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

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 *** on the provision of surgery in humanitarian settings are *** scarcer is literature on pediatric surgery performed in humanitarian settings,particularly protracted humanitarian *** We reviewed patterns,procedures,and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective *** A total of 1221 pediatric surgical procedures were performed over the study *** 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 *** are used by both refugees and local *** 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

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The extended renin-angiotensin system: a promising target for traumatic brain injury therapeutics

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Neural Regeneration Research 2020年第6期15卷 1025-1026页

作者： zachary C.janatpour Aviva j.Symes Department of Pharmacology Uniformed Services University

Traumatic brain injury(TBI)is a leading cause of death and disability *** assessments estimate that over 27 million cases of TBI occur annually,resulting in over 8 million years lived with disability(GBD 2016 Dementia Collaborators,2019).Over 30 clinical trials have failed to show efficacy in TBI,and patients are currently left without any promising therapeutic options(Villapol et al.,2015).The pathophysiology of TBI is commonly divided into primary and secondary *** injury refers to the parenchymal damage that occurs as an immediate consequence of acute kinetic energy transfer to the brain(i.e.,membrane rupture,hemorrhage,axotomy,etc.).Secondary injury encompasses the deleterious molecular and cellular responses that occur in response to the primary injury in the minutes,hours or days *** search for therapeutics that mitigate the effects of the secondary injury and/or assist endogenous repair processes remains a large focus of TBI research(Umschweif et al.,2014;Villapol et al.,2015;janatpour et al.,2019).

关键词： injuries endogenous injury

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Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma:A qualitative study

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World journal of Gastrointestinal Oncology 2022年第6期14卷 1175-1186页

作者： Lena Stevens zachary j Brown Ryan Zeh Christina Monsour Sharla Wells-Di Gregorio Heena Santry Aslam M Ejaz Timothy Michael Pawlik jordan M Cloyd Department of Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of General Surgery University of Pittsburgh Medical CenterPittsburghPA 15213United States Department of Psychiatry Center for Palliative CareThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

BACKGROUND Neoadjuvant therapy(NT)has increasingly been utilized for patients with localized pancreatic ductal adenocarcinoma(PDAC).It is the recommended approach for borderline resectable(BR)and locally advanced(LA)cancers and an increasingly utilized option for potentially resectable(PR)*** its increased use,little research has focused on patient-centered metrics among patients undergoing NT,including patient experiences,preferences,and recommendations.A better understanding of all aspects of the patient experience during NT may identify opportunities to design interventions aimed at improving quality of life;it may also facilitate the completion of NT and receipt of surgery,ultimately optimizing long-term *** To understand the experience of patients initiating and receiving NT to identify opportunities to improve neoadjuvant cancer care *** Semi-structured interviews of patients with localized PDAC during NT were conducted to explore their experience initiating and receiving *** took place between August 2020 and October *** to the descriptive nature of the research,questions were open *** were conducted over the phone,audio recorded and then *** interviews were coded by two independent researchers using NVivo 12,iteratively identifying themes until thematic saturation was *** integrative approach to qualitative analysis was used,utilizing both inductive and deductive *** A total of 12 patients with localized PDAC were *** with BR(n=7),PR(n=2),and LA(n=3)cancers participated in the *** patients indicated that choosing NT was the doctor’s recommendation,while most reported not being familiar with the concept of NT(n=11)and that NT was presented as the only option(n=8).Five themes describing the patient experience emerged:physical symptoms,emotional symptoms,coping mechanisms,access to care,and life *** most commonly cited recommendation for

关键词： Pancreatic ductal adenocarcinoma Neoadjuvant therapy Patient experience Patient-centered care Quality of life Qualitative research

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Recent advancements in noninvasive brain modulation for individuals with autism spectrum disorder

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Neural Regeneration Research 2023年第6期18卷 1191-1195页

作者： jessica R.Griff jake Langlie Nathalie B.Bencie zachary j.Cromar jeenu Mittal Idil Memis Steven Wallace Alexander E.Marcillo Rahul Mittal Adrien A.Eshraghi Hearing Research and Communication Disorders Laboratory Department of OtolaryngologyNeurotology DivisionUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Neurological Surgery University of Miami Miller School of MedicineMiamiFLUSA Department of Biomedical Engineering University of MiamiCoral GablesFLUSA Department of Pediatrics University of Miami Miller School of MedicineMiamiFLUSA

Autism spectrum disorder is classified as a spectrum of neurodevelopmental disorders with an unknown definitive *** with autism spectrum disorder show deficits in a variety of areas including cognition,memory,attention,emotion recognition,and social *** no definitive treatment or cure,the main interventions for individuals with autism spectrum disorder are based on behavioral ***,noninvasive brain modulation techniques including repetitive transcranial magnetic stimulation,intermittent theta burst stimulation,continuous theta burst stimulation,and transcranial direct current stimulation have been studied for their therapeutic properties of modifying neuroplasticity,particularly in individuals with autism spectrum *** evidence from small cohort studies,pilot studies,and clinical trials suggests that the various noninvasive brain stimulation techniques have therapeutic benefits for treating both behavioral and cognitive manifestations of autism spectrum ***,little data is available for quantifying the clinical significance of these findings as well as the long-term outcomes of individuals with autism spectrum disorder who underwent transcranial *** objective of this review is to highlight the most recent advancements in the application of noninvasive brain modulation technology in individuals with autism spectrum disorder.

关键词： autism spectrum disorder behavior cognition neurostimulation interventions noninvasive brain modulation theta burst stimulation transcranial direct current stimulation transcranial magnetic stimulation

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Biodegradable magnesium materials regulate ROS-RNS balance in pro-inflammatory macrophage environment

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Bioactive Materials 2023年第5期23卷 261-273页

作者： Maria P.Kwesiga Amani A.Gillette Fatemeh Razaviamri Margaret E.Plank Alexia L.Canull zachary Alesch Weilue He Bruce P.Lee Roger j.Guillory II Department of Biomedical Engineering Michigan Technological UniversityHoughtonMIUSA Morgridge Institute for Research MadisonWIUSA Department of Biomedical Engineering University of Wisconsin-MadisonMadisonWIUSA

The relationship between reactive oxygen and nitrogen species(ROS-RNS)secretion and the concomitant biocorrosion of degradable magnesium(Mg)materials is poorly *** found that Mg foils implanted short term in vivo(24 h)displayed large amounts of proinflammatory F4/80+/iNOS+macrophages at the *** sought to investigate the interplay between biodegrading Mg materials(98.6%Mg,AZ31&AZ61)and macrophages(RAW 264.7)stimulated with lipopolysaccharide(RAW 264.7^(LPS))to induce ROS-RNS *** test how these proinflammatory ROS-RNS secreting cells interact with Mg corrosion in vitro,Mg and AZ61 discs were suspended approximately 2 mm above a monolayer of RAW 264.7 cells,either with or without ^(LPS).The surfaces of both materials showed acute(24 h)changes when incubated in the proinflammatory RAW 264.7^(LPS) *** discs incubated with RAW 264.7^(LPS) macrophages showed greater corrosion pitting,while AZ61 showed morphological and elemental bulk product changes via scanning electron microscopy-energy dispersive X-ray spectroscopy(SEM-EDX).X-ray photoelectron spectroscopy(XPS)analysis showed a reduction in the Ca/P ratio of the surface products for AZ61 disc incubated with RAW 264.7^(LPS),but not the Mg ***,RAW 264.7^(LPS) macrophages were found to be more viable in the acute biodegradative environment generated by Mg materials,as demonstrated by calcein-AM and cleaved(active)caspase-3 staining(CC3).^(LPS) stimulation caused an increase in ROS-RNS,and a decrease in antioxidant peroxidase *** and AZ61 were found to change this ROS-RNS balance,independently of physiological antioxidant *** findings highlight the complexity of the cellular driven acute inflammatory responses to different biodegradable Mg,and how it can potentially affect performance of these materials.

关键词： Biocorrosion Macrophage activation Nitroso-redox balance Mg

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Inhibiting WNT secretion reduces high bone mass caused by Sost loss-of-function or gain-of-function mutations in Lrp5

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骨研究:英文版 2023年第3期11卷 595-606页

作者： Cassandra R.Diegel Ina Kramer Charles Moes Gabrielle E.Foxa Mitchell j.McDonald zachary B.Madaj Sabine Guth jun Liu jennifer L.Harris Michaela Kneissel Bart O.Williams Department of Cell Biology Van Andel Institute333 Bostwick Ave.NEGrand RapidsMI 49503USA Diseases of Aging and Regenerative Medicine Novartis Institutes for Biomedical ResearchCH-4002 BaselSwitzerland Bioinformatics and Biostatistics Core Van Andel Institute333 Bostwick Ave.NEGrand RapidsMI 49503USA Oncology Novartis Institutes for Biomedical ResearchSan DiegoCA 92121USA

Proper regulation of Wnt signaling is critical for normal bone development and *** in several Wnt signaling components,which increase the activity of the pathway in the skeleton,cause high bone mass in human subjects and mouse *** bone mass is often accompanied by severe headaches from increased intracranial pressure,which can lead to fatality and loss of vision or hearing due to the entrapment of cranial *** addition,progressive forehead bossing and mandibular overgrowth occur in almost all *** that would provide symptomatic relief in these subjects are ***-mediated palmitoylation is necessary for Wnt secretion and binding to the frizzled *** inhibition of porcupine is a highly selective method of Wnt signaling *** treated three different mouse models of high bone mass caused by aberrant Wnt signaling,including homozygosity for loss-of-function in Sost,which models sclerosteosis,and two strains of mice carrying different point mutations in Lrp5(equivalent to human G171V and A214V),at 3 months of age with porcupine inhibitors for 5–6 *** significantly reduced both trabecular and cortical bone mass in all three *** demonstrates that porcupine inhibition is potentially therapeutic for symptomatic relief in subjects who suffer from these disorders and further establishes that the continued production of Wnts is necessary for sustaining high bone mass in these models.

关键词： homeostasis function mass

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A decision framework for identifying models to estimate forest ecosystem services gains from restoration

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Forest Ecosystems 2016年第2期3卷 126-137页

作者： zachary L. Christin Kenneth j. Bagstad Michael A. Verdone Earth Economics 107 N Tacoma Ave Tacoma WA 98403 USA. U.S. Geological Survey Geosciences & Environmental Change Science Center Box 25046 MS 980 Denver CO 80225 USA. International Union for the Conservation of Nature 1630 Connecticut Ave. NW #300 Washington DC 20009 USA.

Restoring degraded forests and agricultural lands has become a global conservation priority. A growing number of tools can quantify ecosystem service tradeoffs associated with forest restoration. This evolving ＂tools landscape＂ presents a dilemma： more tools are available, but selecting appropriate tools has become more challenging. We present a Restoration Ecosystem Service Tool Selector （RESTS） framework that describes key characteristics of 13 ecosystem service assessment tools. Analysts enter information about their decision context, services to be analyzed, and desired outputs. Tools are filtered and presented based on five evaluative criteria： scalability, cost, time requirements, handling of uncertainty, and applicability to benefit-cost analysis. RESTS uses a spreadsheet interface but a web-based interface is planned. Given the rapid evolution of ecosystem services science, RESTS provides an adaptable framework to guide forest restoration decision makers toward tools that can help quantify ecosystem services in support of restoration.

关键词： Decision support Ecosystem services Forest restoration Modeling Valuation Comparative toolsassessment

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Nanocrystal-semiconductor interface： Atomic-resolution cross-sectional transmission electron microscope study of lead sulfide nanocrystal quantum dots on crystalline silicon

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Nano Research 2014年第2期7卷 219-227页

作者： zachary Lingley Krishnamurthy Mahalingam Siyuan Lus Gail j. Brown Anupam Madhukar Mork Family Department of Chemical Engineering and Materials Science University of Southern California Los Angeles California 90089 USA Air Force Research Laboratory Materials and Manufacturing Directorate Wright-Patterson Air Force Base Ohio 45433-7707 USA Department of Physics and Astronomy University of Southern California Los Angeles California 90089 USA

We report on a cross-sectional high resolution transmission electron microscope study of lead sulfide nanocrystal quantum dots （NCQDs） dispersed on electron-transparent silicon nanopillars that enables nearly atomically-resolved simultaneous imaging of the entire composite： the quantum dot, the interfacial region, and the silicon substrate. Considerable richness in the nanocrystal shape and orientation with respect to the substrate lattice is observed. The average NCQD-substrate separation is found to be significantly smaller than the length of the ligands on the NCQDs. Complementary photoluminescence measurements show that light emission from PbS NCQDs on silicon is effectively quenched which we attribute to intrinsic mechanisms of energy and charge transfer from PbS NCQDs to Si.

关键词： nanocrystal quantum dots semiconductor substrate interface atomic structure high resolutiontransmission electronmicroscopy energy and charge transfer solar cells

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Differences in Metabolic Stress Using a Breathing Restrictive Mask Compared to Hypobaric Hypoxia During Cycling at a Matched Workload

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journal of Science in Sport and Exercise 2022年第4期4卷 397-404页

作者： Bryanne N.Bellovary Andrew D.Wells zachary j.Fennel jonathan M.Houck Desmond j.Millender Kelsey C.Bourbeau Christine M.Mermier Department of Health Exerciseand Sports SciencesUniversity of New MexicoJohnson Center B143 MSC042610AlbuquerqueNM 87131-0001USA

Purpose The Elevation Training Mask(ETM)has been assessed for its impact on exercise performance using acute and training *** the ETM is widely available to consumers,little research exists for validation of the ETM mask ***,the purpose of this study was to compare physiological responses during exercise for the ETM mask settings against moderate hypobaric *** Nine participants living at moderate altitude(1600-1650 m)rested(10 min)and cycled in hypobaric hypoxia simulating 2743 m(ALT),in hypobaric hypoxia simulating 1829 m with the ETM set to 914 m(ALT+ETM),and with the ETM set to 2743 m(ETM)in a randomized *** cycled for 20 min at 60%VO_(2max)as determined by a maximal exertion test(VO_(2max))at baseline *** consumption was measured throughout each *** There were no differences between conditions at *** measures ANOVA showed the ALT condition elicited significantly greater VO_(2) compared to the ETM condition and 60%VO_(2max)at baseline altitude(P<0.05).Conclusion When cycling at a matched workload,the exercising VO_(2) was higher in the ALT condition than at the ETM mask setting of 2743 m and exercising VO2 during the ETM condition was similar to 60%VO_(2max)at baseline *** results of this study indicate that the ETM did not produce additional metabolic stress compared to hypobaric hypoxia during steady-state exercise in moderate-altitude living individuals.

关键词： Intermittent hypoxia Training mask Acute cycling Altitude

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Surgery for pancreatic cancer:recent progress and future directions

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 376-378页

作者： zachary j.Brown jordan M.Cloyd Department of Surgery The Ohio State University Wexner Medical CenterColumbusOHUSA

Pancreatic ductal adenocarcinoma(PDAC)is a highly aggressive malignancy in which multimodality therapy is necessary to achieve good long-term *** recent seminar by Mizrahi et *** in The Lancet not only summarizes the fundamental knowledge of PDAC but also provides a concise overview of landmark studies that guide modern clinical practice(1).

关键词： Surgery al. adenocarcinoma

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