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Neoadjuvant and adjuvant treatment strategies for hepatocellular carcinoma

World Journal of Gastroenterology 2019年第28期25卷 3704-3721页

作者： Clifford Akateh Sylvester m Black Lanla Conteh Eric D miller Anne Noonan Eric Elliott Timothy m Pawlik Allan Tsung jordan m Cloyd Department of Surgery The Ohio State University Wexner Medical Center Columbus OH 43210 United States Division of Transplant Surgery Department of Surgery The Ohio State University Wexner Medical Center Columbus OH 43210 United States Division of Gastroenterology Hepatology and Nutrition Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus OH 43210 United States Department of Radiation Oncology The Ohio State University Wexner Medical Center Columbus OH 43210 United States Division of medical Oncology Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus OH 43210 United States Division of Diagnostic Radiology Department of Radiology The Ohio State University Wexner Medical Center Columbus OH 43210 United States Division of Surgical Oncology Department of Surgery The Ohio State University Wexner Medical Center Columbus OH 43210 United States

Hepatocellular carcinoma (HCC) is the most common liver malignancy worldwide and a major cause of cancer-related mortality for which liver resection is an important curative-intent treatment option. However, many patients present with advanced disease and with underlying chronic liver disease and/or cirrhosis, limiting the proportion of patients who are surgical candidates. In addition, the development of recurrent or de novo cancers following surgical resection is common. These issues have led investigators to evaluate the benefit of neoadjuvant and adjuvant treatment strategies aimed at improving resectability rates and decreasing recurrence rates. While high-level evidence to guide treatment decision making is lacking, recent advances in locoregional and systemic therapies, including antiviral treatment and immunotherapy, raise the prospect of novel approaches that may improve the outcomes of patients with HCC. In this review, we evaluate the evidence for various neoadjuvant and adjuvant therapies and discuss opportunities for future clinical and translational research.

关键词： Hepatocellular carcinoma Neoadjuvant therapy Adjuvant therapy Neoplasm recurrence Hepatectomy Liver cirrhosis

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microbial symphony orchestrated by mucosal IgA

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Cellular & molecular Immunology 2022年第4期19卷 456-457页

作者： Alejandra Reyes-Ruiz jordan D.Dimitrov Centre de Recherche des Cordeliers INSERMCNRSSorbonne UniversitéUniversitéde Paris75006ParisFrance

The ability of an organism to handle the beauty and cruelty of existence is largely due to a complex network of molecular and cellular interactions and processes named the immune *** components of this network are antibodies(Abs)that have key roles in immune defense and *** biological functions of Abs include neutralizing pathogens by blocking functionally important molecules and/or to eliciting lethal effector functions by bridging the recognition of pathogens with binding to different innate immune receptors.

关键词： bridging neutral network

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Update on Liver Failure Following Hepatic Resection: Strategies for Prediction and Avoidance of Post-operative Liver Insufficiency

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Journal of Clinical and Translational Hepatology 2018年第1期6卷 97-104页

作者： Amir A. Rahnemai-Azar jordan m. Cloyd Sharon m. Weber mary Dillhoff Carl Schmidt Emily R. Winslow Timothy m. Pawlik Department of Surgery Division of Surgical OncologyUniversity of Wisconsin HospitalMadisonWIUSA Department of Surgery Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusOHUSA Department of Surgery Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusOH 43210USA

Liver resection is increasingly used for a variety of benign and malignant *** advances in preoperative selection,surgical technique and perioperative management,posthepatectomy liver failure(PHLF)is still a leading cause of morbidity and mortality following liver *** the devastating physiological consequences of PHLF and the lack of effective treatment options,identifying risk factors and preventative strategies for PHLF is *** the past,a major limitation to conducting high quality research on risk factors and prevention strategies for PHLF has been the absence of a standardized *** this article,we describe relevant definitions for PHLF,discuss risk factors and prediction models,and review advances in liver assessment tools and PHLF prevention strategies.

关键词： Complication Hepatectomy Liver failure Liver resection Prevention Risk models

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Efficient Communication in Wireless Sensor Networks Using Optimized Energy Efficient Engroove Leach Clustering Protocol

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Tsinghua Science and Technology 2024年第4期29卷 985-1001页

作者： N.meenakshi Sultan Ahmad A.V.Prabu J.Nageswara Rao Nashwan Adnan Othman Hikmat A.m.Abdeljaber R.Sekar Jabeen Nazeer SRm Institute of Science and Technology KattankulathurChennai 603203India Department of Computer Science College of Computer Engineering and SciencesPrince Sattam Bin Abdulaziz UniversityAlkharj 11942Saudi Arabia University Center for Research and Development(UCRD) Department of Computer Science and EngineeringChandigarh UniversityGharuanMohali 140413India Department of ECE Koneru Lakshmaiah Education FoundationVaddeswaramGuntur 522502India Department of Computer Science and Engineering Lakireddy Balireddy College of Engineering(A)NTR District 521230India Department of Computer Engineering College of EngineeringKnowledge UniversityErbil 44001Iraq Department of Computer Science Faculty of Information TechnologyApplied Science Private UniversityAmman 11937Jordan Department of Electronics and Communication Engineering(ECE) School of EngineeringPresidency UniversityBangalore 834001India

The Wireless Sensor Network(WSN)is a network that is constructed in regions that are inaccessible to human *** widespread deployment of wireless micro sensors will make it possible to conduct accurate environmental monitoring for a use in both civil and military *** make use of these data to monitor and keep track of the physical data of the surrounding environment in order to ensure the sustainability of the *** data have to be picked up by the sensor,and then sent to the sink node where they may be *** nodes of the WSNs are powered by batteries,therefore they eventually run out of *** energy restriction has an effect on the network life span and environmental *** objective of this study is to further improve the Engroove Leach(EL)protocol’s energy efficiency so that the network can operate for a very long time while consuming the least amount of *** lifespan of WSNs is being extended often using clustering and routing *** meta Inspired Hawks Fragment Optimization(mIHFO)system,which is based on passive clustering,is used in this study to do *** cluster head is chosen based on the nodes’residual energy,distance to neighbors,distance to base station,node degree,and node *** on distance,residual energy,and node degree,an algorithm known as Heuristic Wing Antfly Optimization(HWAFO)selects the optimum path between the cluster head and Base Station(BS).They examine the number of nodes that are active,their energy consumption,and the number of data packets that the BS *** overall experimentation is carried out under the mATLAB *** the analysis,it has been discovered that the suggested approach yields noticeably superior outcomes in terms of throughput,packet delivery and drop ratio,and average energy consumption.

关键词： wireless sensor networks energy efficient engroove leach protocol meta inspired Hawks fragment optimization heuristic wing antfly optimization

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Simultaneous removal of arsenic and antimony from mining wastewater

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Journal of Environmental Sciences 2020年第7期32卷 117-119页

作者： Jiaojiao Xie jordan R.m.Schofield Lejun Liao Hanyong Peng Jagdeesh S.Uppal Qi Zheng X.Chris Le Division of Analytical and Environmental Toxicology Department of Laboratory Medicine and PathologyFaculty of Medicine and DentistryUniversity of Alberta10-102 Clinical Sciences BuildingEdmontonAlberta T6G 2G3Canada Department of Chemistry University of AlbertaEdmontonAlbertaCanada Key Laboratory of Optoelectronic Chemical materials and Devices Ministry of EducationInstitute of Environment and HealthJianghan UniversityWuhan 430056China Division of Analytical and Environmental Toxicology Department of Laboratory Medicine and PathologyFaculty of Medicine and DentistryUniversity of Alberta10-102 Clinical Sciences BuildingEdmontonAlberta T6G 2G3Canada Department of ChemistryUniversity of AlbertaEdmontonAlbertaCanada

Arsenic(As)and antimony(Sb)rank 1 st and 244 th,respectively,on the 2019 Substance Priority List of the Agency for Toxic Substances and Disease Registry(ATSDR,2019).ATSDR lists substances,in order of priority,that are"most commonly found at facilities on the National Priorities List(NPL)and which are determined to pose the most significant potential threat to human health due to their known or suspected toxicity and potential for human exposure at these NPL sites".

关键词： wastewater mining arsenic

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Long-term irritable bowel syndrome symptom control with reintroduction of selected FODmAPs

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World Journal of Gastroenterology 2017年第25期23卷 4632-4643页

作者： Ruth m Harvie Alexandra W Chisholm jordan E Bisanz Jeremy P Burton Peter Herbison Kim Schultz michael Schultz Department of medicine Dunedin School of MedicineUniversity of Otago Department of Human Nutrition University of Otago Departments of Surgery and microbiology&Immunology Western UniversityOntario Department of Preventative and Social medicine University of Otago

To investigate the long-term effect of dietary education on a low fermentable oligosaccharide, disaccharide and polyol (FODmAP) diet on irritable bowel syndrome (IBS) symptoms and quality of life (QoL). mETHODSParticipants with IBS (Rome III) were randomized to two groups. Group I commenced a low FODmAP diet at baseline. At three months, group II, so far a comparator group, crossed over to a low FODmAP diet while group I started re-challenging foods. All patients completed the IBS SSS (IBS symptom severity scoring system, 0-500 points increasing with severity), IBS QoL questionnaire (0-100 increasing with QoL), a FODmAP specific food frequency questionnaire and provided a stool sample at baseline, three and six months for microbiome analysis. RESULTSFifty participants were enrolled into group I (n = 23) or group II (n = 27). Participants in both groups were similar in baseline values but with more men in group I. There was a significantly lower IBS SSS (275.6 ± 63.6 to 128.8 ± 82.5 vs 246.8 ± 71.1 to 203.6 ± 70.1) (P mo. The reduced IBS SSS was sustained at 6 mo in group I (160 ± 102) and replicated in group II (124 ± 76). Fiber intake decreased on the low FODmAP diet (33 ± 17 g/d to 21 ± 8 g/d) (P mAP containing foods increased again to 27 ± 9 g/d. There was no change seen in the intestinal microbiome when participants adopted a low FODmAP diet. CONCLUSIONThis study demonstrated that a reduction in FODmAPs improves symptoms in IBS and this improvement can be maintained while reintroducing FODmAPs.

关键词： Irritable bowel syndrome FODmAP Short chain fermentable carbohydrates microbiota Diet microbiome

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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

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Current concepts on osteonecrosis of the femoral head

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世界骨科杂志：英文版 2015年第8期6卷 590-601页

作者： Joaquin moya-Angeler Arianna L Gianakos jordan C Villa Amelia Ni Joseph m Lane Hospital for Special Surgery

It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. Thelack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging(mRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore mRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures(FHSP) and femoral head replacement procedures(FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated.

关键词： Osteonecrosis Femoral head Conservative treatment Core decompression Stem cells Total hip arthroplasty

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Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma:A qualitative study

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World Journal of Gastrointestinal Oncology 2022年第6期14卷 1175-1186页

作者： Lena Stevens Zachary J Brown Ryan Zeh Christina monsour Sharla Wells-Di Gregorio Heena Santry Aslam m Ejaz Timothy michael Pawlik jordan m Cloyd Department of Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of General Surgery University of Pittsburgh Medical CenterPittsburghPA 15213United States Department of Psychiatry Center for Palliative CareThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

BACKGROUND Neoadjuvant therapy(NT)has increasingly been utilized for patients with localized pancreatic ductal adenocarcinoma(PDAC).It is the recommended approach for borderline resectable(BR)and locally advanced(LA)cancers and an increasingly utilized option for potentially resectable(PR)*** its increased use,little research has focused on patient-centered metrics among patients undergoing NT,including patient experiences,preferences,and recommendations.A better understanding of all aspects of the patient experience during NT may identify opportunities to design interventions aimed at improving quality of life;it may also facilitate the completion of NT and receipt of surgery,ultimately optimizing long-term *** To understand the experience of patients initiating and receiving NT to identify opportunities to improve neoadjuvant cancer care *** Semi-structured interviews of patients with localized PDAC during NT were conducted to explore their experience initiating and receiving *** took place between August 2020 and October *** to the descriptive nature of the research,questions were open *** were conducted over the phone,audio recorded and then *** interviews were coded by two independent researchers using NVivo 12,iteratively identifying themes until thematic saturation was *** integrative approach to qualitative analysis was used,utilizing both inductive and deductive *** A total of 12 patients with localized PDAC were *** with BR(n=7),PR(n=2),and LA(n=3)cancers participated in the *** patients indicated that choosing NT was the doctor’s recommendation,while most reported not being familiar with the concept of NT(n=11)and that NT was presented as the only option(n=8).Five themes describing the patient experience emerged:physical symptoms,emotional symptoms,coping mechanisms,access to care,and life *** most commonly cited recommendation for

关键词： Pancreatic ductal adenocarcinoma Neoadjuvant therapy Patient experience Patient-centered care Quality of life Qualitative research

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Association between tourniquet use and intraoperative blood loss during below-knee amputation

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World Journal of Orthopedics 2022年第7期13卷 644-651页

作者： Alden E Wyland Erik Woelber Liam H Wong jordan Arakawa Zachary m Working James meeker School of medicine Oregon Health and Sciences UniversityPortlandOR 97239United States Department of Orthopaedics and Rehabilitation Oregon Health and Sciences UniversityPortlandOR 97239United States

BACKGROUND Despite over 150000 amputations of lower limbs annually,there remains a wide variation in tourniquet practice patterns and no consensus on their necessity,especially among orthopedic patient *** purpose of this study was to determine whether tourniquet use in orthopedic patients undergoing below knee amputation(BKA) was associated with a difference in calculated blood loss relative to no tourniquet *** To determine if tourniquet use in orthopedic patients undergoing BKA was associated with a difference in calculated blood loss relative to no tourniquet *** We performed a retrospective review of consecutive patients undergoing BKA by orthopedic surgeons at a tertiary care hospital from 2008 through *** loss was calculated using a combination of the Nadler equation for preoperative blood volume and a novel formula utilizing preoperative and postoperative hemoglobin levels and *** and forwards step-wise multivariate linear regressions were performed to determine the association between tourniquet use and blood loss.A Wilcoxon was used to determine the univariate relationship between tourniquet use and blood loss for in the restricted subgroups of patients who underwent BKA for trauma,tumor,and *** Of 97 eligible patients identified,67 underwent surgery with a tourniquet and 30 did *** multivariate regression,tourniquet use was associated with a 488 mL decrease in calculated blood loss(CI 119-857,P = 0.01).In subgroup analysis,no individual group showed a statistically significant decrease in blood loss with tourniquet *** was no significant association between tourniquet use and either postoperative transfusions or reoperation at one *** We found that tourniquet use during BKA is associated with decreased calculated intraoperative blood *** recommend that surgeons performing this procedure use a tourniquet to minimize blood loss.

关键词： Amputation Tourniquet Blood loss Hemostasis

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