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Prediction of survival after left-sided pancreatic resection for adenocarcinoma: Introduction of a new prognostic score

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Hepatobiliary & Pancreatic Diseases International 2019年第6期18卷 569-575页

作者： jill Gwiasda Zhi Qu Harald Schrem Felix Oldhafer Markus Winny jürgen klempnauer Gerrit Grannas Alexander Kaltenborn Transplant Center Hannover Medical SchoolCarl-Neuberg Str.130625 HannoverGermany Department of General Visceral and Transplant SurgeryHannover Medical SchoolHannoverGermany

Background:Due to the clinically unapparent course the entity of left-sided pancreatic adenocarcinoma is often diagnosed at advanced stages,resulting in small numbers of patients qualifying for *** study strives to develop a prognostic model for survival after left-sided pancreatic ***:A total of 54 patients were ***-and intra-operative predictive factors for 18-month mortality were identified with multivariable binary logistic regression analysis and compiled into a prognostic *** applicability was evaluated by assessment of the area under the receiver operating characteristic curve(AUROC).The model was internally validated applying a randomized backwards bootstrapping ***:The 18-month mortality rate was 74.1%(n=40).Mean survival was 19.1 months.A prognostic model for 18-month mortality after left sided-pancreatectomy showed an AUROC>0.800:18-month mortality risk in%=Exp(Y)/(1+Exp(Y))with y=-0.927+(1.724,if CA 19-9 elevated,otherwise 0)+(1.212×number of intra-operative transfused packed red blood cells)+(2.771,if prior abdominal surgery,otherwise 0)-(3.612,if gastric resection,otherwise 0)This model was internally validated in 40 randomized backwards bootstrapping steps with AUROCs ranging from 0.757 to ***:The 18-month mortality risk for patients after left-sided pancreatectomy for adenocarcinoma of the pancreatic body can be assessed with the number of intra-operatively transfused packed red blood cells,elevated CA 19-9 levels,additional gastric resection and prior abdominal surgeries in the patient’s history.

关键词： Pancreatic cancer Mortality Risk factors

Biliary complications following liver transplantation: Singlecenter experience over three decades and recent risk factors

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World journal of Hepatology 2017年第3期9卷 147-154页

作者： Alexander Kaltenborn André Gutcke jill Gwiasda jürgen klempnauer Harald Schrem Department of Trauma and Orthopedic Surgery Federal Armed Forces Hospital Wester-stede Core Facility Quality Management and Health Tech-nology Assessment in Transplantation Integrated Research and Treatment Facility Transplantation (IFB-Tx)Hannover Medical School Department of General Visceral and Transplant Surgery Hannover Medical School

AIM To identify independent risk factors for biliary complications in a center with three decades of experience in liver *** A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease(MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logisticregression analyses. The identified risk factors in regression analyses were compiled into a prognostic model. The applicability was evaluated with receiver operating characteristic curve analyses. Furthermore, Kaplan-Meier analyses with the log rank test were applied where appropriate. RESULTS Biliary complications were observed in 227 cases(14.1%). Four hundred and seventeen(26%) transplantations were performed after the introduction of MELD-based donor organ allocation. Since then, 21%(n = 89) of the patients suffered from biliary complications, which are further categorized into anastomotic bile leaks [46%(n = 41)], anastomotic strictures [25%(n = 22)], cholangitis [8%(n = 7)] and non-anastomotic strictures [3%(n = 3)]. The remaining 18%(n = 16) were not further classified. After adjustment for all univariably significant variables, the recipient MELD-score at transplantation(P = 0.006; OR = 1.035; 95%CI: 1.010-1.060), the development of hepatic artery thrombosis post-operatively(P = 0.019; OR = 3.543; 95%CI: 1.233-10.178), as well as the donor creatinine prior to explantation(P = 0.010; OR = 1.003; 95%CI: 1.001-1.006) were revealed as independent risk factors for biliary complications. The compilation of these identified risk factors into a prognostic model was shown to have good prognostic abilities in the investigated cohort with an area under the receiver operating curve of *** The parallel occurrence of high recipient MELD and imp

关键词： Biliary complications Liver transplantation Prognostic model Risk factors Multivariable analyses

Supervision of two fundamental problems in modern fluid dynamics for sparing energy

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journal of Thermal Science 2009年第2期18卷 97-98页

作者： jürgen Zierep Institut für Strmungslehre Universitt Karlsruhe

The normal shock at a curved surface in transonic flow leads to a superdetermined boundary value problem. A bump behind the shock decreases the drag of the airfoil and reduces the necessary energy. Flows of non-Newtonian media lead in the contrary to subdetermined boundary initial problems. The energy balance for these fluids is of great interest for chemical engineering.

关键词： Transonic flow Shock at a curved wall Superdetermined problem Non- Newtonian media Subdeermined problem Energy balance.

Hepatic encephalopathy before and neurological complications after liver transplantation have no impact on the employment status 1 year after transplantation

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World journal of Hepatology 2017年第10期9卷 519-532页

作者： Henning Pflugrad Anita B Tryc Annemarie Goldbecker Christian P Strassburg Hannelore Barg-Hock jürgen klempnauer Karin Weissenborn Department of Neurology Hannover Medical School Integrated Research and Treatment Centre Transplantation Department of Gastroenterology Hepatology and EndocrinologyHannover Medical School Department of Medicine I University Hospital Bonn Clinic for Visceral and Transplant Surgery Hannover Medical School

To investigate the impact of hepatic encephalopathy before orthotopic liver transplantation (OLT) and neurological complications after OLT on employment after OLT. METHODSOne hundred and fourteen patients with chronic liver disease aged 18-60 years underwent neurological examination to identify neurological complications, neuropsychological tests comprising the PSE-Syndrome-Test yielding the psychometric hepatic encephalopathy score, the critical flicker frequency and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), completed a questionnaire concerning their occupation and filled in the short form 36 (SF-36) to assess health-related quality of life before OLT and 12 mo after OLT, if possible. Sixty-eight (59.6%) patients were recruited before OLT, while on the waiting list for OLT at Hannover Medical School [age: 48.7 ± 10.2 years, 45 (66.2%) male], and 46 (40.4%) patients were included directly after OLT. RESULTSBefore OLT 43.0% of the patients were employed. The patients not employed before OLT were more often non-academics (employed: Academic/non-academic 16 (34.0%)/31 vs not employed 10 (17.6%)/52, P = 0.04), had more frequently a history of hepatic encephalopathy (HE) (yes/no; employed 15 (30.6%)/34 vs not employed 32 (49.2%)/33, P = 0.05) and achieved worse results in psychometric tests (RBANS sum score mean ± SD employed 472.1 ± 44.5 vs not employed 443.1 ± 56.7, P = 0.04) than those employed. Ten patients (18.2%), who were not employed before OLT, resumed work afterwards. The patients employed after OLT were younger [age median (range, min-max) employed 47 (42, 18-60) vs not employed 50 (31, 29-60), P = 0.01], achieved better results in the psychometric tests (RBANS sum score mean ± SD employed 490.7 ± 48.2 vs not employed 461.0 ± 54.5, P = 0.02) and had a higher health-related quality of life (SF 36 sum score mean ± SD employed 627.0 ± 138.1 vs not employed 433.7 ± 160.8; P < 0.001) compared to patients not employed after OLT.

关键词： Hepatic encephalopathy Employment Neurological complications Cognitive function Health-related quality of life Liver transplantation

Dust growth in protoplanetary disks-a comprehensive experimental / theoretical approach

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Research in Astronomy and Astrophysics 2010年第12期10卷 1199-1214页

作者： jürgen Blum Institut für Geophysik und extraterrestrische Physik University of Braunschweig

More than a decade of dedicated experimental work on the collisional physics of protoplanetary dust has brought us to a point at which the growth of dust aggregates can - for the first time - be self-consistently and reliably modeled. In this article, the emergent collision model for protoplanetery dust aggregates, as well as the numerical model for the evolution of dust aggregates in protoplanetary disks, is reviewed. It turns out that, after a brief period of rapid collisional growth of fluffy dust aggregates to sizes of a few centimeters, the protoplanetary dust particles are subject to bouncing collisions, in which their porosity is considerably decreased. The model results also show that low-velocity fragmentation can reduce the final mass of the dust aggregates but that it does not trigger a new growth mode as discussed previously. According to the current stage of our model, the direct formation of kilometer-sized planetesimals by collisional sticking seems unlikely, implying that collective effects, such as the streaming instability and the gravitational instability in dust-enhanced regions of the protoplanetary disk, are the best candidates for the processes leading to planetesimals.

关键词： planetary systems: protoplanetary disks -- planetary systems: formation-- methods: laboratory -- methods: numerical

Exaptation at the molecular genetic level

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Science China(Life Sciences) 2019年第4期62卷 437-452页

作者： jürgen Brosius Institute of Experimental Pathology (ZMBE) Centre for Molecular Biology of Inflammation University of Münster Brandenburg Medical School (MHB)

The realization that body parts of animals and plants can be recruited or coopted for novel functions dates back to, or even predates the observations of Darwin. S.j. Gould and E.S. Vrba recognized a mode of evolution of characters that differs from adaptation. The umbrella term aptation was supplemented with the concept of exaptation. Unlike adaptations, which are restricted to features built by selection for their current role, exaptations are features that currently enhance fitness, even though their present role was not a result of natural selection. Exaptations can also arise from nonaptations; these are characters which had previously been evolving neutrally. All nonaptations are potential exaptations. The concept of exaptation was expanded to the molecular genetic level which aided greatly in understanding the enormous potential of neutrally evolving repetitive DNA—including transposed elements, formerly considered junk DNA—for the evolution of genes and genomes. The distinction between adaptations and exaptations is outlined in this review and examples are given. Also elaborated on is the fact that such distinctions are sometimes more difficult to determine; this is a widespread phenomenon in biology, where continua abound and clear borders between states and definitions are rare.

关键词： exaptation adaptation aptation neofunctionalization subfunctionalization non-protein coding RNA cooptation recruitment novel functional gene modules de novo genes retrogenes

Taguchi Analysis for Improving Optimization of Integrated Forward/Reverse Logistics

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journal of the Operations Research Society of China 2023年第3期11卷 529-552页

作者： Elham Behmanesh jürgen Pannek International Graduate School for Dynamics in Logistics University of BremenBremenGermany Faculty of Production Engineering University of BremenBremenGermany BIBA Bremer Institut für Produktion und Logistik GmbH BremenGermany

The distribution–allocation problem is known as one of the most comprehensive strategic *** real-world cases,it is impossible to solve a distribution–allocation problem completely in acceptable *** forces the researchers to develop efficient heuristic techniques for the large-term operation of the whole supply *** techniques provide near optimal solution and are comparably fast particularly for large-scale test *** paper presents an integrated supply chain model which is flexible in the delivery *** solution methodology,we apply a memetic algorithm with a novelty in population *** identify the optimum operating condition of the proposed memetic algorithm,Taguchi method is *** this study,four factors,namely population size,crossover rate,local search iteration and number of iteration,are *** the best level of the considered parameters is the outlook of this research.

关键词： Integrated logistics network Flexible path Memetic algorithm Taguchi analysis

Apples to oranges:environmentally derived,dynamic regulation of serotonin neuron subpopulations in adulthood?

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Neural Regeneration Research 2025年第9期20卷 2596-2597页

作者： Christopher j.O’Connell Matthew j.Robson Department of Genetics College of MedicineHarvard UniversityBostonMAUSA james L.Winkle College of Pharmacy Division of Pharmaceutical SciencesUniversity of CincinnatiCincinnatiOHUSA Neuroscience Graduate Program College of MedicineUniversity of CincinnatiCincinnatiOHUSA

Traumatic brain injury(TBI)is a public health problem with an undue economic burden that impacts nearly every age,ethnic,and gender group across the globe(Capizzi et al.,2020).TBIs are often sustained during a dynamic range of exposures to energetic environmental forces and as such outcomes are typically heterogeneous regarding severity and pathology(Capizzi et al.,2020).

关键词： sustained orange dynamic

Multi-Product Expansion with Suzuki’s Method: Generalization

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Numerical Mathematics(Theory,Methods and Applications) 2011年第1期4卷 68-91页

作者： jürgen Geiser Department of Mathematics Humboldt University of BerlinUnter den Linden 6D-10099 BerlinGermany

In this paper we discuss the extension to exponential splitting methods withrespect to time-dependent operators. We concentrate on the Suzuki’s method, whichincorporates ideas to the time-ordered exponential of [3, 11, 12, 34]. We formulate themethods with respect to higher order by using kernels for an extrapolation scheme. Theadvantages include more accurate and less computational intensive schemes to specialtime-dependent harmonic oscillator problems. The benefits of the higher order kernelsare given on different numerical examples.

关键词： Suzuki’s method multiproduct expansion multiplicate and additive splitting schemes exponential splitting