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Outcomes after natural orifice extraction vs conventional specimen extraction surgery for colorectal cancer: A propensity scorematched analysis

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World Journal of Clinical Oncology 2022年第10期13卷 789-801页

作者： isaac seow-en Lionel Raphael Chen Yi-Xin Li Yun Zhao Jing-Hui Chen Hairil Rizal Abdullah Emile Kwong-Wei Tan Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of Surgery Duke-NUS Graduate Medical SchoolSingapore 169857Singapore Department of Anaesthesiology Singapore General HospitalSingapore 169608Singapore

BACKGROUND Natural orifice specimen extraction(NOSE)via the anus or vagina replaces conventional transabdominal specimen retrieval via the transabdominal route through a limited mid-line laparotomy or Pfannenstiel *** the number of laparoscopic ports further decreases operative abdominal wall *** techniques reduce the surgical wound size as well as the risk of incisionrelated *** To compare short-term outcomes following 3-port NOSE surgery with a matched cohort of conventional non-NOSE colorectal cancer *** Patients who underwent elective 3-port laparoscopic colorectal NOSE surgery between February to October 2021 were *** criteria for NOSE surgery was adapted from the 2019 International Consensus on Natural Orifice Specimen Extraction Surgery for colorectal *** with clinical T4 or N2 tumors on staging computed tomography were also *** propensity score-matched cohort was identified amongst patients who underwent conventional laparoscopic colorectal surgery from January 2019 to December *** was performed in the ratio of 1:4 based on age,gender,type of resection,and p-tumor node metastasis *** Over the eight-month study duration,14 consecutive cases(nine female,five male)of elective 3-port laparoscopic surgery with NOSE were performed for colorectal *** age and body mass index were 70(range 43-82)years and 24.1(range 20.0-31.7)kg/m2 *** patients underwent transanal NOSE and eight had transvaginal *** operative time,intraoperative blood loss and postoperative length of stay were 208(range 165-365)min,30(range 10-150)mL and 3(range 2-6)d ***(14%)suffered minor postoperative compilations not attributable to the NOSE *** follow-up duration was 12(range 8-15)*** instances of mortality,local or distant disease recurrence were recorded in this *** to the conventional surgery cohort of 56 patients,the 3

关键词： 3-port laparoscopy Colorectal surgery Natural orifice specimen extraction Transanal Transvaginal Minimally invasive surgery

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Palliative surgery for Krukenberg tumors—12-year experience and review of the literature

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World Journal of Clinical Oncology 2018年第1期9卷 13-19页

作者： isaac seow-en Gwen Hwarng Grace Hwei Ching Tan Leonard Ming Li Ho Melissa Ching Ching Teo Department of Colorectal Surgery Singapore General Hospital Duke-NUS Medical School Department of Surgical Oncology National Cancer CentreSingapore

AIM To determine the clinical characteristics of patients undergoing palliative surgery for Krukenberg tumors,including disease presentation,outcomes,and prognostic *** This was a retrospective clinical study of all patients who underwent palliative surgery for Krukenberg tumors between January 2004 and December *** information was obtained from inpatient and outpatient case notes as well as the hospital electronic *** who underwent potential y curative resection,and patients with Krukenberg tumors who did not undergo surgery were also excluded from the *** surgery was defined as those performed for either alleviation of symptoms or for asymptomatic patients for whom surgical removal of the tumors were deemed necessary following a multidisciplinary *** were diagnosed pre-operatively by computed tomography scans and all had histologic confirmation of the surgical *** Over the study duration,38 female patients underwent palliative surgery for Krukenberg tumors at our *** age was 54.2±11.7 *** colon was the most frequent primary source of metastases(n=21)followed by the stomach(n=4).Prophylactic palliative surgery was performed for eight(21.1%)asymptomatic *** post-operative length of stay was 8 d(IQR 6-12 d).Five patients(13.2%)experienced postoperative complications,although high grade morbidity was only seen in one patient(2.6%).Median overall survival from surgery was 17 mo(95%CI:12.1-21.9)at a median follow-up duration of 12 mo(IQR 8-17mo).The median survival was shorter for patients who underwent emergency surgery,younger patients,those with a colorectal primary,larger tumors,or synchronous peritoneal or hepatic *** Pal iative surgery for Krukenberg tumors can be performed safely with acceptable complication *** oophorectomy should be performed to prevent the risk of symptomatic contralateral tumors.

关键词： Krukenberg tumor Palliative surgery

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Intestinal type gastric adenocarcinoma with unusual synchronous metastases to the colorectum and bladder

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World Journal of Clinical Cases 2015年第6期3卷 533-537页

作者： isaac seow-en Francis seow-Choen Department of General Surgery Singapore General Hospital seow-Choen Colorectal Centre Pte Ltd

A 75-year-old male presented with difficult defecationand increasing urinary frequency over a few months. He had a significant history of previous partial gastrectomy for gastric carcinoma 20 years prior. Computed tomography of the abdomen and pelvis showed extensive lymphadenopathy, a gastric mass and rectal as well as bladder wall thickening with bilateral ureterohydronephrosis. Normal looking serosal surfaces of the bladder and bowel were seen on laparoscopy and a defunctioning ileostomy was created. Gastroscopy revealed a malignant mass while cystoscopy and sigmoidscopy found extensive tumour growth lining the mucosal surfaces. Biopsies from all sites were compatible with intestinal type adenocarcinoma of gastric origin with few signet ring cells. Metabolic response to palliative chemotherapy was good and the patient's symptoms have improved on follow-up four months post ileostomy. We discuss the immunohistochemical profile of the tumour and review the literature.

关键词： Gastric adenocarcinoma Intestinal-type Metastasis Colorectum Bladder

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Classifying rockburst with confidence:A novel conformal prediction approach

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International Journal of Mining Science and Technology 2024年第1期34卷 51-64页

作者： Bemah Ibrahim isaac Ahenkorah University of South Australia UniSA STEMSA 5000Australia

The scientific community recognizes the seriousness of rockbursts and the need for effective mitigation *** literature reports various successful applications of machine learning(ML)models for rockburst assessment;however,a significant question remains unanswered:How reliable are these models,and at what confidence level are classifications made?Typically,ML models output single rockburst grade even in the face of intricate and out-of-distribution samples,without any associated confidence *** the susceptibility of ML models to errors,it becomes imperative to quantify their uncertainty to prevent consequential *** address this issue,we propose a conformal prediction(CP)framework built on traditional ML models(extreme gradient boosting and random forest)to generate valid classifications of rockburst while producing a measure of confidence for its *** proposed framework guarantees marginal coverage and,in most cases,conditional coverage on the test *** CP was evaluated on a rockburst case in the Sanshandao Gold Mine in China,where it achieved high coverage and efficiency at applicable confidence ***,the CP identified several“confident”classifications from the traditional ML model as unreliable,necessitating expert verification for informed *** proposed framework improves the reliability and accuracy of rockburst assessments,with the potential to bolster user confidence.

关键词： Rockburst Machine learning Uncertainty quantification Conformal prediction

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Prediction of overall survival following colorectal cancer surgery in elderly patients

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 247-260页

作者： isaac seow-en Winson Jianhong Tan Sreemanee Raaj Dorajoo Sharon Hui Ling Soh Yi Chye Law Soo Yeun Park Gyu-Seok Choi Wah Siew Tan Choong Leong Tang Min Hoe Chew Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang General HospitalSingapore 544886Singapore Department of Pharmacy National University of SingaporeSingapore 117559Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Colorectal Cancer Center Kyungpook National University Chilgok HospitalKyungpook National University School of MedicineDaegu 702-210South Korea

BACKGROUND With advanced age and chronic illness,the life expectancy of a patient with colorectal cancer(CRC)becomes less dependent on the malignant disease and more on their pre-morbid *** major surgery for these elderly patients can be *** accurate tool demonstrating post-operative survival probability would be useful for surgeons and their *** To integrate clinically significant prognostic factors relevant to elective colorectal surgery in the elderly into a validated pre-operative scoring *** In this retrospective cohort study,patients aged 70 and above who underwent surgery for CRC at Singapore General Hospital between 1 January 2005 and 31 December 2012 were identified from a prospectively maintained *** with evidence of metastatic disease,and those who underwent emergency surgery or had surgery for benign colorectal conditions were excluded from the *** primary outcome was overall 3-year overall survival(OS)following surgery.A multivariate model predicting survival was derived and validated against an equivalent external surgical cohort from Kyungpook National University Chilgok Hospital,South *** analyses were performed using Stata/MP Version *** A total of 1267 patients were identified for *** median post-operative length of stay was 8[interquartile range(IQR)6-12]d and median follow-up duration was 47(IQR 19-75)*** OS was 78(IQR 65-85)*** multivariate analysis,the factors significant for predicting overall mortality were serum albuminen≥20μg/L,T stage 3 or 4,moderate tumor cell differentiation or worse,mucinous histology,rectal tumors,and pre-existing chronic obstructive lung *** age alone was not found to be *** Korean cohort consisted of 910 *** Singapore cohort exhibited a poorer OS,likely due to a higher proportion of advanced *** the clinicopathologic di

关键词： Colorectal cancer surgery Elderly Overall survival Pre-operative prognostic score

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(Sm/Eu/Tm)^(3+) doped tantalum semiconductor system for photovoltaic and electrochemical functionality amplification

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Journal of Rare Earths 2024年第8期42卷 1586-1594,I0007页

作者： Shaan Bibi Jaffri Khuram Shahzad Ahmad isaac Abrahams Ibrahim A.A Materials and environmental Chemistry Lab Lab-E21Department of Environmental SciencesFatima Jinnah Women UniversityRawalpindiPakistan School of Physical and Chemical Sciences Queen Mary University of LondonLondonUnited Kingdom Department of Botany and Microbiology College of ScienceKing Saud UniversityP.O.Box 2455Riyadh11451Saudi Arabia

This work reports the synthesis,characterization,and energy focused applications of the novel lanthanides co-doped tantalum pentoxide hetero-system(Sm^(3+)-Eu^(3+)-Tm^(3+):Ta_(2)O_(5)).Ln^(3+)-doped Ta_(2)O_(5) express excellent opto-electronic features reflected by the narrow band gap energy of 3.87 *** vibrations confirm the presence of Ta-O-Ta and Ta-O *** synthesized system possesses orthorhombic geometry with 59.46 nm particle *** the smoother and compact morphology,the synthesized material succeeds in augmenting the performance of different systems aimed at energy *** ambient perovskite solar cell device fabricated with the Ln^(3+)-doped Ta_(2)O_(5) as an electron transport layer excels in achieving an efficiency and fill factor of 14.17% and 76% under artificial *** device was marked by the negligible hysteresis behavior showing profound photovoltaic *** electrochemical activity of the Ln^(3+)-doped Ta_(2)O_(5) decorated electrode was evaluated for electrical charge storage potential with pseudocapacitive behavior,With the highest specific capacitance of 355.39 F/g and quicker ionic diffusion rate,the designed electrode excels conventionally used ***-catalysis of water with Ln^(3+)-doped Ta_(2)O_(5) material indicates its capacity for H_(2) production with the lowest overpotential and Tafel slope values of 148 and 121.2 mV/dec,while the O_(2) generation is comparatively *** the stable electrochemical output,this rare earth modified material has the potential to replace conventionally used environmentally perilous and costly materials.

关键词： Lanthanide doping Rare earth materials Perovskite solar cells Supercapacitors Water splitting

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5-Fluorouracil dose escalation generated desensitized colorectal cancer cells with reduced expression of protein methyltransferases and no epithelial-to-mesenchymal transition potential

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Oncology Research 2024年第6期32卷 1047-1061页

作者： KIMBERLY FenECH isaac MICALLEF BYRON BARON Centre for Molecular Medicine and Biobanking University of MaltaMsidaMSD 2080Malta Department of Tumor Genetics and Biology Graduate School of Medical SciencesFaculty of Life SciencesKumamoto UniversityKumamoto860-8556Japan

Background:Colorectal cancer(CRC)is one of the most frequently diagnosed *** many cases,the poor prognosis of advanced CRC is associated with resistance to treatment with chemotherapeutic drugs such as 5-Fluorouracil(5-FU).The epithelial-to-mesenchymal transition(EMT)and dysregulation in protein methylation are two mechanisms associated with chemoresistance in many *** study looked into the effect of 5-FU dose escalation on EMT and protein methylation in *** and Methods:HCT-116,Caco-2,and DLD-1 CRC cell lines were exposed to dose escalation treatment of *** motility and invasive potentials of the cells before and after treatment with 5-FU were investigated through wound healing and invasion *** was followed by aWestern blot which analyzed the protein expressions of the epithelial marker E-cadherin,mesenchymal marker vimentin,and the EMT transcription factor(EMTTF),the snail family transcriptional repressor 1(Snail)in the parental and desensitized *** blotting was also conducted to study the protein expressions of the protein methyltransferases(PMTs),Euchromatic histone lysine methyltransferase 2(EHMT2/G9A),protein arginine methyltransferase(PRMT5),and SET domain containing 7/9(SETD7/9)along with the global lysine and arginine methylation ***:The dose escalation method generated 5-FU desensitized CRC cells with distinct morphological features and increased tolerance to high doses of *** 5-FU desensitized cells experienced a decrease in migration and invasion when compared to the parental *** was reflected in the observed reduction in E-cadherin,vimentin,and Snail in the desensitized cell ***,the protein expressions of EHMT2/G9A,PRMT5,and SETD7/9 also decreased in the desensitized cells and global protein lysine and arginine methylation became dysregulated with 5-FU ***:This study showed that continuous,dose-escalation treatment of 5-FU in CRC cells generated 5-FU

关键词： Chemoresistance Epithelial-to-mesenchymal transition Protein methylation Protein methyltransferases

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Large porewater exchange reshapes saltmarsh carbon and greenhouse gas budgets on local and global scales

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Science China Earth Sciences 2024年第7期67卷 2195-2209页

作者： Xiaogang CHen isaac RSANTOS Lucheng ZHAN Yu Yan YAU Yan ZHANG Ling LI Key Laboratory of Coastal environment and Resources of Zhejiang Province School of EngineeringWestlake UniversityHangzhou 310024China Department of Marine Sciences University of GothenburgGothenburg 41319Sweden College of Water Conservancy and Hydropower engineering Hohai UniversityNanjing 210024China

Saltmarshes are carbon-rich ecosystems that play a role in climate regulation by efficiently sequestrating atmospheric CO_(2).Climate change is a major threat to saltmarshes and will impact saltmarsh carbon ***,porewater-derived carbon outwelling emerges as a crucial pathway for carbon sequestration,but it has been largely overlooked in ***,we assessed the drivers of dissolved carbon exports and greenhouse gas emissions in a saltmarsh and placed those observations into a global *** our study site,porewater exchange(PEX)was the major process controlling dissolved carbon and greenhouse gas *** our results with 33 other studies in saltmarshes worldwide,porewater-derived carbon fluxes were equivalent to~48% of average global saltmarsh primary productivity and 2.2 times greater than global organic carbon ***,our local observations and global upscaling demonstrate the major role played by PEX in saltmarsh carbon *** part of dissolved inorganic carbon returns to the atmosphere as CO_(2),the remaining bicarbonate fraction is stored in the ocean over long time *** findings strengthen global blue carbon assessments and build arguments for the use of saltmarshes as nature-based solutions for global climate change.

关键词： Coastal carbon Global carbon budget Carbon neutrality Nature-based solutions Coastal wetlands Submarine groundwater discharge

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Optimization of gas lift system for well performance improvement in Asmari formation:A techno-economic perspective

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Petroleum Research 2024年第1期9卷 115-124页

作者： Hari Sreenivasan Jash Patel Dev Jain Setu Patel isaac Wilson Shanker Krishna Drilling Cementing&Stimulation(DCS)Research CentreDepartment of Petroleum EngineeringSchool of Energy Technology(SoET)Pandit Deendayal Energy University(PDEU)Knowledge CorridorRaysanGandhinagarGujarat382426India

Well productivity in the Asmari carbonate formation of southwest Iran has decreased in recent years as a result of production *** production rate must be maintained below 1500 STB/day to prevent water *** this study,a gas lift well is modeled using data from one of the producing wells of this *** analysis is performed using lift-gas injection rates and wellhead pressures at different reservoir pressures and water cut conditions to optimize *** aspects are considered to optimize the artificial gas injection rates at different tubing head pressures and water cut *** the lift-gas injection rate from 0.4 MMscf/day to 1 MMscf/day enhances the oil production rate by 37.71%and 43.89%for 10%and 30%water cut conditions,*** injection rates of 5.2 MMscf/day and 5.4 MMscf/day are determined to be economically optimal for 30%water cut with tubing head pressures of 260 psig and 270 psig,respectively.

关键词： Production enhancement Artificial lift Gas lift Asmari carbonate formation Techno-economic analysis Well productivity

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environmental and Climate Justice in Palestine

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American Journal of Climate Change 2024年第2期13卷 251-280页

作者： Jad isaac Jane Hilal Applied Research Institute-Jerusalem (ARIJ) Society Bethlehem Palestine Water and enviromenat Department Applied Research Institute-Jerusalem Society (ARIJ) Society Bethlehem Palestine

To have a clean, safe, and functional environment is not only essential for the purpose of preservation, but also imperative for safeguarding the most fundamental of human rights. Resolution 45/94 of the United Nations (UN) General Assembly also stresses and acknowledges that: “all individuals are entitled to live in an environment adequate for their health and wellbeing” (United Nations Digital Library System, 1991). environmental and climate justice, which: “emerged in the context of the local environmental struggles of directly oppressed groups”, is a global movement dedicated to ensuring equal protection of people’s human rights (i.e., water, health, life, etc.) in the face of the climate crisis. Moreover, health, environment and human rights are part of the 2030 agenda (in particular, SDG 1, SDG 5, SDG 6, SDG 7, SDG 13, SDG 16, SDG 17). Individually, both environmental and climate justice are rooted in an intersectional outlook, by which they highlight the common threads between communities and the people’s inclusion, irrespective of race, class, or gender, in the pursuit of justice. On the other hand, they recognise and acknowledge the role and consequences of climate change in economic, social, and political dimensions;thus, drawing emphasis on the rights of people under the emerging inequities. In the case of Palestine, the Palestinian community is increasingly becoming vulnerable to these effects and the resulting inequalities of climate change. This vulnerability stems from: 1) The right to life;clean WASH;equitable work opportunities;access to resources;and free movement;are all examples of human rights that the Israeli colonial regime infringes upon;2) Infrastructure is essential for climate adaptation: 61% of the West Bank is ultimately barred from building infrastructure (B’Tselem, 2019) and Gaza Strip has major gaps in infrastructure due to intentional destruction by Israel;3) Palestinian deprivation of the sovereign right to natural resources by Isra

关键词： environmental Degradation Climate Change environmental and Climate Justice Human Rights Causes and Solution

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