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Multimodality treatment of potentially curative gastric cancer: Geographical variations and future prospects

World Journal of Gastroenterology 2014年第36期20卷 12892-12899页

作者： neil d merrett discipline of Surgery School of Medicine University Of Western Sydney Penrith NSW 2751 Australia department of Upper Gastrointestinal Surgery Sydney South West Local Health District Liverpool NSW 2170 Australia

After much controversy, multimodality therapy is now accepted worldwide as the gold standard for treatment of resectable bulky localized gastric cancer. There is significant regional variation in the style of multimodality treatment with adjuvant chemoradiation the North American standard, neoadjuvant chemotherapy preferred in Europe and Australasia, whilst adjuvant chemotherapy is preferred in Asia. With further standardization of surgery and d1+/d2 resections increasingly accepted world wide, and in particular in the West, as the surgical standard of care for potentially curable disease, it is timely to reassess the multimodality regimes being used. The challenge in the use of multimodality therapy is how current outcomes can be standardized and improved further. Recent studies indicate that mere intensification of the regime in time, dosage or addition of further agents does not improve localized gastric cancer outcomes. More novel strategies including early commencement of adjuvant therapies, intra-peritoneal chemotherapy or assessing neoadjuvant response with positron emission tomography scanning may give improvements in outcomes. The introduction of targeted therapies means that the adjuvant use of biological agents needs to be explored. By proper assessment of the patient’s co-morbidities, full tumour staging, and a better understanding of the tumour’s molecular pathology, multimodality therapy for gastric adenocarcinoma may be individualized to optimize the likelihood of cure.

关键词： Gastric cancer Gastrectomy Multimodality Adjuvant treatment Neoadjuvant Targeted therapy Human epidermal growth factor receptor

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Ampullary cancer of intestinal origin and duodenal cancer-A logical clinical and therapeutic subgroup in periampullary cancer

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World Journal of Gastrointestinal Oncology 2017年第10期9卷 407-415页

作者： Manju d Chandrasegaram Anthony J Gill Jas Samra Tim Price John Chen Jonathan Fawcett neil d merrett the Prince Charles Hospital School of Medicine University of Queensland Sydney Medical School University of Sydney Cancer diagnosis and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital department of Surgery Royal North Shore Hospital Queen Elizabeth Hospital University of Adelaide Flinders Medical Centre Royal Adelaide Hospital Princess Alexandra Hospital department of Upper GI Surgery Bankstown Hospital discipline of Surgery Western Sydney University

Periampullary cancers include pancreatic, ampullary, biliary and duodenal cancers. At presentation, the majority of periampullary tumours have grown to involve the pancreas, bile duct, ampulla and duodenum. This can result in difficulty in defining the primary site of origin in all but the smallest tumors due to anatomical proximity and architectural distortion. This has led to variation in the reported proportions of resected periampullary cancers. Pancreatic cancer is the most common cancer resected with a pancreaticoduodenectomy followed by ampullary(16%-50%), bile duct(5%-39%), and duodenal cancer(3%-17%). Patients with resected duodenal and ampullary cancers have a better reported median survival(29-47 mo and 22-54 mo) compared to pancreatic cancer(13-19 mo). The poorer survival with pancreatic cancer relates to differences in tumour characteristics such as a higher incidence of nodal, neural and vascular invasion. While small ampullary cancers can present early with biliary obstruction, pancreatic cancers need to reach a certain size before biliary obstruction ensues. This larger size at presentation contributes to a higher incidence of resection margin involvement in pancreatic cancer. Ampullary cancers can be subdivided into intestinal or pancreatobiliary subtype cancers with histomolecular staining. This avoids relying on histomorphology alone, as even some poorly differentiated cancers preserve the histomolecular profile of their mucosa of origin. Histomolecular profiling is superior to anatomic location in prognosticating survival. Ampullary cancers of intestinal subtype and duodenal cancers are similar in their intestinal origin and form a logical clinical and therapeutic subgroup of periampullary cancers. They respond to 5-FU based chemotherapeutic regimens such as capecitabine-oxaliplatin. Unlike pancreatic cancers, KRAS mutation occurs in only approximately a third of ampullary and duodenal cancers. Future clinical trials should group ampullary cancer

关键词： Periampullary cancer Pancreatobiliary subtype Intestinal subtype Ampullary cancer duodenal cancer Epidermal growth factor receptor Pancreatic cancer Chemotherapy Pancreaticoduodenectomy KRAS

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A hot future for cool materials

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Frontiers in Energy 2023年第4期17卷 447-449页

作者： Xavier MOYA neil d.MATHUR department of Materials Science University of CambridgeCambridge CB3 0FSUK

The ewidespreadneed to pump heat necessitates simprovements that will increase energy efficiency and,more generally,reduce eenvironmental *** discussed at the recent Calorics 2022 Conference,heat-pump devices based on... 详细信息

关键词： magnetocaloric electrocaloric mechanoca-loric elastocaloric barocaloric

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Functional group resolved NMR relaxation of 3-carbon adsorbates in mesoporous alumina

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Magnetic Resonance Letters 2023年第3期3卷 248-255,I0004页

作者： neil Robinson Carmine d’Agostino Michael LJohns department of Chemical Engineering The University of Western Australia35 Stirling HighwayPerthWA 6009Australia department of Chemical Engineering The University of ManchesterOxford RoadManchesterM139PLUK dipartimento di Ingegneria Civile ChimicaAmbientale e Dei Materiali(DICAM)Alma Mater Studiorum e Universita di BolognaVia Terracini28Bologna40131Italy

NMR relaxation analysis provides a unique and non-invasive probe of fluid dynamics within porous materials,and may be applied to the interpretation of a wide variety of material and interfacial ***,we report two-dimensional^(1)H T_(1)-T_(2)relaxation correlation measurements of a range of three-carbon adsorbates(1-propanol,2-propanol and propanoic acid)imbibed within the mesoporous metal oxide *** data,acquired across field strengths of 2 MHz,12.7 MHz and 43 MHz,clearly reveal two populations in each measurement,identified as the alkyl and hydroxyl moieties of each *** results expand the range of materials in which such functional group resolved relaxation is known to occur,and demonstrate the clear persistence of such phenomena using a range of typical benchtop NMR systems employed to study fluid-saturated porous media.

关键词： NMR relaxation Adsorption Porous media Low-field NMR

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An uncommon source of upper gastrointestinal bleeding:epiphrenic esophageal diverticulum

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Gastroenterology Report 2017年第4期5卷 313-315,I0003页

作者： Chung Sang Tse neil d.Parikh department of Internal Medicine Mayo ClinicRochesterMNUSA division of Gastroenterology Department of Internal MedicineYale School of MedicineNew HavenCTUSA

Esophageal diverticula are rare findings that have an estimated incidence of 1 per 500000 people per year,even though acute upper gastrointestinal bleeding is a relatively common medical emergency with an incidence of up to 150 per 100000 people per year and a mortality rate of 7-14%.An 83-year-old man presented with hematemesis and *** upper endoscopy revealed an esophageal diverticulum,within which was an adherent *** of the clot identified a bleeding vessel within the diverticulum;this was successfully clipped and hemostasis was *** the best of our knowledge,this is the first case report of a bleeding epiphrenic esophageal diverticulum that was successfully managed endoscopically with hemostatic clips *** rare,our case serves as a reminder that bleeding epiphrenic esophageal diverticula can present as massive upper gastrointestinal bleeding and urgent endoscopic therapy can be life-saving.

关键词： upper gastrointestinal bleed epiphrenic esophageal diverticulum esophago-gastroduodenoscopy

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Controlling human platelet activation with calcium-binding nanoparticles

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Nano Research 2020年第10期13卷 2697-2705页

作者： david Cabrera Karen Walker Sandhya Moise neil d.Telling Alan G.S.Harper School of Pharmacy and Bioengineering Keele UniversityGuy Hilton Research CenireThormburrow DriveHartshill Stoke-on Trent ST47QBUK ?Central Electron Microscope Unit School of Life SciencesKeele UniversityNewcastle-under LIymeStaffordshireST55BGUK department of Chemical Engineering University of BathBath BA27AYUK School of Medicine Keele UniversityNewcastle-under-LymeStaffordshireST55BGUK

Human platelets aggregate at sites of blood vessel damage in response to a rise in their cytosolic calcium *** these cytosolic calcium rises would provide a method to inhibit platelet activation and prevent the unwanted blood clots that causes heart attack and *** we have predicted that calcium accumulation within the lumen of an infolded portion of the platelet plasma membrane called the open canalicular system(OCS)is essential for maintaining this cytosolic calcium *** to its nanometer dimensions of the OCS,it has been difficult to measure or interfere with the predicted luminal calcium *** we utilise iron oxide magnetic nanoparticles coated with the known calcium chelator,citrate,to create calcium-binding *** were used to assess whether an OCS calcium store plays a role in controlling the dynamics of human platelet activation and *** demonstrate that citrate-coated nanoparticles are rapidly and selectively uptaken into the OCS of activated human platelets,where they act to buffer the accumulation of calcium *** with these calcium-binding nanoparticles reduced thrombin-evoked cytosolic calcium rises,and slowed platelet aggregation and clot retraction in human *** contrast,nanoparticles that cannot bind calcium have no *** study demonstrates that the OCS acts as a key source of calcium for maintaining cytosolic calcium rises and accelerating platelet aggregation,and that calcium-binding nanoparticles targeted to the OCS could provide an anti-platelet therapy to treat patients at risk of suffering heart attacks or strokes.

关键词： nanochelators human platelets open canalicular system calcium signaling nanoparticles

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Intestinal stasisassociated bowel in flam mation

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World Journal of Gastroenterology 1999年第6期5卷 518-521页

作者： Shunichiro Komatsu 1, Yuji Nimura 1 and d.neil Granger 2 Nagoya University School of Medicine 日本 Louislana State University Health Sciences Genter 美国

INTROdUCTIONAnatomical structures that create reservoirs for stagnant intestinal contents are a characteristic feature of common inflammatory disorders such as diverticulitis and appendicitis.

关键词： intestinal stasis bowel inflammation endothelial cell intercellular adhesion molecule 1

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Long-term, in vivo therapeutic effects of a single dose of miR-145 micelles for atherosclerosis

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Bioactive Materials 2023年第9期27卷 327-336页

作者： deborah d.Chin neil Patel Woori Lee Sonali Kanaya Jackson Cook Eun Ji Chung department of Biomedical Engineering University of Southern CaliforniaLos AngelesCA90089United States division of Vascular Surgery and Endovascular Therapy Department of SurgeryKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States Mork Family department of Chemical Engineering and Materials Science University of Southern CaliforniaLos AngelesCA90089United States Eli and Edythe Broad Center for Regenerative Medicine and Stem Cell Research Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States division of Nephrology and Hypertension Department of MedicineKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90033United States Norris Comprehensive Cancer Center Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA90089United States

Atherosclerosis is a chronic inflammatory disease that is characterized by the build-up of lipid-rich plaques in the arterial walls. The standard treatment for patients with atherosclerosis is statin therapy aimed to lower serum lipid levels. despite its widespread use, many patients taking statins continue to experience acute events. Thus, to develop improved and alternative therapies, we previously reported on microRNA-145 (miR-145 micelles) and its ability to inhibit atherosclerosis by targeting vascular smooth muscle cells (VSMCs). Importantly, one dose of miR-145 micelles significantly abrogated disease progression when evaluated two weeks post-administration. Thus, in this study, to evaluate how long the sustained effects of miR-145 micelles can be maintained and towards identifying a dosing regimen that is practical for patients with chronic disease, the therapeutic effects of a single dose of miR-145 micelles were evaluated for up to two months in vivo. After one and two months post-treatment, miR-145 micelles were found to reduce plaque size and overall lesion area compared to all other controls including statins without causing adverse effects. Furthermore, a single dose of miR-145 micelle treatment inhibited VSMC transdifferentiation into pathogenic macrophage-like and osteogenic cells in plaques. Together, our data shows the long-term efficacy and sustained effects of miR-145 micelles that is amenable using a dosing frequency relevant to chronic disease patients.

关键词： MicroRNA-145 Atherosclerosis Vascular smooth muscle cell Nanoparticle Gene therapy

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Upper bounds of Schubert polynomials

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Science China Mathematics 2022年第6期65卷 1319-1330页

作者： neil Jiuyu Fan Peter Long Guo department of Mathematics Sichuan UniversityChengdu 610064China Center for Combinatorics LPMCNankai UniversityTianjin 300071China

Let w be a permutation of{1,2,...,n},and let d(w)be the Rothe diagram of *** Schubert polynomial■w_(x)can be realized as the dual character of the flagged Weyl module associated with d(w).This implies the following coefficient-wise inequality:Min_(x)≤■_(w)(x)≤Max_(w)xwhere both Min_(w)(x)and Max_(w)(x)are polynomials determined by d(w).Fink et al.(2018)found that■w_(x)equals the lower bound Min_(w)(x)if and only if w avoids twelve permutation *** this paper,we show that■w_(x)reaches the upper bound Max_(w)(x)if and only if w avoids two permutation patterns 1432 and ***,for any given compositionα∈Z^(n)≥0,one can define a lower bound Min_(α)(x)and an upper bound Max_(α)(x)for the key polynomialκ_(α)(x).Hodges and Yong(2020)established thatκ_(α)(x)equals Min_(α)(x)if and only ifαavoids five composition *** show thatκ_(α)(x)equals Max_(α)(x)if and only ifαavoids a single composition pattern(0,2).As an application,we obtain that whenαavoids(0,2),the key polynomialκ_(α)(x)is Lorentzian,partially verifying a conjecture of Huh et al.(2019).

关键词： Schubert polynomial key polynomial flagged Weyl module upper bound Lorentzian polynomial

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An inexpensive underwater mine countermeasures simulator with real-time 3d after action review

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defence Technology（防务技术） 2016年第5期12卷 367-379页

作者： Robert STONE Timothy SNELL neil COOKE Human Interface Technologies Team University of Birmingham UK University of Birmingham UK

This paper presents the results of a concept capability demonstration pilot study, the aim of which was to investigate how inexpensive gaming software and hardware technologies could be exploited in the development and evaluation of a simulator prototype for training Royal Navy mine clearance divers, specifically focusing on the detection and accurate reporting of the location and condition of underwater ordnance. The simulator was constructed using the Blender open source 3d modelling toolkit and game engine, and featured not only an interactive 3d editor for underwater scenario generation by instructors, but also a real-time, 3d After Action Review(AAR) system for formative assessment and *** simulated scenarios and AAR architecture were based on early human factors observations and briefings conducted at the UK's defence diving School(ddS), an organisation that provides basic military diving training for all Royal Navy and Army(Royal Engineers) divers. An experimental pilot study was undertaken to determine whether or not basic navigational and mine detection components of diver performance could be improved as a result of exposing participants to the AAR system, delivered between simulated diving scenarios. The results suggest that the provision of AAR was accompanied by significant performance improvements in the positive identification of simulated underwater ordnance(in contrast to non-ordnance objects) and on participants' description of their location, their immediate in-water or seabed context and their structural condition. Only marginal improvements were found with participants' navigational performance in terms of their deviation accuracies from a pre-programmed expert search path. Overall, this project contributes to the growing corpus of evidence supporting the development of simulators that demonstrate the value of exploiting open source gaming software and the significance of adopting established games design techniques in delivering highly

关键词： Simulation Virtual reality diver training Ordnance disposal Mine clearance

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