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Effects of Electrical Stimulation in People with Post-Concussion Syndromes: A Pilot Study

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Health 2018年第4期10卷 381-395页

作者： Yi-Ning Wu Jessica Gravel Naseem Chatiwala Terrie Enis Caroline Stark Robert C. Cantu Department of Physical Therapy University of Massachusetts Lowell Lowell MA USA Dr. Robert C. Cantu Concussion Center Emerson Hospital Concord MA USA Center for Rehabilitative and Sports Therapies Emerson Hospital Concord MA USA Department of Neurosurgery and Neurology Boston University School of Medicine Boston MA USA

Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.

关键词： Post-Concussion Syndrome Cognitive Function Physical Therapy Electrical Stimulation

Acceptability of an adjunct equine-assisted activities and therapies program for veterans with posttraumatic stress disorder and/or traumatic brain injury

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Journal of Integrative Medicine 2020年第2期18卷 169-173页

作者： Louisa Sylvia emerson West Allyson M.Blackburn Carina Gupta Eric Bui Tara Mahoney Geraldine Duncan Edward C.Wright Simon Lejeune Thomas J.Spencer Home Base:A Red Sox Foundation and Massachusetts General hospital Program Massachusetts General HospitalCharlestownMA 02129USA Harvard Medical School BostonMA 02115USA Dauten Family Center for Bipolar Treatment Innovation Massachusetts General HospitalBostonMA 02114USA Equine Immersion ProgramsTM USA Pediatric Psychopharmacology and Adult ADHD Program Massachusetts General HospitalBostonMA 02114USA

Objective: Equine-assisted activities and therapies(EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder(PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury(TBI).Methods: A family member or support person could accompany veterans and participate in the *** hundred and six participants(veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program(IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic ***: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program’s ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76(standard deviation[SD] = 0.61) as reported by veterans and a mean score of 9.91(SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall ***: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.

关键词： Posttraumatic stress disorder Military personnel Traumatic brain injury Complementary and alternative medicine Equine-assisted therapy

Association between Helicobacterpylori, Epstein-Barr virus, human papillomavirus and gastric adenocarcinomas

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World Journal of Gastroenterology 2018年第43期24卷 4928-4938页

作者： Carolina Rosal Teixeira de Souza Marcelli Carolini Alves Almeida Andre Salim Khayat emerson Lucena da Silva Paulo Cardoso Soares Luiz Claudio Chaves Rommel Mario Rodriguez Burbano Laboratory of Human Cytogenetics Institute of Biological Sciences Federal University of Para Belem Para 66075-110 Brazil Oncology Research Center Federal University of Para Joao deBarros Barreto University Hospital Belem Para 66073-000Brazil Ophir Loyola hospital Belem Para 66060-281 Brazil

AIM TO correlate Helicobacter pylori （H. pylorli）, EpsteinBarr virus （EBV） and human papillomavirus （HPV） with gastric cancer （GC） cases in Para State, *** Tissue samples were obtained from 302 gastric adenocarcinomas. A rapid urease test was used to detect the presence of H. pylori, and the presence of the cagA gene in the HP-positive samples was confirmed by PCR. An RNA in situ hybridization test designed to complement Eberl RNA was used to detect the presence of EBV in the samples, and the L1 region of HPV was detected using nested PCR. Positive HPV samples were genotyped and analyzed for E6 and E7 viral gene expression. Infections were also correlated with the clinical and pathological characteristics of the *** The majority of the 302 samples analyzed were obtained from men （65%） aged 55 years or older （67%） and were classified as the intestinal subtype （55%）. All three pathogens were found in the samples analyzed in the present study （H. pylori： 87%, EBV： 20%, HPV： 3%）. Overall, 78% of the H. pylori-positive （H. pylorl＋） samples were cagA＋（H. pylori-cagA＋）, and there was an association between the cytotoxic product of this gene and EBV. Coinfections of H. pylori-cagA＋ and EBV were correlated with the most advanced tumor stages. Although only 20% of the tumors were positive for EBV, infection with this virus was associated with distant metastasis. Only the HPV 16 and 18 strains were found in the samples, although no expression of the E6 and E7 oncoproteins was detected. The fundus of the stomach was the region least affected by the *** HPV was not involved in gastric tumorigenesis. Prophy- lactic and therapeutic measures against H. pylori and EBV may prevent the development of GC, especially the more aggressive forms.

关键词： Gastric cancer Gastric adenocarcinomas Microorganisms Helicobacter pylori cagA Epstein-Barr virus Human papillomavirus

Stroma-targeting strategies in pancreatic cancer:Past lessons,challenges and prospects

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World Journal of Gastroenterology 2021年第18期27卷 2105-2121页

作者： Faran Polani Patrick M Grierson Kian-Huat Lim Division of Oncology Department of Internal MedicineBarnes-Jewish Hospital and The Alvin J.Siteman Comprehensive Cancer CenterWashington University School of MedicineSaint LouisMO 63110United States

Pancreatic ductal adenocarcinoma(PDAC)is projected to emerge as the second leading cause of cancer-related death after *** treatment resistance is perhaps the most significant factor that underlies the poor prognosis of *** date,combination chemotherapy remains the mainstay of treatment for most PDAC *** to other cancer types,treatment response of PDAC tumors to similar chemotherapy regimens is clearly much lower and *** from typically harboring genetic alterations that to date remain undruggable and are drivers of treatment resistance,PDAC tumors are uniquely characterized by a densely fibrotic stroma that has well-established roles in promoting cancer progression and treatment ***,emerging evidence also suggests that indiscriminate targeting and near complete depletion of stroma may promote PDAC aggressiveness and lead to detrimental *** conflicting results undoubtedly warrant the need for a more in-depth understanding of the heterogeneity of tumor stroma in order to develop modulatory strategies in favor of tumor *** advent of novel techniques including single cell RNA sequencing and multiplex immunohistochemistry have further illuminated the complex heterogeneity of tumor cells,stromal fibroblasts,and immune *** new knowledge is instrumental for development of more refined therapeutic strategies that can ultimately defeat this ***,we provide a concise review on lessons learned from past stromatargeting strategies,new challenges revealed from recent preclinical and clinical studies,as well as new prospects in the treatment of PDAC.

关键词： Stroma Pancreatic cancer Treatment resistance Cancer-associated fibroblasts Clinical trials

Experience with Miniaturized Cardiopulmonary Bypass in Cardiac Surgery: A Prospective Comparison of the NovoSCI Ready System to Off-Pump and Conventional Coronary Artery Bypass Grafting

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World Journal of Cardiovascular Surgery 2014年第12期4卷 232-238页

作者： Dominic emerson Debbie Baldwin Miguel Pinales Michael Greenberg Melissa Mattes Gregory Trachiotis Veterans Affairs Medical Center Washington DC USA Georgetown University hospital Washington DC USA The George Washington University hospital Washington DC USA

The major source of morbidity following cardiopulmonary bypass (CPB) is the systemic inflammatory response (SIRS response) which leads to multiple derangements in different organ systems. To combat this, miniaturized cardiopulmonary bypass circuits (MCPBC) have been created to lessen the inflammatory response to CPB. Here we examine early outcomes following coronary artery bypass grafting (CABG) using a MCPBC system compared to conventional bypass techniques at a single institution. Methods: 60 consecutive patients undergoing elective CABG were prospectively enrolled. Nine patients underwent coronary artery bypass grafting (CABG) with conventional CPB (cCABG), 33 underwent off-pump CABG (OPCAB), and the remaining 18 patients underwent CABG with a MCPBC system. Demographics and outcomes were compared between groups and statistical analyses applied. Results: No significant difference was observed in mortality between groups, with only one death reported in total. Morbidity was also low, totaling only 6.7%, with none occurring in the MCPBC group. The MCPBC group required less PRBC and total blood product transfusion than the cCABG and OPCABG groups (p = 0.05), but changes in PLT and Hct over time were not different between groups. Conclusions: The MCPBC system was shown to be comparable to conventional bypass and OPCABG in terms of postoperative complications and mortality. Furthermore, the MCPBC system had the advantage of a decreased transfusion requirement. Based on our preliminary observations, this mini-cardiopulmonary bypass circuit provides a safe alternative to conventional bypass techniques.

关键词： Miniaturized Circuits Coronary Artery Bypass Graft Outcomes

Evaluation of sentinel lymph nodes in vulvar, endometrial and cervical cancers

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World Journal of Obstetrics and Gynecology 2016年第1期5卷 78-86页

作者： Jenna emerson Katina Robison Department of Obstetrics and Gynecology Women and Infants Hospital Alpert Medical School Brown University

Sentinel lymph node （SLN） biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic malignancies has been studied extensively over the past decade. We review the current literature on SLN dissection in vulvar, endometrial and cervical cancers. Large, well-designed trials in each of the three types of cancer have demonstrated high sensitivity and low false-negative rates when SLN biopsy is performed in the correct patients and with an appropriate technical approach. In all of these cases the addition of ultra-staging to conventional pathology yields increased detection of micrometastatic disease. Biopsy of the sentinel nodes is feasible and safe in early vulvar malignancies, with multiple studies describing low recurrence rates in those women who have with negative SLNs. There does not appear to be a survival benefit to lymphadenectomy over SLN biopsy and quality of life is improved in women undergoing SLN biopsy. Optimal treatment strategies for women with positive nodal biopsies, particularly in cases with micrometastatic disease, remain unclear. Multiple large studies investigating the utility of SLN biopsy in endometrial malignancy have found that sentinel nodal status is a reliable predictor of metastases in women with low-risk disease. Prospective studies are ongoing and suggest sentinel nodal detection may soon become widely accepted as an alternative standard of care for select cases of endometrial cancer. In cervical cancer, SLN biopsy is accurate for diagnosing metastatic disease in early stage tumors （≤ 2 cm diameter or stage ≤ IB2） where the risk of metastasis is low. It is unknown if women who undergo SLN biopsy alone will have different survival outcomes than women who undergo complete lymphadenectomy in these cases. In a specific population of women with vulvar cancer, SLN dissection is an effective and safe alternative to com

关键词： Gynecologic malignancies Sentinel lymph node Endometrial cancer Cervical cancer Vulvar cancer

Induction of Bronchiolitis and Airway Remodeling by Respiratory Syncytial Virus in Nonhuman Primates

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Induction of Bronchiolitis and Airway Remodeling by Respirat...

Clinical translation of neuro-regenerative medicine in India: A study on barriers and enabling strategies

中华医学会呼吸病学年会——2013（第十四次全国呼吸病学学术会议）

作者： Zhijun Jie ShanZe Wang Bilan Li Jennifer A.Berger Jennifer B.Knight Carol L.emerson Kevin S.Harrod The Fifth Peoples hospital of Shanghai Fudan University Lovelace Respiratory Research Institute AlbuquerqueNM

Objective The limitations of mouse models have been increasingly recognized for studying the pathogenesis of human *** study seeks to assess the induction of bronchiolitis and airway remodeling by respiratory syncytial virus in a nonhuman primate model. Methods Cynomolgus macaques were infected with respiratory syncytial virus via bronchoscopy for 4,7,and 14 days.A temporal assessment of viral replication,lung histopathological changes,and airway remodeling were

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Open Journal of Regenerative Medicine 2013年第2期2卷 20-27页

作者： Mark J. Messih Claudia emerson Halla Thorsteinsdóttir Michael G. Fehlings Abdallah S. Daar McLaughin-Rotman Centre for Global Health University Health Network & University of Toronto Toronto Canada Toronto Western General hospital University Health Network University of Toronto Toronto Canada

We present the findings of a study of barriers and enabling strategies to clinical translation of Neuro-Regenerative Medicine (Neuro-RM) technologies in India. Twenty-three people were included in this qualitative study, including researchers, clinicians, firm representatives and policy makers working in Neuro-RM. The study has identified barriers that may arise at each stage of translation and how these are being addressed. Understanding of the molecular and cellular basis of Neuro-RM is being supported through government investment in existing neuroscience centres and the creation of new centres with regenerative medicine expertise. Clinical trials benefit from the support of clinicians who partner with researchers in study design and data collection. Government agencies have developed guidelines to inform best practices in preclinical and clinical studies. Addressing the barriers to Neuro-RM translation identified in this study can be achieved through continued support for capacity building and priority setting in preclinical studies, international efforts to achieve clinical trial protocol standardization, and multidisciplinary collaborations between clinicians, researchers, government and industry.

关键词： Regenerative Medicine Translational Research Stem Cell Policy Indian Biotechnology Neuro-Regeneration

Gastric cancer with concurrent pancreatic schwannoma: A casereport

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 107-113页

作者： Mateus Barradas Ribeiro emerson Shigueaki Abe AndréKondo Adriana Vaz Safatle-Ribeiro Marina Alessandra Pereira Bruno Zilberstein Ulysses Ribeiro Jr Department of Gastroenterology Instituto do CancerHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSao Paulo 01249000Brazil

BACKGROUND The differential diagnosis of abdominal masses is somewhat troublesome,especially when there is a malignancy to be *** report herein a unique case of gastric adenocarcinoma concurrent with a pancreatic *** assessment of intraoperative findings is essential for adequate tumor staging and to decide the proper management of a concurrent pancreatic *** SUMMARY Computed tomography scan performed for gastric cancer staging revealed a solid and cystic pancreatic mass that had no signs of local *** resection of the pancreas was decided preoperatively since a radical approach of the gastric tumor could be *** were no signs of distant metastases,and the large pancreatic mass was in contact with the posterior gastric *** study revealed a pancreatic schwannoma,which is an uncommon neoplasm that arises from Schwann cells around peripheral *** Therefore,pancreatic masses deserve special attention regarding the differential diagnosis in patients with gastric *** presence of a large pancreatic mass should not preclude the potentially curative intent of the gastric cancer treatment.

关键词： Stomach neoplasms Gastric adenocarcinoma Schwannoma Pancreas Case report