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The Impact of a Prior Norwood Procedure on Cardiac Transplantation in Failed Fontan Physiology

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Congenital Heart Disease 2024年第3期19卷 257-266页

作者： Ryan G.mcQueen Nikki m.Singh ronald K.Woods medical College of Wisconsin Herma Heart Institute at Children’s WisconsinMilwaukeeUSA Division of Pediatric Cardiology Medical College of WisconsinHerma Heart Institute at Children’s WisconsinMilwaukeeUSA Division of Pediatric Cardiothoracic Surgery Medical College of WisconsinHerma Heart Institute at Children’s WisconsinMilwaukeeUSA

Objective:The objective of this study was to compare cardiac transplant operative and postoperative courses of patients with failed Fontan physiology who were initially palliated with a Norwood(FFN)to those without a prior Norwood(FF).methods:A single-institution retrospective review of all patients with Fontan failure who under-went cardiac transplantation from 2003–2021 was completed-22 underwent prior Norwood(FFN)and 11 did not(FF).Descriptive and inferential statistics were calculated for operative course and patient ***:The operative course of the FFN cohort appeared to be more complex(not statistically significant,but clinically relevant)-this group exclusively experienced sternal re-entry events(3 of 22 patients)and concomitant neo-aor-tic reconstruction(6 patients),had a longer duration of surgery(median of 682 min vs.575.5 min),more time on circulatory arrest(median of 25.5 min vs.12.5 min),and more frequent use of open sternal management[50%of patients(11/22)vs.27.3%of patients(3/11)].Postoperatively,these patients underwent more mediastinal explora-tions[other than sternal closure;40.9%of patients(9/22)vs.18.2%of patients(2/11)],spent more time on mechanical ventilation(median of 5 days vs.2 days),had a longer length of stay(median of 30 days vs.19 days),and required more catheter-based re-interventions[22.7%of patients(5/22)vs.9.1%of patients(1/11)].Conclu-sion:Although underpowered,our results suggest that the operative course of FFN patients is more challenging,based mostly on neo-aortic arch *** turn,this likely leads to a more complex postoperative *** are currently collaborating with other institutions to increase the cohort size and power of the study.

关键词： Fontan Fontan failure Norwood cardiac transplantation

Design,Synthesis,and Applications of mesoporous Covalent Organic Frameworks

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CCS Chemistry 2024年第1期6卷 57-68页

作者： Niyati Arora Cassandra Flores milinda C.Senarathna Christina m.Thompson ronald A.Smaldone Department of Chemistry and Biochemistry University of TexasDallasRichardsonTexas 75080

Covalent organic frameworks(COFs)are highly ordered and permanently porous organic polymers that can be classified as two-dimensional or *** tunable design and crystalline order endow a range of pore sizes,shapes,functions,and applications that differentiate them from other *** COF pore sizes and shapes rely on the geometry of the monomers and dynamic covalent chemistry,while the stacking of the sheets relies on noncovalent *** tunability allows for post-modification or the incorporation of additional functional groups for the reinforcement by various noncovalent *** limits of mesoporous COFs are still being investigated,with the design rules continuing to *** we report a comprehensive review of mesoporous COFs,explore strategies for large pore reinforcement,highlight structural design and features,elucidate their various functions and applications,discuss fundamental challenges faced that need to be addressed,and predict future directions.

关键词： covalent organic frameworks mesoporous supramolecular chemistry polymers pore size

Tumor necrosis factor-alpha, transforming growth factor-beta, degree of lower urinary tract symptoms as predictors of erectile dysfunction in benign prostatic hyperplasia patients

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Asian Journal of Urology 2024年第2期11卷 280-285页

作者： Gede W.K.Duarsa Yeremia G.Kusumah ronald Sugianto Pande m.W.Tirtayasa Tjokorda G.B.mahadewa Department of Urology Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia Department of General Surgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia medical Doctor Study Program Faculty of MedicineUniversitas UdayanaBaliIndonesia Department of Urology Faculty of MedicineUniversitas UdayanaUniversitas Udayana Teaching HospitalBaliIndonesia Department of Neurosurgery Faculty of MedicineUniversitas UdayanaProf.Dr.I.G.N.G Ngoerah General HospitalBaliIndonesia

Objective: Erectile dysfunction (ED) is a condition of insufficient penile erection, consistently or recurrently, for sexual activity. Tumor necrosis factor-alpha (TNF-α) induces transforming growth factor-beta (TGF-β), which causes the transition of epithelial cells into mesenchymal cells that affect ED. This study aimed to evaluate the roles of TNF-α, TGF-β, degree of lower urinary tract symptoms, and prostatic volume for the presence of ED in benign prostatic hyperplasia (BPH) ***: Our study performed an analytic observational retrospective cohort study using secondary data from four hospitals in Bali, Indonesia, including medical records and other administrative data. The sample was BPH patients with several history ***: Our sample was 83 respondents, ranging from 50 years to 80 years, 61 respondents with ED and 22 with non-ED. The International Prostate Symptom Score showed a significant result, which indicates that ED is more common in patients with higher International Prostate Symptom Score (p=0.002). moreover, the TNF-α of ≥43.9 pg/mg and TGF-β of ≥175.8 pg/mL were significantly associated with the presence of ED in BPH patients (pme is not significant with ED (p=0.947).Conclusion: TNF-α, TGF-β, and lower urinary tract symptoms severity can predict the occurrence of ED in BPH, while prostatic volume was not significant.

关键词： Prostate enlargement Biomarker Erectiledysfunction Riskfactor

Enhancing Pneumonia Detection in Pediatric Chest X-Rays Using CGAN-Augmented Datasets and Lightweight Deep Transfer Learning models

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Journal of Data Analysis and Information Processing 2024年第1期12卷 1-23页

作者： Coulibaly mohamed ronald Waweru mwangi John m. Kihoro Department of mathematics Pan African University Institute for Basic Sciences Technology and Innovation (PAUSTI) Nairobi Kenya Department of Computing Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya School of Computing and mathematics The Cooperative University of Kenya Nairobi Kenya

Pneumonia ranks as a leading cause of mortality, particularly in children aged five and under. Detecting this disease typically requires radiologists to examine chest X-rays and report their findings to physicians, a task susceptible to human error. The application of Deep Transfer Learning (DTL) for the identification of pneumonia through chest X-rays is hindered by a shortage of available images, which has led to less than optimal DTL performance and issues with overfitting. Overfitting is characterized by a model’s learning that is too closely fitted to the training data, reducing its effectiveness on unseen data. The problem of overfitting is especially prevalent in medical image processing due to the high costs and extensive time required for image annotation, as well as the challenge of collecting substantial datasets that also respect patient privacy concerning infectious diseases such as pneumonia. To mitigate these challenges, this paper introduces the use of conditional generative adversarial networks (CGAN) to enrich the pneumonia dataset with 2690 synthesized X-ray images of the minority class, aiming to even out the dataset distribution for improved diagnostic performance. Subsequently, we applied four modified lightweight deep transfer learning models such as Xception, mobileNetV2, mobileNet, and EfficientNetB0. These models have been fine-tuned and evaluated, demonstrating remarkable detection accuracies of 99.26%, 98.23%, 97.06%, and 94.55%, respectively, across fifty epochs. The experimental results validate that the models we have proposed achieve high detection accuracy rates, with the best model reaching up to 99.26% effectiveness, outperforming other models in the diagnosis of pneumonia from X-ray images.

关键词： Pneumonia Detection Pediatric Radiology CGAN (Conditional Generative Adversarial Networks) Deep Transfer Learning medical Image Analysis

Storylines of family medicine Ⅳ:perspectives on practice—lenses of appreciation

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Family medicine and Community Health 2024年第S3期12卷 33-42页

作者： William B Ventres Leslie A Stone Radeeb Akhtar Jeffrey m Ring Lucy m Candib Erick messias ronald m Epstein marc Tunzi Amy L Lee Christopher P morley Carina m Brown David Slawson Jill Konkin David G Campbell Ian Couper Susan Williams Robert Brooks Lucie Walters Family and Preventive medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family medicine and Community Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Independent Health Psychologist Los AngelesCaliforniaUSA Family medicine and Community Health UMass Chan Medical SchoolWorcesterMassachusettsUSA Psychiatry and Behavioral Neurosciences Saint Louis University School of MedicineSaint LouisMissouriUSA Family medicine University of Rochester Medical CenterRochesterNew YorkUSA Family medicine Residency Program Natividad Medical CenterSalinasCaliforniaUSA Family medicine Tufts University School of MedicineBostonMassachusettsUSA Public Health and Preventive medicine SUNY Upstate Medical UniversitySyracuseNew YorkUSA Cone Health Family medicine Residency The University of North Carolina School of MedicineGreensboroNorth CarolinaUSA Family medicine Atrium HealthCharlotteNorth CarolinaUSA Family medicine University of Alberta Faculty of Medicine&DentistryEdmontonAlbertaCanada Cunninghame Arm medical Centre Australian College of Rural and Remote MedicineLakes EntranceQueenslandAustralia Ukwanda Centre for Rural Health Stellenbosch University Faculty of Medicine and Health SciencesCape TownWestern CapeSouth Africa Adelaide Rural Clinical School The University of AdelaideAdelaideSouth AustraliaAustralia Department of Rural Health Broken Hill UniversityBroken HillNew South WalesAustralia Adelaide Rural Clinical School The University of Adelaide Faculty of Health and Medical SciencesMount GambierSouth AustraliaAustralia

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 ***‘Ⅳ:perspectives on practice—lenses of appreciation’,authors address the following themes:‘Relational connections in the doctor–patient partnership’,‘Feminism and family medicine’,‘Positive family medicine’,‘mindful practice’,‘The new,old ethics of family medicine’,‘Public health,prevention and populations’,‘Information mastery in family medicine’and‘Clinical courage.’may readers nurture their curiosity through these essays.

关键词： thematic illustration doctor

代谢综合征的诊断和治疗——美国心脏协会/国立心肺血液研究所指南概要

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世界核心医学期刊文摘（心脏病学分册） 2006年第4期2卷 8-11页

作者： Scott m. Grundy James I. Cleeman Stephen R. Daniels Karen A. Donato Robert H. Eckel Barry A.Franklin David J. Gordon ronald m. krauss Peter J. Savage Sidney C. Smith John A. Spertus Fernando Costa

0引言近几年,代谢综合征越来越受到人们的关注.它包括了可能直接促进动脉粥样硬化性心血管疾病(ASCVD)的多种相关代谢性危险因素.这些代谢性危险因素与2型糖尿病及其风险具有强相关性.这些代谢性危险因素包括致粥样硬化性血脂异常(甘油... 详细信息

0引言近几年,代谢综合征越来越受到人们的关注.它包括了可能直接促进动脉粥样硬化性心血管疾病(ASCVD)的多种相关代谢性危险因素.这些代谢性危险因素与2型糖尿病及其风险具有强相关性.这些代谢性危险因素包括致粥样硬化性血脂异常(甘油三酯、载脂蛋白B及小LDL颗粒升高,HDL-C浓度降低)、血压升高、血糖升高以及血栓前状态、前炎性状态.

关键词：代谢综合征美国心脏协会动脉粥样硬化性心血管疾病血液研究所血栓前状态概要指南心肺治疗诊断

Why ecosystem characteristics predicted from remotely sensed data are unbiased and biased at the same time-and how this affects applications

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Forest Ecosystems 2024年第1期11卷 24-31页

作者： Goran Ståhl Terje Gobakken Svetlana Saarela Henrik J.Persson magnus Ekstrom Sean P.Healey Zhiqiang Yang Johan Holmgren Eva Lindberg Kenneth Nystrom Emanuele Papucci Patrik Ulvdal Hans OleØrka Erik Næsset Zhengyang Hou Håkan Olsson ronald E.mcRoberts Department of Forest Resource management Swedish University of Agricultural Sciences90183UmeåSweden Faculty of Environmental Sciences and Natural Resource management Norwegian University of Life SciencesÅsNorway USDA Forest Service Rocky Mountain Research StationOgdenUTUSA The Key Laboratory for Silviculture and Conservation of ministry of Education Beijing Forestry UniversityBeijing100083China Department of Forest Resources University of MinnesotaSt.PaulMNUSA

Remotely sensed data are frequently used for predicting and mapping ecosystem characteristics,and spatially explicit wall-to-wall information is sometimes proposed as the best possible source of information for ***,wall-to-wall information typically relies on model-based prediction,and several features of model-based prediction should be understood before extensively relying on this type of *** such feature is that model-based predictors can be considered both unbiased and biased at the same time,which has important implications in several areas of *** this discussion paper,we first describe the conventional model-unbiasedness paradigm that underpins most prediction techniques using remotely sensed(or other)auxiliary *** this point of view,model-based predictors are typically ***,we show that for specific domains,identified based on their true values,the same model-based predictors can be considered biased,and sometimes severely *** suggest distinguishing between conventional model-bias,defined in the statistical literature as the difference between the expected value of a predictor and the expected value of the quantity being predicted,and design-bias of model-based estimators,defined as the difference between the expected value of a model-based estimator and the true value of the quantity being *** show that model-based estimators(or predictors)are typically design-biased,and that there is a trend in the design-bias from overestimating small true values to underestimating large true ***,we give examples of applications where this is important to acknowledge and to potentially make adjustments to correct for the design-bias *** argue that relying entirely on conventional model-unbiasedness may lead to mistakes in several areas of application that use predictions from remotely sensed data.

关键词： Bias model-based inference Design-based inference

Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation:a multi-institutional,retrospective study

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Stroke & Vascular Neurology 2024年第3期9卷 221-229,I0130,I0131页

作者： Chloe Dumot Georgios mantziaris Sam Dayawansa Zhiyuan Xu Stylianos Pikis Selcuk Peker Yavuz Samanci Gokce D Ardor Ahmed m Nabeel Wael A Reda Sameh R Tawadros Khaled Abdelkarim Amr m N El-Shehaby Reem m Emad Eldin Ahmed H Elazzazi Nuria martínez moreno Roberto martínezÁlvarez Roman Liscak Jaromir may David mathieu Jean-Nicolas Tourigny manjul Tripathi Akshay Rajput Narendra Kumar Rupinder Kaur Piero Picozzi Andrea Franzini Herwin Speckter Wenceslao Hernandez Anderson Brito ronald E Warnick Juan Alzate Douglas Kondziolka Greg N Bowden Samir Patel Jason Sheehan Department of Neurological Surgery Hospices Civils de LyonLyonFrance Department of Neurological Surgery University of VirginiaCharlottesvilleVirginiaUSA Department of Neurosurgery Koc University School of MedicineIstanbulTurkey Gamma-knife Center Nasser institute HospitalCairoEgypt Neurosurgery Department Benha UniversityBenhaEgypt Departments of Neurosurgery Ain Shams UniversityCairoEgypt Department of Clinical Oncology Ain Shams UniversityCairoEgypt Department of Radiation Oncology National Cancer InstituteCairo UniversityGizaEgypt Faculty of medicine Extended Modular ProgramAin Shams UniversityCairoEgypt Department of Radiosurgery Rúber Internacional HospitalMadridSpain Department of Stereotactic and Radiation Neurosurgery Na Homolce HospitalPragueCzech Republic Neurosurgery Centre de recherche du CHUSUniversitéde SherbrookeSherbrookeQuebecCanada Neurosurgery PGIMERChandigarhChandigarhIndia Radiation Therapy PGIMERChandigarhChandigarhIndia Neurosurgery IRCCS Istituto Clinico HumanitasRozzanoMilanItaly Dominican Gamma Knife Center and Radiology Department CEDIMATSanto DomingoDominican Republic Gamma Knife Center Mayfield ClinicThe Jewish Hospital-Mercy HealthCincinnatiOhioUSA Neurosurgery NYU Langone HealthNew YorkNew YorkUSA Neurosurgery University of AlbertaEdmontonAlbertaCanada Division of Radiation Oncology Department of OncologyUniversity of AlbertaEdmontonAlbertaCanada

Background Cerebral cavernous malformations(CCms)frequently manifest with *** radiosurgery(SRS)has been employed for CCm not suitable for *** effect on reducing haemorrhage risk is still *** aim of this study was to expand on the safety and efficacy of SRS for haemorrhagic *** This retrospective multicentric study included CCm with at least one haemorrhage treated with single-session *** annual haemorrhagic rate(AHR)was calculated before and after *** event analysis and Cox regression were used to evaluate factors associated with *** radiation effects(AREs)and occurrence of new neurological deficits were *** The study included 381 patients (median age:37.5 years(Q1–Q3:25.8–51.9))with 414 *** AHR from diagnosis to SRS excluding the first haemorrhage was 11.08 per 100 CCm-years and was reduced to 2.7 per 100 CCm-years after *** recurrent event analysis,SRS,HR 0.27(95%CI 0.17 to 0.44),pmorrhage,and the presence of developmental venous anomaly(DVA)with an increased risk,HR 1.60(95%CI 1.07 to 2.40),p=*** cumulative risk of first haemorrhage after SRS was 9.4%(95%CI 6%to 12.6%)at 5 years and 15.6%(95%CI%9 to 21.8%)at 10 *** doses>13 Gy,HR 2.27(95%CI 1.20 to 4.32),p=0.012 and the presence of DVA,HR 2.08(95%CI 1.00 to 4.31),p=0.049 were factors associated with higher probability of post-SRS ***-SRS haemorrhage was symptomatic in 22 out of 381(5.8%)patients,presenting with transient(15/381)or permanent(7/381)neurological *** occurred in 11.1%(46/414)CCm and was responsible for transient neurological deficit in 3.9%(15/381)of the patients and permanent deficit in 1.1%(4/381)of the *** doses>13 Gy and CCm volume>0.7 cc were associated with increased risk of ARE.

关键词： doses haemorrhagic diagnosis

Effects of grassland management, endophytic fungi and predators on aphid abundance in two distinct regions

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Journal of Plant Ecology 2014年第5期7卷 490-498页

作者： Carmen Börschig Alexandra-m.Klein Jochen krauss Agroecology Department of Crop SciencesUniversity of GöttingenGrisebachstrasse 6D-37075 GöttingenGermany Ecosystem Functions Institute of EcologyUniversity of LüneburgScharnhorstrasse 1D-21335 LüneburgGermany Nature Conservation and Landscape Ecology Institute of Earth and Environmental SciencesUniversity of FreiburgTennenbacherstr.4D-79106 FreiburgGermany Department of Animal Ecology and Tropical Biology University of WürzburgBiocentreAm HublandD-97074 WürzburgGermany

Aims Fungal endophytes of cool-season grass species produce alkaloids toxic to herbivores,affecting food webs in agricultural and natural *** studies about the effects of endophytes on herbi-vores are rare and show contradictory results,leading to uncertain conclusions about the nature of endophyte-grass *** asked whether the environmental contexts of local and regional scales and predation could modify the effects of endophytes on *** In a full factorial field experiment,we quantified the abundance of the aphid species Rhopalosiphum padi on the potted host grass Lolium perenne,which was either infected or uninfected with the endophytic fungus Neotyphodium *** were either excluded or had free access to the pots with the *** hun-dred and sixty grass pots were located in two regions on altogether 40 grassland sites,half of the sites intensively and half extensively *** tested the importance of endophyte infection,study region,management intensity of grasslands,predation and all two-way interactions on aphid *** Findings Endophyte infection reduced aphid abundance significantly in one study region *** both regions,we found that the impacts of aphidophagous predators and grassland management intensity on aphid abundance were substantially stronger and more consistent than that of endophytes on aphid *** excluding preda-tors and pots placed on extensive grasslands contained higher aphid *** impact of predators and management on aphid abundance were not modified by the *** conclude that the effect of endophytes on herbivores can be weak in field experi-ments and depends on environmental context at a regional ***,more field research efforts are necessary to detect the rela-tive importance of endophytes and the environmental context on biotic interactions in ecosystems.

关键词： bottom-up control microorganism multi-trophic interaction predator exclosure top-down control