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Effect of a region-wide incorporation of an algorithm based on the 2012 international consensus guideline on the practice pattern for the management of pancreatic cystic neoplasms in an integrated health system

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World Journal of Clinical Cases 2018年第13期6卷 624-631页

作者： Andrew Khoi Nguyen Agathon Girgis Timnit Tekeste Karen Chang Mopelola Adeyemo Armen Eskandari emilio alonso Priyanka Yaramada Charles Chaya Albert Ko Edmund Burke Isaiah Roggow Rebecca Butler Aniket Kawatkar Brian S Lim School of Medicine University of California Department of Gastroenterology Kaiser Permanente Riverside Medical Center Department of Surgery Kaiser Permanente Riverside Medical Center Department of Research and Evaluation Southern California Permanente Medical Group

AIM To examine the practice pattern in Kaiser Permanente Southern California(KPSC), i.e., gastroenterology(GI)/surgery referrals and endoscopic ultrasound(EUS), for pancreatic cystic neoplasms(PCNs) after the regionwide dissemination of the PCN management *** Retrospective review was performed; patients with PCN diagnosis given between April 2012 and April 2015(18 mo before and after the publication of the algorithm) in KPSC(integrated health system with 15 hospitals and 202 medical offices in Southern California) were ***2558(1157 pre-and 1401 post-algorithm) received a new diagnosis of PCN in the study period. There was no difference in the mean cyst size(pre-19.1 mm vs post-18.5 mm, P = 0.119). A smaller percentage of PCNs resulted in EUS after the implementation of the algorithm(pre-45.5% vs post-34.8%, P < 0.001). A smaller proportion of patients were referred for GI(pre-65.2% vs post-53.3%, P < 0.001) and surgery consultations(pre-24.8% vs post-16%, P < 0.001) for PCN after the implementation. There was no significant change in operations for PCNs. Cost of diagnostic care was reduced after the implementation by 24%, 18%, and 36% for EUS, GI, and surgery consultations, respectively, with total cost saving of 24%.CONCLUSION In the current healthcare climate, there is increased need to optimize resource utilization. Dissemination of an algorithm for PCN management in an integrated health system resulted in fewer EUS and GI/surgery referrals, likely by aiding the physicians ordering imaging studies in the decision making for the management of PCNs. This translated to cost saving of 24%, 18%, and 36% for EUS, GI, and surgical consultations, respectively, with total diagnostic cost saving of 24%.

关键词： Pancreatic cyst Algorithm incorporation Pancreas Optimization of resource utilization Fukuoka criteria Sendai criteria Pancreatic cancer Intraductal papillary mucinous neoplasm Practice management Algorithm

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The impact of maternal immune activation on the morphology and electrophysiological properties of postnatally-born neurons in the offspring

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Neural Regeneration Research 2024年第2期19卷 399-400页

作者： emilio J.Galván Angelica Zepeda Departamento de Farmacobiología CINVESTAV Unidad Sur CdMxMéxico、Centro de Investigaciones sobre el EnvejecimientoCIE-CinvestavCdMxMéxico Departamento de Medicina Genómica y Toxicología Ambiental Instituto de Investigaciones BiomédicasUniversidad Nacional Autónoma de MéxicoUNAMCdMxMéxico

Pregnancy comes with a combination of physical changes and physiological immunosuppression that increases the susceptibility of women to pathogens and in turn,rises the prevalence of infectious diseases.

关键词： prevalence activation impact

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Seismic responses of an intensively constructed metro station-passageway-shaft structure system

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Frontiers of Structural and Civil Engineering 2024年第5期18卷 760-775页

作者： Ruohan LI Yong YUAN Hong CHEN Xinxing LI emilio BILOTTA Department of Geotechnical Engineering Tongji UniversityShanghai 200092China Department of Civil Architectural and Environmental EngineeringUniversity of Naples Federico IINaples 80125Italy State Key Laboratory of Disaster Reduction in Civil Engineering Tongji UniversityShanghai 200092China Shanghai Tunnel Engineering&Rail Transit Design and Research Institute Shanghai 200235China

Intensive construction methods offer benefits for metro station development,yet they present challenges for seismic design due to the spatially asymmetric configuration of passageway-shaft *** this study,a detailed numerical model of a station-passageway-shaft structure system built using intensive construction methods was developed and the deformation and damage modes under seismic loadings were *** results indicate that inconsistent deformation between the shaft and the station generates interaction through the connecting passageway,leading to damage near the opening of the station structure and both ends of the connecting passageway Damage is more severe under longitudinal *** with the opening plan that spans four segments,the opening plan that spans five segments exacerbates the overall degree of damage to the structure *** transverse excitation,the presence of interior structures intensifies the damage to the station and connecting passageway,while with such internal structure in place the impact is relatively minor under longitudinal *** with steel segments near the station opening can appreciably attenuate the *** contrast,introducing flexible joints at both ends of the connecting passageway intensifies the ***,reinforcement using steel segments emerges as an optimal seismic mitigation strategy.

关键词： earthquake intensive construction metro station numerical simulation

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Solar hydrogen production from electrochemical ammonia splitting powered by a single perovskite solar cell

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Journal of Energy Chemistry 2024年第5期92卷 292-295页

作者： Anna MBeiler Wenhui Li Alisa Denisiuk emilio Palomares Antoni Llobet Institute of Chemical Research of Catalonia(ICIQ).Barcelona Institute of Science and Technology(BIST) 43007 TarragonaSpain Catalan Institution for Research and Advanced Studies(ICREA) 08010 BarcelonaSpain Departament de Química Universitat Autònoma de BarcelonaCerdanyola del Vallès08193 BarcelonaSpain

For carbon-free electrochemical fuel formation,the electrochemical cell must be powered by renewable *** solar-powered H_(2) fuel from water typically requires multiple photovoltaic cells and/or junctions to drive the water splitting *** of the lower thermodynamic requirements to oxidize ammonia compared to water,solar cells with smaller open circuit voltages can provide the required potential for ammonia *** this work,a single perovskite solar cell with an open-circuit potential of 1.08 V is coupled to a 2-electrode electrochemical cell employing hybrid electroanodes functionalized with Ru-based molecular *** device is active for more than 30 min,producing N_(2) and H_(2) in a 1:2.9 ratio with 89%faradaic efficiency with no external applied *** work illustrates that hydrogen production from ammonia can be driven by conventional semiconductors.

关键词： Ammonia oxidation Redox catalysis Perovskites Solarfuels Transitionmetal complexes

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Temporal stability and directional change in a color cline of a marine snail from NW Spain

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Current Zoology 2024年第2期70卷 163-173页

作者： Juan Gefaell Ramon Vigo A.Honorato Gonzalez-Vazquez Juan Galindo emilio Rolan-Alvarez Centro de Investigacion Marina Universidade de VigoDepartamento de BioquimicaGenetica e Inmunologia36310 VigoSpain

The evolution and maintenance of color clines is a classic topic of research in evolutionary ***,studies analyzing the temporal dynamics of such clines are much less frequent,due to the difficulty of obtaining reliable data about past color distributions along environmen-tal *** this article,we describe a case of decades-long temporal stability and directional change in a color cline of the marine snail Littorina saxatilis along the coastal inlet of the Ria de Vigo(NW Spain).*** from this area shows a clear color cline with 3 distinct areas from the innermost to the more wave-exposed localities of the Ria:the inner,protected localities show an abundance of fawn-like individuals;the intermediate localities show a high diversity of colors;and the outer,wave-exposed localities show populations with a high frequency of a black and lineated *** compare data from the 1970s and 2022 in the same localities,showing that the cline has kept relatively stable for at least over half a century,except for some directional change and local variability in the frequency of certain *** regression analyses and biodiversity measures are presented to provide clues into the selective pressures that might be involved in the maintenance of this color *** research avenues to properly test the explanatory power of these selective agents as well as the possible origins of the cline are discussed.

关键词： clinal variation color polymorphism ecological gradient Littorina saxatilis natural selection wave exposure.

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Prevalence and ecological factors affecting the distribution of plant-parasitic nematodes in Prunus groves in Spain

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Journal of Integrative Agriculture 2024年第2期23卷 566-589页

作者： Ilenia Clavero-Camacho Antonio Archidona-Yuste Carolina Cantalapiedra-Navarrete Pablo Castillo Juan emilio Palomares-Rius Institute for Sustainable Agriculture(IAS) Spanish National Research Council(CSIC)Córdoba 14004Spain Andalusian Institute of Agricultural and Fisheries Research and Training(IFAPA) Centro Alameda del ObispoCórdoba 14004Spain

A wide survey was conducted to study plant-parasitic nematodes(PPNs)associated with Prunus groves in *** research aimed to determine the prevalence and distribution of PPNs in Prunus groves,as well as the influence of explanatory variables describing soil,climate and agricultural management in structuring the variation of PPNs community composition.A total of 218 sampling sites were surveyed and 84 PPN species belonging to 32 genera were identified based of an integrative taxonomic *** species considered as potential limiting factors in Prunus production,such as Meloidogyne arenaria,***,***,Pratylenchus penetrans and ***,were identified in this *** soil physico-chemical(C,Mg,N,Na,OM,P,pH and clay,loamy sand and sandy loam texture classes),four climate(Bio04,Bio05,Bio13 and Bio14)and four agricultural management variables(grove-use history less than 10 years,irrigation,apricot seedling rootstock,and Montclar rootstock)were identified as the most influential variables driving spatial patterns of PPNs *** particular,younger plantations showed higher values for species richness and diversity indices than groves cultivated for more than 20 years with Prunus *** study increases the knowledge of the distribution and prevalence of PPNs associated with Prunus rhizosphere,as well as on the influence of explanatory variables driving the spatial structure PPNs communities,which has important implications for the successful design of sustainable management strategies in the future in this agricultural system.

关键词： nematodes Meloidogyne Pratylenchus Paratylenchus rootstock distribution soil grove-use almond peach

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In‑depth proteome characterization of endometrium and extraembryonic membranes during implantation in pig

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1027-1055页

作者： Maria A.Gil Josep M.Cambra Heriberto Rodriguez‑Martinez Cristina Cuello Inmaculada Parrilla emilio A.Martinez Department of Medicine and Animal Surgery International Excellence Campus for Higher Education and Research“Campus Mare Nostrum”University of MurciaMurciaSpain Institute for Biomedical Research of Murcia(IMIB-Pascual Parrilla) MurciaSpain Technical University of Munich MunichGermany Department of Biomedical&Clinical Sciences(BKV) BKH/Obstetrics&GynaecologyLinkoping UniversityLinkopingSweden

Background Proteome characterization of the porcine endometrium and extraembryonic membranes is important to understand mother-embryo *** this study,the proteome of the endometrium and cho-rioallantoic membrane was characterized in pregnant sows(PS)during early gestation(d 18 and 24 of gestation)and in the endometrium of non-pregnant sows(NPS)during the same days using LC-MS/MS *** UniProtKB database and ClueGO were used to obtain functional Gene Ontology annotations and biological and functional networks,*** Our analysis yielded 3,254 and 3,457 proteins identified in the endometrium of PS and NPS,respectively;of these,1,753 being common while 1,501 and 1,704 were exclusive to PS and NPS,*** addition,we iden-tified 3,968 proteins in the extraembryonic membranes of *** analyses of function revealed some proteins had relevance for the immune system process and biological adhesion in endometrium while the embryonic chorion displayed abundance of proteins related to cell adhesion and cytoskeletal organization,suggesting they dominated the moment of endometrial remodeling,implantation and adhesion of the lining *** are available via Pro-teomeXchange with identifier *** This is the first in-depth proteomic characterization of the endometrium and extraembryonic mem-branes during weeks 3 to 4 of gestation;data that contribute to the molecular understanding of the dynamic environ-ment during this critical period,associated with the majority of pregnancy losses.

关键词： Endometrium Extraembryonic membranes Implantation Pig Proteome

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PACK-CXL *** therapy for bacterial,fungal,and mixed infectious keratitis:a prospective randomized phase 3 trial

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Eye and Vision 2024年第1期10卷 10-20页

作者： Farhad Hafezi Mohammed Hosny Rohit Shetty Boris Knyazer Shihao Chen Qinmei Wang Hassan Hashemi emilio A.Torres‑Netto 无 Center for Applied Biotechnology and Molecular Medicine(CABMM) University of ZurichZurichSwitzerland ELZA Institute DietikonSwitzerland. Faculty of Medicine University of GenevaGenevaSwitzerland Department of Ophthalmology Medical University of WenzhouWenzhouChina USC Roski Eye Institute University of Southern California Los AngelesLos AngelesUSA Department of Ophthalmology University of CairoCairoEgypt Narayana Nethralaya Eye Hospital and the Postgraduate Institute of Ophthal‑mology BangaloreIndia Department of Ophthalmology Soroka University Medical CenterBen-Gurion University of the NegevBeershebaIsrael Noor Ophthalmology Research Center Noor Eye HospitalTehranIran University Hospital Zurich ZurichSwitzerland. the PACK-CXL Working Group

Background:Infectious keratitis is a major cause of global *** tested whether standalone photoactivated chromophore corneal cross-linking(PACK-CXL)may be an efective frst-line treatment in early to moderate infectious keratitis,compared with standard antimicrobial ***:This is a randomized,controlled,multinational phase 3 clinical *** in fve centers in Egypt,India,Iran,Israel,and China,aged≥18 years,with infectious keratitis of presumed bacterial,fungal,or mixed origin,were randomly assigned(1:1)to PACK-CXL,or antimicrobial *** measures included healing,defned as time to re-epithelialization of the corneal epithelial defect in the absence of infammatory activity in the anterior chamber and clearance of stromal *** success was defned as the complete resolution of signs of ***:Between July 21,2016,and March 4,2020,participants were randomly assigned to receive PACK-CXL(n=18)or antimicrobial therapy per American Academy of Ophthalmology(AAO)guidelines(n=21).No participants were lost to *** eyes were excluded from the epithelialization time analysis due to treatment failure:two in the antimicrobial therapy group,and two in the PACK-CXL *** rates were 88.9%(16/18 patients)in the PACK-CXL group and 90.5%(19/21 patients)in the medication *** was no signifcant diference in time to complete corneal re-epithelialization(P=0.828)between both treatment ***:PACK-CXL may be an alternative to antimicrobial drugs for frst-line and standalone treatment of early to moderate infectious keratitis of bacterial or fungal origin.

关键词： Photoactivated chromophore Corneal cross-linking Infectious keratitis Corneal melting PACK-CXL

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Federated Network Intelligence Orchestration for Scalable and Automated FL-Based Anomaly Detection in B5G Networks

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Computers, Materials & Continua 2024年第7期80卷 163-193页

作者： Pablo Fernández Saura José M.Bernabé Murcia emilio García de la Calera Molina Alejandro Molina Zarca Jorge Bernal Bernabé Antonio F.Skarmeta Gómez Department of Information and Communications Engineering University of MurciaMurcia30100Spain University Center of Defense Spanish Air Force AcademySan Javier30720Spain

The management of network intelligence in Beyond 5G(B5G)networks encompasses the complex challenges of scalability,dynamicity,interoperability,privacy,and *** are essential steps towards achieving the realization of truly ubiquitous Artificial Intelligence(AI)-based analytics,empowering seamless integration across the entire Continuum(Edge,Fog,Core,Cloud).This paper introduces a Federated Network Intelligence Orchestration approach aimed at scalable and automated Federated Learning(FL)-based anomaly detection in *** leveraging a horizontal Federated learning approach based on the FedAvg aggregation algorithm,which employs a deep autoencoder model trained on non-anomalous traffic samples to recognize normal behavior,the systemorchestrates network intelligence to detect and prevent *** into a B5G Zero-touch Service Management(ZSM)aligned Security Framework,the proposal utilizes multi-domain and multi-tenant orchestration to automate and scale the deployment of FL-agents and AI-based anomaly detectors,enhancing reaction capabilities against *** proposed FL architecture can be dynamically deployed across the B5G Continuum,utilizing a hierarchy of Network Intelligence orchestrators for real-time anomaly and security threat *** includes FL enforcement operations for interoperability and extensibility,enabling dynamic deployment,configuration,and reconfiguration on *** validation of the proposed solution was conducted through dynamic orchestration,FL,and real-time anomaly detection processes using a practical test *** of key performance metrics,leveraging the 5G-NIDD dataset,demonstrates the system’s capability for automatic and near real-time handling of anomalies and attacks,including real-time network monitoring and countermeasure implementation for mitigation.

关键词： Federated learning 6G orchestration anomaly detection security policy

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Did pediatric drug development advance epilepsy treatment in young patients?It is time for new research goals

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World Journal of Methodology 2024年第2期14卷 65-74页

作者： Earl B Ettienne emilio Russo Pasquale Striano Jane M Grant-Kels Klaus Rose College of Pharmacy Howard University College of PharmacyWashingtonDC 20059United States Department of Health Sciences School of MedicineRussoUniversity"Magna Graecia"of CatanzaroCatanzaro 88100Italy IRCCS Istituto Giannina Gaslini Genova 16148Italy Department of Dermatology University of Connecticut Health CenterFarmingtonCT 06032United States klausrose Consulting Pediatric Drug Development and moreMedical ScienceCH-4125 RiehenSwitzerland

Modern drugs have changed epilepsy,which affects people of all ***,for young people with epilepsy,the framework of drug development has *** the wake of the thalidomide catastrophe,the misconception emerged that for people<18 years of age drugs,including antiseizure medications(ASMs),need separate proof of efficacy and safety,overall called"pediatric drug development".For ASMs,this has changed to some *** now accept that ASMs are effective in<18 years as well,but they still require"extrapolation of efficacy,"as if minors were another *** a result,some of the pediatric clinical epilepsy research over the past decades was *** more importantly,this has hampered research on meaningful research *** do not need to confirm that ASMs work before as they do after the 18th ***,we need to learn how to prevent brain damage in young patients by preventing seizures and optimize ASMs’*** we discuss how to proceed in this endeavor.

关键词： Epilepsy Pediatric drug development Therapeutic orphans Antiseizure medications Pediatric investigation plan Clinical pharmacology

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