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Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

World Journal of Gastrointestinal Oncology 2024年第4期16卷 1374-1383页

作者： Laura Sahyoun Kay Chen Cynthia Tsay George Chen Petr Protiva Department of Gastroenterology and Hepatology Weill Cornell MedicineNew YorkNY 10065United States Gastroenterology Section Jennifer Moreno VA San Diego Healthcare SystemSan DiegoCA 92161United States Division of Gastroenterology Department of MedicineUniversity of California San DiegoLa JollaCA 92093United States Department of Gastroenterology and Hepatology John Hopkins HospitalBaltimoreMD 21287United States Department of Digestive Diseases Yale New Haven HospitalNew HavenCT 06520United States Department of Gastroenterology VA Connecticut Health Care SystemWest HavenCT 06516United States

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival outcomes.Currently,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer survival.Data from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to 2016.Socioe-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban population.Survival was calculated with Cox proportional hazards models for death in the 5-year period following diagnosis.RESULTS Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma cases.When analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,Poutcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.

关键词： Biliary tract cancers Survival outcomes research Socioeconomic factors Healthcare disparities

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Interrelationship between physical activity and depression in nonalcoholic fatty liver disease

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World Journal of Hepatology 2022年第3期14卷 612-622页

作者： Ali A Weinstein Leyla De Avila Saisruthi Kannan James M Paik Pegah Golabi Lynn H Gerber Zobair M Younossi Betty and Guy Beatty Center for Integrated research Inova Health SystemFalls ChurchVA 22042United States Global and Community Health George Mason UniversityFairfaxVA 22030United States Center for Liver Disease Department of MedicineInova Fairfax Medical CampusFalls ChurchVA 22042United States Inova Medicine Inova Health SystemFalls ChurchVA 22042United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is associated with a sedentary lifestyle and depressive symptoms.It is also well established that physical inactivity and depressive symptoms are related.However,an investigation of the interaction between all of these factors in NAFLD has not been previously conducted.AIM To investigate the interrelationship between physical inactivity and depressive symptoms in individuals with NAFLD.METHODS Data from the Rancho Bernardo Study of Healthy Aging were utilized.589 individuals were included in the analyses(43.1%male;95.8%non-Hispanic white;aged 60.0±7.0 years).NAFLD was defined by using the hepatic steatosis index,depression using the Beck Depression Inventory,and physical activity by selfreport of number of times per week of strenuous activity.Multivariable generalized linear regression models with Gamma distribution were performed to investigate the proposed relationship.RESULTS About 40%of the sample had evidence of NAFLD,9.3%had evidence of depression,and 29%were physically inactive.Individuals with NAFLD and depression were more likely to be physically inactive(60.7%)compared to individuals with neither NAFLD nor depression(22.9%),individuals with depression without NAFLD(37.0%),and individuals with NAFLD without depression(33.3%).After accounting for various comorbidities(i.e.,age,sex,diabetes,hypertension,obesity),individuals with NAFLD and higher levels of physical activity were at a decreased odds of having depressive symptoms[16.1%reduction(95%confidence interval:-25.6 to-5.4%),P=0.004],which was not observed in those without NAFLD.CONCLUSION Individuals with NAFLD have high levels of physical inactivity,particularly those with depressive symptoms.Because this group is at high risk for poor outcomes,practitioners should screen for the coexistence of depressive symptoms and NAFLD.This group should receive appropriate interventions aimed at increasing both participation and levels of intensity of physical activity.

关键词： Liver disease outcomes research Psychiatric disorders Exercise

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China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction： Study Design

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Chinese Medical Journal 2016年第1期129卷 72-80页

作者： Rachel P Dreyer Xi Li Xue Du Nicholas S Downing Li Li Hai-Bo Zhang Fang Feng Wen-Chi Guan Xiao Xu Shu-Xia Li Zhen-Qiu Lin Frederick A Masoudi John A Spertus Harlan M Krumholz Li-Xin Jiang National Clinical research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100037 China Center for outcomes research and Evaluation Yale-New Haven Hospital New Haven Connecticut USA Section of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA Department of Obstetrics Gynecology and Reproductive Sciences Yale School of Medicine New Haven Connecticut USA Division of Cardiology University of Colorado Anschutz Medical Campus Aurora Colorado USA Department of Biomedical and Health Informatics University of Missouri - Kansas City Kansas City Missouri USA Saint Luke's Mid America Heart Institute Kansas City Missouri USA The Robert Wood Johnson Foundation Clinical Scholars Program Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA Department of Health Policy and Management Yale School of Public Health New Haven Connecticut USA

Background： Despite the rapid growth in the incidence of acute myocardial infarction （AMI） in China, there is limited information about patients＇ experiences after AMI hospitalization, especially on long-tern1 adverse events and patient-reported outcomes （PROs）. Methods： The China Patient-centered Evaluative Assessment of Cardiac Events （PEACE）-Prospective AMI Study will enroll 4000 consecutive AM I patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to docunlent their treatment, recovery, and outcomes. Details of patients＇ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1 - and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics. Conclusion： The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient＇s experiences and outcomes alter AMI in China and seiwe as a foundation for quality improveinent activities.

关键词： Acute Myocardial Infarction outcomes research Patient-reported Outcome Measures Prospective Cohort

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Impact of surgical volume and resident involvement on patency rates after vasectomy reversaldA 14-year experience in an open access system

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Asian Journal of Urology 2021年第2期8卷 197-203页

作者： Alexandria M.Hertz Andrew W.Stamm Mark I.Anderson Karen C.Baker Department of Urology Madigan Army Medical CenterTacomaWAUSA Division of Urology and Transplantation Virginia Mason Medical CenterSeattleWAUSA Division of Urology Duke University HospitalDurhamNCUSA

Objective:Evaluate the influence of fellowship training,resident participation,reconstruction type,and patient factors on outcomes after vasectomy reversals in a high volume,open access system.Methods:Retrospective review of all vasectomy reversals performed at a single institution from January 1,2002 to December 31,2016 was conducted.Patient and spouse demographics,patient tobacco use and comorbidities,surgeon training and case volume,resident participation,reconstruction type,and postoperative patency were collected and analyzed.Results:Five hundred and twenty-six vasectomy reversals were performed during the study period.Follow-up was available in 80.6%of the cohort and overall patency,regardless of reconstruction type was 88.7%.The mean time to reversal was 7.87 years(range of 0-34 years).The majority of cases included resident participation.Case volume was high with faculty and residents logging a mean of 37.0 and 38.7(median 18 and 37)cases respectively.Bilateral vasovasostomy was the most common reconstruction type(83%)and demonstrated a significantly better patency rate(89%)than all other reconstructions(p=0.0008).Overall patency and patency by reconstruction type were not statistically different among faculty surgeons and were not impacted by fertility fellowship training,resident participation or postgraduate year.Multivariate analysis demonstrated that increased time to reversal and repeat reconstructions had a negative impact on patency(p=0.0023 and p=0.043,respectively).Conclusions:Surgeons with a high volume of vasectomy reversals have outcomes consistent with contemporary series regardless of fellowship training in fertility.Patency was better for bilateral vasovasostomies.Patency was not negatively impacted by tobacco use,comorbidities,resident participation,or post-graduate year.

关键词： Vasectomy reversal Vasoepididymostomy Obstructive azoospermia outcomes research Learning curve

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Understanding celiac disease monitoring patterns and outcomes after diagnosis:A multinational,retrospective chart review study

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World Journal of Gastroenterology 2021年第20期27卷 2603-2614页

作者： Knut EA Lundin Ciaran P Kelly David S Sanders Kristina Chen Sheena Kayaniyil Sisi Wang Rajvi J Wani Caitlin Barrett Shakira Yoosuf Ellen S Pettersen Robert Sambrook Daniel A Leffler K.G.Jebsen Coeliac Disease research Centre University of OsloOslo 0450Norway Department of Gastroenterology Oslo University Hospital RikshospitaletOslo 0372Norway Celiac Center Beth Israel Deaconess Medical Center Celiac Research Program Harvard Medical SchoolBostonMA 02115United States Royal Hallamshire Hospital University of SheffieldSheffield S102TNUnited Kingdom Takeda Pharmaceuticals International Co. CambridgeMA 02139United States Real World Evidence Strategy and Analytics ICON plc.TorontoON L7N 3G2Canada Real World Evidence Strategy and Analytics ICON plc.VancouverBC V6B 1P1Canada

BACKGROUND Long-term outcomes and monitoring patterns in real-world practice are largely unknown among patients with celiac disease.AIM To understand patterns of follow-up and management of patients with celiac disease,and to characterize symptoms and villous atrophy after diagnosis.METHODS A retrospective chart review study was performed using medical chart data of patients diagnosed with celiac disease.Three gastroenterology referral centers,with substantial expertise in celiac disease,participated in the United Kingdom,United States,and Norway.Demographic and clinical data were collected from medical charts.Descriptive analyses were conducted on patients with biopsyconfirmed celiac disease,diagnosed between 2008 and 2012,with at least one follow-up visit before December 31,2017.Patient demographic and clinical characteristics,biopsy/serology tests and results,symptoms,and comorbidities were captured at diagnosis and for each clinic visit occurring within the study period(i.e.,before the study end date of December 31,2017).RESULTS A total of 300 patients were included in this study[72%female;mean age at diagnosis:38.9 years,standard deviation(SD)17.2].Patients were followed-up for a mean of 29.9 mo(SD 22.1)and there were,on average,three follow-up visits per patient during the study period.Over two-thirds(68.4%)of patients were recorded as having ongoing gastrointestinal symptoms and 11.0%had ongoing symptoms and enteropathy during follow-up.Approximately 80%of patients were referred to a dietician at least once during the follow-up period.Half(50.0%)of the patients underwent at least one follow-up duodenal biopsy and 36.6%had continued villous atrophy.Patterns of monitoring varied between sites.Biopsies were conducted more frequently in Norway and patients in the United States had a longer follow-up duration.CONCLUSION This real-world study demonstrates variable follow-up of patients with celiac disease despite most patients continuing to have abnormal histology and symptoms after diagnosis.

关键词： Celiac disease outcomes research Endoscopy Real-world General practice Villous atrophy

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A Review of Foreign researches on Energy and Environment Field: Based on the research Perspective of CGE Model

A Review of Foreign Researches on Energy and Environment Fie...

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2012 Asian Pacific Conference on Energy,Environment and Sustainable Development(APEESD 2012)

作者： Wei Liang Huiying Zhang Faculty of Management and Economics Tianjin University School of Management University of Jinan

Policy modeling has been widely applied in the economy, environment and other fields. As one of a core technology, CGE model plays an irreplaceable role in all areas of policy modeling studies. In thi

关键词： CGE Model Energy and Environment Policy Policy Simulation Energy Saving Emission Reduction Energy sources Fields environmental policy Environments Policies outcomes research Modeling Key technology Perspective research trends

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A Correlation Study between Dictation and English Proficiency of Chinese English-Major Students

A Correlation Study between Dictation and English Proficienc...

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2011 International Conference on Control, Automation and Systems Engineering(CASE)

作者： LUO Yuzhi ZHANG Xiaolong School of Foreign Language Anhui Agricultural University

The present study was to examine the relationship between dictation scores measured by the mean score of five class dictation tests and English proficiency of Chinese learners measured by TEM-4. 106 s

ISBN: (纸本)9781457708596

关键词： Correlation analysis dictation English English language Language Proficiency teaching rooms MULTI-MEDIA SYSTEM outcomes research Chinese philosophy Chinese art

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