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Biliary endoscopy in the management of primary sclerosing cholangitis and its complications

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Liver Research 2019年第2期3卷 106-117页

作者： Brian M.Fung james h.tabibian University of California Los Angeles-Olive View Internal Medicine Residency Program SylmarCAUSA Division of Gastroenterology Department of MedicineOlive View-University of California Los Angeles Medical CenterSylmarCAUSA

Primary sclerosing cholangitis(PSC)is a chronic,idiopathic,cholestatic liver disease characterized by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile *** can affect individuals of all age groups and gender,has no established pharmacotherapy,and is associated with a variety of neoplastic(***)and non-neoplastic(*** strictures)hepatobiliary *** these considerations,endoscopy plays a major role in the care of patients with *** this review,we discuss and provide updates regarding endoscopic considerations in the management of hepatobiliary manifestations and complications of *** evidence is limited,we suggest pragmatic approaches based on currently available data and expert opinion.

关键词： Primary sclerosing cholangitis(PSC) Biliary tract disease Balloon dilation Cholangioscopy Dominant stricture Cholangiocarcinoma(CCA) Endoscopic retrograde cholangiopancreatography(ERCP)

hemobilia: Etiology, diagnosis, and treatment

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Liver Research 2018年第4期2卷 200-208页

作者： Rani Berry james han Ani A.Kardashian Nicholas F.LaRusso james h.tabibian Department of Internal Medicine UCLA Ronald Reagan Medical CenterLos AngelesCAUSA Department of Internal Medicine University of California IrvineIrvineCAUSA UCLA Gastroenterology Fellowship Training Program Vatche and Tamar ManoukianDivision of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal *** of hemobilia date back to the 1600s,but due to its relative rarity and challenges in diagnosis,only in recent decades has hemobilia been more critically *** majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver,pancreas,bile ducts and/or the hepatopancreatobiliary vasculature,with trauma and malignancy rep-resenting the two other leading causes.A classic triad of right upper quadrant pain,jaundice,and overt upper gastrointestinal bleeding has been described(***'s triad),but this is present in only 25%e30%of patients with ***,prompt diagnosis depends critically on having a high index of suspicion,which may be based on a patient's clinical presentation and having recently undergone(peri-)biliary instrumentation or other predisposing *** treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic,interventional radiologic,or surgical *** we provide a clinical overview and update regarding the eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.

关键词： hemobilia Upper gastrointestinal hemmorhage Etiology Diagnosis Imaging hepatopancreatobiliary interventions

Preventative care in cholestatic liver disease: Pearls for the specialist and subspecialist

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Liver Research 2019年第2期3卷 118-127页

作者： Adnan Malik Ani A.Kardashian Kais Zakharia Christopher L.Bowlus james h.tabibian Department of Public health and Business Administration The University of Alabama at BirminghamBirminghamALUSA Department of Internal Medicine Beaumont HospitalDearbornMIUSA University of California Los Angeles Gastroenterology Fellowship Training Program Vatche and Tamar Manoukian Division of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and hepatology University of IowaIowaIAUSA Division of Gastroenterology and hepatology University of California DavisSacramentoCAUSA Division of Gastroenterology Department of MedicineOlive View-University of California Los Angeles Medical CenterSylmarCAUSA

Cholestatic liver diseases(CLDs)encompass a variety of disorders of abnormal bile formation and/or *** often lead to progressive hepatic insult and injury and following the development of cirrhosis and associated *** such complications are clinically silent until they manifest with severe sequelae,including but not limited to life-altering symptoms,metabolic disturbances,cirrhosis,and hepatobiliary diseases as well as other *** sclerosing cholangitis(PSC)and primary biliary cholangitis(PBC)are the most common CLDs,and both relate to mutual as well as unique *** review provides an overview of PSC and PBC,with a focus on preventive measures aimed to reduce the incidence and severity of disease-related complications.

关键词： Biliary tract diseases Primary sclerosing cholangitis(PSC) Primary biliary cholangitis(PBC) Cirrhosis Inflammatory bowel disease(IBD) Metabolic bone disease Pruritus Prophylaxis

Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis

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Liver Research 2021年第1期5卷 28-32页

作者： Simcha Weissman Saad Saleem Sachit Sharma Menashe Krupka Faisal Inayat Muhammad Aziz james h.tabibian Department of Medicine Hackensack Meridian Health Palisades Medical CenterNorth BergenNJUSA Department of Medicine Sunrise Hospital and Medical CenterLas VegasNVUSA Department of Medicine University of Toledo Medical CenterToledoOHUSA Department of Medicine Westchester Medical CenterValhallaNYUSA Department of Medicine Allama Iqbal Medical CollegeLahorePakistan Division of Gastroenterology and hepatology University of Toledo Medical CenterToledoOHUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA David Geffen School of Medicine at UCLA Los AngelesCAUSA

Background and aims Anti-neoplastic immunotherapy has revolutionized cancer management;however,its safety profile with respect to liver-related injury remains largely ***,we analyzed a United States national database to determine the incidence,mortality,and predictors of hepatotoxicity in the setting of anti-neoplastic *** This was a nationwide retrospective study of hospital encounters from 2011 to 2014 using the National Inpatient Sample(NIS)*** utilized the International Classification of Diseases,Ninth Revision(ICD-9)coding system to identify all adult patients who underwent anti-neoplastic immunotherapy during *** primary outcome was the incidence of hepatotoxicity during the same *** outcomes included in-hospital mortality as well as socioeconomic and ethno-racial predictors of *** were performed using IBM SPSS Statistics *** The sample included 3002 patients who underwent inpatient anti-neoplastic *** incidence of hepatotoxicity was 10.1%,which was significantly higher as compared to a matched inpatient population(adjusted odds ratio(aOR)4.93,95%confidence interval(CI):3.80–6.40,P=0.001).No significant mortality difference was seen in those that developed hepatotoxicity compared to those who did not(aOR 0.47,95%CI:0.03–8.03,P=0.612).Age under 60(aOR 1.56,95%CI:1.23–1.78,P=0.050)and white race(aOR 1.85,95%CI:1.35–2.04,Pherapy-associated *** In this large,nationwide database analysis,we found that anti-neoplastic immunotherapy was associated with a nearly five-fold risk of in-hospital hepatotoxicity as compared to a matched inpatient population,though without an associated mortality ***,younger age and white race were identified as predictors of immunotherapy-associated *** vigilance and prospective investigation of the

关键词： hepatotoxicity Tumor immunotherapy Liver enzymes Outcomes Risk factors Mortality

Machine learning models compared to existing criteria for noninvasive prediction of endoscopic retrograde cholangiopancreatography-confirmed choledocholithiasis

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Liver Research 2021年第4期5卷 224-231页

作者： Camellia Dalai John M Azizian harry Trieu Anand Rajan Formosa C Chen Tien Dong Simon W Beaven james h.tabibian UCLA-Olive View Internal Medicine Residency Program Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA Keck School of Medicine University of Southern CaliforniaLos AngelesCAUSA Department of Surgery David Geffen School of Medicine at UCLALos AngelesCAUSA Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLALos AngelesCAUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Background and aims:Noninvasive predictors of choledocholithiasis have generally exhibited marginal performance *** aimed to identify noninvasive independent predictors of endoscopic retrograde cholangiopancreatography(ERCP)-confirmed choledocholithiasis and accordingly developed predictive machine learning models(MLMs).Methods:Clinical data of consecutive patients undergoing first-ever ERCP for suspected chol-edocholithiasis from 2015 to 2019 were abstracted from a prospectively-maintained *** logistic regression was used to identify predictors of ERCP-confirmed *** were then trained to predict ERCP-confirmed choledocholithiasis using pre-ERCP ultrasound(US)imaging only as well as using all available noninvasive imaging(US,computed tomography,and/or magnetic reso-nance cholangiopancreatography).The diagnostic performance of American Society for Gastrointestinal Endoscopy(ASGE)“high-likelihood”criteria was compared to ***:We identified 270 patients(mean age 46 years,62.2%female,73.7%hispanic/Latino,59%with noninvasive imaging positive for choledocholithiasis)with native papilla who underwent ERCP for suspected choledocholithiasis,of whom 230(85.2%)were found to have ERCP-confirmed *** regression identified choledocholithiasis on noninvasive imaging(odds ratio(OR)¼3.045,P¼0.004)and common bile duct(CBD)diameter on noninvasive imaging(OR¼1.157,P¼0.011)as predictors of ERCP-confirmed *** the various MLMs trained,the random forest-based MLM performed best;sensitivity was 61.4%and 77.3%and specificity was 100%and 75.0%,using US-only and using all available imaging,*** high-likelihood criteria demonstrated sensitivity of 90.9%and specificity of 25.0%;using cut-points achieving this specificity,MLMs achieved sensitivity up to 97.7%.Conclusions:MLMs using age,sex,race/ethnicity,presence of diabetes,fever,body mass index(BMI),total bilirubin,maximum CBD di

关键词： Machine learning models(MLMs) Endoscopic retrograde cholangiopancreatography(ERCP) Noninvasive imaging Bile duct disorders Common bile duct stones Gallstones

Analysis of the Oscillatory Flows of Multiple Shock Waves in a Constant Area Duct

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Journal of Thermal Science 2024年第3期33卷 794-806页

作者： K james Jintu KIM heuy Dong Department of Mechanical Engineering Andong National UniversityAndong36729Republic of Korea CAD-IT Korea Co. Ltd.Seoul08591Republic of Korea

The oscillatory response of multiple shock waves to downstream perturbations in a supersonic flow is studied numerically in a rectangular *** shock waves are formed inside the duct at a shock Mach number of *** duct has an exit height of h,and the effect of duct resonance on multiple shock oscillations is investigated by attaching exit ducts of lengths 0h,50h,and *** downstream disturbance frequency varied from 10 hz to 200 hz to explore the oscillation characteristics of the multiple shock *** oscillatory response of shock waves under self-excited and forced oscillation conditions are analyzed in terms of wall static pressure,shock train leading-edge location,shock train length,and the size of the separation *** extent of the initial shock location increases with an increase in exit duct length for the self-excited oscillation *** analysis of the shock train leading edge and the spectral analysis of wall static pressure variations are *** variation in the shock train length is analyzed using the pressure ratio method for self-excited as well as forced *** RMS amplitude of the normalized shock train length(ζ_(ST))increases with an increase in the exit duct length for the self-excited oscillation *** the downstream perturbation frequency is increased,ζ_(ST)is decreased for exit duct *** all exit duct designs and downstream forcing frequencies,the size of the separation bubble grows and shrinks during the shock oscillations,demonstrating the dependence on duct resonance and forced oscillations.

关键词： shock train downstream disturbance supersonic flow shock wave boundary layer interaction duct resonance flow separation

New Opportunities for Neutrons in Environmental and Biological Sciences

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Frontiers of Environmental Science & Engineering 2024年第7期18卷 179-186页

作者： Alexander Johs Shuo Qian Leighton Coates Brian h.Davison james G.Elkins Xin Gu Jennifer Morrell-Falvey hugh O'Neill Jeffrey M.Warren Eric M.Pierce Kenneth herwig Oak Ridge National Laboratory Oak RidgeTN37831USA

The use of neutron methods in environmental and biological sciences is rapidly emerging and accelerating with the development of new instruments at neutron user *** article,based on a workshop held at Oak Ridge National Laboratory(ORNL),offers insights into the application of neutron techniques in environmental and biological *** highlight recent advances and identify key challenges and potential future research *** include soil and rhizosphere processes,root water dynamics,plant-microbe interactions,structure and dynamics of biological systems,applications in synthetic biology and enzyme engineering,next-generation bioproducts,biomaterials and bioenergy,nanoscale structure,and fluid dynamics of porous materials in *** provide an outlook on emerging opportunities with an emphasis on new capabilities that will be enabled at the Spallation Neutron Source Second Target Station currently under design at *** mission of scientific neutron user facilities worldwide is to enable science using state-of-the-art neutron *** aim to encourage researchers in the environmental and biological research community to explore the unique capability afforded by neutrons at these facilities.

关键词： Neutrons Environment Biology Neutron imaging Neutron scattering Second Target Station(STS)

Fully integrated and broadband Si-rich silicon nitride wavelength converter based on Bragg scattering intermodal four-wave mixing

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Photonics Research 2024年第3期12卷 I0001-I0010页

作者： VALERIO VITALI ThALÍA DOMÍNGUEZ BUCIO hAO LIU JOSÉMANUEL LUQUE GONZÁLEZ FRANCISCO JURADO-ROMERO ALEJANDRO ORTEGA-MOÑUX GLENN ChURChILL james C.GATES james hILLIER NIKOLAOS KALFAGIANNIS DANIELE MELATI JENS h.SChMID ILARIA CRISTIANI PAVEL ChEBEN J.GONZALO WANGÜEMERT-PÉREZ ÑIGO MOLINA-FERNÁNDEZ FREDERIC GARDES COSIMO LACAVA PERIKLIS PETROPOULOS Optoelectronics Research Centre University of SouthamptonSouthampton SO171BJUK Electrical Computer and Biomedical Engineering DepartmentUniversity of PaviaPavia 27100Italy Telecommunication Research Institute(TELMA) Universidad de MálagaCEI Andalucı´a TECHE.T.S.I.Telecomunicación29010 MálagaSpain School of Science and Technology Nottingham Trent UniversityNottingham NG118NSUK Department of Electrical Engineering Eindhoven University of TechnologyEindhoven 5600 MBThe Netherlands Department of Materials Science and Engineering University of IoanninaIoannina 45110Greece Centre de Nanosciences et de Nanotechnologies UniversitéParis-SaclayCNRS91120 PalaiseauFrance Advanced Electronics and Photonics Research Center National Research Council CanadaOttawaOntario K1A 0R6Canada

Intermodal four-wave mixing(FWM)processes have recently attracted significant interest for all-optical signal processing applications thanks to the possibility to control the propagation properties of waves exciting distinct spatial modes of the same *** allows,in principle,to place signals in different spectral regions and satisfy the phase matching condition over considerably larger bandwidths compared to intramodal ***,the demonstrations reported so far have shown a limited bandwidth and suffered from the lack of on-chip components designed for broadband manipulation of different *** demonstrate here a silicon-rich silicon nitride wavelength converter based on Bragg scattering intermodal FWM,which integrates mode conversion,multiplexing and de-multiplexing functionalities *** system enables wavelength conversion between pump waves and a signal located in different telecommunication bands(separated by 60 nm)with a 3 dB bandwidth exceeding 70 nm,which represents,to our knowledge,the widest bandwidth ever achieved in an intermodal FWM-based system.

关键词： scattering pump modal

Recent Ventures in Interdisciplinary Arctic Research:The ARCPATh Project

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Advances in Atmospheric Sciences 2024年第8期41卷 1559-1568页

作者： Astrid E.J.OGILVIE Leslie A.KING Noel KEENLYSIDE François COUNILLON Brynhildur DAVIÐSDÓTTIR Níels EINARSSON Sergey GULEV Ke FAN Torben KOENIGK james R.MCGOODWIN Marianne h.RASMUSSON Shuting YANG Institute of Arctic and Alpine Research(INSTAAR) University of ColoradoBoulder CO 80303USA Stefansson Arctic Institute AkureyriÍS-600Iceland Royal Roads University BC V9B 5Y2Canada University of Bergen Bergen N-5007Norway Nansen Environmental and Remote Sensing Centre Bergen N-5007Norway University of Iceland Reykjavík 102Iceland Shirshov Institute of Oceanology Moscow 117218Russia Moscow State University Moscow 11991Russia Chinese Academy of Sciences Beijing 100045China Swedish Meteorological and hydrological Institute SE-60176 NorrköpingSweden Danish Meteorological Institute CopenhagenØ2100Denmark Obukhov Institute of Atmospheric Physics RAS119017MoscowRussia

This paper celebrates Professor Yongqi GAO's significant achievement in the field of interdisciplinary studies within the context of his final research project Arctic Climate Predictions: Pathways to Resilient Sustainable Societies-ARCPATh(https://***/en/projects/finished-projects/arcpath). The disciplines represented in the project are related to climatology, anthropology, marine biology, economics, and the broad spectrum of social-ecological studies. Team members were drawn from the Nordic countries, Russia, China, the United States, and Canada. The project was transdisciplinary as well as interdisciplinary as it included collaboration with local knowledge holders. ARCPATh made significant contributions to Arctic research through an improved understanding of the mechanisms that drive climate variability in the Arctic. In tandem with this research, a combination of historical investigations and social, economic, and marine biological fieldwork was carried out for the project study areas of Iceland, Greenland, Norway, and the surrounding seas, with a focus on the joint use of ocean and sea-ice data as well as social-ecological drivers. ARCPATh was able to provide an improved framework for predicting the near-term variation of Arctic climate on spatial scales relevant to society, as well as evaluating possible related changes in socioeconomic realms. In summary, through the integration of information from several different disciplines and research approaches, ARCPATh served to create new and valuable knowledge on crucial issues, thus providing new pathways to action for Arctic communities.

关键词： Recent Ventures in Interdisciplinary Arctic Research:The ARCPATh Project