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Change in mean postoperative pain in patients undergoing tonsillectomy with cold water versus usual practice:A pragmatic trial

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 24-28页

作者： Haissan Iftikhar Nida Zahid Adan Zubair Mohammad Wasif Nabeel N.Baig Khadijah Abid Muhammad Ozair Awan Muhammad Sohail Awan Department of Otolaryngology Queen Elizabeth HospitalBirminghamUK Department of Surgery Aga Khan University HospitalKarachiPakistan college of physicians and surgeons Higher Education CommissionKarachiPakistan Department of UGME Aga Khan UniversityKarachiPakistan

Introduction:Tonsillectomy is one of the most common procedures performed in *** are various methods to perform tonsillectomies(cold and hot).Thermal damage and inflammation of the surrounding tissue using monopolar cautery is said to point to increased pain whereas immediate cooling of the burnt area is thought to reduce pain owing to heat *** objective was to determine the difference in mean post‐tonsillectomy pain scores among patients irrigated with cold water(4℃)and in patients not irrigated with cold *** and Methods:A quasi‐experimental trial was conducted from January 2016 to December 2017 at a tertiary care *** tonsillectomies were carried out with monopolar cautery at a power of 20 *** either received cold water irrigation post tonsillectomy of the tonsillar bed(intervention arm)or no irrigation(control arm).The pain score was measured on Days 0,1,3,5,and *** scores were charted on a visual analog scale on the respective ***:Seventy‐eight patients were included in the *** mean age of our patients was 10.26(4.24)years old in the intervention arm,and 11.95(4.19)years old in the control *** was observed that the pain was significantly lower in patients with cold water irrigation of the tonsillar fossa on Days 1,3,5,and 7(p=0.001).There were no readmissions postprocedure and none of our patients developed any complications ***:In this trial,we report a reduced pain score at all days of observation in the intervention *** of the tonsillar fossa is a safe,cost-effective,and less technically demanding technique that could be employed to reduce postoperative *** studies with randomization,blinding and a larger sample size could further improve on our results.

关键词： cold water tonsillectomy monopoalr tonsillectomy postoperative pain tonsillectomy

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Recovery rates of persistent post-COVID-19 olfactory dysfunction using psychophysical assessment:A longitudinal cohort study

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 79-87页

作者： Jeremy P.Tervo Patricia T.Jacobson Brandon J.Vilarello Tiana M.Saak Francesco F.Caruana Liam W.Gallagher Joseph B.Gary David A.Gudis Paule V.Joseph D.P.Devanand Terry E.Goldberg Jonathan B.Overdevest Columbia University vagelos college of physicians and surgeons New YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery New York-Presbyterian/Columbia University Irving Medical CenterNew YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery University of PittsburghPittsburghPennsylvaniaUSA Department of Otolaryngology-Head and Neck Surgery University of MinnesotaMinneapolisMinnesotaUSA National Institute of Alcohol Abuse and Alcoholism Section of Sensory Science and Metabolism&National Institute of Nursing ResearchBethesdaMarylandUSA New York-Presbyterian/Columbia University Irving Medical Center New YorkNew YorkUSA

Objectives:Persistent olfactory dysfunction(OD)following loss of smell associated with SARS-CoV-2 infection is a major feature of long *** on the prevalence of persistent OD predominantly rely on self-reported olfactory *** studies have tracked longitudinal rates of recovery using psychophysical assessment among patients presenting for evaluation of persistent OD beyond a window of acute *** anchored in standardized testing methods are needed to counsel patients who fail to acutely regain their sense of *** study aims to quantify the degree of persistent OD in post-COVID-19 patients who experience subjective and psychophysical ***:We grouped participants presenting for OD evaluation into cohorts based on both subjective and psychophysical olfactory status at a baseline assessment and assessed their olfactory abilities with a visual analogue scale and the Sniffin'Sticks extended test at baseline and 1-year time *** had confirmed a history of COVID-19 by lab evaluation or clinical diagnosis if lab evaluation was not ***:Baseline olfactory evaluation was completed by 122 participants,53 of whom completed the 1-year follow-up *** participants presenting with perceived OD,74.5%had confirmed psychophysical OD at baseline,with 55.1%at 1-year *** had reliable trends in self-rated versus psychophysically tested olfactory function at both time *** total threshold,discrimination,and identification(TDI)score improved by+3.25 points in the cohort with psychophysical OD(p=0.0005),with this improvement largely attributable to an increase in median threshold scores(+2.75 points;p=0.0004).Conclusions:OD persists in a significant number of patients who fail to acutely recovery their sense of smell after COVID-19,with many demonstrating lingering deficits at *** in threshold,but not discrimination or identification,most significantly mediate improvement

关键词： long COVID olfaction post-COVID condition smell dysfunction

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Vibration-controlled Transient Elastography for Assessment of Liver Fibrosis at a USA Academic Medical Center

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Journal of Clinical and Translational Hepatology 2022年第2期10卷 197-206页

作者： Max Shen Anna Lee Jay H.Lefkowitch Howard J.Worman Department of Medicine Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA Department of Pathology and Cell Biology Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA

Background and Aims:Vibration-controlled transient elastography(VCTE)is a noninvasive tool that uses liver stiffness measurement(LSM)to assess *** real-life data during everyday clinical practice in the USA are lacking,we describe the patterns of use and diagnostic performance of VCTE in patients at an academic medical center in New York ***:Patients who received VCTE scans were included if liver biopsy was performed within 1 *** performance of VCTE in differentiating dichotomized fibrosis stages was assessed via area under the receiver operating characteristics(AUROC).Fibrosis stage determined from VCTE LSM was compared to liver ***:Of 109 patients,49 had nonalcoholic fatty liver disease,16 chronic hepatitis C,15 congestive hepatopathy,and 22 at least two *** was 0.90 for differentiating cirrhosis(stage 4)with a positive predictive value(PPV)range of 0.28 to 0.45 and negative predictive value range of 0.96 to *** 31(32%)patients,VCTE fibrosis stage was at least two stages higher than liver biopsy fibrosis *** of thirty-five pa-tients considered to have cirrhosis by VCTE had stage 0 to 2 and 12 stage 3 fibrosis on liver ***:VCTE has reasonable diagnostic accuracy and is reliable at ruling out ***,because of its low PPV,caution must be exercised when used to diagnose cirrhosis,as misdiagnosis can lead to unnecessary health care *** routine practice,VTCE is also sometimes performed for disease etiologies for which it has not been robustly validated.

关键词： Chronic liver disease Cirrhosis Hepatitis Liver histopathology Nonalcoholic fatty liver disease

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The energetics of cellular life transitions

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Life Metabolism 2024年第3期3卷 12-20页

作者： Anna S.Monzel Michael Levin Martin Picard Department of Psychiatry Division of Behavioral MedicineCollege of Physicians and SurgeonsColumbia University Irving Medical CenterNew YorkNY 10032United States Department of Biology Tufts UniversityMedfordMA 02155United States Allen Discovery Center at Tufts University MedfordMA 02155United States Wyss Institute for Biologically Inspired Engineering Harvard UniversityBostonMA 02115United States Department of Neurology H.Houston Merritt CenterColumbia Translational Neuroscience InitiativeCollege of Physicians and SurgeonsColumbia University Irving Medical CenterNew YorkNY 10032United States New York State Psychiatric Institute New YorkNY 10032United States Robert N Butler Columbia Aging Center Columbia University Mailman School of Public HealthNew YorkNY 10032United States

Major life transitions are always difficult because change costs *** findings have demonstrated how mitochondrial oxidative phosphorylation(OxPhos)defects increase the energetic cost of living and that excessive integrated stress response(ISR)signaling may prevent cellular identity transitions during *** this perspective,we discuss general bioenergetic principles of life transitions and the costly molecular processes involved in reprograming the cellular hardware/software as cells shift *** energetic cost of cellular differentiation has not been directly quantified,representing a gap in *** propose that the ISR is an energetic checkpoint evolved to(i)prevent OxPhos-deficient cells from engaging in excessively costly transitions and(ii)allow ISR-positive cells to recruit systemic energetic resources by signaling via GDF15 and the brain.

关键词： energy mitochondria signaling pathway growth differentiation factor 15 energy balance development

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Embracing different languages and local differences:Coconstructive patient simulation strengthens host countries’clinical training in psychiatry

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World Journal of Psychiatry 2024年第1期14卷 111-118页

作者： Şafak ErayÇamlı Büşra Ece Yavuz Meliha Feyza Gök Idil Yazgan Yanki Yazgan Ayelet Brand-Gothelf Doron Gothelf Doron Amsalem Andrés Martin Department of Child and Adolescent Psychiatry Bursa UludağUniversity Faculty of MedicineBursa 16059 Turkey Yale University School of Medicine New HavenCT 06510United States Güzel Günler Clinic Beşiktaş/İstanbul 34335 Turkey Child Study Center Yale School of MedicineNew HavenCT 06520United States The Feinberg Child Study Center Schneider Children's Medical Center of IsraelTel Aviv UniversityPetach Tikvah 4920235Israel The Child Psychiatry Division Edmond and Lily Safra Children’s HospitalSheba Medical CenterTel HashomerRamat Gan 52561Israel Faculty of Medicine and Sagol School of Neuroscience Tel Aviv UniversityTel Aviv 6997801Israel Department of Psychiatry Columbia University Vagelos College of Physicians and SurgeonsNew YorkNY 10032United States

BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and *** To adapt a human simulation model to psychiatric education in a context that is specific to local languages and *** We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)*** local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native *** Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing *** Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for *** adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of ***,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.

关键词： Human simulation Standardized patients Medical education Psychiatric education Capacity building Local languages

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Coronavirus Disease 2019 and Liver Injury:A Retrospective Analysis of Hospitalized Patients in New York City

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 551-558页

作者： Joshua M.Bender Howard J.Worman Department of Medicine Vagelos College of Physicians&SurgeonsColumbia UniversityNew YorkNYUSA Department of Pathology and Cell Biology Vagelos College of Physicians&SurgeonsColumbia UniversityNew YorkNYUSA

Background and Aims:Coronavirus disease 2019(COVID-19)is a global threat,affecting more than 100 million people and causing over 2 million *** laboratory test abnormalities are an extrapulmonary manifestation of COVID-19,yet characterization of hepatic injury is *** objective was to further characterize and identify causes of liver injury in patients with ***:We conducted a retrospective cohort study of 551 patients hospitalized with COVID-19 at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center between March 1,2020 and May 31,*** analyzed patient demographics,liver laboratory test results,vital signs,other relevant test results,and clinical outcomes(mortality and intensive care unit admission).Results:Abnormal liver laboratory tests were common on hospital admission for COVID-19 and the incidence increased during *** those with elevated serum alanine aminotransferase and/or alkaline phosphatase activities on admission,58.2%had a cholestatic injury pattern,35.2%mixed,and 6.6%*** liver disease was not associated with outcome;however,abnormal direct bilirubin or albumin on admission were associated with intensive care unit stay and *** average,patients who died had greater magnitudes of abnormalities in all liver laboratory tests than those who *** hepatitis was a mechanism of severe hepatocellular injury in some ***:Liver laboratory test abnormalities are common in hospitalized patients with COVID-19,and some are associated with increased odds of intensive care unit stay or *** hepatocellular injury is likely attributable to secondary effects such as systemic inflammatory response syndrome,sepsis,and ischemic hepatitis.

关键词： Aminotransferase Bilirubin Ischemic hepatitis SARS-CoV-2

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Analysis and validation of diagnostic biomarkers and immune cell infiltration characteristics in pediatric sepsis by integrating bioinformatics and machine learning

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World Journal of Pediatrics 2023年第11期19卷 1094-1103页

作者： Wen‑Yuan Zhang Zhong‑Hua Chen Xiao‑Xia An Hui Li Hua‑Lin Zhang Shui‑Jing Wu Yu‑Qian Guo Kai Zhang Cong‑Li Zeng Xiang‑Ming Fang Department of Anesthesiology and Intensive Care School of MedicineThe First Affiliated HospitalZhejiang UniversityQingChun Road 79Hangzhou 310003China Department of Anesthesiology Shaoxing People’s Hospital(Shaoxing HospitalZhejiang University School of Medicine)Shaoxing 312000China Department of Anesthesiology Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA

Background Pediatric sepsis is a complicated condition characterized by life-threatening organ failure resulting from a dysregulated host response to infection in *** is associated with high rates of morbidity and mortality,and rapid detection and administration of antimicrobials have been *** objective of this study was to evaluate the diagnostic biomarkers of pediatric sepsis and the function of immune cell infiltration in the development of this *** Three gene expression datasets were available from the Gene Expression Omnibus ***,the differentially expressed genes(DEGs)were found with the use of the R program,and then gene set enrichment analysis was carried ***,the DEGs were combined with the major module genes chosen using the weighted gene co-expression *** hub genes were identified by the use of three machine-learning algorithms:random forest,support vector machine-recursive feature elimination,and least absolute shrinkage and selection *** receiver operating characteristic curve and nomogram model were used to verify the discrimination and efficacy of the hub *** addition,the inflammatory and immune status of pediatric sepsis was assessed using cell-type identification by estimating relative subsets of RNA transcripts(CIBERSORT).The relationship between the diagnostic markers and infiltrating immune cells was further *** Overall,after overlapping key module genes and DEGs,we detected 402 overlapping *** pediatric sepsis diagnostic indicators,CYSTM1(AUC=0.988),MMP8(AUC=0.973),and CD177(AUC=0.986)were investigated and demonstrated statistically significant differences(P<0.05)and diagnostic efficacy in the validation *** indicated by the immune cell infiltration analysis,multiple immune cells may be involved in the development of pediatric ***,all diagnostic characteristics may correlate with immune cells to varying *** The candida

关键词： Paediatric sepsis Bioinformatics Machine-Learning Biomarkers Immune cell infiltration

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Simulation training in endoscopic skull base surgery: A scoping review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第1期8卷 73-81页

作者： Joel James Alexandria L.I race David A.Gudis Jonathan B.Overdevest City University of New York School of Medicine New YorkNew YorkUSA Department of Otolaryngology-Head and Neck Surgery Columbia University Vagelos College of Physicians and SurgeonsColumbia University Irving Medical CenterNew York-Presbyterian HospitalNew YorkNew YorkUSA

Objective:Proficiency in endoscopic endonasal skull base surgery requires both substantial baseline training and progressive lifelong *** simulation models continue to evolve in an effort to optimize trainee education and preoperative preparation and improve surgical *** current scoping review systematically reviews all available literature and synthesizes the current paradigms of simulation models for endoscopic skull base surgery training and skill ***:In accordance with Preferred Reporting Items for Systemic Review and Meta-Analyses guidelines,we systematically searched PubMed,Embase,CINAHL,and Cochrane *** were categorized according to the type of simulation models ***:We identified 238 unique references,with 55 studies ultimately meeting inclusion *** these,19 studies described cadaveric dissection models,17 discussed three-dimensional(3D)printed models,14 examined virtual surgical planning and augmented reality-based models,and five 5 articles described task ***:There are a wide variety of simulation models for endoscopic skull base surgery,including high-fidelity cadaveric,virtual reality,and 3D-printed *** models are an asset for trainee development and preoperative surgical preparation.

关键词： resident education skull base surgery surgical simulation training virtual reality virtual surgical planning

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An information theoretic method to identify combinations of genomic alterations that promote glioblastoma

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分子细胞生物学报:英文版 2015年第3期7卷 203-213页

作者： Rachel D.Melamed Jiguang Wang Antonio Iavarone Raul Rabadan Department of Systems Biology Columbia University College of Physicians and SurgeonsNew YorkNYUSA Department of Biomedical Informatics Columbia University College of Physicians and SurgeonsNew YorkNYUSA Institute for Cancer Genetics Columbia University College of Physicians and SurgeonsNew YorkNYUSA Department of Pathology and Cell Biology Columbia University College of Physicians and SurgeonsNew YorkNYUSA Department of Neurology Columbia University College of Physicians and SurgeonsNew YorkNYUSA

Tumors are the result of accumulated genomic alterations that cooperate synergistically to produce uncontrollable cell *** identifying recurrent alterations among large collections of tumors provides a way to pinpoint genes that endow a selective advantage in oncogenesis and progression,it fails to address the genetic interactions behind this selection process.A non-random pattern of co-mutated genes is evidence for selective forces acting on tumor cells that harbor combinations of these genetic *** existing methods have successfully identified mutually exclusive gene sets,no current method can systematically discover more general genetic *** develop Genomic Alteration Modules using Total Correlation(GAMToC),an information theoretic frameworkthat integrates copynumberandmutation datato identify genemodules with any non-randompattern of joint ***,wepresent theSeed-GAMToCprocedure,which uncoversthe mutational context of any putative cancer *** software is publicly *** to glioblastoma multiforme samples,GAMToC results show distinct subsets of co-occurring mutations,suggesting distinct mutational routes to cancer and providing new insight into mutations associated with proneural,proneural/G-CIMP,and classical types of the *** results recapitulate known relationships such as mutual exclusive mutations,place these alterations in the context of other mutations,and find more complex relationships such as conditional mutual exclusivity.

关键词： genomics sequencing entropy copy number cancer cancer genetics

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p53 modifications:exquisite decorations ofthe powerful guardian

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Journal of Molecular Cell Biology 2019年第7期11卷 564-577页

作者： Yanqing Liu Omid Tavana Wei Gu Institute for Cancer Genetics College of Physicians and SurgeonsColumbia UniversityNew YorkNY 10032USA Department of Pathology and Cell Biology College of Physicians and SurgeonsColumbia UniversityNew YorkNY 10032USA Herbert Irving Comprehensive Cancer Center College of Physicians and SurgeonsColumbia UniversityNew YorkNY 10032USA

The last 40 years have witnessed how p53 rose from a viral binding protein to a central factor in both stress responses and tumor *** exquisite regulation of p53 functions is of vital importance for cell fate *** the multiple layers of mechanisms controlling p53 function,posttranslational modifications (PTMs) represent an efficient and precise *** p53 PTMs include phosphorylation,ubiquitination,acetylation,and ***,other PTMs like sumoylation,neddylation,O-GlcNAcylation,adenosine diphosphate (ADP)-ribosylation,hydroxylation,and p-hydroxybutyrylation are also shown to play various roles in p53 *** independent action or interaction,PTMs affect p53 stability,conformation,localization,and binding *** of the PTM-related pathway is among the major causes of p53-associated developmental disorders or diseases,especially in *** review focuses on the roles of different p53 modification types and shows how these modifications are orchestrated to produce various outcomes by modulating p53 activities or targeted to treat different diseases caused by p53 dysregulation.

关键词： p53 acetylation deacetylation phosphorylation ubiquitination methylation transcriptional regulation

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