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Underutilization of Living Donor Liver Transplantation in the United States: Bias against mELD 20 and Higher

Journal of clinical and Translational Hepatology 2016年第3期4卷 169-174页

作者： Ryan B.Perumpail Eric R.Yoo George cholankeril Lupe Hogan melodie deis Waldo c.concepcion c.Andrew Bonham Zobair m.Younossi Robert J.Wong Aijaz Ahmed Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford CA USA department of medicine University of Illinois College of Medicine Chicago IL USA Division of Gastroenterology and Hepatology University of Tennessee Health Sciences Center Memphis TN USA Division of Surgery Division of Abdominal Transplantation Stanford University School of Medicine Stanford CA USA department of medicine Center for Liver Diseases Inova Fairfax HospitalFalls Church VA USA Division of Gastroenterology and Hepatology Alameda Health System Highland Hospital CampusOakland CA USA

Background and Aims:Utilization of living donor liver transplantation (LDLT) and its relationship with recipient model for End-Stage Liver Disease (mELD) needs further evaluation in the United States (U.S.).We evaluated the association between recipient mELD score at the time of surgery and survival following ***:All *** LDLT recipients with mELDvaluated using the 1995-2012 United Network for Organ Sharing *** following LDLTwas stratified into three mELD categories (mELDvaluated using Kaplan-meier methods and multivariate cox proportional hazards ***:Overall,2,258 patients underwent *** to patients with mELDval following LDLT was similar among patients with mELD 15-19 (80.9% vs.80.3%,p =0.77) and mELD 20-24 (81.2% vs.80.3%,p =0.73).When compared to patients with mELDcant difference in long-term post-LDLT survival among those with mELD 15-19 (HR:1.11,95% cI:0.85-1.45,p =0.45) and a non-significant trend towards lower survival in patients with mELD 20-24 (HR:1.28,95%cI:0.91-1.81,p =0.16).Only 14% of LDLTs were performed in patients with mELD 20-24 and the remaining 86% in patients with mELDderutilized in patients with mELD 20 and higher.

关键词： Living donors Liver transplantation Waitlist model for End-Stage Liver Disease(mELD)

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Switchgrass Biochar Effects on Plant Biomass and microbial Dynamics in Two Soils from Different Regions

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Pedosphere 2015年第3期25卷 329-342页

作者： charlene N.KELLY Francisco c.cALdeRóN Verónica AcOSTA-mARTíNEZ maysoon m.mIKHA Joseph BENJAmIN David W.RUTHERFORD colleen E.ROSTAD Western carolina University Department of Geosciences and Natural Resources331 Stillwell HallCullowheeNC 28723 (USA) U.S.Geological Survey Denver CO 80225 (USA) USDA-ARS Akron CO 80720 (USA) USDA-ARS Lubbock TX 79403 (USA)

Biochar amendments to soils may alter soil function and fertility in various ways, including through induced changes in the microbial community. We assessed microbial activity and community composition of two distinct clayey soil types, an Aridisol from colorado （cO） in the U.S. central Great Plains, and an Alfisol from Virginia （va） in the southeastern USA following the application of switchgrass （Panicum virgatum） biochar. The switchgrass biochar was applied at four levels, 0%,0, 2.5%, 5%, and 10%, approximately equivalent to biochar additions of 0, 25, 50, and 100 t ha^-1, respectively, to the soils grown with wheat （Triticum aestivum） in an eight-week growth chamber experiment. We measured wheat shoot biomass and nitrogen （N） content and soil nutrient availability and N mineralization rates, and characterized the microbial fatty acid methyl ester （FAmE） profiles of the soils. Net N mineralization rates decreased in both soils in proportion to an increase in biochar levels, but the effect was more marked in the va soil, where net N mineralization decreased from -2.1 to -38.4 mg kg^-1. The 10% biochar addition increased soil pH, electrical conductivity, mehlich- and bicarbonate-extractable phosphorus （P）, and extractable potassium （K） in both soil types. The wheat shoot biomass decreased from 17.7 to 9.1 g with incremental additions of biochar in the cO soil, but no difference was noted in plants grown in the va soil. The FAmE recovery assay indicated that the switchgrass biochar addition could introduce artifacts in analysis, so the results needed to be interpreted with caution. Non-corrected total FAmE concentrations indicated a decline by 457o and 34% with 10% biochar addition in the cO and va soils, respectively, though these differences became nonsignificant when the extraction efficiency correction factor was applied. A significant decline in the fungi：bacteria ratio was still evident upon correction in the cO soil with biochar. Switchgrass biochar had the p

关键词： correction factor extraction efficiency fatty acid methyl ester profile nitrogen mineralization soil microbial community soil nutrient availability wheat

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Predicting the outcome of closed-loop small bowel obstruction by preoperative characteristics

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World Journal of Gastrointestinal Surgery 2022年第6期14卷 556-566页

作者： masja K Toneman Bente m de Kok Frank m Zijta Stanley Oei Gijs J D van Acker marinke Westerterp Anne E m van der Pool department of Surgery Haaglanden Medical CentreThe Hague 2512 VANetherlands department of Radiology Haaglanden Medical CentreThe Hague 2512 VANetherlands

BAcKGROUND closed-loop small bowel obstruction(cL-SBO)can threaten the viability of the intestine by obstructing a bowel segment at two adjacent *** recognition and surgery are *** To analyze the outcomes of patients who underwent surgery for cL-SBO and to evaluate clinical *** Patients who underwent surgery for suspected cL-BSO on computed tomography(cT)at a single center between 2013 and 2019 were evaluated *** were divided into three groups by perioperative outcome,including viable bowel,reversible ischemia,and irreversible *** and laboratorial variables at presentation were compared and postoperative outcomes were *** Of 148 patients with cL-SBO,28(19%)had a perioperative viable small bowel,86(58%)had reversible ischemia,and 34(23%)had irreversible *** with a higher age had higher risk for perioperative irreversible ischemia[odds ratio(OR):1.03,95%confidence interval(cI):0.99-1.06].Patients with American Society of Anaesthesiologists(ASA)classification≥3 had higher risk of perioperative irreversible ischemia compared to lower ASA classifications(OR:3.76,95%cI:1.31-10.81).Eighty-six patients(58%)did not have elevated c-reactive protein(>10 mg/L),and between-group differences were *** in-hospital stay was significantly longer for patients with irreversible ischemia(median 8 d,P=0.001)than for those with reversible ischemia(median 6 d)or a viable bowel(median 5 d).Postoperative morbidity was significantly higher in patients with perioperative irreversible ischemia(45%,P=0.043)compared with reversible ischemia(20%)and viable bowel(4%).cONcLUSION Older patients or those with higher ASA classification had an increased risk of irreversible ischemia in case of *** irreversible ischemia,postoperative morbidity was increased.

关键词： General surgery Laparoscopy Laparotomy critical care Intestinal obstruction morbidity

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A comparison of three methods of decellularization of pig corneas to reduce immunogenicity

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International Journal of Ophthalmology(English edition) 2014年第4期7卷 587-593页

作者： Whayoung Lee Yuko miyagawa cassandra Long David K.c.cooper Hidetaka Hara department of Surgery Thomas E. Starzl Transplantation Institute University of Pittsburgh

·AIm: To investigate whether decellularization using different techniques can reduce immunogenicity of the cornea, and to explore the decellularized cornea as a scaffold for cultured corneal endothelial cells(cEcs).Transplantation of decellularized porcine corneas increases graft transparency and survival for longer periods compared with fresh grafts.·mETHODS: Six-month-old wild-type pig corneas were cut into 100-200 μm thickness, and then decellularized by three different methods: 1) 0.1% sodium dodecyl sulfate(SDS); 2) hypoxic nitrogen(N2); and 3) hypertonic Nacl. Thickness and transparency were assessed visually. Fresh and decellularized corneas were stained with hematoxylin/eosin(H&E), and for the presence of galactose-α1,3-galactose(Gal) and N-glycolylneuraminic acid(NeuGc, a nonGal antigen). Also, a human Igm/IgG binding assay was performed. cultured porcine cEcs were seeded on the surface of the decellularized cornea and examined after H&E staining.· RESULTS: All three methods of decellularization reduced the number of keratocytes in the stromal tissue by >80% while the collagen structure remained preserved. No remaining nuclei stained positive for Gal or NeuGc, and expression of these oligosaccharides on collagen was also greatly decreased compared to expression on fresh corneas. Human Igm/IgG binding to decellularized corneal tissue was considerably reduced compared to fresh corneal tissue. The cultured cEcs formed a confluent monolayer on the surface of decellularized tissue.· cONcLUSION: Though incomplete, the significant reduction in the cellular component of the decellularized cornea should be associated with a significantly reduced in vivo immune response compared to fresh corneas.

关键词： cornea decellularization immuneresponse pig xenotransplantation

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Legacy Effects of Explosive contamination on Vegetative communities

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Open Journal of Ecology 2016年第8期6卷 496-508页

作者： Stephen m. Via Julie c. Zinnert Donald R. Young department of Biology Virginia Commonwealth University Richmond VA USA

Natural selection processes are constantly influencing vegetation community composition. In the presence of anthropogenic contaminants additional forces act as filters controlling persistence of naturally occurring species. classical species diversity and richness metrics can miss subtle changes under disturbance regimes while species composition and functional characteristics may be able to detect them. Our study was designed to investigate legacy impacts of explosives contaminated soils in an experimental minefield on vegetative communities using ecological metrics. As hypothesized, species diversity and richness showed no change in the presence of explosive compounds while species composition provided clear separation of groups and functional trait dominance was also observed to change. Overall, presence of anthropogenic contaminates have led to community composition and functional shifts for vegetation after initial contamination. The responses in species composition and functional diversity/richness were a result of new tolerant species filling open niches in contaminated plots. more work is needed to confirm this in varied systems and in the presence of diverse contaminants.

关键词： RDX TNT composition B Functional Traits community

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Wavefront-optimized surface retreatments of refractive error following previous laser refractive surgery: a retrospective study

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Eye and Vision 2016年第1期3卷 22-28页

作者： Kevin m.Broderick Rose K Sia denise S.Ryan Richard D.Stutzman michael J.mines Travis c.Frazier mark F.Torres Kraig S.Bower Ophthalmology Service Walter Reed National Military Medical Center8901 Wisconsin AvenueBethesdaMD 20814USA Warfighter Refractive Eye Surgery Program and Research center Ft.BelvoirVAUSA Ophthalmology Service Madigan Army Medical CenterTacomaWAUSA The Wilmer Eye Institute Johns Hopkins UniversityBaltimoreMDUSA

Background:Retreatments are sometimes necessary to correct residual or induced refractive errors following refractive *** different combinations of primary treatment methods and retreatment techniques have been studied,however,few studies have investigated wavefront-optimized(WFO)technology for retreatment following primary refractive *** study aimed to report the outcomes of WFO photorefractive keratectomy(PRK)retreatments of refractive error following previous laser refractive surgery with PRK,laser in situ keratomileusis(LASIK),or laser-assisted subepithelial keratectomy(LASEK).methods:We reviewed records of patients who underwent WFO PRK retreatments using the Allegretto Wave Eye-Q 400 Hz Excimer Laser System(Alcon Surgical)between January 2008 and April 2011 at Walter Reed Army medical center and madigan Army medical *** were recorded in terms of uncorrected distance visual acuity(UDva),manifest refraction spherical equivalent(mRSE),corrected distance visual acuity(cDva),and complications at 1 month(m),3 m,and 6 m ***:Seventy-eight patients(120 eyes)underwent WFO PRK retreatment during the study *** surgery was surface ablation in 87 eyes(78 PRK,9 LASEK)and LASIK in 33 *** mean spherical equivalent before retreatment was−0.79±0.94 D(−3.00 to 1.88 D).UDva was≥20/20 in 69 eyes(60.0%)at 1 m,54 eyes(71.1%)at 3 m,and 27 eyes(73.0%)at 6 m *** was within±0.50 D of emmetropia in 78 eyes(67.8%)at 1 m,59 eyes(77.6%)at 3 m,and 25 eyes(67.6%)at 6 m *** was maintained within±1 line of pre-op in 113 of 115 eyes(98.3%)at 1 m,74 of 76 eyes(97.4%)at 3 m,and 37 eyes(100%)at 6 m ***:Although follow-up was limited beyond 3 m,WFO PRK retreatments in patients with residual refractive error may be a safe and effective *** studies are necessary to determine the long-term safety and stability of outcomes.

关键词： Wavefront-optimized PRK LASIK LASEK Retreatment Enhancement

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microseismic monitoring and analysis of induced seismicity source mechanisms in a retreating room and pillar coal mine in the Eastern United States

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Underground Space 2017年第2期2卷 115-124页

作者： morgen R.Leake William J.conrad Erik c.Westman Setareh Ghaychi Afrouz Ryan J.molka mining and minerals Engineering department Virginia Polytechnic Institute and State University445 Old Turner Street100 Holden HallBlacksburgVA 24060USA

A microseismic monitoring system was installed in an underground room and pillar coal mine in the Eastern United States to analyze the occurrence and characteristics of induced seismicity during the retreat of two panels in the *** study is the first microseismic monitoring effort at an underground coal mine in nearly 30 *** the retreat of the first panel,an array of eight uniaxial geophones,installed 10 *** the roof,recorded events and their *** second panel was monitored using an array of twelve uniaxial geophones and two triaxial geophones,also installed 10 *** the *** the results of these studies,it has been found that the magnitude of seismic events is minimally affected by immediate roof geology or depth of ***,it was observed in both studies that the rate at which seismic events occurred did vary with changing roof geology and depth of *** the seismic data from the second panel retreat,focal mechanism solutions were generated for 50 hand-picked events in order to determine if the failure was in compression,tension,or *** of the focal mechanism solutions show that stress relief resulting in dilational events occurs at significant depths,150-200 m in this case,beneath the active mining face.

关键词： deep mining Induced seismicity coal mining Rock mechanics Source mechanisms Subsidence

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An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: The balancing lupus experiences with stress strategies study

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Open Journal of Preventive medicine 2014年第1期4卷 22-31页

作者： Edith m. Williams megan Penfield Diane Kamen James c. Oates Division of Rheumatology and Immunology Department of Medicine Medical University of South Carolina Charleston USA Division of Rheumatology and Immunology Department of Medicine Medical University of South Carolina Charleston USA medical Service Ralph H. Johnson va medical center Charleston USA Institute for Partnerships to Eliminate Health Disparities Arnold School of Public Health University of South Carolina Columbia USA Institutional Assessment and compliance University of South Carolina Columbia USA

Objective: Very little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory of stressors throughout life, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. methods: The Balancing Lupus Experiences with Stress Strategies (BLESS) study piloted the validated “Better choices, Better Health” chronic Disease Self-management Program (cDSmP) in 30 African-American lupus patients participating in the SLE clinic Database Project at the medical University of South carolina (mUSc). measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions before and after intervention activities, as well as four months’ post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress. Results: Participation in the workshops had large effects upon depression (d = 1.63 and d = 1.68), social/role activities limitations (d =1.15), health distress (d = 1.13 and d = 0.78), fatigue (d = 1.03), pain (d = 0.96), and lupus self-efficacy (d = 0.85). Neither the differences in cortisol or DHEA levels pre- and post-intervention were found to be significantly different between intervention participants and controls. conclusion: The intervention workshops acted to reduce perceived stress and improve quality of life. Our findings imply that comparable, if not more significant gains in relevant health indicators are possible in African American patients when provided the opportunity to participate in cDSmP’s.

关键词： Lupus Stress African-American Self-management

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Stress intervention and disease in African American lupus patients: The balancing lupus experiences with stress strategies (BLESS) study

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Health 2014年第1期6卷 71-79页

作者： Edith m. Williams Diane Kamen megan Penfield James c. Oates Division of Rheumatology and Immunology Department of Medicine Medical University of South Carolina Charleston USA Institute for Partnerships to Eliminate Health Disparities Arnold School of Public Health University of South Carolina Columbia USA Institutional Assessment and compliance University of South Carolina Columbia USA University of South carolina Charleston USA 3Institutional Assessment and Compliance University of South Carolina Columbia USA Medical Service Ralph H. Johnson VA Medical Center Charleston USA

Very little is known about the impact of psychosocial stress on underlying biological mechanisms in African American lupus patients, although African American women display the highest rates of lupus. Due to the exposure of African Americans to a unique trajectory of stressors throughout the life course, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. To begin to fill this research void, an evidence-based self-management program was piloted among a cohort of African American lupus patients participating in a SLE database project at the medical University of South carolina (mUSc). To assess disease activity, during each clinic visit, a history is obtained, and physical examination, phlebotomy, and urine collection are performed. SLE Disease Activity Index (SLEDAI) and Systemic Lupus International collaborating clinics/American college of Rheumatology (SLIcc/AcR) Damage Index (SDI) scores are assessed at each visit. Disease data corresponding with data collection timeframes for each participant were extracted from the mUSc SLE Database to assess the effectiveness of the program. Several differences were observed between the intervention and control groups on symptoms pertaining to lupus activity, and many of these differences had large effect sizes. Our findings can be rapidly translated into improved delivery of health care and targeted trials/interventions with relevance to health disparities, and if widely implemented, morbidities and mortality related to lupus could be drastically reduced in African-Americans.

关键词： SLE African Americans Self management Stress Lupus Disease Activity

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Epigenetic origins of metabolic disease:The impact of the maternal condition to the offspring epigenome and later health consequences

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Food Science and Human Wellness 2013年第1期2卷 1-11页

作者： Rhianna c.Laker mary E.Wlodek Jessic J.connelly Zhen Yan department of medicine University of VirginiaCharlottesvilleVA 22908USA Robert m.Berne cardiovascular Research center University of VirginiaCharlottesvilleVA 22908USA department of Physiology The University of MelbourneRoyal ParadeParkvilleVIC 3010Australia

It has long been established that an adverse maternal condition impacts on the developing fetus and predisposes the offspring to develop metabolic and cardiovascular disease in later ***,the underlying mechanisms that are initiated during development and contribute to the disease predisposition are ***,epigenetic reprogramming in early life has emerged as a promising candidate that could cause altered DNA transcription and gene expression into adulthood and contribute to disease *** review will focus on the impact of maternal high fat diet to the offspring in early life and the adult health *** will then discuss the current literature supporting a role for epigenetic modification,such as DNA methylation and histone modifications,as a key mechanism underlying developmental programming.©2013 Beijing Academy of Food *** and hosting by Elsevier *** rights reserved.

关键词： Epigenetics developmental programming metabolic disease maternal high-fat diet DNA methylation Histone modifications

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