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What strategies are implied by STRATEGY?

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Science China(Life Sciences) 2017年第3期60卷 319-320页

作者： zachary Bloomgarden Department of Medicine Icahn School of Medicine at Mount SinaiNew York NY 10029USA

Weng and coauthors enrolled 5,535 type 2 diabetic patients in a study of the combined effect of metformin with sitagliptin,nearly half achieving HbAlc<7.0%,with an average 0.85%fall from a baseline of 8.03%.This supports many previous studies of the effect of such combined metformin plus DPP-4 inhibitor regimens.After 16 weeks the authors then randomized 2,202 of those not achieving HbAlc<7%to either of the sulfonylureas glimepiride(mean dose 1.8 mg)

关键词：隐含二甲双胍 2型糖尿病联合效应抑制剂

Association between tourniquet use and intraoperative blood loss during below-knee amputation

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World Journal of Orthopedics 2022年第7期13卷 644-651页

作者： Alden E Wyland Erik Woelber Liam H Wong Jordan Arakawa zachary M Working James Meeker School of Medicine Oregon Health and Sciences UniversityPortlandOR 97239United States Department of Orthopaedics and Rehabilitation Oregon Health and Sciences UniversityPortlandOR 97239United States

BACKGROUND Despite over 150000 amputations of lower limbs annually,there remains a wide variation in tourniquet practice patterns and no consensus on their necessity,especially among orthopedic patient populations.The purpose of this study was to determine whether tourniquet use in orthopedic patients undergoing below knee amputation(BKA) was associated with a difference in calculated blood loss relative to no tourniquet use.AIM To determine if tourniquet use in orthopedic patients undergoing BKA was associated with a difference in calculated blood loss relative to no tourniquet use.METHODS We performed a retrospective review of consecutive patients undergoing BKA by orthopedic surgeons at a tertiary care hospital from 2008 through 2018.Blood loss was calculated using a combination of the Nadler equation for preoperative blood volume and a novel formula utilizing preoperative and postoperative hemoglobin levels and transfusions.Univariate and forwards step-wise multivariate linear regressions were performed to determine the association between tourniquet use and blood loss.A Wilcoxon was used to determine the univariate relationship between tourniquet use and blood loss for in the restricted subgroups of patients who underwent BKA for trauma,tumor,and infection.RESULTS Of 97 eligible patients identified,67 underwent surgery with a tourniquet and 30 did not.In multivariate regression,tourniquet use was associated with a 488 mL decrease in calculated blood loss(CI 119-857,P = 0.01).In subgroup analysis,no individual group showed a statistically significant decrease in blood loss with tourniquet use.There was no significant association between tourniquet use and either postoperative transfusions or reoperation at one year.CONCLUSION We found that tourniquet use during BKA is associated with decreased calculated intraoperative blood loss.We recommend that surgeons performing this procedure use a tourniquet to minimize blood loss.

关键词： Amputation Tourniquet Blood loss Hemostasis

A GPU-Accelerated Mixed-Precision WENO Method for Extremal Black Hole and Gravitational Wave Physics Computations

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Communications on Applied Mathematics and Computation 2023年第1期5卷 97-115页

作者： Scott E.Field Sigal Gottlieb zachary J.Grant Leah F.Isherwood Gaurav Khanna University of Massachusetts Dartmouth North DartmouthMA 02747USA Department of Computational and Applied Mathematics Oak Ridge National LaboratoryOak RidgeTN 37830USA University of Rhode Island KingstonRI 02881USA

We develop and use a novel mixed-precision weighted essentially non-oscillatory(WENO)method for solving the Teukolsky equation,which arises when modeling perturbations of Kerr black holes.We show that WENO methods outperform higher-order finite-difference methods,standard in the discretization of the Teukolsky equation,due to the need to add dissipation for stability purposes in the latter.In particular,as the WENO scheme uses no additional dissipation,it is well suited for scenarios requiring long-time evolution such as the study of price tails and gravitational wave emission from extreme mass ratio bina-ries.In the mixed-precision approach,the expensive computation of the WENO weights is performed in reduced floating-point precision that results in a significant speedup factor of≈3.3.In addition,we use state-of-the-art Nvidia general-purpose graphics processing units and cluster parallelism to further accelerate the WENO computations.Our optimized WENO solver can be used to quickly generate accurate results of significance in the field of black hole and gravitational wave physics.We apply our solver to study the behavior of the Aretakis charge—a conserved quantity,that if detected by a gravitational wave observatory like LIGO/Virgo would prove the existence of extremal black holes.

关键词： Numerical methods-Finite differencing Hyperbolic Partial differential equations Black holesblack holes WENO

From landrace to modern hybrid broccoli:the genomic and morphological domestication syndrome within a diverse B.oleracea collection

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Horticulture Research 2020年第1期7卷 574-590页

作者： zachary Stansell Thomas Björkman Cornell University School of Integrative Plant ScienceCornell UniversityIthacaNY 14850USA Cornell AgriTech Cornell UniversityGenevaNY 14456USA

Worldwide,broccoli(Brassica oleracea var.italica)is among the most economically important,nutritionally rich,and widely-grown vegetable crops.To explore the genomic basis of the dramatic changes in broccoli morphology in the last century,we evaluated 109 broccoli or broccoli/cauliflower intermediates for 24 horticultural traits.Genotype-bysequencing markers were used to determine four subpopulations within italica:Calabrese broccoli landraces and hybrids,sprouting broccoli,and violet cauliflower,and to evaluate between and within group relatedness and diversity.While overall horticultural quality and harvest index of improved hybrid broccoli germplasm has increased by year of cultivar release,this improvement has been accompanied by a considerable reduction in allelic diversity when compared to the larger pool of germplasm.Two landraces are the most likely founding source of modern broccoli hybrids,and within these modern hybrids,we identified 13 reduction-in-diversity genomic regions,53 selective sweeps,and 30(>1 Mbp)runs of homozygosity.Landrace accessions collected in southern Italy contained 4.8-fold greater unique alleles per accessions compared to modern hybrids and provide a valuable resource in subsequent improvement efforts.This work broadens the understanding of broccoli germplasm,informs conservation efforts,and enables breeding for complex quality traits and regionally adapted cultivars.

关键词： cultivar germplasm breeding

Utility of circulating tumor DNA for predicting prognosis in the management of resectable pancreatic cancer

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Journal of Cancer Metastasis and Treatment 2022年第1期8卷 293-301页

作者： zachary Tyerman Emily Ambler Cary Jo R.Schlick Felix Nwajei Akhil Chawla Department of Surgery Feinberg School of MedicineNorthwestern UniversityChicagoIL 60611USA Division of Surgical Oncology Department of SurgeryNorthwestern Medicine Regional Medical GroupNorthwestern University Feinberg School of MedicineChicagoIL 60190USA Robert H.Lurie Comprehensive Cancer Center ChicagoIL 60611USA Department of Neurology Duke University School of MedicineDurhamNC 27710USA

Background:The measurement of circulating tumor DNA(ctDNA)has been studied in several malignancies,including metastatic pancreatic cancer,but less is known about its utility in monitoring treatment response and recurrence in resectable pancreatic cancer.Methods:We conducted a systematic review of the literature examining the association of ctDNA with overall survival(OS)and disease-free survival.Results:Five articles met our exclusion criteria.Baseline and/or postoperative ctDNA was found to be associated with decreased OS and recurrence-free survival.Discussion:ctDNA has the potential to be used as a prognostic biomarker and to guide therapy in resectable pancreatic cancer.

关键词： Pancreatic cancer circulating tumor DNA prognosis survival

Exogenous reference gene normalization for real-time reverse transcription-polymerase chain reaction analysis under dynamic endogenous transcription

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Neural Regeneration Research 2012年第14期7卷 1064-1072页

作者： Stephen Johnston zachary Gallaher Krzysztof Czaja Programs in Neuroscience and Department of Veterinary and Comparative Anatomy Pharmacology and Physiology College of Veterinary Medicine Washington State University Pullman WA 99164-6520 USA

Quantitative real-time reverse transcription-polymerase chain reaction （qPCR） is widely used to investigate transcriptional changes following experimental manipulations to the nervous system. Despite the widespread utilization of qPCR, the interpretation of results is marred by the lack of a suitable reference gene due to the dynamic nature of endogenous transcription. To address this inherent deficiency, we investigated the use of an exogenous spike-in mRNA, luciferase, as an internal reference gene for the 2ct normalization method. To induce dynamic transcription, we systemically administered capsaicin, a neurotoxJn selective for C-type sensory neurons expressing the TRPV-1 receptor, to adult male Sprague-Dawley rats. We later isolated nodose ganglia for qPCR analysis with the reference being either exogenous luciferase mRNA or the commonly used endogenous reference 13-111 tubulin. The exogenous luciferase mRNA reference clearly demonstrated the dynamic expression of the endogenous reference. Furthermore, variability of the endogenous reference would lead to misinterpretation of other genes of interest. In conclusion, traditional reference genes are often unstable under physiologically normal situations, and certainly unstable following the damage to the nervous system. The use of exogenous spike-in reference provides a consistent and easily implemented alternative for the analysis of qPCR data.

关键词： exogenous reference gene sensory ganglia reverse transcription-polymerase chain reaction normalization injury neural regeneration

Patterns,procedures,and indications for pediatric surgery in a Tanzanian Refugee Camp:a 20-year experience

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World Journal of Pediatric Surgery 2023年第3期6卷 161-167页

作者： Sarah Rapaport zachary Obinna Enumah Hilary Ngude Daniel S Rhee Mohamed Abbas Amber Lekey Peter J Winch Joseph V Sakran Kent A Stevens Center for Global Surgery Johns Hopkins MedicineBaltimoreMarylandUSA Department of International Health Johns Hopkins University Bloomberg School of Public HealthBaltimoreMarylandUSA Tanzania Red Cross Society Dar es SalaamTanzania Department of Pediatric Surgery Johns Hopkins MedicineBaltimoreMarylandUSA Department of Surgery Tulane University School of MedicineNew OrleansLouisianaUSA Satcher Health Leadership Institute Morehouse School of MedicineAtlantaGeorgiaUSA

Background There are 103 million displaced people worldwide,41%of whom are children.Data on the provision of surgery in humanitarian settings are limited.Even scarcer is literature on pediatric surgery performed in humanitarian settings,particularly protracted humanitarian settings.Methods We reviewed patterns,procedures,and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective dataset.Results A total of 1221 pediatric surgical procedures were performed over the study period.Teenagers between the ages of 12 and 17 years were the most common age group undergoing surgery(n=991;81%).A quarter of the procedures were performed on local Tanzanian children seeking care in the camp(n=301;25%).The most common procedures performed were cesarean sections(n=858;70%),herniorrhaphies(n=197;16%),and exploratory laparotomies(n=55;5%).Refugees were more likely to undergo exploratory laparotomy(n=47;5%)than Tanzanian children(n=7;2%;p=0.032).The most common indications for exploratory laparotomy were acute abdomen(n=24;44%),intestinal obstruction(n=10;18%),and peritonitis(n=9;16%).Conclusions There is a significant volume of basic pediatric general surgery performed in the Nyarugusu Camp.Services are used by both refugees and local Tanzanians.We hope this research will inspire further advocacy and research on pediatric surgical services in humanitarian settings worldwide and illuminate the need for including pediatric refugee surgery within the growing global surgery movement.

关键词： surgery pediatric seeking

Tianmu Mountain:A Treasure Chest of Flora and Fauna

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China Today 2022年第1期71卷 74-77页

作者： zachary LUNDQUIST 不详

Over the last 60 years,China’s efforts to protect the local ecological environment of the Tianmu Mountain National Nature Reserve has paid off in making it into a rare"gene bank of species"and"treasure house of cultu... 详细信息

关键词： Tian heritage Reserve

A Multi-Point Distance-Bounding Protocol for Securing Automatic Dependent Surveillance-Broadcast in Unmanned Aerial Vehicle Applications

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Journal of Computer Science & Technology 2020年第4期35卷 825-842页

作者： zachary P.Languell Qijun Gu Department of Computer Science Texas State UniversitySan MarcosTX 78666USA

The Automatic Dependent Surveillance-Broadcast(ADS-B)protocol is being adopted for use in unmanned aerial vehicles(UAVs)as the primary source of information for emerging multi-UAV collision avoidance algorithms.The lack of security features in ADS-B leaves any processes dependent upon the information vulnerable to a variety of threats from compromised and dishonest UAVs.This could result in substantial losses or damage to properties.This research proposes a new distance-bounding scheme for verifying the distance and flight trajectory in the ADS-B broadcast data from surrounding UAVs.The proposed scheme enables UAVs or ground stations to identify fraudulent UAVs and avoid collisions.The scheme was implemented and tested in the ArduPilot SITL(Software In The Loop)simulator to verify its ability to detect fraudulent UAVs.The experiments showed that the scheme achieved the desired accuracy in both flight trajectory measurement and attack detection.

关键词： automatic dependent surveillance-broadcast (ADS-B) unmanned aerial vehicle (UAV) distance bounding collision airspace safety