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A review of the current evidence for the role of minimally invasive pancreatic surgery following neo-adjuvant chemotherapy

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第2期5卷 47-51页

作者： francis p.robertson Rowan W.parks Department of Hepatobiliary and Transplant Surgery Freeman HospitalNewcastleUnited Kingdom Department of Clinical Surgery Royal Infirmary of EdinburghEdinburghUnited Kingdom Division of Surgical and Interventional Science Royal Free CampusUniversity College LondonLondonUnited Kingdom

Objective:Surgical resection of pancreatic cancer remains the only potentially curative treatment for pancreatic ductal *** robotic platform has been introduced to surgical practice and recent large studies from national registries have demonstrated similar or improved peri-operative outcomes compared to the standard open ***-adjuvant chemotherapy is increasingly being offered to patients with borderline resectable/locally advanced disease but this has led to more challenging *** of patients undergoing minimally invasive resection following neo-adjuvant chemotherapy remain *** aim of this review is to assess the current evidence for the peri-operative safety and long-term oncological outcomes associated with minimally invasive pancreatic resection following neo-adjuvant ***:Medline,Embase and Cochrane Central Register for Clinical Trials were searched up until 31st October *** search terms include“minimally invasive”,“robotic”,“laparoscopic”,“pancreatectomy”,“pancreatic resection”,“whipple's pancreaticoduodenectomy”,“distal pancreatectomy”,“chemotherapy”,“neo-adjuvant chemotherapy”,“radiotherapy”,“neo-adjuvant chemoradiotherapy”,“induction therapy”,and“conversion surgery”.All studies including patients undergoing pancreatic resections were *** which did not clearly state the approach to resection(minimally invasive or open)were ***:Seventy-eight studies were identified of which 8 compared open and minimally invasive resection following neo-adjuvant *** was insufficient data to perform a *** surgery was associated with lower blood loss and shorter length of hospital ***-year overall survival rates were similar between patients who underwent robotic or open resection however the robotic approach was associated with higher lymph node yield and a lower R1 resection ***:Currently the evidence for minimally invasive surgery foll

关键词： pancreatic resection Minimally invasive Robotic Neo-adjuvant chemotherapy

Intraoperative pancreas stump perfusion assessment during pancreaticoduodenectomy:A systematic scoping review

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世界胃肠外科杂志:英文版(电子版) 2023年第8期15卷 1799-1807页

作者： francis p robertson Harry V M Spiers Wei Boon Lim Benjamin Loveday Keith Roberts Sanjay pandanaboyana Department of HpB and Transplant Surgery Freeman HospitalNewcastle Upon Tyne NE77DNUnited Kingdom Department of HpB Surgery Addenbrookes HospitalCambridge CB20QQUnited Kingdom Department of General Surgery Royal Melbourne HospitalMelbourne VIC 3050Australia Department of HpB Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham BG152GWUnited Kingdom

BACKGROUND post-operative pancreatic fistula(pOpF)is the primary cause of morbidity following *** of pOpF have remained high despite well known risk *** theory that hypoperfusion of the pancreatic stump leads to anastomotic failure has recently gained *** To define the published literature with regards to intraoperative pancreas perfusion assessment and its correlation with *** A systematic search of available literature was performed in November *** extracted included study characteristics,method of assessment of pancreas stump perfusion,pOpF and other post-pancreatic surgery specific *** Five eligible studies comprised two prospective non-randomised studies and three case reports,total 156 *** studies used indocyanine green fluorescence angiography to assess the pancreatic stump,with the remaining study assessing pancreas perfusion by visual inspection of arterial bleeding of the pancreatic *** was significant heterogeneity in the definition of *** had a combined pOpF rate of 12%;intraoperative perfusion assessment revealed hypoperfusion was present in 39%of patients who developed *** rate of pOpF was 11%in patients with no evidence of hypoperfusion and 13%in those with evidence of hypoperfusion,suggesting that not all hypoperfusion gives rise to pOpF and further analysis is required to analyse if there is a clinically relevant cut *** variance in practice was seen in the pancreatic stump management once hypoperfusion was *** The current published evidence around pancreas perfusion during pancreaticoduodenectomy is of poor *** does not support a causative link between hypoperfusion and *** well-designed prospective studies are required to investigate this.

关键词： pancreatico-duodenectomy post-operative pancreatic fistula perfusion Indocyanine green post pancreatectomy pancreatitis

Impact of COVID-19-related lifestyle changes on diabetic macular edema

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 97-106页

作者： Bryce p.Johnson Yu-Guang He Zachary M.robertson Angeline Wang Rafael L.Ufret-Vincenty Department of Ophthalmology UT Southwestern Medical CenterDallasTexas 75390-9057USA

AIM:To assess diabetic macular edema(DME)progression during the early phases of the COVID-19 pandemic,when severe societal restrictions raised the concern of possible deterioration of health in patients with systemic conditions,particularly those requiring frequent office ***:This is a multicenter retrospective chart review of 370 patients(724 eyes)with an established diagnosis of DME seen on 3 separate visits between January 2019 and July *** 1 was January 2019 to February 2020(considered pre-COVID-19),period 2 was March 2020 to December 2020(considered the height of the pandemic;highest level of pandemic-related clinical and societal regulations)and period 3 was January 2021 to July 2021(re-adjustment to the new“pandemic norms”).Main outcome measures included visual acuity,body mass index(BMI),blood pressure(Bp),hemoglobin A1c(HbA1c),macular thickness,patient adherence to scheduled ophthalmology visits,and DME treatment(s)received at each *** facilitate measurement of macular thickness,each macula was divided into 9 Early Treatment Diabetic Retinopathy Study(ETDRS)-defined macular sectors as measured by OCT ***:There was no change of BMI,systolic Bp,and diastolic Bp between any of the time ***1c showed a very small increase from period 1(7.6%)to period 2(7.8%,p=0.015)and decreased back to 7.6%at period 3(p=0.12).Macular thickness decreased for 100%of macular *** central macular thickness decreased across all 3 periods from 329.5 to 316.6μm(p=0.0045).After analysis of multiple variables including HbA1c,BMI,adherence to scheduled appointments,different clinic centers,and treatment interventions,there was no easily identifiable subgroup of patients that experienced the increase in ***:DME doesn’t worsen during the COVID-19 pandemic,instead sustaining a very small but statistically significant *** identifying a mechanism behind our findings is beyond the scope of this study,potential explanat

关键词： COVID-19 diabetic macular edema diabetic retinopathy optical coherence tomography

Understanding the catalysis of chromium trioxide added magnesium hydride for hydrogen storage and Li ion battery applications

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Journal of Magnesium and Alloys 2024年第3期12卷 1117-1130页

作者： D.pukazhselvan IhsanÇaha Catarina de Lemos Sergey M.Mikhalev francis Leonard Deepak Duncan paul Fagg Department of Mechanical Engineering TEMA-Centre for Mechanical Technology and AutomationUniversity of AveiroAveiro 3810-193Portugal LASI-Intelligent Systems Associate Laboratory Guimarães 4800-058Portugal Nanostructured Materials Group International Iberian Nanotechnology Laboratory(INL)Avenida Mestre Jose VeigaBraga 4715-330Portugal

This study explores how the chemical interaction between magnesium hydride(MgH_(2))and the additive CrO_(3) influences the hydrogen/lithium storage characteristics of MgH_(2).We have observed that a 5 wt.%CrO_(3) additive reduces the dehydrogenation activation energy of MgH_(2) by 68 kJ/mol and lowers the required dehydrogenation temperature by 80℃.CrO_(3) added MgH_(2) was also tested as an anode in an Li ion battery,and it is possible to deliver over 90%of the total theoretical capacity(2038 mAh/g).Evidence for improved reversibility in the battery reaction is found only after the incorporation of additives with MgH_(2).In depth characterization study by X-ray diffraction(XRD)technique provides convincing evidence that the CrO_(3) additive interacts with MgH_(2) and produces Cr/MgO *** free energy analyses confirm the thermodynamic feasibility of conversion from MgH_(2)/CrO_(3) to MgO/Cr,which is well supported by the identification of Cr(0)in the powder by X ray photoelectron spectroscopy(XpS)*** high resolution transmission electron microscopy(HRTEM)and energy dispersive spectroscopy(EDS)we found evidence for the presence of 5 nm size Cr nanocrystals on the surface of MgO rock salt *** is also convincing ground to consider that MgO rock salt accommodates Cr in the *** observations support the argument that creation of active metal–metal dissolved rock salt oxide interface may be vital for improving the reactivity of MgH_(2),both for the improved storage of hydrogen and lithium.

关键词： Hydrogen storage Rechargeable batteries Binary hydrides Metal oxides Catalytic mechanism.

Fuzzy Difference Equations in Diagnoses of Glaucoma from Retinal Images Using Deep Learning

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Computer Modeling in Engineering & Sciences 2024年第4期139卷 801-816页

作者： D.Dorathy prema Kavitha L.francis Raj Sandeep Kautish Abdulaziz S.Almazyad Karam M.Sallam Ali Wagdy Mohamed Department of Mathematics Voorhees CollegeVelloreTamil NaduIndia Chandigarh Group of Colleges JhanjeriMohaliPunjabIndia Department of Computer Engineering College of Computer and Information SciencesKing Saud UniversityP.O.Box 51178Riyadh11543Saudi Arabia Faculty of Science and Technology School of IT and SystemsUniversity of CanberraCanberraAustralia Operations Research Department Faculty of Graduate Studies for Statistical ResearchCairo UniversityGiza12613Egypt Applied Science Research Center Applied Science Private UniversityAmman11937Jordan

The intuitive fuzzy set has found important application in decision-making and machine *** enrich and utilize the intuitive fuzzy set,this study designed and developed a deep neural network-based glaucoma eye detection using fuzzy difference equations in the domain where the retinal images *** image detections are categorized as normal eye recognition,suspected glaucomatous eye recognition,and glaucomatous eye *** degrees associated with weighted values are calculated to determine the level of concentration between the fuzzy partition and the retinal *** proposed model was used to diagnose glaucoma using retinal images and involved utilizing the Convolutional Neural Network(CNN)and deep learning to identify the fuzzy weighted regularization between *** methodology was used to clarify the input images and make them adequate for the process of glaucoma *** objective of this study was to propose a novel approach to the early diagnosis of glaucoma using the Fuzzy Expert System(FES)and Fuzzy differential equation(FDE).The intensities of the different regions in the images and their respective peak levels were *** the peak regions were identified,the recurrence relationships among those peaks were then *** partitioning was done due to varying degrees of similar and dissimilar concentrations in the *** and dissimilar concentration levels and spatial frequency generated a threshold image from the combined fuzzy matrix and *** distinguished between a normal and abnormal eye condition,thus detecting patients with glaucomatous eyes.

关键词： Convolutional Neural Network(CNN) glaucomatous eyes fuzzy difference equation intuitive fuzzy sets image segmentation retinal images

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

Split Addition of Nitrogen-Rich Substrate at Thermophilic and Mesophilic Stages of Composting: Effect on Green House Gases Emission and Quality of Compost

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Open Journal of Soil Science 2024年第2期14卷 133-158页

作者： Boakye Acheampong Kodwo Miezah Enoch Bessah Benedicta Essel Ayamba francis Kemausour Department of Agricultural and Biosystems Engineering College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana Department of Environmental Science College of Science Kwame Nkrumah University of Science and Technology Kumasi Ghana Soil Fertility and plant Nutrition Division CSIR-Soil Research Institute Kumasi Ghana The Brew-Hammond Energy Center College of Engineering Kwame Nkrumah University of Science and Technology Kumasi Ghana

Composting as a solution to the increasing generation of municipal solid waste (MSW), also contribute to GHGs emission when not controlled and could lack some basic nutrients, especially nitrogen. This study assessed the split-additions of nitrogen-rich substrate to composting materials and their effect on GHGs emissions as well as the quality of the composts. Nitrogen-rich substrates formulated from pig and goat manure were co-composted with MSW for a 12-weeks period by split adding at mesophilic (˚C) and thermophilic (>50˚C) stages in five different treatments. Representative samples from the compost were taken from each treatment for physicochemical, heavy metals and bacteriological analysis. In-situ CH4, CO2, N2O gas emissions were also analyzed weekly during composting. It was observed that all the treatments showed significant organic matter decomposition, reaching thermophilic temperatures in the first week of composting. The absence affects the suitable agronomic properties. All nitrogen-rich substrate applied at thermophilic stage (Treatment two) recorded the highest N, p and K concentrations of 1.34%, 0.97% and 2.45%, respectively with highest nitrogen retention. In terms of GHG emissions, CO2 was highest at the thermophilic stage when N-rich substrate was added in all treatment, while CH4 was highest in the mesophilic stage with N-rich substrate addition. N2O showed no specific trend in the treatments. Split addition of the N-rich substrate for co-composting of MSW produced compost which is stable, has less nutrient loss and low GHG emissions. Split addition of a nitrogen-rich substrate could be an option for increasing the fertilizer value of MSW compost.

关键词： Compost Nitrogen-Rich Substrate Thermophilic Mesophilic Greenhouse Gas Emissions

Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon parul J Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil W pearce Wesley francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND pancreaticoduodenectomy(pD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-pD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-pD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-pD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of pancreatic Surgery were used to define post-pD complications,and the modified Clavien-Dindo classification was used to classify post-pD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent pDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;p=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： pancreas Complication Rescue Failure Morbidity Mortality pancreaticoduodenectomy

Socio-Demographic and Clinical Characteristics of patients presenting with Lower Urinary Tract Symptoms Secondary to BpH, in a Tertiary Hospital

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Open Journal of Urology 2024年第8期14卷 447-457页

作者： Abdul-Jalilu Mohammed Muntaka Edwin Mwintiereh Ta-Ang Yenli francis Atindaana Abantanga Department of Surgery School of Medicine University for Development Studies Tamale Ghana Department of Surgery Tamale Teaching Hospital Tamale Ghana

Background: Benign prostatic hyperplasia (BpH) is the proliferation of the stromal and epithelial cells of the prostate gland, resulting in an increase in its size. This may result in obstruction of the lower urinary tract causing storage and voiding symptoms. Methods: This was a prospective cross-sectional study from August 2020 to July 2021, to evaluate the characteristic of patients presenting to the Tamale Teaching Hospital with lower urinary tract symptoms secondary to BpH. Results: The median age at presentation with LUTS secondary to BpH is 68.88 ± 11.10 years with an average prostate volume of 70 g. The average time of presentation to the hospital is 5 months, mostly with moderate to severe symptoms. Correlation between prostate volume (pV) and age yielded a positive relationship;however, this was not statistically significant, (r = 0.028, p-value = 0.747). There was a significant positive relationship between pV and the IpSS score, (r = 0.334, p-value Conclusion: Our patients with symptomatic BpH present at age 60 years and above, with nearly all of them presenting with moderate to severe LUTS.

关键词： Benign prostate Hyperplasia Lower Urinary Tract Symptoms Sociodemographic Characteristics