USA Key Laboratory of Zoological Systematics and Evolution Chinese Academy of Sciences Beijing 100101 China Department of Biology University of Florida Gainesville FL 32611 USA Department of Vertebrate Zoology Smithsonian Institution Washington DC20560 USA Department of Integrative Biology Oklahoma State University Stillwater OK 74078 USA Biology Department Loyola University Chicago Chicago IL 60660 USA Museum of Natural Science and Department of Biological Sciences Louisiana State University Baton Rouge LA 70803 USA Guangdong Entomological Institute Guangzhou 510260 China

An emerging paradigm in analysis of geographic differentiation and speciation is integration of phylogeographic analyses and paleo-distributional projections to gain insight into these complex historical processes （P... 详细信息

关键词：物种形成南亚热带进化鸟类分布预测地理分析形态分析地理分化

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Science to support conservation action in a large river system:The Willamette River,Oregon,USA

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Water Biology and Security 2023年第4期2卷 20-35页

作者： Rebecca Flitcroft luke Whitman James White Rose Wallick Laurel Stratton Garvin Cassandra Smith robert Plotnikoff Michael Mulvey Tobias Kock Krista Jones Peter Gruendike Carolyn Gombert Guillermo Giannico Andrew Dutterer Daniel Brown Hannah Barrett Brian Bangs robert M.Hughes U.S.D.A.Forest Service Pacific Northwest Research Station3200 SW Jefferson WayCorvallisOR97331USA Oregon Department of Fish and Wildlife 28655 OR-34CorvallisOR9733USA U.S.Geological Survey Oregon Water Science Center601 SW 2nd AveSuite 1950PortlandOR97204USA Snohomish County Department of Conservation and Natural Resources 3000 Rockefeller AvenueEverettWA98201USA Oregon Department of Environmental Quality Laboratory and Environmental Assessment Division 7202 NE Evergreen ParkwaySuite 150HillsboroOR97124USA U.S.Geological Survey Western Fisheries Research Center5501A Cook-Underwood RoadCookWashington WA 98605USA River Design Group 311 SW Jefferson AvenueCorvallisOR97333USA Bureau of Reclamation Sedimentation and River Hydraulics GroupDenver Federal CenterDenverCO80225USA Oregon State University Department of FisheriesWildlifeand Conservation SciencesNash 104CorvallisOR97331USA Oregon Watershed Enhancement Board 775 Summer Street NESalemOR97301USA U.S.Fish and Wildlife Service 911 NE 11th AvenuePortlandOR97204USA Amnisopes Institute 2895 SE GlennCorvallisOR97333USA

Management and conservation efforts that support the recovery and protection of large rivers are daunting,reflecting the complexity of the challenge and extent of effort(in terms of policy,economic investment,and spatial extent)needed to afford measurable *** large systems have generally experienced intensive development and regulation,compromising their capacity to respond to disturbances such as climate change ***,large river and basin management require insights gained from social,ecological,geophysical,and hydrological *** multidisciplinary perspective can unveil the integrated relationship between a river network's biotic community and seasonally variableenvironmental conditions that are *** rivers andtheir basins are constantly changing due to anthropogenic influences and as climate modifies patterns of temperature and *** of these factors,the state of knowledge must advance to address changing *** Willamette River,in western Oregon,USA,is a prime example of a basin that has experienced significant degradation and investment in rehabilitation in recent *** science has facilitated development of fine-scale,spatially extensive datasets and models that can generate targeted conservation and rehabilitation actions that are prioritized across the entire river *** prioritization allows investment decisions to be driven by site-specific conditions while simultaneously considering potentials for ecological ***,we review hydrologic,geomorphic,ecologic,and social conditions in the Willamette River basin through time—including pre-settlement,river development,andcontemporary periods—andoffer a futurevisionfor ***,detailed informationaboutfish populations and habitat,hydrologic conditions,geomorphology,water quality,and land use can be leveraged to make informed decisions about protection,rehabilitation,and develop

关键词： Rehabilitation Flood mitigation Hydropower Fish Multidisciplinary

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尿素氮与尿毒症

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山东第一医科大学(山东省医学科学院)学报 1983年第4期 160-160,159页

作者： robert luke 王浩

许多人将血尿素氮(BUN)测定作为肾功能检查的一种方法,以此反映肾小球滤过率(GFR)。但 BUN 的含量不仅与肾脏对尿毒的排泄而且与尿素的生成速度有关。而体内尿素的生成又取决于饮食和内源性蛋白质的分解。即使 GFR 正常,大量的蛋白

关键词：尿毒症肾疾病 BUN GFR

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Using statistics and mathematical modelling to understand infectious disease outbreaks:COVID-19 as an example

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Infectious Disease Modelling 2020年第1期5卷 409-441页

作者： Christopher E.Overton Helena B.Stage Shazaad Ahmad Jacob Curran-Sebastian Paul Dark Rajenki Das Elizabeth Fearon Timothy Felton Martyn Fyles Nick Gent Ian Hall Thomas House Hugo Lewkowicz Xiaoxi Pang Lorenzo Pellis robert Sawko Andrew Ustianowski Bindu Vekaria luke Webb Department of Mathematics University of ManchesterUK IBM Research Hartree CentreSciTech DaresburyUK Department of Global Health and Development London School of Hygiene and Tropical MedicineUK Emergency Response Department Public Health EnglandUK Division of Infection Immunity and Respiratory MedicineNIHR Biomedical Research CentreUniversity of ManchesterUK Department of Virology Manchester Medical Microbiology PartnershipManchester Foundation TrustUK Regional Infectious Diseases Unit North Manchester General HospitalUK School of Medical Sciences University of ManchesterUK Intensive Care Unit Wythenshawe HospitalManchester University NHS Foundation TrustUK Department of Health Sciences University of ManchesterUK Department of Mathematical Sciences University of LiverpoolUK The Alan Turing Institute UK Manchester Academic Health Sciences Centre UK Critical Care Unit Salford Royal HospitalNorthern Care Alliance NHS GroupUK

During an infectious disease outbreak,biases in the data and complexities of the underlying dynamics pose significant challenges in mathematically modelling the outbreak and designing *** by the ongoing response to COVID-19,we provide a toolkit of statistical and mathematical models beyond the simple SIR-type differential equation models for analysing the early stages of an outbreak and assessing *** particular,we focus on parameter estimation in the presence of known biases in the data,and the effect of non-pharmaceutical interventions in enclosed subpopulations,such as households and care *** illustrate these methods by applying them to the COVID-19 pandemic.

关键词： COVID-19 Epidemic modelling Parameter estimation Outbreak Bias Intervention

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Simple DSP Implementation of Maximum Power Pointer Tracking and Inverter Control for Solar Energy Applications

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Journal of Power and Energy Engineering 2016年第9期4卷 61-76页

作者： Woonki Na Thomas Carley luke Ketcham Brendan Zimmer Pengyuan Chen Department of Electrical and Computer Engineering California State University Fresno CA USA Caterpillar Inc. Peoria IL USA robert Bosh Inc. Detroit MI USA

In this paper, a simple Digital Signal Processor (DSP) based Maximum Power Pointer Tracking (MPPT) control and Inverter Control is presented for solar energy applications, especially photovoltaic and wind energy systems. The proposed MPPT controlled boost converter is able to reduce the inrush current and the overshoot of the output voltage of the system. Details of the proposed Maltab-Simulink based MPPT and Inverter Control are shown and implemented using a DSP. The proposed system is analyzed and simulated for verification. To validate the system, a 100 W prototype test-bed is built and tested. The results show that the proposed system can be applicable for solar energy applications.

关键词： DSP MPPT Inverter Solar Energy

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The onset in spring and the end in autumn of the thermal and vegetative growing season affect calving time and reproductive success in reindeer

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Current Zoology 2020年第2期66卷 123-134页

作者： Amelie Paoli robert B.Weladji Фystein Holand Jouko Kumpula Department of Biology Concordia University7141 Sherbrooke Street WestMontrealQCH4B 1R6Canada Department of Animal and Aquacultural Sciences Norwegian University of Life SciencesAsPO Box 5003Norway Natural Resources Institute of Finland(luke) Reindeer Research Station99910Finland

A developing trophic mismatch between the peak of energy demands by reproducing animals and the peak of forage availability has caused many species'reproductive success to *** match-mismatch hypothesis(MMH)is an appealing concept that can be used to assess such fitness ***,concerns have been raised on applying the MMH on capital breeders such as reindeer because the reliance on maternal capita rather than dietary income may mitigate negative effects of changing *** a long-term dataset of reindeer calving dates recorded since 1970 in a semidomesticated reindeer population in Finnish Lapland and proxies of plant phenology;we tested the main hypothesis that the time lag between calving date and the plant phenology in autumn when females store nutrient reserves to finance reproduction would lead to consequences on reproductive success,as the time lag with spring conditions *** predicted,the reproductive success of females of the Kutuharju reindeer population was affected by both the onset of spring green-up and vegetative senescence in autumn as calves were born heavier and with a higher first-summer survival when the onset of the vegetation growth was earlier and the end of the thermal growing season the previous year was earlier as *** results demonstrated that longer plant growing seasons might be detrimental to reindeer's reproductive success if a later end is accompanied by a reduced abundance of mushrooms.

关键词： lagged effect match-mismatch hypothesis plant phenology Rangiter tarandus time lag ungulates

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太空摄影奇人野史大揭秘

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摄影之友 2015年第9期 22-23页

作者： Don Pettit Chris Hadfield Sam Cristoforetti robert luke Lauren Eric Treey Niko

"我们的征途是星辰大海!"人造火箭飞入太空,也带去了人类好奇的心。除了NASA能在官网上频频晒出的各种太空"艳照",还有哪些人也能做到?今天就带大家一起来刨一刨那些为太空拍照的奇趣野史吧!"不务正业"的宇航员们NASA一直用自己的独特... 详细信息

"我们的征途是星辰大海!"人造火箭飞入太空,也带去了人类好奇的心。除了NASA能在官网上频频晒出的各种太空"艳照",还有哪些人也能做到?今天就带大家一起来刨一刨那些为太空拍照的奇趣野史吧!"不务正业"的宇航员们NASA一直用自己的独特身份发布各种太空奇观照片。

关键词：国际空间站地球时超广角镜头小伙伴哈苏 Harrison 航天飞行器尼康气象气球拍摄经验

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Freestanding region-responsive bilayer for functional packaging of ingestible devices

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微系统与纳米工程(英文) 2023年第3期9卷 285-295页

作者： Michael A.Straker Joshua A.Levy Justin M.Stine Vivian Borbash luke A.Beardslee Reza Ghodssi Fischell Department of Bioengineering University of MarylandCollege ParkMD 20742USA Institute for Systems Research University of MarylandCollege ParkMD 20740USA robert E.Fischell Institute for Biomedical Devices University of MarylandCollege ParkMD 20850USA Department of Material Science and Engineering University of MarylandCollege ParkMD 20740USA Department of Electrical and Computer Engineering University of MarylandCollege ParkMD 20742USA

Ingestible capsules have the potential to become an attractive alternative to traditional means of treating and detecting gastrointestinal(GI)*** device complexity increases,so too does the demand for more effective capsule packaging technologies to elegantly target specific GI *** pH-responsive coatings have been traditionally used for the passive targeting of specific GI regions,their application is limited due to the geometric restrictions imposed by standard coating ***,pan,and spray coating methods only enable the protection of microscale unsupported openings against the harsh GI ***,some emerging technologies have millimeter-scale components for performing functions such as sensing and drug *** this end,we present the freestanding region-responsive bilayer(FRRB),a packaging technology for ingestible capsules that can be readily applied for various functional ingestible capsule *** bilayer is composed of rigid polyethylene glycol(PEG)under a flexible pH-responsive Eudragit®FL 30 D 55,which protects the contents of the capsule until it arrives in the targeted intestinal *** FRRB can be fabricated in a multitude of shapes that facilitate various functional packaging mechanisms,some of which are demonstrated *** this paper,we characterize and validate the use of this technology in a simulated intestinal environment,confirming that the FRRB can be tuned for small intestinal *** also show a case example where the FRRB is used to protect and expose a thermomechanical actuator for targeted drug delivery.

关键词： coating packaging attractive

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