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Hepatic grooves:An observational study at laparoscopic surgery

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World Journal of Experimental Medicine 2024年第2期14卷 97-102页

作者： Shamir O Cawich Dexter A Thomas Fawwaz Mohammed Michael T Gardner Marlene Craigie shaneeta johnson Ramnanand S Kedambady Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Port of Spain General HospitalPort of Spain 000000Trinidad and Tobago Section of Anatomy Basic Medical SciencesUniversity of the West IndiesKingston 000000Jamaica Department of Radiology University of the West IndiesKingston 000000Jamaica Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Section of Anatomy Department of Basic Medical SciencesUniversity of the West IndiesKingston KIN7Jamaica

BACKGROUND In traditional descriptions,the upper surface of the liver is smooth and convex,but deep depressions are variants that are present in 5%-40%of *** sought to determine the relationship between surface depressions and the *** To use exploratory laparoscopy to determine the relationship between surface depressions and the *** An observational study was performed in all patients undergoing laparoscopic upper gastro-intestinal operations between January 1,2023 and January 20,2024.A thirty-degree laparoscope was used to inspect the liver and *** surface depressions were present,we recorded patient demographics,presence of diaphragmatic bands,rib protrusions and/or any other source of compression during *** Of 394 patients,343 had normal surface anatomy,and 51(12.9%)had prominent surface depressions on the *** was no significant relationship between the presence of surface depressions and gender nor the presence of rib ***,there was significant association between the presence of surface depressions and diaphragmatic muscular bands(P<0.001).CONCLUSION With these data,the diaphragmatic-band theory has gained increased importance over other theories for surface *** studies are warranted using cross sectional imaging to confirm relationships with intersectional planes as well as beta-catenin assays in the affected liver parenchyma.

关键词： Liver Variant Vein Hepatic Surgery

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon Parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W Pearce Wesley Francis shaneeta johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy

Comparison of a Spectral Bin and Two Multi-Moment Bulk Microphysics Schemes for Supercell Simulation:Investigation into Key Processes Responsible for Hydrometeor Distributions and Precipitation

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Advances in Atmospheric Sciences 2024年第5期41卷 784-800页

作者： Marcus johnson Ming XUE Youngsun JUNG Center for Analysis and Prediction of Storms University of OklahomaNormanOK 73072USA School of Meteorology University of OklahomaNormanOK 73072USA Office of Science and Technology Integration National Weather ServiceSilver SpringMD 20910USA

There are more uncertainties with ice hydrometeor representations and related processes than liquid hydrometeors within microphysics parameterization(MP)schemes because of their complicated geometries and physical *** supercell simulations are produced using the WRF model coupled with“full”Hebrew University spectral bin MP(HU-SBM),and NSSL and Thompson bulk MP(BMP)***-SBM downdrafts are typically weaker than those of the NSSL and Thompson simulations,accompanied by less rain ***-SBM produces more cloud ice(plates),graupel,and hail than the BMPs,yet precipitates less at the *** limiting mass bins(and subsequently,particle size)of rimed ice in HU-SBM and slower rimed ice fall speeds lead to smaller melting-level net rimed ice fluxes than those of the *** from plates in HU-SBM,together with snow–graupel collisions,leads to a greater snow contribution to rain than those of the *** HU-SBM’s fall speeds using the formulations of the BMPs after aggregating the discrete bin values to mass mixing ratios and total number concentrations increases net rain and rimed ice ***,they are smaller in magnitude than bulk rain,NSSL hail,and Thompson graupel net fluxes near the ***,the melting-layer net rimed ice fluxes are reduced when the fall speeds for the NSSL and Thompson simulations are calculated using HU-SBM fall speed formulations after discretizing the bulk particle size distributions(PSDs)into spectral *** results highlight precipitation sensitivity to storm dynamics,fall speed,hydrometeor evolution governed by process rates,and MP PSD design.

关键词： precipitation spectral bin microphysics bulk microphysics parameterization microphysics processes WRF model supercell storm

Integrins and their potential roles in mammalian pregnancy

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Journal of Animal Science and Biotechnology 2024年第1期15卷 1-19页

作者： Gregory A.johnson Robert C.Burghardt Fuller W.Bazer Heewon Seo Joe W.Cain Department of Veterinary Integrative Biosciences School of Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTX 77843‑4459USA Department of Animal Science College of Agriculture and Life SciencesTexas A&M UniversityCollege StationTX 77843‑2471USA

Integrins are a highly complex family of receptors that, when expressed on the surface of cells, can mediate reciprocal cell-to-cell and cell-to-extracellular matrix(ECM) interactions leading to assembly of integrin adhesion complexes(IACs) that initiate many signaling functions both at the membrane and deeper within the cytoplasm to coordinate processes including cell adhesion, migration, proliferation, survival, differentiation, and metabolism. All metazoan organisms possess integrins, and it is generally agreed that integrins were associated with the evolution of multicellularity, being essential for the association of cells with their neighbors and surroundings, during embryonic development and many aspects of cellular and molecular biology. Integrins have important roles in many aspects of embryonic development, normal physiology, and disease processes with a multitude of functions discovered and elucidated for integrins that directly influence many areas of biology and medicine, including mammalian pregnancy, in particular implantation of the blastocyst to the uterine wall, subsequent placentation and conceptus(embryo/fetus and associated placental membranes) development. This review provides a succinct overview of integrin structure, ligand binding, and signaling followed with a concise overview of embryonic development, implantation, and early placentation in pigs, sheep, humans, and mice as an example for rodents. A brief timeline of the initial localization of integrin subunits to the uterine luminal epithelium(LE) and conceptus trophoblast is then presented, followed by sequential summaries of integrin expression and function during gestation in pigs, sheep, humans, and rodents. As appropriate for this journal, summaries of integrin expression and function during gestation in pigs and sheep are in depth, whereas summaries for humans and rodents are brief. Because similar models to those illustrated in Fig. 1, 2, 3, 4, 5 and 6 are present throughout the sc

关键词： Humans Implantation Integrins Pigs Pregnancy Rodents Sheep

Antimicrobial stewardship and targeted therapies in the changing landscape of maternal sepsis

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Journal of Intensive Medicine 2024年第1期4卷 46-61页

作者： Nishel M Shah Esmita Charani Damien Ming Fook-Choe Cheah Mark R johnson Department of Metabolism Digestion and ReproductionImperial College LondonChelsea and Westminster HospitalLondonUK Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance Imperial College LondonLondonUK Division of Infectious Diseases and HIV Medicine Department of MedicineGroote Schuur HospitalUniversity of Cape TownCape TownSouth Africa Department of Infectious Diseases Imperial College LondonChelsea and Westminster HospitalLondonUK Department of Paediatrics Faculty of MedicineUniversiti Kebangsaan Malaysia Medical CentreKuala LumpurMalaysia

Pregnant and postnatal women are a high-risk population particularly prone to rapid progression to sepsis with significant morbidity and mortality ***,severe maternal infections can have a serious detrimental impact on neonates with almost 1 million neonatal deaths annually attributed to maternal infection or *** this review we discuss the susceptibility of pregnant women and their specific physiological and immunological adaptations that contribute to their vulnerability to sepsis,the implications for the neonate,as well as the issues with antimicrobial stewardship and the challenges this poses when attempting to reach a balance between clinical care and urgent ***,we review advancements in the development of pregnancy-specific diagnostic and therapeutic approaches and how these can be used to optimize the care of pregnant women and neonates.

关键词： Sepsis Pregnancy Immunology Cardiovascular Personalised medicine Antibiotic stewardship

Generation of millijoule-level sub-5 fs violet laser pulses

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High Power Laser Science and Engineering 2024年第2期12卷 33-40页

作者： Xinhua Xie Yi Hung Yunpei Deng Adrian L.Cavalieri Andrius Baltuška Steven L.johnson SwissFEL Paul Scherrer InstituteVilligen PSISwitzerland Photonics Institute Technische Universität WienViennaAustria Institute of Applied Physics University of BernBernSwitzerland Institute for Quantum Electronics Physics DepartmentETH ZurichZurichSwitzerland

We demonstrate the generation,spectral broadening and post-compression of second harmonic pulses using a thin beta barium borate(BBO)crystal on a fused-silica substrate as the nonlinear interaction *** combining second harmonic generation in the BBO crystal with self-phase modulation in the fused-silica substrate,we efficiently generate millijoule-level broadband violet pulses from a single optical *** second harmonic spectrum covers a range from long wave ultraviolet(down to 310 nm)to visible(up to 550 nm)with a bandwidth of 65 ***,we compress the second harmonic beam to a duration of 4.8 fs with a pulse energy of 0.64 mJ(5 fs with a pulse energy of 1.05 mJ)using chirped *** all-solid free-space apparatus is compact,robust and pulse energy scalable,making it highly advantageous for generating intense second harmonic pulses from near-infrared femtosecond lasers in the sub-5 fs regime.

关键词： post-compression second harmonic generation self-phase modulation supercontinuum generation

Spatial distribution and potential ecological and health risks associated with heavy metals in the Ijero-Ekiti mining site,Nigeria

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Regional Sustainability 2024年第1期5卷 26-41页

作者： johnson Adedeji OLUSOLA Adeyinka Oluyemi ATURAMU Olufunke ASAOLU Olusesan Sola OGUNLEYE Department of Geography and Planning Science Ekiti State UniversityAdo Ekiti360211Nigeria Institute of Ecology and Environmental Studies Obafemi Awolowo UniversityIle IfeOsun State220101Nigeria Department of Geology(Climate Change and Paleobiology Group) Ekiti State UniversityAdo Ekiti360211Nigeria Environmental Natural Resources and Blue EconomyEurope and Central AsiaWorld Bank GroupWashington D.C.20433the USA

Artisanal gold mining,a labor-intensive and antiquated technique,is a growing industry and the source of income for rural communities all over the ***,artisanal gold mining has potential negative and long-term effects on economy,environment,and *** study collected soil samples from 16 sample points including a control point to examine the pollution degrees and spatial distribution of heavy metals,as well as ecological and health risks associated with heavy metal pollution in the Ijero-Ekiti mining site,*** Information System(GIS)and remote sensing technologies were used to identify regions with high concentrations of heavy metals and assess the environmental impact of gold mining *** results show that the mean heavy metal concentrations of 16 soil pointa are 8.94(±5.97)mg/kg for As,0.18(±0.54)mg/kg for Cd,0.11(±1.06)mg/kg for Co,14.32(±3.43)mg/kg for Cr,6.89(±0.64)mg/kg for Cu,48.92(±11.77)mg/kg for Fe,135.81(±30.75)mg/kg for Mn,5.92(±0.96)mg/kg for Ni,5.72(±1.66)mg/kg for Pb,and 13.94(±1.38)mg/kg for *** study reveals that heavy metal concentration in soils follows the order of Mn>Fe>Cr>Zn>As>Cu>Ni>Pb>Co>*** analysis of soil samples indicates that 3 principal components(PCs)account for 70.008%of the total variance and there are strong positive correlations between various pairs of heavy *** total potential ecological risk index(309.599)in the study area is ***-carcinogenic risk suggests that there may be long-term health impacts on people who work in the mining areas due to chronic exposure to the *** on the study,the hazard index of carcinogenic health risks associated with heavy metals through ingestion is 520.00×10^(–4).Dermal contact from As and Cr also increases the risk of cancer,with the highest hazard index value of 18.40×10^(–4).The lowest exposure pathway,with the hazard index value of 0.68×10^(–4),indicates that the inhalation of heavy metals has a comparatively low risk of can

关键词： Artisanal gold mining Heavy metals Exposure pathway Potential ecological risk Geo-accumulation index Ijero-Ekiti mining site

One-pot and One-step Cu(0)-mediated Reversible-Deactivation Radical Polymerization of N-Isopropylacrylamide(NIPAM) in Water

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Chinese Journal of Polymer Science 2024年第1期42卷 1-6,I0004页

作者： Zi-Shan Li Jing Lyu Bei Qiu Ying-Hao Li Ruth Foley Ri-Jian Song Melissa johnson Qiang Geng Wen-Xin Wang Institute of Precision Medicine(AUST-IPM) Anhui University of Science and TechnologyHuainan 232001China Charles Institute of Dermatology School of MedicineUniversity College DublinDublin D04 V1W8Ireland

Copper(0)-mediated reversible-deactivation radical polymerization(Cu(0)-mediated RDRP) of the water-soluble monomer Nisopropylacrylamide(NIPAM) has been challenging with the problems of high dispersity, poor control over the molecular weights(MWs) or complex or multi reaction steps, etc. In this work, we report the well-controlled polymerization of NIPAM in water via a facile one-pot and one-step Cu(0)-mediated RDRP. The results of this approach show that the key for kicking off the Cu(0)-mediated NIPAM RDRPs is to ensure sufficient Cu~I at the very beginning, and the key to achieve a well-controlled chain growth is to provide adequate deactivation strength during the polymerization process. For NIPAM, which has a high propagation rate constant, the deactivation control can be effectively enhanced by extra adding deactivator(i.e., Cu~II) to the system. Moreover, a low reaction temperature(4 ℃) is necessary in the controlled synthesis of higher MW poly(Nisopropylacrylamide)(PNIPAM) to avoid the compromise in control caused by the phase transition from its lower critical solution temperature(LCST). Through this new kinetically controlled strategy, PNIPAMs with well-defined structure, narrow molecular weight distributions(MWDs) and varied MWs were successfully achieved.

关键词： Cu(0)-mediated RDRP N-isopropylacrylamide Propagation Deactivation Reaction parameters

Exploring the effects of coronary artery disease as a preexisting comorbidity on mortality in hospitalized septic patients:a retrospective observation study

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Emergency and Critical Care Medicine 2024年第2期4卷 47-51页

作者： Anmol Multani Greg Stahl Kerry johnson Scott Goade Robert D.Arnce College of Osteopathic Medicine Kansas City UniversityJoplinMOUSA Department of Data Improvement Freeman Health SystemJoplinMOUSA Department of Mathematics Missouri Southern State UniversityJoplinMOUSA Department of Pharmacy Freeman Health SystemJoplinMOUSA

Background:Sepsis has high prevalence and mortality rate,and it is imperative to identify populations at risk of poor sepsis *** patients with preexisting chronic comorbidities are shown to have worse sepsis *** identifying comorbidities with greater influence on sepsis progression,we can direct limited resources to septic patients with comorbidities and reduce health care *** comorbidities can impact the risk of developing sepsis and having worse *** artery disease(CAD)is a common comorbidity,especially in the elderly,and a leading cause of death *** wished to investigate the influence of CAD as a comorbidity on sepsis and hypothesized that preexisting CAD would increase mortality in hospitalized septic ***:We conducted retrospective observational study using patient data from Freeman Health System in Joplin,*** analyzed patient records from Freeman Health System database from January 1,2019,to June 30,*** patients were identified using the International Classification of Diseases,Tenth Revision sepsis *** identify septic patients with preexisting CAD,we used International Classification of Diseases,Tenth Revision codes for *** compared mortality rates for septic patients with and without ***:Two-sample proportion test was conducted to test the difference in mortality between septic patients with and without preexisting *** difference in mortality for the total population was−0.016(P=0.553).In the male and female subgroups,the differences in mortality were 0.0122(P=0.739)and−0.0511(P=0.208),*** differences in mortality in patients aged 40 to 64 years and 65 years and older were−0.0077(P=0.870)and 0.0007(P=0.983),*** statistical tests failed to find significant differences when comparing septic patients with and without preexisting *** was no significant difference in the age and sex ***:Our study showed that CAD alone was n

关键词： Comorbidity Coronary artery disease Inflammation Mortality rate in sepsis prognosis Sepsis