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Current and future impact of clinical gastrointestinal research on patient care in diabetes mellitus

World Journal of Diabetes 2018年第11期9卷 180-189页

作者： timothy r koch timothy r Shope Michael Camilleri Center for Advanced Laparoscopic General and Bariatric Surgery MedStar Washington Hospital Center and Georgetown University School of Medicine Division of Gastroenterology and Hepatology Mayo Clinic

The worldwide rise in the prevalence of obesity supports the need for an increased interaction between ongoing clinical research in the allied fields of gastrointestinal medicine/surgery and diabetes mellitus. There have been a number of clinically-relevant advances in diabetes, obesity, and metabolic syndrome emanating from gastroenterological research. Gastric emptying is a significant factor in the development of upper gastrointestinal symptoms. However, it is not the only mechanism whereby such symptoms occur in patients with diabetes. Disorders of intrinsic pacing are involved in the control of stomach motility in patients with gastroparesis; on the other hand, there is limited impact of glycemic control on gastric emptying in patients with established diabetic gastroparesis. Upper gastrointestinal functions related to emptying and satiations are significantly associated with weight gain in obesity. Medications used in the treatment of diabetes or metabolic syndrome, particularly those related to pancreatic hormones and incretins affect upper gastrointestinal tract function and reduce hyperglycemia and facilitate weight loss. The degree of gastric emptying delay is significantly correlated with the weight loss in response to liraglutide, a glucagonlike peptide-1 analog. Network meta-analysis shows that liraglutide is one of the two most efficacious medical treatments of obesity, the other being the combination treatment phentermine-topiramate. Interventional therapies for the joint management of obesity and diabetes mellitus include newer endoscopic procedures, which require long-term follow-up and bariatric surgical procedure for which long-term follow up shows advantages for individuals with diabetes. Newer bariatric procedures are presently undergoing clinical evaluation. On the horizon, combination therapies, in part directed at gastrointestinal functions, appear promising for these indications. Ongoing and future gastroenterological research when translated to care of individuals with diabetes mellitus

关键词： Obesity Gastric emptying Diabetes mellitus Gastric bypass Bariatric surgery Weight loss

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Organization of future training in bariatric gastroenterology

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World Journal of Gastroenterology 2017年第35期23卷 6371-6378页

作者： timothy r koch timothy r Shope Christopher J Gostout Center for Advanced Laparoscopic General and Bariatric Surgery Med Star Washington Hospital Center and Georgetown University School of Medicine Division of Gastroenterology and Hepatology Mayo Clinic

A world-wide rise in the prevalence of obesity continues. This rise increases the occurrence of, risks of, and costs of treating obesity-related medical conditions. Diet and activity programs are largely inadequate for the long-term treatment of medically-complicated obesity. Physicians who deliver gastrointestinal care after completing traditional training programs, including gastroenterologists and general surgeons, are not uniformly trained in or familiar with available bariatric care. It is certain that gastrointestinal physicians will incorporate new endoscopic methods into their practice for the treatment of individuals with medically-complicated obesity, although the longterm impact of these endoscopic techniques remains under investigation. It is presently unclear whether gastrointestinal physicians will be able to provide or coordinate important allied services in bariatric surgery, endocrinology, nutrition, psychological evaluation and support, and social work. Obtaining longitudinal results examining the effectiveness of this ad hoc approach will likely be difficult, based on prior experience with other endoscopic measures, such as the adenoma detection rates from screening colonoscopy. As a longterm approach, development of a specific curriculum incorporating one year of subspecialty training in bariatrics to the present training of gastrointestinal fellows needs to be reconsidered. This approach should be facilitated by gastrointestinal trainees' prior residency training in subspecialties that provide care for individuals with medical complications of obesity, including endocrinology, cardiology, nephrology, and neurology. Such training could incorporate additional rotations with collaborating providers in bariatric surgery, nutrition, and psychiatry. Since such training would be provided in accredited programs, longitudinal studies could be developed to examine the potential impact on accepted measures of care, such as complication rates, outcomes, and costs, in individuals with medically-complicate

关键词： Obesity Bariatrics Bariatric surgery Intragastric balloon Endoscopic sleeve gastroplasty Nutrition Endoscopy Training

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Dysphagia after vertical sleeve gastrectomy: Evaluation of risk factors and assessment of endoscopic intervention

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World Journal of Gastroenterology 2016年第47期22卷 10371-10379页

作者： Anand Nath Sayali Yewale Tung Tran John S Brebbia timothy r Shope timothy r koch Department of Medicine Med Star-Washington Hospital Center and Georgetown University School of Medicine Washington DC 20010 United States Unterberg Children’s Hospital at Monmouth Medical Center Long Branch NJ07740 United States Center for Advanced Laparoscopic General and Bariatric Surgery MedS tar-Washington Hospital Center and Georgetown University School of Medicine Washington DC 20010 United States

AIM To evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy(VSG).METHODS VSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage.rESULTS Of 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients(9.3%) have narrowing of the sleeve with 25(7.1%) having sharp angulation or a spiral while 8(2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients(39%); 10 patients(30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids.CONCLUSION Narrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients.

关键词：肥胖 Bariatric 外科垂直袖子 gastrectomy 咽下困难胃膨胀

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Insights into the kinetics–morphology relationship of 1-, 2-, and 3D TiNb_(2)O_(7) anodes for Li-ion storage

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Nano research 2024年第4期17卷 2770-2780页

作者： Wenlei Xu Yaolin Xu Veronika Grzimek Andrea Martin Thorsten Schultz Patrícia Arusso Yan Lu Norbert koch Nicola Pinna Department of Chemistry IRIS Adlershof and the Center for the Science of Materials BerlinHumboldt-Universität zu BerlinBrook-Taylor-Str.212489 BerlinGermany Department of Electrochemical Energy Storage Helmholtz-Zentrum Berlin für Materialien und EnergieHahn-Meitner-Platz 114109 BerlinGermany Institut für Physik and IrIS Adlershof Humboldt-Universität zu BerlinBrook-Taylor-Str.212489 BerlinGermany Joint research Group of Molecular Systems Helmholtz-Zentrum Berlin für Materialien und Energie12489 BerlinGermany

Understanding the influence of electrode material’s morphology on electrochemical behavior is of great significance for the development of rechargeable batteries,however,such studies are often limited by the inability to precisely control the morphology of electrode materials.Herein,nanostructured titanium niobium oxides(TiNb_(2)O_(7))with three different morphologies(one-dimensional(1D),two-dimensional(2D),and three-dimensional(3D))were synthesized via a facile microwave-assisted solvothermal method.The influence of the morphological dimension of TiNb_(2)O_(7) as electrode material on the electrochemical performance in Li-ion batteries(LIBs)and the underlying correlation with the electrochemical kinetics were studied in detail.2D TiNb_(2)O_(7)(TNO-2D)shows a superior rate capability and cycling stability,associated with improved kinetics for charge transfer and Li-ion diffusion,compared to the 1D and 3D materials.Operando X-ray diffraction measurements reveal the structural stability and crystallographic evolution of TNO-2D upon lithiation and delithiation and correlate the Li-ion diffusion kinetics with the lattice evolution during battery charge and discharge.Moreover,carbon-coated TNO-2D achieves enhanced rate capability(205 mAh·g^(-1) at 50 C)and long-term cycling stability(87%after 1000 cycles at 5 C).This work provides insights into the rational morphology design of electrode materials for accelerated charge transfer and enhanced fast-charging capability,pushing forward the development of electrode materials for high-power rechargeable batteries in future energy storage.

关键词： morphological dimension electrochemical kinetics lithium-ion batteries TiNb_(2)O_(7) structural evolution

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Development of minimally invasive techniques for management of medically-complicated obesity

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World Journal of Gastroenterology 2014年第37期20卷 13424-13445页

作者： Farzin rashti Ekta Gupta Suzan Ebrahimi timothy r Shope timothy r koch Christopher J Gostout Section of Gastroenterology and Hepatology MedStar-Washington Hospital Center and Georgetown University Schoolof Medicine Department of Surgery MedStar-Washington Hospital CenterCenter for Advanced Laparoscopic and Bariatric Surgery Division of Gastroenterology and Hepatology Mayo Medical School

The field of bariatric surgery has been rapidly growing and evolving over the past several decades. During the period that obesity has become a worldwide epidemic, new interventions have been developed to combat this complex disorder. The development of new laparoscopic and minimally invasive treatments for medically-complicated obesity has made it essential that gastrointestinal physicians obtain a thorough understanding of past developments and possible future directions in bariatrics. New laparoscopic advancements provide patients and practitioners with a variety of options that have an improved safety profile and better efficacy without open, invasive surgery. The mechanisms of weight loss after bariatric surgery are complex and may in part be related to altered release of regulatory peptide hormones from the gut. Endoscopic techniques designed to mimic the effects of bariatric surgery and endolumenal inter-ventions performed entirely through the gastrointestinal tract offer potential advantages. Several of these new techniques have demonstrated promising, preliminary results. We outline herein historical and current trends in the development of bariatric surgery and its transition to safer and more minimally invasive procedures designed to induce weight loss.

关键词： Obesity Bariatrics Bariatric surgery Weight loss E

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The Soft X-ray Imager(SXI)on the SMILE Mission

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Earth and Planetary Physics 2024年第1期8卷 5-14页

作者： S.Sembay A.L.Alme D.Agnolon T.Arnold A.Beardmore A.Belén Balado Margeli C.Bicknell C.Bouldin G.Branduardi-raymont T.Crawford J.P.Breuer T.Buggey G.Butcher r.Canchal J.A.Carter A.Cheney Y.Collado-Vega H.Connor T.Crawford N.Eaton C.Feldman C.Forsyth T.Frantzen G.Galgóczi J.Garcia G.Y.Genov C.Gordillo H-P.Gröbelbauer M.Guedel Y.Guo M.Hailey D.Hall r.Hampson J.Hasiba O.Hetherington A.Holland S-Y.Hsieh M.W.J.Hubbard H.Jeszenszky M.Jones T.Kennedy K.koch-Mehrin S.Kögl S.Krucker K.D.Kuntz C.Lakin G.Laky O.Lylund A.Martindale J.Miguel Mas Hesse r.Nakamura K.Oksavik N.Østgaard H.Ottacher r.Ottensamer C.Pagani S.Parsons P.Patel J.Pearson G.Peikert F.S.Porter T.Pouliantis B.H.Qureshi W.raab G.randal A.M.read N.M.M.roque M.E.rostad C.runciman S.Sachdev A.Samsonov M.Soman D.Sibeck S.Smit J.Søndergaard r.Speight S.Stavland M.Steller Tianran Sun J.Thornhill W.Thomas K.Ullaland B.Walsh D.Walton C.Wang S.Yang School of Physics and Astronomy University of LeicesterLeicesterLE17RHUK Space Park Leicester University of LeicesterLeicesterLE17RHUK Mullard Space Science Laboratory University College LondonDorkingRH56NTUK Centre for Electronic Imaging Open UniversityMilton KeynesMK76 AAUK Birkeland Centre for Space Science Department of Physics and TechnologyUniv.of BergenN-5007 BergenNorway University of Vienna A-1010 ViennaAustria Space research Institute Austrian Academy of SciencesA-8042 GrazAustria National Institute of Aerospace Technology MadridSpain ESTEC European Space Agency2201 AZ NoordwijkNetherlands State Key Laboratory of Space Weather National Space Science CentreBeijing 100190China University of Applied Sciences and Arts Northwestern Switzerland CH-5210 WindischSwitzerland Koegl Space GmbH CH-8157 DielsdorfSwitzerland Space Acoustics GmbH CH-8157 DielsdorfSwitzerland Zurich University of Applied Sciences 8400 WinterhurSwitzerland Genov Solutions N-5172 LoddefjordNorway STM Engineering N-5165 LaksevagNorway John Hopkins University Applied Physics Laboratory MD 20723USA NASA/Goddard Space Flight Centre MD 20771USA Center for Space Physics Boston UniversityBostonMA 02215USA Department of Theoretical Physics and Astrophysics Masaryk University60177 BrnoCzech Republic Institute of Physics E¨otvo¨s Lor´and University1053 BudapestHungary Aerospace Information research Institute Chinese Academy of SciencesBeijing 100045China Centro de Astrobiologia(CAB) CSIC-INTAMadridSpain

The Soft X-ray Imager(SXI)is part of the scientific payload of the Solar wind Magnetosphere Ionosphere Link Explorer(SMILE)mission.SMILE is a joint science mission between the European Space Agency(ESA)and the Chinese Academy of Sciences(CAS)and is due for launch in 2025.SXI is a compact X-ray telescope with a wide field-of-view(FOV)capable of encompassing large portions of Earth’s magnetosphere from the vantage point of the SMILE orbit.SXI is sensitive to the soft X-rays produced by the Solar Wind Charge eXchange(SWCX)process produced when heavy ions of solar wind origin interact with neutral particles in Earth’s exosphere.SWCX provides a mechanism for boundary detection within the magnetosphere,such as the position of Earth’s magnetopause,because the solar wind heavy ions have a very low density in regions of closed magnetic field lines.The sensitivity of the SXI is such that it can potentially track movements of the magnetopause on timescales of a few minutes and the orbit of SMILE will enable such movements to be tracked for segments lasting many hours.SXI is led by the University of Leicester in the United Kingdom(UK)with collaborating organisations on hardware,software and science support within the UK,Europe,China and the United States.

关键词： Soft X-ray Imaging micropore optics large area CCD

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Distribution Control Centers in the US and Europe:Commonalities,Differences,and Lessons

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Journal of Modern Power Systems and Clean Energy 2022年第2期10卷 259-268页

作者： Subramanian Vadari Izudin Dzafic Dan'l koch ryan Murphy Daniel Hayes Jr. Tarik Donlagic Modem Grid Solutions New YorkUSA University of Sarajevo Faculty of Electrical EngineeringSarajevoBosnia and Herzegovina r.Murphy are with Puget Sound Energy BellevueUSA Commonwealth Edison ChicagoUSA Siemens AG ErlanglenGermany

The distribution control center(DCC)has evolved from a sideshow in the traditional distribution service center to a major centerpiece of the utility moving into the decentralized world.Mostly,this is the place where much of the action is happening due to new forms of energy that are coining into the distribution system.This creates the flexibility of operation and in-creased complexity due to the need for increased coordination between the transmission control center and DCC.However,the US and European utilities have adapted to this change in very different ways.Firstly,we describe the research works done in a DCC and their evolutions from the perspectives of major US utilities,and those enhanced by the European perspective focusing on the coordination of distribution system operator and transmission system operator(DSO-TSO).We pres-ent the insights into the systems used in these control centers and the role of vendors in their evolution.Throughout this paper,we present the perspectives of challenges,operational capabilities,and the involvement of various parties who will be re-sponsible to make the transition successful.Key differences are pointed out on how distribution operations are conducted between the US and Europe.

关键词： Distribution control center(DCC) power system operation distributed generation asset flexibility volt-var optimization and control.

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EndoN treatment allows neuroblasts to leave the rostral migratory stream and migrate towards a lesion within the prefrontal cortex of rats

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Neural regeneration research 2020年第9期15卷 1740-1747页

作者： Jannis Gundelach Michael koch Department of Neuropharmacology Center for Cognitive Sciences University of Bremen

The binding properties of neural cell adhesion molecule are modulated by a polysialic acid moiety. This plays an important role in the migration of adult born neuroblasts from their area of origin, the subventricular zone, towards the olfactory bulb. Polysialisation increases the migration speed of the cells and helps to prevent the neuroblasts from leaving their migration route, the rostral migratory stream. Here, we evaluated the potential of intraventricular application of endoneuraminidase-N, an enzyme that specifically cleaves polysialic acid from neural cell adhesion molecule, in a rat model for structural prefrontal cortex damage. As expected, endoneuraminidase-N caused the rostral migratory stream to become wider, with a less uniform cellular orientation. Furthermore, endoneuraminidase-N treatment caused the neuroblasts to leave the rostral migratory stream and migrate towards the lesioned tissue. Despite the neuroblasts not being differentiated into neurons after a survival time of three weeks, this technique provides a solid animal model for future work on the migration and differentiation of relocated neuroblasts and might provide a basis for a future endogenous stem cell-based therapy for structural brain damage. The experiments were approved by the local animal care committee(522-27-11/02-00, 115;Senatorin für Wissenschaft, Gesundheit und Verbraucherschutz, Bremen, Germany) on February 10, 2016.

关键词： endogenous stem cells endoneuraminidase neural cell adhesion molecule neuroblast migration olfactory bulb polisialic acid structural brain damage subventricular zone

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DISPErSION rELATION AND LANDAU LEVELS OF INVErSION LAYEr SUBBAND ON p-HgCdTe

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Science China Mathematics 1990年第10期33卷 1192-1200页

作者：褚君浩 r.SIZMANN F.koch National Laboratory for Infrared Physics Shanghai Institute of Technical Physics Chinese Academy of Sciences Shanghai 200083 PRC Physik-Department E-16 T. U. München D-8046 Garching F. R. Germany

Starting from Kane’s model and taking into account the surface electron spin-orbit interaction, we have derived the dispersion relation and Landau levels of inversion layer subband on narrow-gap semiconductors. The capacitance-voltage spectroscopy, magnetoconductivity oscillations and cyclotron resonance spectroscopy for the p-Hg1-xCdx Te MIS structure sample at temperature 4.2 K have been measured. From the experimental data, the subband parameters and spin-orbit coupling intensity, which are involved in the expressions of subband dispersion relation and Landau levels, have been determined. As a result, the inversion layer electron subband dispersion relation and Landau level fan chart for HgCdTe as well as the zero field spin splitting effect, the shifting and the crossing effect of Landau levels have been described quantitatively.

关键词： narrow-gap semiconductors HgCdTe 2-dimensional electron gas subband Landau level.

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TrANSFOrMATIONS FOr THE PrIZE-COLLECTING STEINEr TrEE PrOBLEM AND THE MAXIMUM-WEIGHT CONNECTED SUBGrAPH PrOBLEM TO SAP

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Journal of Computational Mathematics 2018年第3期36卷 459-468页

作者： Daniel rehfeldt Thorsten koch Department of Mathematics Technische Universitat Berlin Germany Zuse Institute Berlin and Technische Universitat Berlin Germany

Transformations of Steiner tree problem variants have been frequently discussed in the literature. Besides allowing to easily transfer complexity results, they constitute a central pillar of exact state-of-the-art solvers for well-known variants such as the Steiner tree problem in graphs. In this article transformations for both the prize-collecting Steiner tree problem and the maximum-weight connected subgraph problem to the Steiner arborescence problem are introduced for the first time. Furthermore, the considerable implications for practical solving approaches will be demonstrated, including the computation of strong upper and lower bounds.

关键词： Prize-collecting Steiner tree problem Maximum-weight connected subgraphproblem Graph transformations Dual-ascent heuristics.

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