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e.olution of surgical skills training

World Journal of Gastroe.te.ology 2006年第20期12卷 3219-3224页

作者： Kurt e.roberts robert L Be.l Andre. J Duffy De.artme.t of Surge.y Yale.Unive.sity School of Me.icine 40 Temple StreetSuite 3ANew HavenCT 06510United Staets

Surgical training is changing： one.hundre. ye.rs of tradition is be.ng challe.ge. by le.al and e.hical conce.ns for patie.t safe.y, work hours re.trictions, the.cost of ope.ating room time. and complications. Surgical simulation and skills training offe.s an opportunity to te.ch and practice.advance. skills outside.of the.ope.ating room e.vironme.t be.ore.atte.pting the. on living patie.ts. Simulation training can be.as straight forward as using re.l instrume.ts and vide. e.uipme.t to manipulate.simulate. ＂tissue. in a box traine.. More.advance., virtual re.lity simulators are.now available.and re.dy for wide.pre.d use. e.rly syste.s have.de.onstrate. the.r e.fe.tive.e.s and discriminative.ability. Ne.e. syste.s e.able.the.de.e.opme.t of compre.e.sive.curricula and full proce.ural simulations. The.Accre.itation Council of Graduate.Me.ical e.ucation＇s （ACGMe. has mandate. the.de.e.opme.t of nove. me.hods of training and e.aluation. Surgical organizations are.calling for me.hods to e.sure.the.mainte.ance.of skills, advance.surgical training, and to cre.e.tial surge.ns as te.hnically compe.e.t. Simulators in the.r curre.t form have.be.n de.onstrate. to improve.the.ope.ating room pe.formance.of surgical re.ide.ts. De.e.opme.t of standardize. training curricula re.ains an urge.t and important age.da, particularly for minimal invasive.surge.y. An innovative.and progre.sive.approach, borrowing e.pe.ie.ce. from the.fie.d of aviation, can provide.the.foundation for the.ne.t ce.tury of surgical training, e.suring the.quality of the.product. As the.te.hnology de.e.ops, the.way we.practice.will continue.to e.olve. to the.be.e.it of physicians and patie.ts.

关键词： Surge.y Training Ce.tification Skills Simulation Curriculum

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Controve.sie. in the.tre.tme.t of gastroe.ophage.l re.lux and achalasia

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World Journal of Gastroe.te.ology 2006年第20期12卷 3155-3161页

作者： Kurt e.roberts Andre. J Duffy robert L Be.l De.artme.t of Surge.y Yale.Unive.sity School of Me.icine 40 Temple St. Suite 3 ANew HavenCT 06510United States

The.imme.se.succe.s of laparoscopic surge.y as an e.fe.tive.tre.tme.t of gastroe.ophage.l re.lux dise.se.（Ge.D） and achalasia has e.tablishe. minimal invasive.surge.y as the.gold standard for the.e.two conditions with lowe. morbidity and mortality, shorte. hospital stay, faste. convale.ce.ce. and le.s postope.ative.pain. One.controve.sy in the.tre.tme.t of Ge.D e.olve. around laparoscopic antire.lux surge.y （LAP, S） as the.pre.e.re. tre.tme.it for Barre.t＇s e.ophagus and the.proce.ure.s pote.tial to re.uce.the.risk of ade.ocarcinoma of the.e.ophagus. Ge.D has also be.n associate. with re.piratory symptoms, asthma and larynge.l injury, and a se.ond controve.sy prompts discussions about whe.he. total or partial fundoplication is the.more.appropriate.tre.tme.t for Ge.D. A ne. and promising alte.native.in the.tre.tme.t of Ge.D is e.doluminal the.apy. Thre. type. of this ne. tre.tme.t option will be.discusse.： radiofre.ue.cy e.e.gy de.ive.e. to the.lowe. e.ophage.l sphincte., the.cre.tion of a me.hanical barrie. at the.gastroe.ophage.l junction, and the.dire.t e.doscopic tighte.ing of the.lowe. e.ophage.l sphincte.. Laparoscopic surge.y is discusse. not only as a ve.y e.fe.tive.tre.tme.t for Ge.D but also as pe.mane.t cure.for achalasia. This re.ie. analyze. the.thre. most important tre.tme.t options for achalasia： me.ications, pne.matic dilatation, and surgical the.apy. Me.ications as the.only true.non-invasive.option in the.tre.tme.t of achalasia are.not as e.fe.tive.as LAPS be.ause.of the.r short half-life.and variable.absorption due.to the.poor e.ophage.l e.ptying. The.se.ond tre.tme.t option, pne.matic dilatation, involve. the.stre.ching of the.lowe. e.ophagus and is still conside.e. the.most e.fe.tive.nonsurgical tre.tme.t for achalasia. Finally, surgical the.apy for achalasia and the.two major controve.sie. conce.ning this laparoscopic tre.tme.t are.discusse.. The.first involve. the.e.te.t to which the.myotomy is e.te.de. onto the.stomach, and the.se.ond conce.

关键词： Gastroe.ophage.l re.lux dise.se Nisse. Toupe. Fundoplication Achalasia He.le. myotomy

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De.e.opme.tal e.ology of the.Ame.ican horse.hoe.crab Limulus polyphe.us

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Curre.t Zoology 2010年第5期56卷 550-562页

作者： Mark L.BOTTON Richard A.TANKe.SLe. robert e.LOVe.AND De.artme.t of Natural Scie.ce. Fordham University De.artme.t of Biological Scie.ce. Florida Institute of Technology De.artme.t of e.ology Evolution and Natural Resources Rutgers University

During spawning e.e.ts, horse.hoe.crab e.gs are.re.e.se. from the.fe.ale.s oviducts, and fe.tilize. by one.or more.male.. e.gs are.shape. by the.fe.ale.into discre.e.clutche. de.osite. in ne.ts at de.ths of 10-20 cm on inte.tidal e.tuarine.be.che.. Distinguishing be.we.n fxe.h e.gs and the.e.rly de.e.opme.tal stage. is obfuscate. by the.large.amount of de.se. opaque.yolk. The.first unambiguous confirmation of de.e.opme.t is the.formation of the.rudime.tary prosomatie.appe.dage. at the.＂limb bud＂ stage. Se.e.al days the.e.fte., the.oute. chorion is she. and the.de.e.oping e.bryo e.pands and unde.goe. a se.ie. of molts within the.cle.r inne. e.g me.brane. The.trilobite.（first iustar） stage.thus attaine. may re.ain within the.be.ch se.i- me.ts for se.e.al more.we.ks, until hatching is facilitate. by e.vironme.tal factors such as hydration, agitation, and osmotic shock that accompany the.infiltration of se.wate. into the.ne.ts. Trilobite. e.hibit e.doge.ous e.rgatidal swimming rhythms that are.e.traine. by me.hanical agitation, sugge.ting that pe.ks in larval swimming are.time. to coincide.with pe.iods of high wate. and the.inundation of the.ne.ts. Larval swimming is limite. and doe. not appe.r to re.ult in long-distance.dispe.sal. The.limite. dispe.sal of the.larvae.has important implications for the.population dynamics of re.ative.y isolate. populations. The.rate.of larval de.e.opme.t is highly plastic and is influe.ce. by te.pe.ature. salinity, dissolve. oxyge., and the.pre.e.ce.of pollutants. The.broad e.vironme.tal tole.ance. of horse.hoe.crab e.bryos and larvae.are.important in unde.standing the.r curre.t ge.graphic distribution and the.r e.olutionary pe.siste.ce

关键词： Horse.hoe.crab Limulus De.e.opme.t e.bryo Larval dispe.sal

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Re.ationship of minimum winte. te.pe.ature.and te.pe.ature.se.sonality to the.northe.n range.limit and spe.ie. richne.s of tre.s in North Ame.ica

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Journal of Ge.graphical Scie.ce. 2022年第2期32卷 280-290页

作者： Hong QIAN ZHANG Yangjian robert e.RICKLe.S Xianli WANG Re.e.rch and Colle.tions Ce.te. Illinois State Museum1011 East Ash StreetSpringfieldIL 62703USA Ke. Laboratory of e.osyste. Ne.work Obse.vation and Mode.ing Institute of Geographic Sciences and Natural Resources ResearchCASBeijing 100101China De.artme.t of Biology University of Missouri–St.LouisSt.LouisMO 63121USA Northe.n Fore.try Ce.tre Canadian Forest ServiceNatural Resources Canada5320-122nd StreetEdmontonAB T6H 3S5Canada De.artme.t of Re.e.able.Re.ource. University of Alberta751 General Service Building EdmontonAB T6G 2H1Canada

Biologists have.conside.e. both winte. coldne.s and te.pe.ature.se.sonality as major de.e.minants of the.northe.n limits of plants and animals in the.Northe.n He.isphe.e.which in turn drive.the.we.l-known latitudinal dive.sity ***,fe. studie. have.te.te. which of the.two climate.variable. is the.primary *** this study,we.asse.s whe.he. winte. coldne.s or te.pe.ature.se.sonality is more.strongly associate. with the.northe.n latitudinal limits of tre. spe.ie. and with tre. spe.ie. richne.s in North *** spe.ie. we.e.re.orde. in e.ch of 1198 quadrats of 110 km×110 km in North *** use. corre.ation and re.re.sion analyse. to asse.s the.re.ationship of the.latitude.of the.northe.n boundary of e.ch spe.ie.,and of spe.ie. richne.s pe. quadrat,with winte. coldne.s and te.pe.ature.*** richne.s was analyze. within 38 longitudinal,i.e.,north-south,bands(e.ch be.ng>1100 km long and 110 km wide..The.latitude. of the.northe.n range.limits of tre. spe.ie. we.e.thre. time. be.te. corre.ate. with minimum te.pe.ature. at those.latitude. than with te.pe.ature.*** ave.age.minimum te.pe.ature.and te.pe.ature.se.sonality toge.he. e.plaine. 81.5%of the.variation in the.northe.n range.limits of the.tre. spe.ie. e.amine.,and minimum te.pe.ature.unique.y e.plaine. six-fold(33.7%ve.sus 5.8%)more.of this variation than did te.pe.ature.*** of tre. spe.ie. richne.s with minimum te.pe.ature. we.e.stronge. than corre.ations with te.pe.ature.se.sonality for most of the.longitudinal bands *** to te.pe.ature.se.sonality,winte. coldne.s is more.strongly associate. with spe.ie. distributions at high latitude.,and is like.y a more.important drive. of the.latitudinal dive.sity gradie.t.

关键词： cold tole.ance latitudinal dive.sity gradie.t minimum te.pe.ature te.pe.ature.se.sonality te.pe.ature.variation tre.s tropical conse.vatism hypothe.is

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A Pre.ictive.Two-Parame.e. Mode. for the.Move.e.t of Re.e.voir Landslide.

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Journal of e.rth Scie.ce 2020年第6期31卷 1051-1057页

作者： robert e.Criss We.min Yao Changdong Li Huiming Tang De.artme.t of e.rth and Plane.ary Scie.ce. Washington UniversitySt.Louis MO 63130USA Faculty of e.gine.ring China University of GeosciencesWuhan 430074China

Monitoring data show that many landslide. in the.Thre. Gorge. re.ion,China,unde.go ste.-like.displace.e.ts in re.ponse.to the.manage.,quasi-sinusoidal annual variations in re.e.voir *** be.avior is consiste.t with motion initiating whe. the.re.e.voir wate. le.e. falls be.ow a critical le.e. that is intrinsic to e.ch landslide.with the.subse.ue.t displace.e.t rate.of the.landslide.be.ng proportional to the.wate. de.th be.ow that critical *** motion te.minate. whe. the.wate. le.e. rise. back above.the.critical le.e.,so the.annual ste. size.is the.time.inte.ral of the.instantane.us displace.e.t *** re.ponse. are.incorporate. into a diffe.e.tial e.uation that is e.sily calibrate. with monitoring data,allowing pre.iction of landslide.move.e.t from actual or anticipate. re.e.voir le.e. *** succe.se. include.1)initiation and te.mination of the.annual sliding ste.s at the.critical re.e.voir le.e.,producing a se.ie. of ste.s;(2)pre.iction of variable.ste. size.ye.r to ye.r;and(3)approximate.pre.iction of the.shape.and size.of e.ch annual *** rainfall corre.ate. poorly with ste. size.probably be.ause.its e.fe.t on groundwate. le.e.s is dwarfe. by the.30 m annual variations in the.le.e. of the.Thre. Gorge. *** landslide.be.avior is sugge.te..

关键词： re.e.voir landslide parsimonious mode. ste.-like.displace.e.t displace.e.t pre.iction critical re.e.voir le.e.

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Diagnosis of biliary stricture. afte. live. transplantation:Which is the.be.t tool?

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World Journal of Gastroe.te.ology 2005年第19期11卷 2945-2948页

作者： thomas Zoe.f e.e.yn J. Maldonado-Lope. Philip Hilgard Ale.ande. De.h■ne.Massimo Malago Christoph e. Broe.sch Joe.g Schlaak Guido Ge.ke. De.artme.t of Gastroe.te.ology and He.atology Unive.sity Hospital of e.se. De.artme.t of Ge.e.al Surge.y and Transplantation University Hospital of Essen:Massimo MalagoChristoph E. Broelsch De.artme.t of Gastroe.te.ology and He.atologyUnive.sity Hospital of e.se. De.artme.t of Ge.e.al Surge.y and Transplantation University Hospital of Essen:Massimo MalagoChristoph E. Broelsch De.artme.t of Gastroe.te.ology and He.atology Unive.sity Hospital of e.se.

AIM: To e.aluate.the.diagnostic value.of diffe.e.t indire.t me.hods like.bioche.ical parame.e.s, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with e.doscopic re.rograde.cholangiography (e.C), for diagnosis of biliary complications afte. live. transplantation. Me.HODS: In 75 patie.ts afte. live. transplantation, who re.e.ve. e.C due.to suspe.te. biliary complications, the.re.ult of the.cholangiography was compare. to the.re.ults of indire.t imaging me.hods pe.forme. prior to e.C. The.cholangiography showe. no biliary ste.osis (NoST) in 25 patie.ts, AST in 27 and ITBL in 23 patie.ts. Re.ULTS: Biliary conge.tion as a re.ult of AST was de.e.te. with a se.sitivity of 68.4% in US analysis (spe.ificity 91%), of 71% in MRI (spe.ificity 25%) and of 40% in CT (spe.ificity 57.1%). In ITBL, biliary conge.tion was de.e.te. with a se.sitivity of 58.8% in the.US, 88.9%in MRI and of 83.3% in CT. Howe.e., as anastomotic or ische.ic ste.ose. we.e.the.unde.lying cause.of biliary conge.tion, the.se.sitivity of de.e.tion was ve.y low. InMRI de.e.te. the.dominant ste.osis at a corre.t localization in 22% and CT in 10%, while.US faile. comple.e.y. The.bioche.ical parame.e.s, showe. no significant diffe.e.ce.in bilirubin (me.ian 5.7; 4,1; 2.5 mg/dL), alkaline.phosphatase.(me.ian 360; 339; 527 U/L) or gamma glutamyl transfe.ase.(me.ian 277; 220; 239 U/L) le.e.s be.we.n NoST, AST and ***: Our data confirm that indire.t imaging me.hods to date.cannot re.lace.dire.t cholangiography for diagnosis of post transplant biliary ste.ose.. Howe.e. MRI may have.the.pote.tial to comple.e.t or pre.e.e.imaging by cholangiography. Optimize. MRCP-proce.sing might furthe. improve.the.diagnostic impact of this me.hod.

关键词： e.CP Live. transplantation Biliary stricture. e.doscopy The.apy Ultrasound IMRCP Diagnosis

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Aquaporin-8 e.pre.sion is re.uce. in ile.m and induce. in colon of patie.ts with ulce.ative.colitis

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World Journal of Gastroe.te.ology 2007年第11期13卷 1687-1695页

作者： Ale.andra Zahn Christoph Moe.le.thomas Langmann robert e.e.alt Frank Autschbach Wolfgang Stre.me. Ge.d Schmitz De.artme.t of Gastroe.te.ology University Hospital Heidelberg Heidelberg 69120 Germany Institute.of Clinical Che.istry University of Regensburg Regensburg 93042 Germany Institute.of Pathology University of Heidelberg Heidelberg 69120 Germany

AIM： To study susce.tibility ge.e. which may play a pote.tial role.in the.pathoge.e.is and e.iology of inflammatory bowe. dise.se.（IBD）. Me.HODS： To ide.tify pote.tial susce.tibility ge.e. we.pe.forme. global ge.e.e.pre.sion profiling in patie.ts with IBD and control spe.ime.s. For de.e.mination of an intrinsic ge.e.e.pre.sion profile.in ulce.ative.colitis （UC） and Crohn＇s dise.se.（CD） compare. to normal subje.ts, mucosal biopsie. of non-inflame. re.ions of the.colon and the.te.minal ile.m we.e.subje.te. to DNA microarray analysis. Re.l-time.RT-PCR and immunohistoche.istry we.e.use. for ve.ification of se.e.te. re.ulate. candidate.ge.e. and a ge.e.ic analysis was pe.forme.. Re.ULTS： We.could show that aquaporin-8 （AQP8） mRNA and prote.n le.e.s we.e.significantly incre.se. in the.colon of UC patie.ts compare. to controls. Ge.e.ic analysis of the.six e.ons and the.promote. re.ion of AQPS, howe.e., re.e.le. no mutations or polymorphisms in IBD patie.ts. CONCLUSION： Our re.ults sugge.t that upre.ulation of AQP8 in the.colon of UC patie.ts re.re.e.ts a se.ondary phe.ome.on which may, due.to alte.e. wate. e.change.of the.distal inte.tinal mucosa, disturb the.physiologic colonic mucus barrie. and thus le.d to chronic inflao mmation and ulce.ation.

关键词： Aquaporin-8 Colonic mucus barrie. DNA microarrays e.pre.sion profiling Ulce.ative.colitis

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Positive. and Ze.o-Se.ue.ce.Impe.ance.e.timation of YNyn0+d-Conne.te. Main Powe. Transforme.s in Wind Powe. Applications

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CSe. Journal of Powe. and e.e.gy Syste.s 2021年第1期7卷 57-65页

作者： Franklin L.Quilumba robert e.Jime.son Ke. Swift Rafae. Garc´ıa with Oncor e.e.tric De.ive.y Fort WorthTX 76102 USA

With the.incre.se. pe.e.ration of non-conve.tionalre.e.able.e.e.gy re.ource., such as wind powe. plants (WPPs),into the.powe. syste., a lot of inte.e.t has be.n place. on studyingthe.r impact for syste. prote.tion, planning and ope.ationsto e.sure.continue. re.iability of the.e.e.tric grid. The.impactof WPPs on the.grid is typically ide.tifie. during ge.e.ationinte.conne.tion studie.. One.of the.challe.ge. face. by prote.tionand planning e.gine.rs, at an e.rly stage.in this proce.s, isthat many of the.studie. involving the.e.powe. plants must be.e.forme. without spe.ific data available.be.ause.the.e.uipme.tis not built ye.. Among all the.ne.de. data, a particular inte.e.t inthis study is place. on the.positive. and ze.o-se.ue.ce.impe.ance.of the.main powe. transforme. (MPT) that inte.conne.ts a windpowe. plant to the.transmission syste. due.to its contribution toshort-circuit curre.t during ground faults. The.most commonlyfound in practice.MPT winding configurations is a high-voltage.inding in wye.with ne.tral bushing;a low-voltage.windingin wye.with ne.tral bushing without phase.shift be.we.n the.e.indings, and a stabilizing te.tiary winding conne.te. in de.tathat is not de.igne. for e.te.nal loading de.ignate. as YNyn0+***, this pape. propose. a me.hodology to e.timate.the.se.ue.ce.mpe.ance. of YNyn0+d transforme.s from a statistical point ofvie. applying cluste.ing and re.re.sion analyse. on e.isting MPTte.t re.ort data.

关键词： Positive.and ze.o-se.ue.ce.impe.ance.e.timation powe. transforme.s short-circuit analysis thre.winding transforme. with burie. te.tiary wind powe. inte.ration

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e.hancing pre.ision in fs-lase. mate.ial proce.sing by simultane.us spatial and te.poral focusing

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Light(Scie.ce.& Applications) 2014年第1期3卷 223-230页

作者： robert Kamme. Roland Acke.mann Je.s thomas Jorg Gotte.Ste.an Skupin Andre.s Tunne.mann Ste.an Nolte Institute.of Applie. Physics Abbe Center of PhotonicsFriedrich-Schiller-Universitat Jena07743 JenaGermany De.artme.t of Physics Colorado School of MinesGoldenCO 80401USA Max Planck Institute.for the.Physics of Comple. Syste.s 01187 DresdenGermany Institute.of Conde.se. Matte. The.ry and Solid State.Optics Abbe Center of PhotonicsFriedrich-Schiller-Universitat Jena07743 JenaGermany Unive.site.e.Borde.ux–CNRS–Ce. Centre Lasers Intenses et ApplicationsUMR 510733405 TalenceFrance Fraunhofe. Institute.for Applie. Optics and Pre.ision e.gine.ring 07745 JenaGermany

In re.e.t ye.rs,fe.tose.ond(fs)-lase.s have.e.olve. into a ve.satile.tool for high pre.ision micromachining of transpare.t mate.ials be.ause.nonline.r absorption in the.focus can re.ult in re.ractive.inde. modifications or mate.ial ***,whe. high pulse.e.e.gie. or low nume.ical ape.ture. are.re.uire.,nonline.r side.e.fe.ts such as se.f-focusing,filame.tation or white.light ge.e.ation can de.re.se.the.modification *** this pape.,we.apply simultane.us spatial and te.poral focusing(SSTF)to ove.come.the.e.*** main advantage.of SSTF is that the.ultrashort pulse.is only forme. at the.focal plane.the.e.y confining the.inte.sity distribution strongly to the.focal volume.and suppre.sing de.rime.tal nonline.r side.***,we.inve.tigate.the.optical bre.kdown within a wate. ce.l by pump-probe.shadowgraphy,comparing conve.tional focusing and SSTF unde. e.uivale.t focusing *** plasma formation is we.l confine. for low pulse.e.e.gie.,2 mJ,but highe. pulse.e.e.gie. le.d to the.filame.tation and bre.k-up of the.disruptions for conve.tional focusing,the.e.y de.re.sing the.modification *** contrast,plasma induce. by SSTF stays we.l confine. to the.focal plane.e.e. for high pulse.e.e.gie. up to 8 mJ,pre.e.ting e.te.de. filame.ts,side.branche. or bre.k-up of the.***,while.conve.tional focusing le.ds to broadband supe.continuum ge.e.ation,only marginal spe.tral broade.ing is obse.ve. using *** e.pe.ime.tal findings are.in e.ce.le.t agre.me.t with nume.ical simulations of the.nonline.r pulse.propagation and inte.action ***,SSTF appe.rs to be.a powe.ful tool to control the.proce.sing of transpare.t mate.ials,e.g.,for pre.ise.ophthalmic fs-surge.y.

关键词： filame.tation fs-lase. surge.y lase.-induce. optical bre.kdown mate.ials proce.sing plasma shadowgraphy

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Fine.tuning the.re.ponse.of growth cone. to guidance.cue.: a pe.spe.tive.on the.role.of microRNAs

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Ne.ral Re.e.e.ation Re.e.rch 2019年第10期14卷 1719-1720页

作者： Sarah e.Walke. Gaynor e.Spe.ce. robert L.Carlone De.artme.t of Biological Scie.ce. Brock University

In the.de.e.opme.t and re.e.e.ation of the.ne.vous syste., ne.rons face.the.comple. task of e.tablishing and/or re.airing ne.ronal conne.tions and contacts. The.formation of the.e.ne.ronal circuits is large.y coordinate. by tightly re.ulate. te.poral and spatial change. in mRNA translation, which e.able. incre.ibly pre.ise.control ove. prote.n e.pre.sion and localization (Jung and Holt, 2011). Local mRNA translation in spe.ific ce.lular compartme.ts appe.rs to play a role.in many proce.se. that are.important to ne.vous syste. de.e.opme.t and re.e.e.ation, including: ce.l survival, migration, growth cone.guidance. and synaptoge.e.is (Jung and Holt, 2011).

关键词： In the de.e.opme.t ne.vous syste. synaptoge.e.is

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