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Hepatic grooves:An observational study at laparoscopic surgery

World Journal of Experimental Medicine 2024年第2期14卷 97-102页

作者： Shamir O Cawich Dexter A Thomas Fawwaz Mohammed Michael T Gardner Marlene Craigie Shaneeta Johnson Ramnanand S Kedambady Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Port of Spain General HospitalPort of Spain 000000Trinidad and Tobago Section of Anatomy Basic Medical SciencesUniversity of the West IndiesKingston 000000Jamaica Department of Radiology University of the West IndiesKingston 000000Jamaica Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Section of Anatomy Department of Basic Medical SciencesUniversity of the West IndiesKingston KIN7Jamaica

BACKGROUND In traditional descriptions,the upper surface of the liver is smooth and convex,but deep depressions are variants that are present in 5%-40%of patients.We sought to determine the relationship between surface depressions and the diaphragm.AIM To use exploratory laparoscopy to determine the relationship between surface depressions and the diaphragm.METHODS An observational study was performed in all patients undergoing laparoscopic upper gastro-intestinal operations between January 1,2023 and January 20,2024.A thirty-degree laparoscope was used to inspect the liver and diaphragm.When surface depressions were present,we recorded patient demographics,presence of diaphragmatic bands,rib protrusions and/or any other source of compression during inspection.RESULTS Of 394 patients,343 had normal surface anatomy,and 51(12.9%)had prominent surface depressions on the liver.There was no significant relationship between the presence of surface depressions and gender nor the presence of rib projections.However,there was significant association between the presence of surface depressions and diaphragmatic muscular bands(P<0.001).CONCLUSION With these data,the diaphragmatic-band theory has gained increased importance over other theories for surface depressions.Further studies are warranted using cross sectional imaging to confirm relationships with intersectional planes as well as beta-catenin assays in the affected liver parenchyma.

关键词： Liver Variant Vein Hepatic Surgery

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Liver surface depressions in the presence of diaphragmatic muscular bands on trans-illumination

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World Journal of Experimental Medicine 2024年第2期14卷 5-10页

作者： Shamir O Cawich Michael T Gardner Ramanand Shetty Jean Pierre Louboutin Zenica Dabichan Shaneeta Johnson Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Section of Anatomy Department of Basic Medical SciencesUniversity of the West IndiesKingston KIN7Jamaica Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States

Traditional descriptions of liver anatomy refer to a smooth,convex surface contacting the diaphragm.Surface depressions are recognized anatomic variants.There are many theories to explain the cause of the depressions.... 详细信息

关键词： Liver Anatomy Depressions Fissure Groove Sulcus Variant

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A CFD Model to Evaluate Near-Surface Oil Spill from a Broken Loading Pipe in Shallow Coastal Waters

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Fluid Dynamics & Materials Processing 2024年第1期20卷 59-77页

作者： Portia Felix Lee Leon Derek Gay Stefano Salon Hazi Azamathulla Department of Civil and Environmental Engineering The University of the West IndiesSt.AugustineTrinidad and Tobago National Institute of Oceanography and Experimental Geophysics-OGS TriesteItaly

Oil spills continue to generate various issues and concerns regarding their effect and behavior in the marine environment,owing to the related potential for detrimental environmental,economic and social implications.It is essential to have a solid understanding of the ways in which oil interacts with the water and the coastal ecosystems that are located nearby.This study proposes a simplified model for predicting the plume-like transport behavior of heavy Bunker C fuel oil discharging downward from an acutely-angled broken pipeline located on the water surface.The results show that the spill overall profile is articulated in three major flow areas.The first,is the source field,i.e.,a region near the origin of the initial jet,followed by the intermediate or transport field,namely,the region where the jet oil flow transitions into an underwater oil plume flow and starts to move horizontally,and finally,the far-field,where the oil re-surface and spreads onto the shore at a significant distance from the spill site.The behavior of the oil in the intermediate field is investigated using a simplified injection-type oil spill model capable of mimicking the undersea trapping and lateral migration of an oil plume originating from a negatively buoyant jet spill.A rectangular domain with proper boundary conditions is used to implement the model.The Projection approach is used to discretize a modified version of the Navier-Stokes equations in two dimensions.A benchmark fluid flow issue is used to verify the model and the results indicate a reasonable relationship between specific gravity and depth as well as agreement with the aerial data and a vertical temperature profile plot.

关键词： CFD model Navier-Stokes equations projection method water surface oil spill shallow coastal waters

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Bidirectional relationship between type 2 diabetes mellitus and coronary artery disease:Prospective cohort study and genetic analyses

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Chinese Medical Journal 2024年第5期137卷 577-587页

作者： Wenqiang Zhang Li Zhang Chenghan Xiao Xueyao Wu Huijie Cui Chao Yang Peijing Yan Mingshuang Tang Yutong Wang Lin Chen Yunjie Liu Yanqiu Zou Ling Zhang Chunxia Yang Yuqin Yao Jiayuan Li Zhenmi Liu Xia Jiang Ben Zhang Department of epidemiology and Biostatistics Institute of Systems EpidemiologyWest China-Peking Union Medical College C.C.Chen Institute of HealthWest China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuan 610041China Department of Maternal Child and Adolescent HealthWest China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuan 610041China Department of Iatrical Polymer Material and Artificial Apparatus School of Polymer Science and EngineeringSichuan UniversityChengduSichuan 610041China Department of Occupational and Environmental Health West China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuan 610041China Department of Nutrition and Food Hygiene West China School of Public Health and West China Fourth HospitalSichuan UniversityChengduSichuan 610041China Department of Clinical Neuroscience Karolinska InstitutetStockholm 17177Sweden

Background:While type 2 diabetes mellitus(T2DM)is considered a putative causal risk factor for coronary artery disease(CAD),the intrinsic link underlying T2DM and CAD is not fully understood.We aimed to highlight the importance of integrated care targeting both diseases by investigating the phenotypic and genetic relationships between T2DM and CAD.Methods:We evaluated phenotypic associations using data from the united Kingdom Biobank(N=472,050).We investigated genetic relationships by leveraging genomic data conducted in European ancestry for T2DM,with and without adjustment for body mass index(BMI)(T2DM:N_(case)/N_(control)=74,124/824,006;T2DM adjusted for BMI[T2DM_(adj)BMI]:N_(case)/N_(control)=50,409/523,897)and for CAD(N_(case)/N_(control)=181,522/984,168).We performed additional analyses using genomic data conducted in multiancestry individuals for T2DM(N_(case)/N_(control)=180,834/1,159,055).Results:Observational analysis suggested a bidirectional relationship between T2DM and CAD(T2DM→CAD:hazard ratio[HR]=2.12,95%confidence interval[CI]:2.01–2.24;CAD→T2DM:HR=1.72,95%CI:1.63–1.81).A positive overall genetic correlation between T2DM and CAD was observed(r_(g)=0.39,P=1.43×10^(-75)),which was largely independent of BMI(T2DM_(adj)BMI–CAD:r_(g)=0.31,P=1.20×10^(–36)).This was corroborated by six local signals,among which 9p21.3 showed the strongest genetic correlation.Cross-trait meta-analysis replicated 101 previously reported loci and discovered six novel pleiotropic loci.Mendelian randomization analysis supported a bidirectional causal relationship(T2DM→CAD:odds ratio[OR]=1.13,95%CI:1.11-1.16;CAD→T2DM:OR=1.12,95%CI:1.07-1.18),which was confirmed in multiancestry individuals(T2DM→CAD:OR=1.13,95%CI:1.10-1.16;CAD→T2DM:OR=1.08,95%CI:1.04-1.13).This bidirectional relationship was significantly mediated by systolic blood pressure and intake of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors,with mediation proportions of 54.1%(95%CI:24.9-83.4%)and 90.4%(95%CI:29.3-151.5%),respectively.Conclusion:Our observ

关键词： Type 2 diabetes mellitus Coronary artery disease Phenotypic association Genetic correlation Mendelian randomization

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Sacrificial piles as a countermeasure against local scour around underwater pipelines

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Water Science and Engineering 2024年第2期17卷 187-196页

作者： Forough Raeisi Seyed Mohammad Ali Zomorodiann Masih Zolghadr Hazi Mohammad Azamathulla Department of Water Engineering Shiraz UniversityShiraz ***Iran Department of Water Sciences Engineering Jahrom UniversityJahrom ***Iran Department of Civil and Environmental Engineering The University of the West IndiesSt.Augustine CampusTrinidad 331310Republic of Trinidad and Tobago

Local scour around pipelines crossing rivers or in marine environments is a significant concern.It can lead to failure of the pipelines resulting in environmental side effects and economic losses.This study developed an experimental method to reduce local scour around pipelines with a steady flow of clear water by installing cylindrical and cubical sacrificial piles.Three sizes of sacrificial piles were examined in a linear arrangement.Sacrificial piles were installed on the upstream side of the pipeline at three distances.Maximum scour depth reduction rates below the pipeline were computed.The results showed that sacrificial piles could protect a pipeline from local scour.A portion of scoured sediment around the sacrificial piles was deposited beneath the pipeline.This sediment accumulation reduced the scour depth beneath the pipeline.Analysis of the experimental results demonstrated that the size of piles(d),the spacing between piles,and the distance between the pipe and piles(Xp)were the variables that reduced the maximum scour beneath the pipeline with a diameter of D.For the piles with d=0.40D and 0.64D,X_(p)=4OD was the optimal distance to install a group of piles,and cubical piles could mitigate scour more effectively than cylindrical piles under similar conditions.For the piles with d=D,the greatest reduction in scour depth was achieved at X_(p)=50D with any desired spacings between piles,and cylindrical piles in this dimension could protect the pipeline against scour more effectively than cubical piles.

关键词： Clear water River crossing pipeline Local scour Self-burial process Sediment transport

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Association of physical activity with risk of chronic kidney disease in China:A population-based cohort study

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Journal of Sport and Health Science 2024年第2期13卷 204-211页

作者： Kexiang Shi Yunqing Zhu Jun Lv Dianjianyi Sun Pei Pei Huaidong Du Yiping Chen Ling Yang Bing Han Rebecca Stevens Junshi Chen Zhengming Chen Liming Li Canqing Yu China Kadoorie Biobank collaborative group Department of epidemiology&Biostatistics School of Public HealthPeking University Health Science CenterBeijing 100191China Peking university Center for Public Health and Epidemic Preparedness&Response Beijing 100191China Key Laboratory of epidemiology of Major Diseases(Peking university) Ministry of EducationBeijing 100191China Clinical Trial Service unit&Epidemiological Studies unit(CTSU) Nuffield Department of Population HealthUniversity of OxfordOxford OX37LFUK Medical research Council Population Health research unit at the university of Oxford Oxford OX37LFUK NCDs Prevention and Control Department Henan Center for Disease Control and PreventionZhengzhou 450016China China National Center for Food Safety Risk Assessment Beijing 100022China 不详

Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.

关键词： Chronic kidney disease Domain Intensity Physical activity

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Association between body mass index and in vitro fertilization/intra-cytoplasmic sperm injection outcomes: An analysis of 15,124 normal ovarian responders in China

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中华医学杂志(英文版) 2024年第7期137卷 837-845页

作者： Zheng Danlei Wang Yuanyuan Chen Lixue Zeng Lin Li Rong Department of Obstetrics and Gynecology Center for Reproductive Medicine Peking university Third Hospital Beijing 100191 China research Center of Clinical epidemiology

Background: High body mass index (BMI) results in decreased fecundity, and women with high BMI have reduced rates of clinical pregnancy and live birth inin vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Meanwhile, ovarian responses show great heterogeneity in patients with a high BMI. This study aimed to analyze the effects of a high BMI on IVF/ICSI outcomes in the Chinese female with normal ovarian response.Methods: We performed a retrospective cohort study comprising 15,124 patients from the medical record system of the Reproductive Center of Peking university Third Hospital, with 3530 (23.3%) in the overweight group and 1380 (9.1%) in the obese group, who had a normal ovarian response (5-15 oocytes retrieved) and underwent fresh embryo transfer (ET) cycles from January 2017 to December 2018, followed by linked frozen-thawed embryo transfer (FET) cycles from January 2017 to December 2020. Cumulative live birth rate (CLBR) was used as the primary outcome. Furthermore, a generalized additive model was applied to visually illustrate the curvilinear relationship between BMI and the outcomes. We used a decision tree to identify the specific population where high BMI had the greatest effect on IVF/ICSI outcomes.Results: High BMI was associated with poor IVF/ICSI outcomes, both in cumulative cycles and in separate fresh ET or FET cycles. In cumulative cycles, compared with the normal weight group, obesity was correlated with a lower positive pregnancy test rate (adjusted odds ratio [aOR]: 0.809, 95% confidence interval [CI]: 0.682-0.960), lower clinical pregnancy rate (aOR: 0.766, 95% CI: 0.646-0.907), lower live birth rate (aOR: 0.706, 95% CI: 0.595-0.838), higher cesarean section rate (aOR: 2.066, 95% CI: 1.533-2.785), and higher rate of large for gestational age (aOR: 2.273, 95% CI: 1.547-3.341). In the generalized additive model, we found that CLBR declined with increasing BMI, with 24 kg/m2 as an inflection point. In the decision tree, BMI only made a difference in the population aged ≤34.5 yea

关键词： Obesity Body mass index In vitro fertilization Live birth Decision trees Normal ovarian response

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Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy

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World Journal of Clinical Cases 2024年第3期12卷 488-494页

作者： Shamir O Cawich Joseph Martin Plummer Sahle Griffith Vijay Naraynsingh Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Department of General Surgery and Consultant General and Colorectal Surgeon Department of SurgeryUniversity of the West IndiesKingstonKIN7Jamaica Department of Surgery Queen Elizabeth HospitalBridgetownBarbados Department of Surgery Port of Spain General HospitalPort of SpainTrinidad and Tobago

BACKGROUND Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer,but we have experienced resistance to the introduction of the FreeHandffrobotic camera holder to augment laparoscopic colorectal surgery.AIM To compare the initial results between conventional and FreeHandffrobot-assisted laparoscopic colectomy in Trinidad and Tobago.METHODS This was a prospective study of outcomes from all laparoscopic colectomies per-formed for colorectal carcinoma from November 29,2021 to May 30,2022.The following data were recorded:Operating time,conversions,estimated blood loss,hospitalization,morbidity,surgical resection margins and number of nodes har-vested.All data were entered into an excel database and the data were analyzed using SPSS ver 20.0.RESULTS There were 23 patients undergoing colectomies for malignant disease:8(35%)FreeHandff-assisted and 15(65%)conventional laparoscopic colectomies.There were no conversions.Operating time was significantly lower in patients under-going robot-assisted laparoscopic colectomy(95.13±9.22 vs 105.67±11.48 min;P=0.045).Otherwise,there was no difference in estimated blood loss,nodal harvest,hospitalization,morbidity or mortality.CONCLUSION The FreeHandffrobot for colectomies is safe,provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

关键词： Laparoscopic Colectomy Robot Surgery Minimally invasive

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Prevalence of Anemia in Patients with Diabetes Mellitus:A Systematic Review and Meta-Analysis

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Biomedical and Environmental Sciences 2024年第1期37卷 96-107页

作者： Monireh Faghir-Ganji Narjes Abdolmohammadi Maryam Nikbina Alireza Amanollahi Alireza Ansari-Moghaddam Rozhan Khezri Hamidreza Baradaran Student research Committee Iran University of Medical SciencesTehranIran Department of epidemiology School of Public HealthIran University of Medical SciencesTehranIran Department of epidemiology School of Public HealthTehran University of Medical SciencesTehranIran Department of Midwifery Shoushtar Faculty of Medical SciencesShoushtarIran Department of epidemiology School of Public Health and SafetyShahid Beheshti University of Medical SciencesTehranIran Trauma and Injury research Center Iran University of Medical SciencesTehranIran Health Promotion research Center Zahedan University of Medical SciencesZahedanIran Endocrine research Center Institute of Endocrinology and MetabolismIran University of Medical SciencesTehranIran

Objective Anemia is a common public health concern in patients with type 2 diabetes worldwide.This study aimed to identify the prevalence of anemia among patients with diabetes.Methods Electronic databases,including PubMed,Scopus,Web of Sciences,and Google Scholar,were searched systematically for studies published between 2010 and 2021.After removing duplicates and inappropriate reports,the remaining manuscripts were reviewed and appraised using theNewcastleOttawa Scale(NOS)tool.A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17.Heterogeneity of the studies was assessed using the Q statistic.Results A total of 51 articles containing information on 26,485 patients with diabetes were included in this study.The articles were mainly from Asia(58.82%)and Africa(35.29%).The overall prevalence of anemia was 35.45%(95%CI:30.30–40.76),with no evidence of heterogeneity by sex.Among the two continents with the highest number of studies,the prevalence of anemia in patients with diabetes was significantly higher in Asia[40.02;95%CI:32.72–47.54]compared to Africa[28.46;95%CI:21.90–35.50](P for heterogeneity=0.029).Moreover,there has been an increasing trend in the prevalence of anemia in patients with diabetes over time,from[15.28;95%CI:9.83–22.21]in 2012 to[40.70;95%CI:10.21–75.93]in 2022.Conclusion Globally,approximately 4 in 10 patients with diabetes suffer from anemia.Therefore,routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

关键词： Prevalence Diabetic foot Anemia Diabetes mellitus

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Weight change and all-cause and cause-specific mortality: A 25-year follow-up study

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中华医学杂志(英文版) 2024年第10期137卷 1169-1178页

作者： Yang Huan Wang Jianbing Wang Xiaokun Sun Wanyi Tong Chenyunhao Fan Jinhu Qiao Youlin Abnet Christian C. Department of Cancer epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Public Health Zhejiang University School of Medicine National Clinical Research Center for Children’s Health Hangzhou Zhejiang China Metabolic epidemiology Branch Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD USA

Background: Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort.Methods: Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change <2 kg) or stable normal weight group was treated as the reference. Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to estimate the risk of mortality.Results: A total of 21,028 subjects were included in the final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HRAll-cause = 1.14, 95% CI: 1.09-1.19,P <0.001), cancer (HRCancer = 1.12, 95% CI: 1.03-1.21,P = 0.009), and heart disease (HRHeart diseases = 1.21, 95% CI: 1.11-1.31,P <0.001), whereas subjects with weight gain ≥5 kg had 11% (HRCancer = 0.89, 95% CI: 0.79-0.99,P = 0.033) lower risk of cancer mortality and 23% higher risk of stroke mortality (HRStroke = 1.23,95% CI: 1.12-1.34,P <0.001). For the change of weight status, both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death (HROverweight to normal = 1.18, 95% CI: 1.09-1.27; HRBecoming underweight = 1.35, 95% CI: 1.25-1.46) and cancer death (HROverweight to normal = 1.20, 95% CI: 1.04-1.39; HRBecoming underweight = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HRStable overweight = 1.11, 95% CI: 1.05-1.17) and death from stroke (HRStable overweight = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease,

关键词： Weight change All-cause mortality Cancer Stroke Heart diseases Body mass index

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