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Treatment of hemorrhoids: A survey of surgical practice in Australia and New Zealand

World Journal of Clinical Cases 2019年第22期7卷 3742-3750页

作者： George E Fowler Javariah Siddiqui Assad Zahid christopher john young Department of Colorectal Surgery Royal Devon and Exeter NHS Foundation TrustExeter EX25DWUnited Kingdom Department of Colorectal Surgery Royal Prince Alfred HospitalNewtown 2042NSWAustralia

BACKGROUND Hemorrhoidal disease is the most common anorectal *** can be classified as external or internal,according to their relation to the dentate *** hemorrhoids originate below the dentate line and are managed conservatively unless the patient cannot keep the perianal region clean,or they cause significant *** hemorrhoids originate above the dentate line and can be managed according to the graded degree of prolapse,as described by ***,low-grade internal hemorrhoids are effectively treated conservatively,by non-operative measures,while high-grade internal hemorrhoids warrant procedural *** To determine the application of clinical practice guidelines for the current management of hemorrhoids and colorectal surgeon consensus in Australia and New *** An online survey was distributed to 206 colorectal surgeons in Australia and New Zealand using 17 guideline-based hypothetical clinical *** There were 82 respondents(40%)to 17 guideline-based ***(53%)reached consensus,of which only 1(6%)disagreed with the *** was based on low quality evidence for the management of acutely thrombosed external *** were 8 scenarios which showed community equipoise(47%)and they were equally divided for agreeing or disagreeing with the *** topics were based on low and moderate levels of *** included the initial management of grade I internal hemorrhoids,grade III internal hemorrhoids when initial management had failed and the patient had recognised risks factors for septic complications;and finally,the decision-making when considering patient preferences,including a prompt return to work,or minimal post-operative *** Although there are areas of consensus in the management of hemorrhoids,there are many areas of community equipoise which would benefit from further research.

关键词： Hemorrhoids Clinical practice guidelines Survey Consensus

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Colorectal surgeon consensus with diverticulitis clinical practice guidelines

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World Journal of Gastrointestinal Surgery 2017年第11期9卷 224-232页

作者： Javariah Siddiqui Assad Zahid Jonathan Hong christopher john young Discipline of Surgery University of Sydney Department of Colorectal Surgery Royal Prince Alfred Hospital

AIM To determine the application of clinical practice guidelines for the current management of diverticulitis and colorectal surgeon specialist consensus in Australia and New *** A survey was distributed to 205 colorectal surgeons in Australia and New Zealand, using 22 hypothetical clinical *** The response rate was 102(50%). For 19 guidelinebased scenarios, only 11(58%) reached consensus(defined as > 70% majority opinion) and agreed with guidelines; while 3(16%) reached consensus and did not agree with guidelines. The remaining 5(26%) scenarios showed community equipoise(defined as less than/equal to 70% majority opinion). These included diagnostic imaging where CT scan was contraindicated, management options in the failureof conservative therapy for complicated diverticulitis, surgical management of Hinchey grade 3, proximal extent of resection in sigmoid diverticulitis and use of oral mechanical bowel preparation and antibiotics for an elective colectomy. The consensus areas not agreeing with guidelines were management of simple diverticulitis, management following the failure of conservative therapy in uncomplicated diverticulitis and follow-up after an episode of complicated diverticulitis. Fifty-percent of rural/regional based surgeons would perform an urgent sigmoid colectomy in failed conservative therapy of diverticulitis compared to only 8% of surgeons city-based(Fisher's exact test P = 0.016). In right-sided complicated diverticulitis, a greater number of those in practice for more than ten years would perform an ileocecal resection and ileocolic anastomosis(79% vs 41%, P < 0.0001).CONCLUSION While there are areas of consensus in diverticulitis management, there are areas of community equipoise for future research, potentially in the form of RCTs.

关键词： Diverticulitis Clinical practice guidelines Consensus

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In situ nanoscale mapping of electrical and catalytic properties

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National Science Review 2024年第7期11卷 65-66页

作者： christopher S.Kley Helmholtz young Investigator Group Nanoscale Operando CO2 Photo-Electrocatalysis Helmholtz-Zentrum Berlin für Materialien und Energie GmbH Department of Interface Science Fritz Haber Institute of the Max Planck Society

By enabling the conversion of sustainably-derived electrical energy into chemical energy, electrocatalytic reactions are vital for closing the anthropogenic carbon cycle. A wide array of electrocatalytic reactions have gained extensive attention, including hydrogen evolution（HER）, oxygen evolution（OER）, and CO2electroreduction（CO2RR）.

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How to decide on stent insertion or surgery in colorectal obstruction?

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World Journal of Gastrointestinal Surgery 2016年第1期8卷 84-89页

作者： assad zahid christopher john young Department of Colorectal Surgery Royal Prince Alfred HospitalCamperdownSydneyNSW 2050Australia discipline of surgery university of sydneySydneyNSW 2006Australia rpah medical centre NewtownSydneyNSW 2042Australia

Colorectal cancer is one of the most common cancers in western society and malignant obstruction of the colon accounts for 8%-29% of all large bowel obstructions. Conventional treatment of these patients with malignant obstruction requiring urgent surgery is associated with a greater physiological insult on already nutritionally replete patients. Of late the utility of colonic stents has offered an option in the management of these patients in both the palliative and bridge to surgery setting. This has been the subject of many reviews which highlight its efficacy, particulary in reducing ostomy rates, allowing quicker return to oral diet, minimising extended post-operative recovery as well as some quality of life benefits. The uncertainity in managing patients with malignant colonic obstructions has lead to a more cautious use of stenting technology as community equipoise exists. Decision making analysis has demonstrated that surgeons' favored the use of stents in the palliative setting preferentially when compared to the curative setting where surgery was preferred. We aim to review the literature regarding the use of stent or surgery in colorectal obstruction, and then provide a discourse with regards to the approach in synthesising the data and applying it when deciding the appropriate application of stent or surgery in colorectal obstruction.

关键词： Self-expanding metallic stent Stenting Surgery Colorectal cancer Large bowel obstruction Radiology

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Pressure-responsive pH-triggered layer-by-layer coating of paclitaxel-eluting balloon catheters for instant high-dose drug delivery for percutaneous coronary artery intervention

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Nano Research 2024年第10期17卷 9141-9151页

作者： Jeong Yu Lee Shonit Nair Sharma Sung-Yu Hong young-Guk Ko Yangsoo Jang Minjae Do Michael christopher Stark Qiwen Peng Benjamin Allen Mossburg Bo Chan Seo Yuhan Lee Department of Materials Science and Engineering Korea Advanced Institute of Science and TechnologyDaejeon 305-701Republic of Korea Department of Anesthesiology Perioperativeand Pain MedicineCenter for Accelerated Medical Innovation&Center for NanomedicineBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115USA Department of Biological Engineering Massachusetts Institute of TechnologyCambridgeMA 02139USA Cardiovascular Product Evaluation Center Yonsei University College of MedicineSeoul 120-752Republic of Korea Division of Cardiology Department of Internal MedicineSeverance Cardiovascular HospitalYonsei University College of MedicineSeoul 120-752Republic of Korea

Cardiovascular diseases remain the leading cause of mortality worldwide,with percutaneous coronary interventions(PCI)using drug-eluting stents(DES)as the standard treatment for coronary artery *** advancements in DES technology,challenges such as restenosis and stent thrombosis still necessitate further interventions and carry considerable risks,highlighting an urgent need for a novel therapeutic approach with lower restenosis rates and reduced reintervention *** balloons(DEBs)coated with anti-proliferative agents offer a novel method of local drug delivery for reducing restenosis by directly administering drugs to the lesion ***,efficient delivery of drugs within the brief procedural window while minimizing drug loss during maneuvering to the target site remains a ***,we developed a pressure-responsive and pH-triggered,paclitaxel(PTX)coated DEB catheter for rapid and high-dose delivery of paclitaxel to the lesion sites,overcoming the limitations of drug dispersion and inefficiencies associated with conventional *** the charge reversion of albumin around its isoelectric point,paclitaxel-loaded human serum albumin nanoparticles(PTX-HSA-NPs)and heparin were coated using a layer-by-layer deposition method at pH *** exposure to physiological pH(i.e.,7.4),the coating is rapidly released from the balloon *** with a protective shellac coating,the DEB achieved controlled release of high-dose paclitaxel to the arterial tissue in vivo(up to 400μg per gram tissue),exceeding current DEBs in the *** results suggest the pH-responsive,multi-layer coated DEB’s potential for superior procedural outcomes,addressing a critical unmet need in PCI.

关键词： drug-eluting balloon layer-by-layer coating coronary artery disease paclitaxel

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Quantized Redshift and its Significance for Recent Observation

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Research in Astronomy and Astrophysics 2024年第9期24卷 156-166页

作者： Arindam Mal Sarbani Palit christopher C.Fulton Sisir Roy Indian Space Research Organization Space Applications CentreAhmedabadIndia Indian Statistical Institute CVPR UnitKolkataIndia Protostar Inc.15652 Carrousel DriveCanyon CountryCA 91387USA National Institute of Advanced Studies IISC CampusBangaloreIndia

With the recent observational evidence in extragalactic astronomy,the interpretation of the nature of quasar redshift continues to be a research *** high redshifts are being detected for extragalactic objects that are presumably very distant and young while also exhibiting properties that are characteristic of a more mature galaxy such as *** to Halton Arp and Geoffrey Burbidge,redshift disparities consist of an intrinsic component and are related to an evolutionary *** observed redshift periodicity at integer multiples of0.089 in log scale and Burbidge observed redshift periodicity at integer multiples of 0.061 in linear *** Singular Value Decomposition based periodicity estimation is known to be superior for noisy data sets,especially when the data contain multiple harmonics and overtones,mainly irregular in nature,we have chosen it to be our primary tool for analysis of the quasar-galaxy pair redshift *** have observed a fundamental periodicity of0.051 with a confidence interval of 95%in linear scale with the site-available Sloan Digital Sky Survey Data Release 7(SDSS DR7)quasar-galaxy pair data *** have independently generated quasar-galaxy pair data sets from both 2d F and SDSS and found fundamental periodicities of 0.077 and 0.089,respectively,in log scale with a confidence interval of 95%.

关键词： galaxies:distances and redshifts (galaxies:)quasars:absorption lines cosmology:observations

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Retinal artery/arteriole occlusion risks after endovascular treatment for unruptured intracranial aneurysm

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Stroke & Vascular Neurology 2024年第3期9卷 295-305,I0251-I0263页

作者： Hae Rang Kim Min Jeoung Kim Sunyeup Kim Myung Soo Chang Dong Joon Kim Byung Moon Kim Keun young Park Yong Bae Kim christopher Seungkyu Lee Suk Ho Byeon Sung Soo Kim Seung Won Lee Yong Joon Kim Department of Ophthalmology CHA Bundang Medical CenterCHA University College of MedicineSeongnamKorea(the Republic of) Department of Neurosurgery Severance Stroke CenterSeverance HospitalYonsei University College of MedicineSeoulKorea(the Republic of) Department of Neurosurgery Uijeongbu St.Mary’s HospitalThe Catholic University of Korea College of MedicineUijeongbuKorea(the Republic of) Department of Medical AI Sungkyunkwan University School of MedicineSuwonKorea(the Republic of) Department of Ophthalmology Institute of Vision ResearchYonsei University College of MedicineSeoulKorea(the Republic of) Department of Radiology Severance Stroke CenterSeverance HospitalYonsei University College of MedicineSeoulKorea(the Republic of) Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonKorea(the Republic of)

Background To evaluate the association between retinal artery/arteriole occlusion(RAO)and unruptured intracranial aneurysm(UIA).Methods Incident UIA patients from a nationwide cohort(n=253240)were categorised into three groups based on subsequent treatment:observation(n=208993),microsurgical clipping(n=14168)and endovascular treatment(EVT)groups(n=30079).The incidence and the incident time of RAO were *** of RAO and associated risk factors were ***,a hospital cohort comprising 2569 consecutive UIA patients treated at a tertiary hospital was analysed with detailed clinical information of *** In the nationwide cohort analysis,the incidence of RAO was significantly higher in EVT group than in observation and clipping groups,especially within 60 days(early RAO(within 60 days):HR=4.00,95%CI:2.44 to 6.56);delayed RAO(after 60 days:HR=1.74,95%CI:1.13 to 2.68).Multivariable analysis showed that the presence of chronic kidney disease(p=0.009)and use of a balloon microcatheter during the procedure(p=0.013)were associated with a higher risk of *** hospital cohort analysis,11(0.8%)cases of RAO occurred after EVT,whereas none occurred after microsurgical clipping(pyounger and received balloon microcatheters more frequently than their *** cases of RAO(90.9%)occurred in paraclinoid aneurysms,where EVT was preferred over microsurgical *** Performing EVT for UIA may increase the risk of subsequent *** should be taken when treating paraclinoid aneurysms with balloon microcatheters.

关键词： treatment nationwide balloon

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Biophotoelectrochemistry:An emerging frontier for channeling photoelectric effect into darkness zone of soils and sediments

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Pedosphere 2024年第1期34卷 5-8页

作者： Jie YE Shungui ZHOU Kenneth H.NEALSON christopher RENSING Fujian Provincial Key Laboratory of Soil Environmental Health and Regulation College of Resources and EnvironmentFujian Agriculture and Forestry UniversityFuzhou 350002China Department of Earth Science University of Southern CaliforniaLos Angeles CA 90007USA

Solar energy captured by photosynthetic plants in the photic zone is recognized as the main driver for the formation of organic matter utilized by soil communities. However, the contribution of organic transformation to the linkage of solar energy and microbial metabolism of soils is reduced when the vadose zone is saturated. In contrast to the conventional biophotoelectrochemistry via photosynthesis with phytoplankton during the periodic saturation of soils, recent studies suggest that non-phototrophic microorganisms in soils and sediments are able to conduct light-dependent metabolism to sustain their functionality with photosensitizers under illumination. These interactions and processes utilize long-distance electron transfer networks to interconnect diverse electron transfer chains that channel photoexcited electrons into the opaque zone for soil communities. Such an emerging process not only allows for a better understanding of biogeochemical processes such as soil carbon sequestration and mitigation, but also shows great potential for environmental treatment such as the bioremediation of contaminated soils. Therefore, we suggest that biophotoelectrochemistry via photoelectric effect can have significant, heretofore unappreciated, theoretical and practical values.

关键词： soils soil metabolism

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Dynamics of self-hybridized exciton–polaritons in 2D halide perovskites

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Light(Science & Applications) 2024年第1期13卷 13-22页

作者： Surendra B.Anantharaman Jason Lynch christopher E.Stevens christopher Munley Chentao Li Jin Hou Hao Zhang Andrew Torma Thomas Darlington Francis Coen Kevin Li Arka Majumdar PJames Schuck Aditya Mohite Hayk Harutyunyan Joshua R.Hendrickson Deep Jariwala Department of Electrical and Systems Engineering University of PennsylvaniaPhiladelphiaPA19104USA KBR Inc. BeavercreekOH45431USA Air Force Research Laboratory Sensors DirectorateWright-Patterson Air Force BaseOH45433USA Department of Physics University of WashingtonSeattleWA98195USA Department of Physics Emory UniversityAtlantaGA30322USA Department of Chemical and Biomolecular Engineering Rice UniversityHoustonTX77005USA Department of Materials Science and Nanoengineering Rice UniversityHoustonTX77005USA Applied Physics Program Smalley‐Curl InstituteRice UniversityHoustonTX77005USA Department of Mechanical Engineering Columbia UniversityNew YorkNY10027USA Department of Electrical and Computer Engineering University of WashingtonSeattleWA98195USA

Excitons,bound electron–hole pairs,in two-dimensional hybrid organic inorganic perovskites(2D HOIPs)are capable of forming hybrid light-matter states known as exciton-polaritons(E–Ps)when the excitonic medium is confined in an optical *** the case of 2D HOIPs,they can self-hybridize into E–Ps at specific thicknesses of the HOIP crystals that form a resonant optical cavity with the ***,the fundamental properties of these self-hybridized E–Ps in 2D HOIPs,including their role in ultrafast energy and/or charge transfer at interfaces,remain ***,we demonstrate that>0.5µm thick 2D HOIP crystals on Au substrates are capable of supporting multiple-orders of self-hybridized E–P *** E–Ps have high Q factors(>100)and modulate the optical dispersion for the crystal to enhance sub-gap absorption and *** varying excitation energy and ultrafast measurements,we also confirm energy transfer from higher energy E–Ps to lower energy E–***,we also demonstrate that E–Ps are capable of charge transport and transfer at *** findings provide new insights into charge and energy transfer in E–Ps opening new opportunities towards their manipulation for polaritonic devices.

关键词： charge polar excitation

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Deterministic epidemic models overestimate the basic reproduction number of observed outbreaks

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Infectious Disease Modelling 2024年第3期9卷 680-688页

作者： Wajid Ali christopher E.Overton Robert R.Wilkinson Kieran J.Sharkey Department of Mathematical Sciences University of LiverpoolPeach StreetLiverpoolL697ZXEnglandUnited Kingdom Department of Applied Mathematics Liverpool John Moores UniversityByrom StreetLiverpoolL35UXEnglandUnited Kingdom

The basic reproduction number,R_(0),is a well-known quantifier of epidemic ***,a class of existing methods for estimating R_(0)from incidence data early in the epidemic can lead to an over-estimation of this *** particular,when fitting deterministic models to estimate the rate of spread,we do not account for the stochastic nature of epidemics and that,given the same system,some outbreaks may lead to epidemics and some may ***,an observed epidemic that we wish to control is a major *** amounts to implicit selection for major outbreaks which leads to the over-estimation *** formally characterised the split between major and minor outbreaks by using Otsu's method which provides us with a working *** show that by conditioning a‘deterministic’model on major outbreaks,we can more reliably estimate the basic reproduction number from an observed epidemic trajectory.

关键词： Estimating R_(0) Simple birth-death process Major outbreak Conditioned epidemic Stochastic fade-out

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