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Advances in alcoholic liver disease:An update on alcoholic hepatitis

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World Journal of Gastroenterology 2015年第42期21卷 11893-11903页

作者： Randy Liang Andy Liu ryan b Perumpail Robert J Wong Aijaz Ahmed Department of Medicine Santa Clara Valley Medical Center Albert Einstein College of Medicine Division of Gastroenterology and Hepatology Stanford University School of Medicine Division of Gastroenterology and Hepatology Alameda Health System-Highland Hospital Campus

Alcoholic hepatitis is a pro-inflammatory chronic liver disease that is associated with high short-term morbidity and mortality(25%-35% in one month) in the setting of chronic alcohol use. Histopathology is notable for micro- and macrovesicular steatosis, acute inflammation with neutrophil infiltration, hepatocellular necrosis, perivenular and perisinusoidal fibrosis, and Mallory hyaline bodies found in ballooned hepatocytes. Other findings include the characteristic eosinophilic fibrillar material(Mallory's hyaline bodies) found in ballooned hepatocytes. The presence of focal intense lobular infiltration of neutrophils is what typically distinguishes alcoholic hepatitis from other forms of hepatitis, in which the inflammatory infiltrate is primarily composed of mononuclear cells. Management consists of a multidisciplinary approach including alcohol cessation, fluid and electrolyte correction, treatment of alcohol withdrawal, and pharmacological therapy based on the severity of the disease. Pharmacological treatment for severe alcoholic hepatitis, as defined by Maddrey's discriminant factor ≥ 32, consists of either prednisolone or pentoxifylline for a period of four weeks. The body of evidence for corticosteroids has been greater than pentoxifylline, although there are higher risks of complications. Recently head-to-head trials between corticosteroids and pentoxifylline have been performed, which again suggests that corticosteroids should strongly be considered over pentoxifylline.

关键词： Alcoholic Hepatitis Maddrey discriminant function

KEEPIN'IT KIMCHI A Journey Through Guangzhou’s Little Korea

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城市漫步（GbA版） 2018年第12期 50-51页

作者： ryan Gandolfo 不详

As a district baiyun is full of *** the area directly north of Yuexiu may not be celebrated for its proximity to Cantons F&b hotspots,you'd be wrong to say the district lacks good *** is one particular spot in baiyun ... 详细信息

关键词： district lights proximity

Like mother, like daughter： heritability of female Richardson＇s ground squirrel Urocitellus richardsonii cortisol stress responses

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Current Zoology 2018年第2期64卷 153-163页

作者： Kevin R. bAIROS-NOVAK Calen R ryan Angela R. FREEMAN W. Gary ANDERSON James F, HARE Department of biological Sciences University of Manitoba Winnipeg Manitoba R3T 2N2 Canada Departmentof biology University of Saskatchewan Saskatoon S7N 5E2 Saskatchewan Canada Department ofAnthropology Northwestern University Evanston 60208 Illinois USA Department of biological Sciences Kent State University Kent 44242 Ohio USA

Activation of the hypothalamic-pituitary-adrenal （HPA） axis liberates glucocorticoids, which provides an acute indication of an individual＇s response to stressors. The heritability of the stress response in wild mammals, however, remains poorly documented. We quantified the cortisol stress response of female Richardson＇s ground squirrels （RGSs） to handling and physical restraint, testing for：（1） the effects of individual age, time of day, and sample latency; （2） repeatability within individuals; （3） narrow-sense heritability; and （4） differences among individuals owing to potential genetic and/or environmental effects. We detected a positive linear relationship between baseline plasma cortisol （bL-cortisol） concentration and stress-induced plasma cortisol （Sl-cortisol） concentration that defined each individual＇s cortisol stress response. bL-cortisol, SI-cortisol, and stress response did not differ according to the time the sample was taken, or by subject age. Cortisol stress response was highly repeatable within individuals, had a mother-offspring heritability of h2 =0.40 ± 0.24 （mean ±SE）, full-sibling heritability of h2s = 0.37 ± 0.71, and half-sibling heritabil- ity of hHS^2 = 0.75 ± 1.41. Stress responses of sibling groups, immediate-family groups, and squir- rels within a given area did not differ, whereas those of individuals from more distantly related matrilines did. Our results highlight the natural variability in HPA axis reactivity among individuals by quantifying both bL- and SI-cortisol levels, demonstrate partial heritability of the stress response that is not attributable to environmental variation, and suggest that at least part of an indi- vidual＇s stress response can be accounted for by differences in matrilineal history.

关键词： glucocorticoids ground squirrel heritability hypothalamic-pituitary-adrenal axis reactivity stress response.

Rapid,high-resolution detection of environmental change over continental scales from satellite data–the Earth Observation Data Cube

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International Journal of Digital Earth 2016年第1期9卷 106-111页

作者： Adam Lewis Leo Lymburner Matthew b.J.Purss brendan brooke ben Evans Alex Ip Arnold G.Dekker James R.Irons Stuart Minchin Norman Mueller Simon Oliver Dale Roberts barbara ryan Medhavy Thankappan Rob Woodcock Lesley Wyborn Geoscience Australia CanberraAustralia National Computational Infrastructure Australian National UniversityCanberraAustralia Commonwealth Scientific and Industrial Research Organisation CanberraAustralia NASA Goddard Space Flight Center GreenbeltMDUSA Research School of Finance Actuarial Studies and Applied StatisticsANUCanberraAustralia The Group on Earth Observations Secretariate GenevaSwitzerland

The effort and cost required to convert satellite Earth Observation(EO)data into meaningful geophysical variables has prevented the systematic analysis of all available *** overcome these problems,we utilise an integrated High Performance Computing and Data environment to rapidly process,restructure and analyse the Australian Landsat data *** this approach,the EO data are assigned to a common grid framework that spans the full geospatial and temporal extent of the observations–the EO Data *** approach is pixel-based and incorporates geometric and spectral calibration and quality assurance of each Earth surface reflectance *** demonstrate the utility of the approach with rapid time-series mapping of surface water across the entire Australian continent using 27 years of continuous,25 m resolution *** preliminary analysis of the Landsat archive shows how the EO Data Cube can effectively liberate high-resolution EO data from their complex sensor-specific data structures and revolutionise our ability to measure environmental change.

关键词： Earth Observation Data Cube HPD HPC surface water Landsat Australia

Gridded 20-year climate parameterization of Africa and South America for a stochastic weather generator (CLIGEN)

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big Earth Data 2023年第2期7卷 349-374页

作者： Andrew Fullhart Guillermo E.Ponce-Campos Menberu b.Meles ryan P.McGehee Gerardo Armendariz Paulo Tarso S.Oliveira Cristiano Das Neves Almeida José C.de Araújo Werner Nel David C.Goodrich Southwest Watershed Research Center USDA-ARS TucsonAZUSA School of Natural Resources and the Environment University of ArizonaTucsonAZUSA Sustainable Agricultural Water Systems Unit USDA-ARS DavisCAUSA Agricultural and biological Engineering Purdue UniversityWest LafayetteINUSA Faculty of Engineering Architecture and Urbanism and GeographyFederal University of Mato Grosso do Sul(UFMS)Campo GrandeMSBrazil Water Resources and Environmental Engineering Laboratory Federal University of ParaíbaJoao PessoaPBBrazil Federal University of Fortaleza Department of Agricultural EngineeringFortalezaBrazil Department of Geography and Environmental Science University of Fort HareAliceSouth Africa

CLIGEN is a stochastic weather generator that creates statistically representative timeseries of daily and sub-daily point-scale weather variables from observed monthly statistics and other parameters. CLIGEN precipitation timeseries are used as climate input for various risk-assessment modelling applications as an alternative to observe long-term, high temporal resolution records. Here, we queried gridded global climate datasets (TerraClimate, ERA5, GPM-IMERG, and GLDAS) to estimate various 20-year climate statistics and obtain complete CLIGEN input parameter sets with coverage of the African and South American continents at 0.25 arc degree resolution. The estimation of CLIGEN precipitation parameters was informed by a ground-based dataset of >10,000 locations worldwide. The ground observations provided target values to fit regression models that downscale CLIGEN precipitation input parameters. Aside from precipitation parameters, CLIGEN’s parameters for temperature, solar radiation, etc. were in most cases directly calculated according to the original global datasets. Cross-validation for estimated precipitation parameters quantified errors that resulted from applying the estimation approach in a predictive fashion. based on all training data, the RMSE was 2.23 mm for the estimated monthly average single-event accumulation and 4.70 mm/hr for monthly maximum 30-min intensity. This dataset facilitates exploration of hydrological and soil erosional hypotheses across Africa and South America.

关键词： Climate CLIGEN Africa South America

Use of the O-Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 355-360页

作者： Austin C.Cao ryan M.Carey Mitali Shah Kevin Chorath Robert M.brody Steven b.Cannady Jason G.Newman Rabie M.Shanti Karthik Rajasekaran Perelman School of Medicine University of PennsylvaniaPhiladelphia19104PA Department of Otorhinolaryngology-Head and Neck Surgery University of PennsylvaniaPhiladelphia19104PA Drexel University College of Medicine Drexel UniversityPhiladelphia19102PA Department of Oral and Maxillofacial Surgery University of PennsylvaniaPhiladelphia19104PA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPA

Objective:The reconstruction of large scalp defects poses both functional and cosmetic *** free tissue transfer remains the standard for defects larger than 30 cm^(2),prolonged anesthesia and postoperative complications remain significant *** purpose of this study is to evaluate the use of O-Z flaps for the reconstruction of large scalp defects and to describe the techniques ***:This is a retrospective analysis of ten patients who underwent reconstructive surgery using an O-Z flap approach for large scalp defects between July 2017 and June *** parameters included in this study were patient demographics,tumor characteristics,and postoperative management,collected for at least a year after ***:In this cohort,the mean age was 76.1 years and 90%were *** patients were treated for neoplastic skin lesions,with 70%located on the vertex and 30%located on the temporoparietal *** mean size of defect was 52.0 cm^(2)(range:38.6 to 63.8 cm^(2)).The maximum hospital stay was two days,and no patients were readmitted within 30 days of *** were no cases of wound infection or flap *** patients reported pain control with acetaminophen and *** patients received adjuvant radiation,and there was no delay to receiving treatment following ***:The O-Z flap is a reliable alternative for the reconstruction of non-irradiated scalp defects in the vertex and temporoparietal regions up to 63 cm^(2).This technique provides advantages for patients,including hairline preservation,shorter hospital stays,and decreased postoperative complications.

关键词： Scalp reconstruction Local flaps Free flap reconstruction Facial plastics Microvascular surgery Head and neck cancer

Update on hepatitis C: Direct-acting antivirals

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World Journal of Hepatology 2015年第28期7卷 2829-2833页

作者： Leon L Seifert ryan b Perumpail Aijaz Ahmed Department of Transplantation Medicine University Hospital Münster Division of Gastroenterology and Hepatology Stanford University School of Medicine

Hepatitis C virus(HCV) was discovered 26 years ago. For decades, interferon-based therapy has been the mainstay of treatment for HCV. Recently, several direct-acting antivirals(DAAs) have been approved for treatment of HCV-infected patients and to help combat the virus. These drugs have revolutionized the management of HCV as all-oral regimens with favorable side effect profiles and superior rates of sustained virological response. Emerging real-world data are demonstrating results comparable to registration trials for DAA agents. Suddenly, the potential for eradicating HCV is on the horizon.

关键词： Hepatitis C virus Direct-acting antivirals Sustained virologic response Management Treatment

Rising Rate of Liver Transplantation in the baby boomer Generation with Non-alcoholic Steatohepatitis in the United States

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Journal of Clinical and Translational Hepatology 2017年第3期5卷 193-196页

作者： Osama Siddique Mairin Joseph-Talreja Eric R.Yoo ryan b.Perumpail George Cholankeril Stephen A.Harrison Zobair M.Younossi Robert J.Wong Aijaz Ahmed Department of Medicine Memorial Hospital of Rhode Island/Alpert Medical School of Brown University Providence RI USA Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford CA USA Department of Medicine University of Illinois College of Medicine Chicago IL USA Division of Gastroenterology and Hepatology University of Tennessee Health Sciences Center Memphis TN USA Radcliffe Department of Medicine University of Oxford Oxford United Kingdom Department of Medicine Center for Liver DiseasesInova Fairfax HospitalFalls ChurchVAUSA Division of Gastroenterology and Hepatology Alameda Health SystemHighland HospitalOaklandCAUSA

background and Aims:Nonalcoholic steatohepatitis (NASH) is the most rapidly growing indication for liver transplantation (LT) in the United States and is on a trajectory to become the leading indication for LT in the next *** aimed to study the trends in NASH-related LT among persons born between 1945 and 1965,the baby boomer (bb) ***:We performed a retrospective cohort analysis using population-based data from the United Network for Organ Sharing/Organ Procurement and Transplantation Network registry from 2004-2015 to evaluate the birth cohort-specific trends in liver transplant waitlist registrations and liver transplant surgeries in patients with *** stratified our study population into three birth cohorts:1) birth before 1945,2) birth between 1945 and 1965,and 3) birth after ***:The overall rates of NASH-related waitlist registrations and liver transplant surgeries steadily increased from 2004 to 2015 and were reflective of a sharp rise noted in the NASH bb *** 2004 to 2015,the proportion of bb patients with NASH added to LT waitlist demonstrated an incremental growth,60.6% in 2004 versus 83.2% in 2015 (p by the bb cohort increased from 56.3% in 2004 to 80.0% in 2015 (p bb sub-cohort was mainly responsible for these alarming trends.

关键词： baby boomers Liver transplantation Non-alcoholic steatohepatitis Waitlist

Canadian children’s and youth’s adherence to the 24-h movement guidelines during the COVID-19 pandemic: A decision tree analysis

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Journal of Sport and Health Science 2020年第4期9卷 313-321页

作者： Michelle D.Guerrero Leigh M.Vanderloo ryan E.Rhodes Guy Faulkner Sarah A.Moore Mark S.Tremblay Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada ParticipACTION TorontoON M5S 1M2Canada Child Health and Evaluative Sciences Hospital for Sick ChildrenTorontoON M5G 0A4Canada behavioral Medicine Laboratory School of Exercise SciencePhysical and Health EducationUniversity of VictoriaVictoriaBC V8W 2Y2Canada School of Kinesiology University of British ColumbiaVancouverBC V6T 1Z1Canada Department of Therapeutic Recreation Faculty of ChildFamilyand Community StudiesDouglas CollegeCoquitlamBC V3B 7X3Canada School of Health and Human Performance Dalhousie UniversityHalifaxNS B3H 4R2Canada Department of Pediatrics University of OttawaOttawaON K1H 8L1Canada

Purpose:The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more and less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease-2019(COVID-19)***:Data for this study were from a nationally representative sample of 1472 Canadian parents(Meanage=45.12,SD=7.55)of children(511 years old)or youth(1217 years old).Data were collected in April 2020 via an online *** items assessed demographic,behavioral,social,micro-environmental,and macro-environmental *** decision trees of adherence and non-adherence to all movement recommendations combined and each individual movement recommendation(physical activity(PA),screen time,and sleep)were ***:Results revealed specific combinations of adherence and non-adherence *** associated with adherence to the recommendation(s)included high parental perceived capability to restrict screen time,annual household income ofCAD 100,000,increases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,being a boy,having parents younger than 43 years old,and small increases in children’s and youth’s sleep duration since the COVID-19 outbreak *** associated with non-adherence to the recommendation(s)included low parental perceived capability to restrict screen time,youth aged 1217 years,decreases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,primary residences located in all provinces except Quebec,low parental perceived capability to support children’s and youth’s sleep and PA,and annual household income ofCAD 99,***:Our results show that specific characteristics interact to contribute to(non)adherence to the movement behavior *** highlight the importance of targeting parents’perceived capability for the promotion of children’s and youth’s movement behaviors during challengin

关键词： Decision tree analysis Parental perceived capability Physical activity Screen time Sleep