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Labadie KP, Olson KA, Sun SH, Ituarte PHG, Hanna M, Zerhouni Y, Lai LL, Sentovich SM, Kaiser AM, Melstrom KA. Outcomes of rectal cancer patients who refuse surgery after incomplete clinical response to neoadjuvant therapy. J Surg Oncol 2024; 129:1131-1138. [PMID: 38396372 DOI: 10.1002/jso.27604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/28/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND OBJECTIVES Total mesorectal excision (TME) remains the standard of care for patients with rectal cancer who have an incomplete response to total neoadjuvant therapy (TNT). A minority of patients will refuse curative intent resection. The aim of this study is to examine the outcomes for these patients. METHODS A retrospective cohort study of stage 1-3 rectal adenocarcinoma patients who underwent neoadjuvant chemoradiation therapy or TNT at a single institution. Patients either underwent TME, watch-and-wait protocol, or if they refused TME, were counseled and watched (RCW). Clinical outcomes and resource utilization were examined in each group. RESULTS One hundred seventy-one patients (Male 59%) were included with a median surveillance of 43 months. Twenty-nine patients (17%) refused TME and had shortened overall survival (OS). Twelve patients who refused TME converted to a complete clinical response (cCR) on subsequent staging with a prolonged OS. 92% of these patients had a near cCR at initial staging endoscopy. Increased physician visits and testing was utilized in RCW and WW groups. CONCLUSION A significant portion of patients convert to cCR and have prolonged OS. Lengthening the time to declare cCR may be considered in select patients, such as those with a near cCR at initial endoscopic staging.
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Affiliation(s)
| | | | - Steven H Sun
- Division of Colorectal Surgery, Duarte, California, USA
| | | | - Mark Hanna
- Division of Colorectal Surgery, Duarte, California, USA
| | | | - Lily L Lai
- Division of Colorectal Surgery, Duarte, California, USA
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Tao J, Song S, Qu C. Recent Progress on Conversion of Lignocellulosic Biomass by MOF-Immobilized Enzyme. Polymers (Basel) 2024; 16:1010. [PMID: 38611268 PMCID: PMC11013631 DOI: 10.3390/polym16071010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
The enzyme catalysis conversion of lignocellulosic biomass into valuable chemicals and fuels showed a bright outlook for replacing fossil resources. However, the high cost and easy deactivation of free enzymes restrict the conversion process. Immobilization of enzymes in metal-organic frameworks (MOFs) is one of the most promising strategies due to MOF materials' tunable building units, multiple pore structures, and excellent biocompatibility. Also, MOFs are ideal support materials and could enhance the stability and reusability of enzymes. In this paper, recent progress on the conversion of cellulose, hemicellulose, and lignin by MOF-immobilized enzymes is extensively reviewed. This paper focuses on the immobilized enzyme performances and enzymatic mechanism. Finally, the challenges of the conversion of lignocellulosic biomass by MOF-immobilized enzyme are discussed.
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Affiliation(s)
- Juan Tao
- School of Life Science, Jiangxi Science and Technology Normal University, Nanchang 330013, China; (J.T.); (S.S.)
| | - Shengjie Song
- School of Life Science, Jiangxi Science and Technology Normal University, Nanchang 330013, China; (J.T.); (S.S.)
| | - Chen Qu
- Advanced Institute for Materials Research (AIMR), Tohoku University, Sendai 9808577, Japan
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Marrelli D, Piccioni SA, Carbone L, Petrioli R, Costantini M, Malagnino V, Bagnacci G, Rizzoli G, Calomino N, Piagnerelli R, Mazzei MA, Roviello F. Posterior and Para-Aortic (D2plus) Lymphadenectomy after Neoadjuvant/ Conversion Therapy for Locally Advanced/Oligometastatic Gastric Cancer. Cancers (Basel) 2024; 16:1376. [PMID: 38611054 PMCID: PMC11010857 DOI: 10.3390/cancers16071376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 03/29/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
Super-extended (D2plus) lymphadenectomy after chemotherapy has been reported in only a few studies. This retrospective study evaluates survival outcomes in a Western cohort of locally advanced or oligometastatic gastric cancer patients who underwent D2plus lymphadenectomy after neoadjuvant chemotherapy. A total of 97 patients treated between 2010 and 2022 were included. Of these, 62 had clinical stage II/III disease, and 35 had stage IV disease. Most patients (65%) received preoperative DOC/FLOT chemotherapy. The mean number of lymph nodes harvested was 39. Pathological positive nodes in the posterior/para-aortic stations occurred in 17 (17.5%) patients. Lymphovascular invasion, ypN stage, clinical stage, and perineural invasion were predictive factors for positive posterior/para-aortic nodes. Postoperative complications occurred in 21 patients, whereas severe complications (grade III or more) occurred in 9 cases (9.3%). Mortality rate was 1%. Median overall survival (OS) was 59 months (95% CI: 13-106), with a five-year survival rate of 49 ± 6%; the five-year OS after R0 surgery was 60 ± 7%. In patients with positive posterior/para-aortic nodes, the median OS was 15 months (95% CI: 13-18). D2plus lymphadenectomy after chemotherapy for locally advanced or oligometastatic gastric cancer is feasible and associated with low morbidity/mortality rates. The incidence of pathological metastases in posterior/para-aortic nodes is not negligible even after systemic chemotherapy, with poor long-term survival.
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Affiliation(s)
- Daniele Marrelli
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
| | - Stefania Angela Piccioni
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
| | - Ludovico Carbone
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
| | - Roberto Petrioli
- Unit of Medical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Maurizio Costantini
- Pathology Unit, University Hospital of Siena, 53100 Siena, Italy; (M.C.); (V.M.)
| | - Valeria Malagnino
- Pathology Unit, University Hospital of Siena, 53100 Siena, Italy; (M.C.); (V.M.)
| | - Giulio Bagnacci
- Unit of Diagnostic Imaging, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (G.B.); (M.A.M.)
| | - Gabriele Rizzoli
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
| | - Natale Calomino
- Unit of Kidney Transplantation, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;
| | - Riccardo Piagnerelli
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (G.B.); (M.A.M.)
| | - Franco Roviello
- Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.P.); (L.C.); (G.R.); (R.P.); (F.R.)
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Walker E, Srienc A, Lew D, Guniganti R, Lanzino G, Brinjikji W, Hayakawa M, Samaniego EA, Derdeyn CP, Du R, Lai R, Sheehan JP, Starke RM, Abla A, Abdelsalam A, Gross B, Albuquerque F, Lawton MT, Kim LJ, Levitt M, Amin-Hanjani S, Alaraj A, Winkler E, Fox WC, Polifka A, Hall S, Bulters D, Durnford A, Satomi J, Tada Y, van Dijk JMC, Potgieser ARE, Chen CJ, Becerril-Gaitan A, Osbun JW, Zipfel GJ. Dural arteriovenous fistulas are not observed to convert to a higher grade after partial embolization. Neurosurg Focus 2024; 56:E8. [PMID: 38428013 DOI: 10.3171/2024.1.focus23745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/02/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Borden-Shucart type I dural arteriovenous fistulas (dAVFs) lack cortical venous drainage and occasionally necessitate intervention depending on patient symptoms. Conversion is the rare transformation of a low-grade dAVF to a higher grade. Factors associated with increased risk of dAVF conversion to a higher grade are poorly understood. The authors hypothesized that partial treatment of type I dAVFs is an independent risk factor for conversion. METHODS The multicenter Consortium for Dural Arteriovenous Fistula Outcomes Research database was used to perform a retrospective analysis of all patients with type I dAVFs. RESULTS Three hundred fifty-eight (33.2%) of 1077 patients had type I dAVFs. Of those 358 patients, 206 received endovascular treatment and 131 were not treated. Two (2.2%) of 91 patients receiving partial endovascular treatment for a low-grade dAVF experienced conversion to a higher grade, 2 (1.5%) of 131 who were not treated experienced conversion, and none (0%) of 115 patients who received complete endovascular treatment experienced dAVF conversion. The majority of converted dAVFs localized to the transverse-sigmoid sinus and all received embolization as part of their treatment. CONCLUSIONS Partial treatment of type I dAVFs does not appear to be significantly associated with conversion to a higher grade.
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Affiliation(s)
- Erin Walker
- 1University of South Carolina School of Medicine, Greenville, South Carolina
- 2Department of Neurological Surgery, Washington University in St. Louis, Missouri
| | - Anja Srienc
- 2Department of Neurological Surgery, Washington University in St. Louis, Missouri
| | - Daphne Lew
- 3Center for Biostatistics and Data Science, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Ridhima Guniganti
- 2Department of Neurological Surgery, Washington University in St. Louis, Missouri
| | | | | | - Minako Hayakawa
- 5Department of Radiology and Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Edgar A Samaniego
- 6Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Colin P Derdeyn
- 5Department of Radiology and Interventional Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Rose Du
- 7Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rosalind Lai
- 7Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Jason P Sheehan
- 8Department of Neurosurgery, University of Virginia, Charlottesville, Virginia
| | - Robert M Starke
- 9Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida
| | - Adib Abla
- 9Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida
- 15Department of Neurosurgery, University of California, San Francisco, California
| | - Ahmed Abdelsalam
- 9Neurosurgery Department, University of Miami Miller School of Medicine, Miami, Florida
| | - Bradley Gross
- 10Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Felipe Albuquerque
- 11Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | - Michael T Lawton
- 11Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | - Louis J Kim
- 12Department of Neurosurgery, University of Washington, Seattle, Washington
| | - Michael Levitt
- 12Department of Neurosurgery, University of Washington, Seattle, Washington
| | - Sepideh Amin-Hanjani
- 13Neurosurgery Department, University Hospitals/Case Western Reserve University, Cleveland, Ohio
- 14Department of Neurosurgery, University of Illinois College of Medicine at Chicago, Illinois
| | - Ali Alaraj
- 14Department of Neurosurgery, University of Illinois College of Medicine at Chicago, Illinois
| | - Ethan Winkler
- 15Department of Neurosurgery, University of California, San Francisco, California
| | - W Christopher Fox
- 16Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Adam Polifka
- 17Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida
| | - Samuel Hall
- 18Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom
| | - Diederik Bulters
- 18Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom
| | - Andrew Durnford
- 18Wessex Neurological Centre, Southampton General Hospital, Southampton, United Kingdom
| | | | - Yoshiteru Tada
- 19Department of Neurosurgery, University of Tokushima, Japan
| | - J Marc C van Dijk
- 20Department of Neurosurgery, University of Groningen, The Netherlands; and
| | | | - Ching-Jen Chen
- 21Department of Neurosurgery, University of Texas-Houston, Texas
| | | | - Joshua W Osbun
- 2Department of Neurological Surgery, Washington University in St. Louis, Missouri
| | - Gregory J Zipfel
- 2Department of Neurological Surgery, Washington University in St. Louis, Missouri
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Guidolin K, Ng D, Zorigtbaatar A, Chadi S, Quereshy F. A machine learning model to predict the need for conversion of operative approach in patients undergoing colectomy for neoplasm. Cancer Rep (Hoboken) 2024; 7:e1917. [PMID: 37884442 PMCID: PMC10809191 DOI: 10.1002/cnr2.1917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Studies comparing conversion from laparoscopic to open approaches to colectomy have found an association between conversion and morbidity, mortality, and length of stay, suggesting that certain patients may benefit from an open approach "up-front." AIM The objective of this study was to use machine learning algorithms to develop a model enabling the prediction of which patients are likely to require conversion. METHODS AND RESULTS We used ACS NSQIP data to identify patients undergoing colectomy (2014-2019). We included patients undergoing elective colectomy for colorectal neoplasm via a minimally invasive approach or a converted approach. The outcome of interest was conversion. Variables were included in the model based on their correlation with conversion by logistic regression (p < .05). Two models were used: weighted logistic regression with regularization, and Random Forest classifier. The data was randomly split into training (70%) and test (30%) cohorts, and prediction performance was calculated. 24 327 cases were included (17 028 training, 7299 test). When applied to the test cohort, the models had an accuracy of 0.675 (range 0.65-0.70) in predicting conversion; c-index ranged from 0.62-0.63. This machine learning model achieved a moderate area under the curve and a high negative predictive value, but a low positive predictive value; therefore, this model can predict (with 95% accuracy) whether a colectomy for neoplasm can be successfully completed using a minimally invasive approach. CONCLUSION This model can be used to reassure surgeons of the appropriateness of a minimally invasive approach when planning for an elective colectomy.
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Affiliation(s)
- Keegan Guidolin
- Department of SurgeryUniversity of TorontoTorontoOntarioCanada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryUniversity Health NetworkTorontoOntarioCanada
| | - Deanna Ng
- Institute of Medical ScienceUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryMount Sinai HospitalTorontoOntarioCanada
| | | | - Sami Chadi
- Department of SurgeryUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryUniversity Health NetworkTorontoOntarioCanada
| | - Fayez Quereshy
- Department of SurgeryUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryUniversity Health NetworkTorontoOntarioCanada
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Xiao J, Gao G, Ding Y, Li J, Gao C, Xu Q, Wu L, Liang H, Ni L, Wang F, Duan Y, Yang D, Zhao H. Reasons, safety and efficacy analysis for conversion of HAART to TAF/FTC/BIC among HIV-infected patients. Chin Med J (Engl) 2023; 136:2931-2937. [PMID: 38032036 PMCID: PMC10917078 DOI: 10.1097/cm9.0000000000002939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
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Affiliation(s)
- Jiang Xiao
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Guiju Gao
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yi Ding
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Jialu Li
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Chengyu Gao
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Qiuhua Xu
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Liang Wu
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Hongyuan Liang
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Liang Ni
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Fang Wang
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Yujiao Duan
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Di Yang
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
| | - Hongxin Zhao
- Clinical and Research Center of AIDS, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
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Devi A, Bajar S, Sihag P, Sheikh ZUD, Singh A, Kaur J, Bishnoi NR, Pant D. A panoramic view of technological landscape for bioethanol production from various generations of feedstocks. Bioengineered 2023; 14:81-112. [PMID: 37401849 DOI: 10.1080/21655979.2022.2095702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023] Open
Abstract
Bioethanol is an appropriate alternate energy option due to its renewable, nontoxic, environmentally friendly, and carbon-neutral nature. Depending upon various feedstocks, bioethanol is classified in different various generations. First-generation ethanol created a food vs fuel problem, which was overcome by second-generation, third-generation and fourth-generation ethanol. The considerable availability of lignocellulosic biomass makes it a suitable feedstock, however, its recalcitrant nature is the main hurdle in converting it to bioethanol. The present study gives a comprehensive assessment of global biofuel policies and the current status of ethanol production. Feedstocks for first-generation (sugar and starch-based), second-generation (lignocellulosic biomass and energy crops), third-generation (algal-based) and fourth-generation (genetically modified algal biomass or crops) are discussed in detail. The study also assessed the process for ethanol production from various feedstocks, besides giving a holestic background knowledge on the bioconversion process, factors affecting bioethanol production, and various microorganisms involved in the fermentation process. Biotechnological tools also play a pivotal role in enhancing process efficiency and product yield. In adddition, most significant development in the field of genetic engineering and adaptive evolution are also highlighted.
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Affiliation(s)
- Arti Devi
- Department of Environmental Sciences, Central University of Jammu, Jammu and Kashmir, India
| | - Somvir Bajar
- Department of Environmental Sciences, J.C. Bose University of Science and Technology, YMCA, Faridabad, Haryana, India
| | - Priyanka Sihag
- Department of Environmental Science & Engineering, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - Zaheer Ud Din Sheikh
- Department of Environmental Sciences, Central University of Jammu, Jammu and Kashmir, India
| | - Anita Singh
- Department of Environmental Sciences, Central University of Jammu, Jammu and Kashmir, India
- Department of Environmental Studies, Central University of Haryana, Jant-Pali, Mahendergarh, Haryana, India
| | - Japleen Kaur
- Department of Environmental Sciences, Central University of Jammu, Jammu and Kashmir, India
| | - Narsi R Bishnoi
- Department of Environmental Science & Engineering, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - Deepak Pant
- Separation and Conversion Technology, Flemish Institute for Technological Research (VITO), Mol, Belgium
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Rhee SJ, Ohlsson H, Sundquist J, Sundquist K, Kendler KS. Predictors of diagnostic conversion from major depression to bipolar disorder: a Swedish national longitudinal study. Psychol Med 2023; 53:7805-7816. [PMID: 37427550 PMCID: PMC10755232 DOI: 10.1017/s0033291723001848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND It is clinically important to predict the conversion of major depression (MD) to bipolar disorder (BD). Therefore, we sought to identify related conversion rates and risk factors. METHODS This cohort study included the Swedish population born from 1941 onward. Data were collected from Swedish population-based registers. Potential risk factors, including family genetic risk scores (FGRS), which were calculated based on the phenotypes of relatives in the extended family and not molecular data, and demographic/clinical characteristics from these registers were retrieved. Those with first MD registrations from 2006 were followed up until 2018. The conversion rate to BD and related risk factors were analyzed using Cox proportional hazards models. Additional analyses were performed for late converters and with stratification by sex. RESULTS The cumulative incidence of conversion was 5.84% [95% confidence interval (95% CI) 5.72-5.96] for 13 years. In the multivariable analysis, the strongest risk factors for conversion were high FGRS of BD [hazard ratio (HR) = 2.73, 95% CI 2.43-3.08], inpatient treatment settings (HR = 2.64, 95% CI 2.44-2.84), and psychotic depression (HR = 2.58, 95% CI 2.14-3.11). For late converters, the first registration of MD during the teenage years was a stronger risk factor when compared with the baseline model. When the interactions between risk factors and sex were significant, stratification by sex revealed that they were more predictive in females. CONCLUSIONS Family history of BD, inpatient treatment, and psychotic symptoms were the strongest predictors of conversion from MD to BD.
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Affiliation(s)
- Sang Jin Rhee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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9
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Kim BG, Yu JY, Jhun BW. Spontaneous Cultural Conversion Rate of Mycobacterium avium Complex Pulmonary Disease Based on BACES Severity. J Clin Med 2023; 12:7125. [PMID: 38002737 PMCID: PMC10671925 DOI: 10.3390/jcm12227125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Only a few clinical factors can aid in predicting spontaneous culture conversion (SCC) in patients with Mycobacterium avium complex-pulmonary disease (MAC-PD). In this study, we aimed to evaluate whether the rate of SCC varies according to the severity of the disease in MAC-PD patients. METHODS We retrospectively classified 373 MAC-PD patients who had undergone watchful waiting without antibiotics based on the severity assessment using the 'body mass index (BMI), age, cavity, erythrocyte sedimentation rate (ESR), and sex (BACES)' criteria. We evaluated the rate of SCC in MAC-PD patients based on BACES severity and analyzed the relevant factors. Results: Of 373 patients, 153 (41%) achieved SCC without antibiotics during a median follow-up of 48.1 months. There was a trend toward a higher SCC rate in patients with lower BACES severity: 48% (87/183), 37% (58/157), and 24% (8/33) in the mild, moderate, and severe BACES groups, respectively. In addition, a favorable outcome, defined as maintaining SCC or having two consecutive negative sputum cultures until the last follow-up date, was also more common in patients with lower BACES severities of 53% (97/183), 34% (54/157), and 18% (6/33) in the mild, moderate, and severe BACES groups, respectively. In multivariate analysis, moderate BACES (hazard ratio [HR] = 0.63; 95% confidence interval [CI] 0.44-0.91; p = 0.013) and severe BACES (HR 0.37; 95% CI 0.16-0.90; p = 0.028) had a significantly negative impact on favorable outcomes compared to mild BACES. CONCLUSIONS Lower BACES severity may be associated with SCC in MAC-PD patients.
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Affiliation(s)
- Bo-Guen Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
| | - Jin Young Yu
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea;
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
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Singh DK. Seeking alternatives, asserting choices: Dr Mahendralal Sarkar's life in medicine and science. J Med Biogr 2023; 31:268-278. [PMID: 34672221 DOI: 10.1177/09677720211049563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This article examines the medical life of a native physician who embraced homoeopathy despite being trained in the dominant pathy i.e. allopathy at the prestigious Calcutta Medical College in the 1860s. Mahendralal Sarkar, the physician in focus, was one of the first famous converts to homoeopathy. His seeking of an alternative option created space and legitimacy for homoeopathy. Through the journal Calcutta Journal of Medicine that Sarkar founded, he, with great ability, asserted and defended his right as a physician to decide in favour of homoeopathy. Sarkar gradually established himself as an accomplished homoeopath and was recognised as an important public figure of Calcutta. The odds and opposition he faced convinced him to embark on a great task of the cultivation of science as, in his view, the inculcation of the spirit of science was the need of the day to break the orthodoxy and mitigate prejudices of the medical profession and society at large.
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Affiliation(s)
- Dhrub Kumar Singh
- Department of History, Faculty of Social Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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11
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Nakajima M, Okada Y, Sonoo T, Goto T. Response to Letter to the Editor: Japan Coma Scale and the Disorientation of the Nervous System. J Epidemiol 2023; 33:544. [PMID: 36244748 PMCID: PMC10483101 DOI: 10.2188/jea.je20220266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 09/10/2023] Open
Affiliation(s)
- Mikio Nakajima
- Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo, Japan
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- TXP Medical Co. Ltd., Tokyo, Japan
| | - Yohei Okada
- TXP Medical Co. Ltd., Tokyo, Japan
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Tadahiro Goto
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- TXP Medical Co. Ltd., Tokyo, Japan
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12
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Nakajima M, Okada Y, Sonoo T, Goto T. Development and Validation of a Novel Method for Converting the Japan Coma Scale to Glasgow Coma Scale. J Epidemiol 2023; 33:531-535. [PMID: 35851565 PMCID: PMC10483104 DOI: 10.2188/jea.je20220147] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/03/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Japan Coma Scale (JCS) is the most frequently adopted method for evaluating level of consciousness in Japan. However, no validated method for converting the JCS to the Glasgow Coma Scale (GCS) exists. The aims of the present study were to develop and validate a method to convert the JCS to GCS. METHODS This is a multicenter retrospective analysis involving three emergency departments (EDs) in Japan. We included all adult patients who visited the ED between 2017 and 2020. The participating facilities were divided into two cohorts-one cohort to develop a table to convert the JCS to GCS (development cohort), and the other cohort to validate the conversion table (validation cohort). The conversion table of the JCS to GCS was developed based on the median values of the GCS. The outcome was the concordance rate between the JCS and GCS. RESULTS We identified 8,194 eligible patients. The development cohort included 7,373 patients and the validation cohort included 821 patients. In the validation cohort, the absolute and relative concordance rates were 80.3% (95% confidence interval, 77.4-82.9%) and 93.2% (95% confidence interval, 91.2-94.8%), respectively. CONCLUSION This study developed and validated a novel method for converting the JCS to GCS. Assuming the offset by a single category between the JCS and GCS is acceptable, the concordance rate was over 90% in the general adult patient population visiting the ED. The conversion method may assist researchers to convert JCS scores into GCS scores, which are more commonly recognized among global audiences.
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Affiliation(s)
- Mikio Nakajima
- Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo, Japan
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- TXP Medical Co. Ltd., Tokyo, Japan
| | - Yohei Okada
- TXP Medical Co. Ltd., Tokyo, Japan
- Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Tadahiro Goto
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
- TXP Medical Co. Ltd., Tokyo, Japan
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Szułdrzyński K, Kowalewski M, Jankowski M, Staromłyński J, Prokop J, Pasierski M, Chudziński K, Drobiński D, Martucci G, Lorusso R, Wierzba W, Zaczyński A, Król Z, Suwalski P. Effects of adding the second drainage cannula in severely hypoxemic patients supported with VV ECMO due to COVID-19-associated ARDS. Artif Organs 2023; 47:1622-1631. [PMID: 37218216 DOI: 10.1111/aor.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is a recognized method of support in patients with severe and refractory acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2 infection. While veno-venous (VV) ECMO is the most common type, some patients with severe hypoxemia may require modifications to the ECMO circuit. In this study, we aimed to investigate the effects of adding a second drainage cannula to the circuit in patients with refractory hypoxemia, on their gas exchange, mechanical ventilation, ECMO settings, and clinical outcomes. METHODS We conducted an observational retrospective study based on a single-center institutional registry including all consecutive cases of COVID-19 patients requiring ECMO admitted to the Centre of Extracorporeal Therapies in Warsaw between March 1, 2020 and March 1, 2022. We selected patients who had an additional drainage cannula inserted. Changes in ECMO and ventilator settings, blood oxygenation, and hemodynamic parameters, as well as clinical outcomes were assessed. RESULTS Of 138 VV ECMO patients, 12 (9%) patients met the inclusion criteria. Ten patients (83%) were men, and mean age was 42.2 ± 6.8. An addition of drainage cannula resulted in a significant raise in ECMO blood flow (4.77 ± 0.44 to 5.94 ± 0.81 [L/min]; p = 0.001), and the ratio of ECMO blood flow to ECMO pump rotations per minute (RPM), whereas the raise in ECMO RPM alone was not statistically significant (3432 ± 258 to 3673 ± 340 [1/min]; p = 0.064). We observed a significant drop in ventilator FiO2 and a raise in PaO2 to FiO2 ratio, while blood lactates did not change significantly. Nine patients died in hospital, one was referred to lung transplantation center, two were discharged uneventfully. CONCLUSIONS The use of an additional drainage cannula in severe ARDS associated with COVID-19 allows for an increased ECMO blood flow and improved oxygenation. However, we observed no further improvement in lung-protective ventilation and poor survival.
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Affiliation(s)
- Konstanty Szułdrzyński
- Department of Anaesthesiology and Intensive Care, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
| | - Mariusz Kowalewski
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Miłosz Jankowski
- Department of Anaesthesiology and Intensive Care, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Jakub Staromłyński
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Joanna Prokop
- Department of Anaesthesiology and Intensive Care, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Michał Pasierski
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Kamil Chudziński
- Department of Anaesthesiology and Intensive Care, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Dominik Drobiński
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Gennaro Martucci
- Department of Anesthesia and Intensive Care, Istituto Mediterraneo per i trapianti e Terapie ad alta specializzazione (IRCCS-ISMETT), Palermo, Italy
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Waldemar Wierzba
- National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Artur Zaczyński
- National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Zbigniew Król
- National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Piotr Suwalski
- Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
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Kwak YJ, Song MY, Lee KT. Conversion of CH 4 and Hydrogen Storage via Reactions with MgH 2-12Ni. Micromachines (Basel) 2023; 14:1777. [PMID: 37763940 PMCID: PMC10534737 DOI: 10.3390/mi14091777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
The main key to the future transition to a hydrogen economy society is the development of hydrogen production and storage methods. Hydrogen energy is the energy produced via the reaction of hydrogen with oxygen, producing only water as a by-product. Hydrogen energy is considered one of the potential substitutes to overcome the growing global energy demand and global warming. A new study on CH4 conversion into hydrogen and hydrogen storage was performed using a magnesium-based alloy. MgH2-12Ni (with the composition of 88 wt% MgH2 + 12 wt% Ni) was prepared in a planetary ball mill by milling in a hydrogen atmosphere (reaction-involved milling). X-ray diffraction (XRD) analysis was performed on samples after reaction-involved milling and after reactions with CH4. The variation of adsorbed or desorbed gas over time was measured using a Sieverts'-type high-pressure apparatus. The microstructure of the powders was observed using a scanning transmission microscope (STEM) with energy-dispersive X-ray spectroscopy (EDS). The synthesized samples were also characterized using Fourier transform infrared (FT-IR) spectroscopy. The XRD pattern of MgH2-12Ni after the reaction with CH4 (12 bar pressure) at 773 K and decomposition under 1.0 bar at 773 K exhibited MgH2 and Mg2NiH4 phases. This shows that CH4 conversion took place, the hydrogen produced after CH4 conversion was then adsorbed onto the particles, and hydrides were formed during cooling to room temperature. Ni and Mg2Ni formed during heating to 773 K are believed to cause catalytic effects in CH4 conversion. The remaining CH4 after conversion is pumped out at room temperature.
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Affiliation(s)
- Young Jun Kwak
- Division of Advanced Materials Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea; (Y.J.K.); (K.-T.L.)
- Hydrogen & Fuel Cell Research Center, Engineering Research Institute, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea
| | - Myoung Youp Song
- Division of Advanced Materials Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea; (Y.J.K.); (K.-T.L.)
- Hydrogen & Fuel Cell Research Center, Engineering Research Institute, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea
| | - Ki-Tae Lee
- Division of Advanced Materials Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea; (Y.J.K.); (K.-T.L.)
- Hydrogen & Fuel Cell Research Center, Engineering Research Institute, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea
- Department of Energy Storage/Conversion Engineering of Graduate School (BK21 FOUR), Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju 54896, Republic of Korea
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Perovnik M, Tang CC, Namías M, Eidelberg D. Longitudinal changes in metabolic network activity in early Alzheimer's disease. Alzheimers Dement 2023; 19:4061-4072. [PMID: 37204815 DOI: 10.1002/alz.13137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The progression of Alzheimer's disease (AD) has been linked to two metabolic networks, the AD-related pattern (ADRP) and the default mode network (DMN). METHODS Converting and clinically stable cognitively normal subjects (n = 47) and individuals with mild cognitive impairment (n = 96) underwent 2-[18 F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) three or more times over 6 years (nscans = 705). Expression levels for ADRP and DMN were measured in each subject and time point, and the resulting changes were correlated with cognitive performance. The role of network expression in predicting conversion to dementia was also evaluated. RESULTS Longitudinal increases in ADRP expression were observed in converters, while age-related DMN loss was seen in converters and nonconverters. Cognitive decline correlated with increases in ADRP and declines in DMN, but conversion to dementia was predicted only by baseline ADRP levels. DISCUSSION The results point to the potential utility of ADRP as an imaging biomarker of AD progression.
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Affiliation(s)
- Matej Perovnik
- Department of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Chris C Tang
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
| | - Mauro Namías
- Fundación Centro Diagnóstico Nuclear, Buenos Aires, Argentina
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
- Molecular Medicine and Neurology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Sebastian-Valverde E, Téllez C, Burdío F, Poves I, Grande L. Individualization of the best approach for adhesive small bowel obstruction. ANZ J Surg 2023; 93:2132-2137. [PMID: 37530170 DOI: 10.1111/ans.18649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Laparoscopic postoperatives outcomes in adhesiolysis are promising but conversion and morbidity remains high. The objective of our study was to determine preoperative factors to individualize and select the most appropriate approach for each patient. METHODS Patients ≥18 years old undergoing emergent surgery for adhesive small bowel obstruction and internal hernias were evaluated. Bivariate and multivariate analysis were performed to investigate factors related to conversion to open surgery and to the type of adhesions. RESULTS Of 333 patients, 224 were operated by laparotomy and 109 by laparoscopy (conversion rate: 40%). Previous abdominal wall mesh, type of adhesions, bowel lesion, need for intestinal resection and laparoscopic skills were statistically related to conversion. In the multivariate analysis, complex adhesions (OR 4.3, 95% CI 1.5-12.2; P = 0.006), the need for intestinal resection (OR 14.16, 95% CI 2.55-78.68; P = 0.002), and non-advanced laparoscopy surgeons (OR 4.31, 95% CI 1.56-11.94; P = 0.005) were independent factors for conversion to open surgery. ASA III-IV, previous surgeries, previous abdominal mesh and previous adhesiolysis were related to complex adhesions. Previous laparoscopic surgery and internal hernia or closed loop in computed tomography were associated with simple adhesions as a cause of the obstruction. In the multivariate, previous adhesiolysis (OR 4.76, 95% CI 1.23-18.3; P = 0.023) and the findings on computed tomography were significantly related with the type of adhesion. CONCLUSION Some preoperative factors allow to individualize the surgical approach in the adhesive small bowel obstruction improving surgical outcomes.
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Affiliation(s)
- Enric Sebastian-Valverde
- Department of Surgery, Hospital de Sant Boi, Sant Boi de Llobregat, Spain
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
| | - Clara Téllez
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
| | - Fernando Burdío
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
- Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ignasi Poves
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
| | - Luis Grande
- Department of Surgery, Hospital Universitari del Mar, Barcelona, Spain
- Department of Surgery, Universitat Autònoma de Barcelona, Barcelona, Spain
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Humphrey TJ, Salimy MS, Duvvuri P, Melnic CM, Bedair HS, Alpaugh K. A Matched Comparison of the Rates of Achieving the Minimal Clinically Important Difference Following Conversion and Primary Total Hip Arthroplasty. J Arthroplasty 2023; 38:1767-1772. [PMID: 36931363 DOI: 10.1016/j.arth.2023.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are often lower following conversion total hip arthroplasty (cTHA) compared to matched primary total hip arthroplasty (THA) controls. However, the minimal clinically important differences (MCIDs) for any PROMs are yet to be analyzed for cTHA. This study aimed to (1) determine if patients undergoing cTHA achieve primary THA-specific 1-year PROM MCIDs at comparable rates to matched controls undergoing primary THA and (2) establish 1-year MCID values for specific PROMs following cTHA. METHODS A retrospective case-control study was conducted using 148 cases of cTHA which were matched 1:2 to 296 primary THA patients. Previously defined anchor values for 2 PROM measures in primary THA were used to compare cTHA to primary THA, while novel cTHA-specific MCID values for 2 PROMs were calculated through a distribution method. Predictors of achieving the MCID of PROMs were analyzed through multivariate logistic regressions. RESULTS Conversion THA was associated with decreased odds of achieving the primary THA-specific 1-year Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement PROM (Odds Ratio: 0.319, 95% Confidence Interval: 0.182-0.560, P < .001) and Patient Reported Outcomes Measurement Information System Physical Function Short-Form-10a PROM (Odds Ratio: 0.531, 95% Confidence Interval: 0.313-0.900, P = .019) MCIDs in reference to matched primary THA patients. Less than 60% of cTHA patients achieved an MCID. The 1-year MCID of the Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement and Patient Reported Outcomes Measurement Information System Physical Function Short-Form-10a specific to cTHA were +10.71 and +4.68, respectively. CONCLUSION While cTHA is within the same diagnosis-related group as primary THA, patients undergoing cTHA have decreased odds of achieving 1-year MCIDs of primary THA-specific PROMs. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Tyler J Humphrey
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Mehdi S Salimy
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Priya Duvvuri
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Christopher M Melnic
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hany S Bedair
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kyle Alpaugh
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, Massachusetts; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Luo T, Huang Y, Wang S, Yang T, Gong J, Zhou B, Song Z, Meng H, Xu B. Laparoscopic common bile duct exploration with primary closure is preferred for selected elderly individuals with choledocholithiasis. Ann Gastroenterol Surg 2023; 7:772-783. [PMID: 37663961 PMCID: PMC10472361 DOI: 10.1002/ags3.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 09/05/2023] Open
Abstract
Background Laparoscopic common bile duct exploration with primary closure (LCBDE-PC) exhibits more benefits than other surgeries for patients with choledocholithiasis. It remains unclear whether it is feasible for and beneficial to elderly individuals. This study aimed to clarify and stratify elderly patients who would benefit from LCBDE-PC. Methods A retrospective study of 1240 patients with choledocholithiasis who underwent laparoscopic procedures between 2011 and 2019 was conducted. Patients were divided into the young group (<65 years old, n = 708) and the elderly group (≥65 years old, n = 532). Perioperative outcomes were compared between the two groups. Results Laparoscopic common bile duct exploration with primary closure was successfully performed in 90.20% of the elderly and 94.20% of the young. No significant differences were observed between the two groups regarding reoperation, postoperative bile leakage, residual stones, drainage removal, and postoperative mortality. Compared with the young, the elderly had longer postoperative hospital stay (p = 0.035) and delayed postoperative eating time (p = 0.036) in the matched cohort. Independent risk factors for failed LCBDE-PC were preoperative pancreatitis (p = 0.018), year of the surgeon's experience (p = 0.008), preoperative C-reactive protein level (p = 0.034), preoperative total bilirubin (p = 0.021), impacted common bile duct (CBD) stones (p = 0.006), blood loss (p = 0.001), and edema of the CBD (p = 0.001). A novel nomogram for predicting failed LCBDE-PC in elderly individuals exhibited a sufficient discriminative ability according to the estimated area under the curve (AUC) of 0.869 (95% CI: 0.817-0.921, p < 0.01). Conclusion Laparoscopic common bile duct exploration with primary closure is safe, feasible, and effective for elderly individuals with choledocholithiasis. Elderly patients with a high risk of failed LCBDE-PC should be cautious of undergoing LCBDE-PC.
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Affiliation(s)
- Tingyi Luo
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Yonggang Huang
- Department of General Surgery, Kunshan Hospital of Traditional Chinese MedicineKunshan Affiliated Hospital of Nanjing University of Chinese MedicineSuzhou, JiangsuChina
| | - Shilin Wang
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Tingsong Yang
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Jian Gong
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Bo Zhou
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Zhenshun Song
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Hongbo Meng
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
| | - Bin Xu
- Department of General Surgery, Shanghai Tenth People's HospitalTongji University School of MedicineShanghaiChina
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Krokowicz L, Biczysko M, Szmyt K, Borejsza-Wysocki M, Banasiewicz T, Ledwosinski W, Bobkiewicz A. Analysis of risk factors for conversion in laparoscopic adrenalectomy: a single-institution series of 256 patients. Wideochir Inne Tech Maloinwazyjne 2023; 18:453-459. [PMID: 37868277 PMCID: PMC10585466 DOI: 10.5114/wiitm.2023.126446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/24/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Although introduction of the laparoscopic approach for adrenal gland surgery revolutionized the strategy in management of adrenal gland tumors, open surgery is still a method of choice in some clinical scenarios. Moreover, laparoscopy may have limitations resulting in conversion. Aim To assess risk factors predisposing for conversion based on our own material, including 256 laparoscopic adrenalectomies performed in 2009-2016. Material and methods A retrospective analysis of patients who underwent adrenalectomies between 2009 and 2016 was conducted. Patients were analyzed for sex, body mass index (BMI), size of the adrenal gland lesion, final histopathological diagnosis and operated side of the adrenal gland, its impact on conversion rate. Results A total of 256 patients underwent laparoscopic adrenalectomy. The reported study comprised of 94 (36.7%) men and 162 (63.3%) women. The most common indication for adrenalectomy were adrenal cortex adenoma (n = 149; 58.2%) and pheochromocytoma (n = 48; 18.75%). The conversion rate was 3.91% (n = 10 patients). Mean BMI of patients without conversion was 27.6 kg/m2, whereas in the group of patients with conversion, BMI was 29.7 kg/m2 (p > 0.05). The conversion rate was precisely the same when comparing the right (5/126; 3.9%) and left (5/126; 3.9%) adrenal gland. There was no correlation between the size of the adrenal lesion and the risk of conversion. Conclusions The laparoscopic approach remains an efficient and safe procedure for adrenal gland tumors. Based on our study, obese patients and those with pheochromocytoma are associated with a higher risk of conversion but without any statistical significance. There was no difference in the conversion rate when analyzing the size of the adrenal gland tumor. No difference was also revealed in the conversion rate when comparing both sides of laparoscopic adrenalectomy.
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Affiliation(s)
- Lukasz Krokowicz
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Mateusz Biczysko
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Szmyt
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Maciej Borejsza-Wysocki
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Banasiewicz
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Witold Ledwosinski
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Adam Bobkiewicz
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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He J, Liu W, Hao J, Ma X, Zheng Z, Fang Y, Liang Y, Tian Z, Sun L, Li C, Yan H. Bipolar Membrane Electrodialysis for Direct Conversion of L-Ornithine Monohydrochloride to L-Ornithine. Int J Mol Sci 2023; 24:13174. [PMID: 37685982 PMCID: PMC10488261 DOI: 10.3390/ijms241713174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
In this study, bipolar membrane electrodialysis was proposed to directly convert L-ornithine monohydrochloride to L-ornithine. The stack configuration was optimized in the BP-A (BP, bipolar membrane; A, anion exchange membrane) configuration with the Cl- ion migration through the anion exchange membrane rather than the BP-A-C (C, cation exchange membrane) and the BP-C configurations with the L-ornithine+ ion migration through the cation exchange membrane. Both the conversion ratio and current efficiency follow BP-A > BP-A-C > BP-C, and the energy consumption follows BP-A < BP-A-C < BP-C. Additionally, the voltage drop across the membrane stack (two repeating units) and the feed concentration were optimized as 7.5 V and 0.50 mol/L, respectively, due to the low value of the sum of H+ ions leakage (from the acid compartment to the base compartment) and OH- ions migration (from the base compartment to the acid compartment) through the anion exchange membrane. As a result, high conversion ratio (96.1%), high current efficiency (95.5%) and low energy consumption (0.31 kWh/kg L-ornithine) can be achieved. Therefore, bipolar membrane electrodialysis is an efficient, low energy consumption and environmentally friendly method to directly convert L-ornithine monohydrochloride to L-ornithine.
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Affiliation(s)
- Jinfeng He
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei 230012, China
| | - Wenlong Liu
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Jianrong Hao
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Xixi Ma
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Zhiyi Zheng
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Yinghan Fang
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Yuxin Liang
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Zhihao Tian
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
| | - Li Sun
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei 230012, China
| | - Chuanrun Li
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei 230012, China
| | - Haiyang Yan
- Pharmaceutical Engineering Technology Research Center, School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230012, China; (J.H.); (W.L.)
- Anhui Province Key Laboratory of Pharmaceutical Preparation Technology and Application, Hefei 230012, China
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21
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Monchaud C, Woillard JB, Crépin S, Tafzi N, Micallef L, Rerolle JP, Dharancy S, Conti F, Choukroun G, Thierry A, Buchler M, Salamé E, Garrouste C, Duvoux C, Colosio C, Merville P, Anglicheau D, Etienne I, Saliba F, Mariat C, Debette-Gratien M, Marquet P. Tacrolimus Exposure Before and After a Switch From Twice-Daily Immediate-Release to Once-Daily Prolonged Release Tacrolimus: The ENVARSWITCH Study. Transpl Int 2023; 36:11366. [PMID: 37588007 PMCID: PMC10425592 DOI: 10.3389/ti.2023.11366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023]
Abstract
LCP-tacrolimus displays enhanced oral bioavailability compared to immediate-release (IR-) tacrolimus. The ENVARSWITCH study aimed to compare tacrolimus AUC0-24 h in stable kidney (KTR) and liver transplant recipients (LTR) on IR-tacrolimus converted to LCP-tacrolimus, in order to re-evaluate the 1:0.7 dose ratio recommended in the context of a switch and the efficiency of the subsequent dose adjustment. Tacrolimus AUC0-24 h was obtained by Bayesian estimation based on three concentrations measured in dried blood spots before (V2), after the switch (V3), and after LCP-tacrolimus dose adjustment intended to reach the pre-switch AUC0-24 h (V4). AUC0-24 h estimates and distributions were compared using the bioequivalence rule for narrow therapeutic range drugs (Westlake 90% CI within 0.90-1.11). Fifty-three KTR and 48 LTR completed the study with no major deviation. AUC0-24 h bioequivalence was met in the entire population and in KTR between V2 and V4 and between V2 and V3. In LTR, the Westlake 90% CI was close to the acceptance limits between V2 and V4 (90% CI = [0.96-1.14]) and between V2 and V3 (90% CI = [0.96-1.15]). The 1:0.7 dose ratio is convenient for KTR but may be adjusted individually for LTR. The combination of DBS and Bayesian estimation for tacrolimus dose adjustment may help with reaching appropriate exposure to tacrolimus rapidly after a switch.
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Affiliation(s)
- Caroline Monchaud
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
| | - Jean-Baptiste Woillard
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
| | - Sabrina Crépin
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
- Unité de Vigilance des Essais Cliniques, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Naïma Tafzi
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Ludovic Micallef
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
| | - Jean-Philippe Rerolle
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
- Department of Nephrology, Dialysis and Transplantation, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | | | - Filomena Conti
- Department of Hepato-Gastro-Enterology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gabriel Choukroun
- Department of Nephrology, Internal Medicine, Transplantation, Centre Hospitalier Universitaire (CHU) d'Amiens, Amiens, France
| | - Antoine Thierry
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Poitiers, France
- Department of Nephrology, Hemodialysis and Renal Transplantation, Centre Hospitalier Universitaire (CHU) de Poitiers, Poitiers, France
| | - Matthias Buchler
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Tours, France
- Department of Nephrology–Arterial Hypertension, Dialyses, Renal Transplantation, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Ephrem Salamé
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Tours, France
- Center for Hepatobiliary and Pancreatic Surgery, Hepatic Transplantation, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Cyril Garrouste
- Department of Nephrology–Hemodialyses, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Christophe Duvoux
- Department of Hepatology, Hôpital Henri-Mondor, Assistance Publique Hôpitaux de Paris, Créteil, France
| | - Charlotte Colosio
- Department of Nephrology, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Pierre Merville
- Department of Nephrology, Transplantation, Dialysis and Aphereses, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Dany Anglicheau
- Department of Kidney and Metabolism Diseases, Transplantation and Clinical Immunology, Hôpital Necker-Enfants Malades, Paris, France
| | - Isabelle Etienne
- Department of Nephrology, Hemodialysis, Transplantation, Centre Hospitalier Universitaire (CHU) de Rouen, Rouen, France
| | | | - Christophe Mariat
- Department of Nephrology, Dialysis and Renal Transplantation, Centre Hospitalier Universitaire (CHU) de Saint-Étienne, Saint-Etienne, France
| | - Marilyne Debette-Gratien
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
- Department of Hepato-Gastro-Enterology and Nutrition, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Pierre Marquet
- Department of Pharmacology, Toxicology and Pharmacovigilance, Centre Hospitalier Universitaire de Limoges, Limoges, France
- INSERM1248 Pharmacolgy and Transplantation, Limoges, France
- Fédération Hospitalo-Universitaire Survival Optimization in Organ Transplantation (FHU SUPORT), Limoges, France
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22
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Kausar A, Ahmad I, Zhao T, Aldaghri O, Ibnaouf KH, Eisa MH. Graphene Nanocomposites as Innovative Materials for Energy Storage and Conversion-Design and Headways. Int J Mol Sci 2023; 24:11593. [PMID: 37511354 PMCID: PMC10380328 DOI: 10.3390/ijms241411593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
This review mainly addresses applications of polymer/graphene nanocomposites in certain significant energy storage and conversion devices such as supercapacitors, Li-ion batteries, and fuel cells. Graphene has achieved an indispensable position among carbon nanomaterials owing to its inimitable structure and features. Graphene and its nanocomposites have been recognized for providing a high surface area, electron conductivity, capacitance, energy density, charge-discharge, cyclic stability, power conversion efficiency, and other advanced features in efficient energy devices. Furthermore, graphene-containing nanocomposites have superior microstructure, mechanical robustness, and heat constancy characteristics. Thus, this state-of-the-art article offers comprehensive coverage on designing, processing, and applying graphene-based nanoarchitectures in high-performance energy storage and conversion devices. Despite the essential features of graphene-derived nanocomposites, several challenges need to be overcome to attain advanced device performance.
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Affiliation(s)
- Ayesha Kausar
- NPU-NCP Joint International Research Center on Advanced Nanomaterials and Defects Engineering, Northwestern Polytechnical University, Xi'an 710072, China
- UNESCO-UNISA Africa Chair in Nanosciences/Nanotechnology, iThemba LABS, Somerset West 7129, South Africa
- NPU-NCP Joint International Research Center on Advanced Nanomaterials and Defects Engineering, National Centre for Physics, Islamabad 44000, Pakistan
| | - Ishaq Ahmad
- NPU-NCP Joint International Research Center on Advanced Nanomaterials and Defects Engineering, Northwestern Polytechnical University, Xi'an 710072, China
- UNESCO-UNISA Africa Chair in Nanosciences/Nanotechnology, iThemba LABS, Somerset West 7129, South Africa
- NPU-NCP Joint International Research Center on Advanced Nanomaterials and Defects Engineering, National Centre for Physics, Islamabad 44000, Pakistan
| | - Tingkai Zhao
- NPU-NCP Joint International Research Center on Advanced Nanomaterials and Defects Engineering, Northwestern Polytechnical University, Xi'an 710072, China
- School of Materials Science & Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Osamah Aldaghri
- Department of Physics, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13318, Saudi Arabia
| | - Khalid H Ibnaouf
- Department of Physics, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13318, Saudi Arabia
| | - M H Eisa
- Department of Physics, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 13318, Saudi Arabia
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23
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Leczycki M, Berne DJ, Shirk DV, Sayers JM. Persistent Neurological, Dissociative, and Amnestic Symptoms Following a Mild Traumatic Brain Injury in an Adolescent: A Complex Case of Conversion Disorder. Cureus 2023; 15:e42755. [PMID: 37654954 PMCID: PMC10468149 DOI: 10.7759/cureus.42755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
The diagnosis of conversion disorder may be given to patients with unexplained neurological symptoms after the exclusion of medical and organic etiologies, suggesting a psychiatric etiology. It requires a thorough examination of all contributing factors across the biopsychosocial model. With a variety of possible presentations, the evaluation and treatment of conversion disorder should reflect its complexity. This case report describes a case of conversion disorder complicated by mild traumatic brain injury and acute psychological re-traumatization in an adolescent with social anxiety and focuses on the connection between symptoms of conversion and dissociation with trauma and memory to form an understanding of the unique presentation and treatment of this condition.
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Affiliation(s)
- Martin Leczycki
- Psychiatry, Reading Hospital/Tower Health, West Reading, USA
| | - Douglas J Berne
- Psychiatry, Reading Hospital/Tower Health, West Reading, USA
| | - Daisy V Shirk
- Psychiatry, Reading Hospital/Tower Health, West Reading, USA
| | - Jerry M Sayers
- Psychiatry, Reading Hospital/Tower Health, West Reading, USA
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Seow YT, Nyandoro MG, Poh S, Tee YC, Yew MK, Wong SL. The Impact of Obesity on Mortality and Complications in Posterior Retroperitoneoscopic Adrenalectomy. Cureus 2023; 15:e42421. [PMID: 37497309 PMCID: PMC10367120 DOI: 10.7759/cureus.42421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 07/28/2023] Open
Abstract
Background Obesity is a global epidemic. It influences surgical technique, ergonomics, safety, and outcomes. However, there is a paucity of evidence of obesity-related impact in posterior retroperitoneoscopic adrenalectomy (PRA). This study compared perioperative outcomes of obese and non-obese participants undergoing PRA. Methodology This is a multi-center retrospective cohort study of elective PRA from March 2014 to December 2022. Patient demographics, surgical techniques, clinicopathological parameters, and outcomes, including overall complication rate, were analyzed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Results Seventy-five patients underwent a PRA, of which 97.3% were completed retroperitoneoscopically. The overall complication rate was (9.3%), and on subgroup analysis, the obese cohort had a lower percentage complication profile at 6.5%. Male participants comprised 52%, with a median age of 55 (IQR=19). The median BMI was 29.0 (IQR=8), of which 41% were obese, and 40% were overweight. Univariate analysis showed that being obese was not significantly associated with a higher complication rate (p=0.471). In addition, there was no significant increase in conversion (p=0.508), bleeding/transfusion (p=0.508), surgical site infection (SSI; p=1.000), incisional hernia (p=1.000), ICU or high dependency unit admission (p=0.292) and any-cause mortality (p=1.000). No sentinel deaths directly related to PRA were recorded. Procedure duration was longer in obese (117 mins) vs. non-obese participants (88.9 mins, p=0.022). However, there was no significant difference in the length-of-hospital stay (p=0.592). The cohort conversion rate was (2.7%), and tumor size was associated with a higher conversion rate (35.4 vs. 62.5mm, p=0.040). Conclusion Posterior retroperitoneoscopic adrenalectomy can be a safe procedure in obese populations, and obesity does not increase perioperative morbidity or mortality.
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Affiliation(s)
- Yi Th'ng Seow
- General and Endocrine Surgery, Royal Perth Hospital, Perth, AUS
| | - Munyaradzi G Nyandoro
- General Surgery, Fiona Stanley Hospital, Perth, AUS
- General and Endocrine Surgery, Royal Perth Hospital, Perth, AUS
| | - Shearn Poh
- General and Endocrine Surgery, Royal Perth Hospital, Perth, AUS
| | | | - Ming Khoon Yew
- General and Endocrine Surgery, Royal Perth Hospital, Perth, AUS
- General and Endocrine Surgery, St. John of God Murdoch Hospital, Murdoch, AUS
| | - Sze Ling Wong
- General and Endocrine Surgery, Royal Perth Hospital, Perth, AUS
- General and Endocrine Surgery, St. John of God Murdoch Hospital, Murdoch, AUS
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Bancke Laverde BL, Maak M, Langheinrich M, Kersting S, Denz A, Krautz C, Weber GF, Grützmann R, Brunner M. Risk Factors for Conversion from Laparoscopic to Open Appendectomy. J Clin Med 2023; 12:4299. [PMID: 37445334 DOI: 10.3390/jcm12134299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/01/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Since its introduction in the 1990s, laparoscopic appendectomy has become established over the years and is today considered the standard therapy for acute appendicitis. In some cases, however, a conversion to the open approach is still necessary. The primary aim of this study was to identify risk factors for the need to convert from the laparoscopic to an open approach during appendectomy for acute appendicitis. (2) Methods: A retrospective analysis of 1220 adult patients who underwent laparoscopic appendectomy for acute appendicitis from 2010 to 2020 at the University Hospital Erlangen was performed. Data, including patient demographics and pre-, intra-, and postoperative findings, were collected and compared between patients with and without conversion. (3) Results: The conversion rate in our cohort was 5.5%. A higher preoperative WBC count and CRP (OR 1.9, p = 0.042, and OR 2.3, p = 0.019, respectively), as well as the presence of intraoperative perforation, necrosis or gangrene, perityphlitic abscess and peritonitis (OR 3.2, p = 0.001; OR 2.3, p = 0.023; OR 2.6, p = 0.006 and OR 2.0, p = 0.025, respectively) were identified as independent risk factors for conversion from the laparoscopic to the open approach. Conversion was again independently associated with higher morbidity (OR 2.2, p = 0.043). (4) Conclusion: The laparoscopic approach is feasible and safe in the majority of patients with acute appendicitis. Only increased inflammatory blood markers could be detected as the preoperative risk factors potentially influencing the choice of surgical approach but only with low specificity and sensitivity. For the decision to convert, intraoperative findings are additionally crucial. However, patients with conversion should receive special attention in the postoperative course, as these have an increased risk of developing complications.
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Affiliation(s)
- Bruno Leonardo Bancke Laverde
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Matthias Maak
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Melanie Langheinrich
- Department of General, Visceral, Thoracic and Vascular Surgery, University Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Stephan Kersting
- Department of General, Visceral, Thoracic and Vascular Surgery, University Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Axel Denz
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Christian Krautz
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Georg F Weber
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Robert Grützmann
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Maximilian Brunner
- Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany
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Weldemhret L, Atsbaha AH, Bekuretsion H, Desta A, Legesse L, Kahsay AG, Hagos D. Time to Sputum Culture Conversion and Its Predictors Among Multidrug Resistant Tuberculosis Patients in Tigray, Northern Ethiopia: Retrospective Cohort Study. Infect Drug Resist 2023; 16:3671-3681. [PMID: 37324659 PMCID: PMC10263018 DOI: 10.2147/idr.s413495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Background Sputum culture conversion status is a cardinal index of treatment response and patient outcome for MDR TB patients on longer anti-TB drugs. But, there is limited information on time to sputum culture conversion of MDR TB patients on a longer anti-TB treatment regimen. Therefore, this study aimed to evaluate time to sputum culture conversion and its predictors among MDR TB patients in Tigray, Northern Ethiopia. Methods A retrospective cohort study was conducted from January 2017 through September 2020 among MDR TB patients in Tigray, Northern Ethiopia. Demographic and clinical characteristics including bacteriological data were extracted from the TB registration book and electronic database in Tigray Health Research Institute. Statistical analysis was performed using SPSS version 25. The time to initial sputum culture conversion was analyzed using the Kaplan-Meier method. Bivariate and multivariate Cox proportional hazards regression analyses were used to identify predictors for culture conversions. P <0.05 was considered statistically significant. Results A total of 294 eligible study participants with a median age of 30 years (IQR: 22.75-40) were included. The participants were followed for a total of 1066.7 person months. Sputum culture conversion was achieved in 269 (91%) of the study participants. The median time of sputum culture conversion was 64 days (IQR: 49-86). In our multivariate model, HIV-positive (aHR=1.529, 95% CI: 1.096-2.132, P=0.012), patients new to anti-TB treatment (aHR=2.093, 95% CI: 1.100-3.982, P=0.024) and baseline AFB smear grading of +1 (aHR=1.982, 95% CI: 1.428-2.750, P=0.001) significantly affected time to initial sputum culture conversion. Conclusion The median time of culture conversion was 64 days. Moreover, the majority of the study participants achieved culture conversion within the first six months of treatment commencement, which supports predefined standard treatment durations.
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Affiliation(s)
| | | | | | - Abraham Desta
- Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Lemlem Legesse
- Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Atsebaha Gebrekidan Kahsay
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle, University, Mekelle, Tigray, Ethiopia
| | - Dawit Hagos
- Department of Medical Microbiology and Immunology, College of Health Sciences, Mekelle, University, Mekelle, Tigray, Ethiopia
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Abstract
Rechargeable sodium-ion batteries (SIBs) have been considered as promising energy storage devices owing to the similar "rocking chair" working mechanism as lithium-ion batteries and abundant and low-cost sodium resource. However, the large ionic radius of the Na-ion (1.07 Å) brings a key scientific challenge, restricting the development of electrode materials for SIBs, and the infeasibility of graphite and silicon in reversible Na-ion storage further promotes the investigation of advanced anode materials. Currently, the key issues facing anode materials include sluggish electrochemical kinetics and a large volume expansion. Despite these challenges, substantial conceptual and experimental progress has been made in the past. Herein, we present a brief review of the recent development of intercalation, conversion, alloying, conversion-alloying, and organic anode materials for SIBs. Starting from the historical research progress of anode electrodes, the detailed Na-ion storage mechanism is analyzed. Various optimization strategies to improve the electrochemical properties of anodes are summarized, including phase state adjustment, defect introduction, molecular engineering, nanostructure design, composite construction, heterostructure synthesis, and heteroatom doping. Furthermore, the associated merits and drawbacks of each class of material are outlined, and the challenges and possible future directions for high-performance anode materials are discussed.
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Affiliation(s)
- Shuangyan Qiao
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE), and Xi'an Institute of Biomedical Materials and Engineering, Northwestern Polytechnical University, Xi'an 710072, PR China
| | - Qianwen Zhou
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE), and Xi'an Institute of Biomedical Materials and Engineering, Northwestern Polytechnical University, Xi'an 710072, PR China
| | - Meng Ma
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE), and Xi'an Institute of Biomedical Materials and Engineering, Northwestern Polytechnical University, Xi'an 710072, PR China
| | - Hua Kun Liu
- Institute of Energy Materials Science (IEMS), University of Shanghai for Science and Technology, Shanghai 200093, PR China
- Institute for Superconducting and Electronic Materials, Australian Insinuate of Innovative Materials, University of Wollongong, Wollongong, New South Wales 2522, Australia
| | - Shi Xue Dou
- Institute of Energy Materials Science (IEMS), University of Shanghai for Science and Technology, Shanghai 200093, PR China
- Institute for Superconducting and Electronic Materials, Australian Insinuate of Innovative Materials, University of Wollongong, Wollongong, New South Wales 2522, Australia
| | - Shaokun Chong
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE), and Xi'an Institute of Biomedical Materials and Engineering, Northwestern Polytechnical University, Xi'an 710072, PR China
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Besa S, Bagur R, Valdis M, Chu MWA. Teamwork makes Dreamwork: Patient-Centered Care includes Rescue Cardiac Surgery during Transcatheter Aortic Valve Implantation. Eur J Cardiothorac Surg 2023:7187029. [PMID: 37255326 DOI: 10.1093/ejcts/ezad216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/01/2023] Open
Affiliation(s)
- Santiago Besa
- Divisions of Cardiac Surgery, Western University, London, ON, Canada
| | - Rodrigo Bagur
- Divisions of Interventional Cardiology, Western University, London, ON, Canada
| | - Matthew Valdis
- Divisions of Cardiac Surgery, Western University, London, ON, Canada
| | - Michael W A Chu
- Divisions of Cardiac Surgery, Western University, London, ON, Canada
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Alosime EM, Adam OA, Basfar AA. Encapsulation of Carbon Nanotubes by Styrene and Butyl Acrylate Particles via Suspension Polymerization for Polymerized Toner Applications. Materials (Basel) 2023; 16:ma16113941. [PMID: 37297076 DOI: 10.3390/ma16113941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
Electrophotographic printing and copying processes primarily use toner, which is a mixture of colorant, polymer, and additives. Toner can be made using traditional mechanical milling techniques or more contemporary chemical polymerization techniques. Suspension polymerization provides spherical particles with less stabilizer adsorption, homogeneous monomers, higher purity, and easier control of the reaction temperature. In contrast to these advantages, however, the particle size resulting from suspension polymerization is too large for toner. To overcome this disadvantage, devices such as high-speed stirrers and homogenizers can be used to reduce the size of the droplets. This research investigated the use of carbon nanotubes (CNTs) instead of carbon black as the pigment in toner development. We succeeded in achieving a good dispersion of four different types of CNT, specifically modified with NH2 and Boron or unmodified with long or short chains in water rather than chloroform, using sodium n-dodecyl sulfate as a stabilizer. We then performed polymerization of the monomers styrene and butyl acrylate in the presence of the different CNT types and found that the best monomer conversion and largest particles (in the micron range) occurred with CNTs modified with boron. The insertion of a charge control agent into the polymerized particles was achieved. Monomer conversion of over 90% was realized with all concentrations of MEP-51, whereas conversion was under 70% with all concentrations of MEC-88. Furthermore, analysis with dynamic light scattering and scanning electron microscopy (SEM) indicated that all polymerized particles were in the micron size range, suggesting that our newly developed toner particles were less harmful and environmentally friendly products than those typically and commercially available. The SEM micrographs clearly showed good dispersion and attachment of the CNTs on the polymerized particles (no CNT aggregation was found), which has never been published before.
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Affiliation(s)
- Eid M Alosime
- King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia
| | - Omar A Adam
- Leibniz Institute of Polymer Research Dresden e.V., Hohe Straße 6, 01069 Dresden, Germany
| | - Ahmed A Basfar
- Mechanical Engineering Department, College of Engineering, King Saud University, P.O. Box 800, Riyadh 11421, Saudi Arabia
- Nuclear Engineering Program, College of Engineering, King Saud University, P.O. Box 800, Riyadh 11421, Saudi Arabia
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30
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Adewale M. Your Organ Is Mine: Rethinking Ownership Issue in 3D Bioprinting. J Law Med 2023; 30:85-98. [PMID: 37271953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This article discusses ownership and property issues in three-dimensional (3D) bioprinting from the perspective of the tangible aspect of the technology. Many scholars have examined property issues in the intangible aspect of the technology, namely, the intellectual property issue. Since a major component of 3D bioprinting is cells taken from patients and donors, it is important to explore the right of ownership over the physical product, including cells used in the 3D bioprinting process and the 3D bioprinted organ itself. What is the extent of the donor's right over his/her cells taken for use in 3D bioprinting and even the 3D bioprinted organ - the product of those cells? For example, can the cell donor determine how his/her cells are used, or even who gets the 3D bioprinted organ? What rights does a person have over the commercial use of his/her cells or tissue for 3D bioprinting?
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Affiliation(s)
- Modupe Adewale
- PhD candidate at Royal Melbourne Institute of Technology - RMIT
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31
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Deng M, Lei Q, Wang J, Lee C, Guan R, Li S, Wei W, Chen H, Zhong C, Guo R. Nomograms for predicting the recurrence probability and recurrence-free survival in patients with hepatocellular carcinoma after conversion hepatectomy based on hepatic arterial infusion chemotherapy: a multicenter, retrospective study. Int J Surg 2023; 109:1299-1310. [PMID: 37038994 PMCID: PMC10389618 DOI: 10.1097/js9.0000000000000376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND This study aimed to establish and validate nomograms to predict the probability of recurrence and recurrence-free survival (RFS) in patients with hepatocellular carcinoma (HCC) after conversion hepatectomy based on hepatic arterial infusion chemotherapy (HAIC). METHODS Nomograms were constructed using data from a retrospective study of 214 consecutive patients treated with HAIC-based conversion liver resection between January 2016 and July 2020. Nomograms predicting the probability of tumor recurrence and RFS were established based on predictors selected by multivariate regression analysis. Predictive accuracy and discriminative ability of the nomogram were examined. Bootstrap method was used for internal validation. External validation was performed using cohorts ( n =128) from three other centers. RESULTS Recurrence rates in the primary and external validation cohorts were 63.6 and 45.3%, respectively. Nomograms incorporating clinicopathological features of tumor recurrence and RFS were generated. Concordance index (C-index) scores of the nomograms for predicting recurrence probability and RFS were 0.822 (95% CI, 0.703-0.858) and 0.769 (95% CI, 0.731-0.814) in the primary cohort, and 0.802 (95% CI, 0.726-0.878) and 0.777 (95% CI, 0.719-0.835) in the external validation cohort, respectively. Calibration curves indicated good agreement between the nomograms and actual observations. Moreover, the nomograms outperformed the commonly used staging systems. Patients with low risk, stratified by the median nomogram scores had better RFS (low risk vs. high risk, 36.5 vs. 5.2 months, P <0.001). The external validation cohort supported these findings. CONCLUSIONS The presented nomograms showed favorable accuracy for predicting recurrence probability and RFS in HCC patients treated with HAIC-based conversion hepatectomy. Identifying risk factors and estimating tumor recurrence may help clinicians in the decision-making process regarding adjuvant therapies for patients with HCC, which eventually achieves better oncological outcomes.
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Affiliation(s)
- Min Deng
- Department of Liver Surgery, Sun Yat-sen University Cancer Center
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
| | - Qiucheng Lei
- Department of Hepatic Surgery, The Affiliated Foshan Hospital of Sun Yat-Sen University, Foshan, China
| | - Jiamin Wang
- Department of Gastroenterology, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen
| | - Carol Lee
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Renguo Guan
- Department of Liver Surgery, Sun Yat-sen University Cancer Center
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
| | - Shaohua Li
- Department of Liver Surgery, Sun Yat-sen University Cancer Center
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
| | - Wei Wei
- Department of Liver Surgery, Sun Yat-sen University Cancer Center
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
| | - Huanwei Chen
- Department of Hepatic Surgery, The Affiliated Foshan Hospital of Sun Yat-Sen University, Foshan, China
| | - Chong Zhong
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou
| | - Rongping Guo
- Department of Liver Surgery, Sun Yat-sen University Cancer Center
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine
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Fasnacht JS, Wueest AS, Berres M, Thomann AE, Krumm S, Gutbrod K, Steiner LA, Goettel N, Monsch AU. Conversion between the Montreal Cognitive Assessment and the Mini-Mental Status Examination. J Am Geriatr Soc 2023; 71:869-879. [PMID: 36346002 DOI: 10.1111/jgs.18124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/20/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Early and accurate detection of cognitive changes using simple tools is essential for an appropriate referral to a more detailed neurocognitive assessment and for the implementation of therapeutic strategies. The Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are two commonly used psychometric tests for cognitive screening. Both tests have different strengths and weaknesses. Preferences regarding test selection may therefore differ among clinicians. The aim of this retrospective observational cohort study was to define corresponding scores for the MMSE and the MoCA. METHODS We examined the relationship between the cognitive screening tests in 803 German-speaking Memory Clinic outpatients, encompassing a wide range of neurocognitive disorders. We produced a conversion table using the equipercentile equating method with log-linear smoothing. In addition, we conducted a systematic review of existing MMSE-MoCA conversions to create a table allowing for the conversion of MoCA scores into MMSE scores and vice versa using the weighted mean method. RESULTS The Memory Clinic sample showed that the prediction of MMSE to MoCA was overall less accurate compared to the conversion from MoCA to MMSE. The 19 studies included after thorough literature search showed that MoCA scores were consistently lower than MMSE scores. Eleven of 19 conversion studies had addressed the conversion of the MoCA to the MMSE, while two studies converted MMSE to MoCA scores. Another six studies applied bi-directional conversions. We provide an easy-to-use table covering the entire range of scores and taking into account all currently existing conversion formulas. CONCLUSION The comprehensive MMSE-MoCA conversion table enables a direct comparison of cognitive test scores at screening examinations and over the course of disease in patients with neurocognitive disorders.
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Affiliation(s)
- Jael S Fasnacht
- From the Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Alexandra S Wueest
- From the Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Anesthesiology, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Germany
| | - Alessandra E Thomann
- From the Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Anesthesiology, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
| | - Sabine Krumm
- From the Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Klemens Gutbrod
- Neurozentrum Bern and Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Luzius A Steiner
- Department of Anesthesiology, Intermediate Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Nicolai Goettel
- Department of Clinical Research, University of Basel, Basel, Switzerland
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Andreas U Monsch
- From the Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Faculty of Psychology, University of Basel, Basel, Switzerland
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Tongyoo A, Liwattanakun A, Sriussadaporn E, Limpavitayaporn P, Mingmalairak C. The Modification of a Preoperative Scoring System to Predict Difficult Elective Laparoscopic Cholecystectomy. J Laparoendosc Adv Surg Tech A 2023; 33:269-275. [PMID: 36445743 PMCID: PMC9997034 DOI: 10.1089/lap.2022.0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Laparoscopic cholecystectomy (LC) is one of the most common abdominal operations. The difficult cases are still challenging for surgeons. There had been many studies providing several preoperative models to predict difficult LC or conversion. Randhawa's scoring system was a simple and practical predictive model for clinicians. The modification was reported to be more preferable for delayed LC. This study aimed to confirm the advantage of modified predictive model in larger sample size. Materials and Methods: This retrospective cohort study reviewed medical records of patients who underwent LC since January 2017 to December 2021. The difficulty of operation was categorized into three groups: easy, difficult, and very difficult. Multivariate analysis was performed to define significant factors of very difficult and converted cases. The predictive scores were calculated by using the original Randhawa's model and the modification, then compared with actual outcome. Results: There were 567 cases of delayed LC in this study, with 44 cases (7.8%) converted to open cholecystectomy. Four factors (previous cholecystitis, previous endoscopic retrograde cholangiopancreatography, higher ALP, and gallbladder wall thickening) for very difficult group and five factors (previous cholecystitis, previous cholangitis, higher white blood cell count, gallbladder wall thickening, and contracted gallbladder) for conversion were significant. The modification provided the better correlation and higher area of receiver operating characteristic (ROC) curve comparing with the original model. Conclusion: The modification of Randhawa's model was supposed to be more preferable for predicting the difficulty in elective LC. Thai Clinical Trials Registry No. 20220712006.
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Affiliation(s)
- Assanee Tongyoo
- Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | | | - Ekkapak Sriussadaporn
- Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Palin Limpavitayaporn
- Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Chatchai Mingmalairak
- Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
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Supawongwattana M, Vanikieti K, Jindahra P, Padungkiatsagul T. Significance of Acetylcholine Receptor Antibody Titers in Acetylcholine Receptor Antibody-Positive Ocular Myasthenia Gravis: Generalization and Presence of Thyroid Autoimmune Antibodies and Thymoma. Clin Ophthalmol 2023; 17:649-656. [PMID: 36875532 PMCID: PMC9983331 DOI: 10.2147/opth.s402181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023] Open
Abstract
Objective To evaluate the association in acetylcholine receptor (AChR) antibody-positive ocular myasthenia gravis (OMG) subjects between AChR antibody titers and conversion to generalized myasthenia gravis (GMG), the presence of thyroid autoimmune antibodies, and the presence of thymoma. Subjects and Methods A total of 118 subjects with AChR antibody-positive OMG were included. Demographic data, clinical characteristics, serology tests, presence of thymoma, treatment, and conversion to GMG were retrospectively reviewed. The presence of thyroid autoimmune antibodies was defined as the presence of at least one of the following: (1) thyroid peroxidase antibody; (2) thyroglobulin antibody; (3) thyroid-stimulating hormone receptor antibody. Univariate and multivariate logistic regression analyses were used as methods of evaluating association. Results AChR antibody titers were determined in all subjects with a median of 3.33 (0.46-141.09) nmol/L. The median follow-up period was 14.5 (3-113) months. At the final follow-up time-point, 99 subjects (83.90%) remained with a diagnosis of pure OMG, while 19 subjects (16.10%) had converted to GMG. An AChR antibody titer ≥8.11 nmol/L was associated with the conversion to GMG (odds ratio (OR) 3.66, 95% CI: 1.19-11.26; p = 0.023). Of the 79 subjects with available thyroid autoimmune antibodies data, 26 subjects (32.91%) displayed the presence of thyroid autoimmune antibodies. An AChR antibody titer ≥2.81 nmol/L was associated with the presence of thyroid autoimmune antibodies (OR 6.16, 95% CI: 1.79-21.22; p = 0.004). Finally, of the 106 subjects with available thoracic computed tomography (CT) data, only 9 subjects (8.49%) demonstrated the presence of thymoma. An AChR antibody titer ≥15.12 nmol/L was associated with the presence of thymoma (OR 4.97, 95% CI: 1.10-22.48; p = 0.037). Conclusion AChR antibody titers should be considered in AChR antibody-positive OMG patients. Those with AChR antibody titers ≥8.11 nmol/L, who are at a greater risk of conversion to GMG, should be closely monitored and encouraged to be aware of early clinical signs of life-threatening GMG. In addition, serum thyroid autoimmune antibodies and thoracic CT screening for thymoma should be performed in AChR antibody-positive OMG patients, particularly in those with AChR antibody titers ≥2.81 nmol/L and ≥15.12 nmol/L, respectively.
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Affiliation(s)
- Montana Supawongwattana
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kavin Vanikieti
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Panitha Jindahra
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanyatuth Padungkiatsagul
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Cipriani F, Ratti F, Fornoni G, Marino R, Tudisco A, Catena M, Aldrighetti L. Conversion of Minimally Invasive Liver Resection for HCC in Advanced Cirrhosis: Clinical Impact and Role of Difficulty Scoring Systems. Cancers (Basel) 2023; 15:cancers15051432. [PMID: 36900223 PMCID: PMC10001094 DOI: 10.3390/cancers15051432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Minimally invasive liver resections (MILRs) in cirrhosis are at risk of conversion since cirrhosis and complexity, which can be estimated by scoring systems, are both independent factors for. We aimed to investigate the consequence of conversion of MILR for hepatocellular carcinoma in advanced cirrhosis. METHODS After retrospective review, MILRs for HCC were divided into preserved liver function (Cohort-A) and advanced cirrhosis cohorts (Cohort-B). Completed and converted MILRs were compared (Compl-A vs. Conv-A and Compl-B vs. Conv-B); then, converted patients were compared (Conv-A vs. Conv-B) as whole cohorts and after stratification for MILR difficulty using Iwate criteria. RESULTS 637 MILRs were studied (474 Cohort-A, 163 Cohort-B). Conv-A MILRs had worse outcomes than Compl-A: more blood loss; higher incidence of transfusions, morbidity, grade 2 complications, ascites, liver failure and longer hospitalization. Conv-B MILRs exhibited the same worse perioperative outcomes than Compl-B and also higher incidence of grade 1 complications. Conv-A and Conv-B outcomes of low difficulty MILRs resulted in similar perioperative outcomes, whereas the comparison of more difficult converted MILRs (intermediate/advanced/expert) resulted in several worse perioperative outcomes for patients with advanced cirrhosis. However, Conv-A and Conv-B outcomes were not significantly different in the whole cohort where "advanced/expert" MILRs were 33.1% and 5.5% in Cohort A and B. CONCLUSIONS Conversion in the setting of advanced cirrhosis can be associated with non-inferior outcomes compared to compensated cirrhosis, provided careful patient selection is applied (patients elected to low difficulty MILRs). Difficulty scoring systems may help in identifying the most appropriate candidates.
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Affiliation(s)
- Federica Cipriani
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Correspondence:
| | - Francesca Ratti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Gianluca Fornoni
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Rebecca Marino
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Antonella Tudisco
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Marco Catena
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Luca Aldrighetti
- Hepatobiliary Surgery Division, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy
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Bertrand D, Matignon M, Morel A, Ludivine L, Lemoine M, Hanoy M, Roy FL, Nezam D, Hamzaoui M, de Nattes T, Moktefi A, François A, Laurent C, Etienne I, Guerrot D. Belatacept rescue conversion in kidney transplant recipients with vascular lesions (Banff cv score >2): a retrospective cohort study. Nephrol Dial Transplant 2023; 38:481-490. [PMID: 35544123 DOI: 10.1093/ndt/gfac178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Immunosuppression in kidney transplant recipients with decreased graft function and histological vascular changes can be particularly challenging. The impact of a late rescue conversion to belatacept on kidney graft survival in this context has never been studied. METHODS We report a bicentric retrospective cohort study comparing a calcineurin inhibitor (CNI) to belatacept switch versus CNI continuation in 139 kidney transplant recipients with histological kidney vascular damage (cv ≥2, g + cpt ≤1, i + t ≤1) and low estimated glomerular filtration rate (≤40 mL/min/1.73 m²). Primary outcome was death-censored graft survival. RESULTS During the study follow-up, 10 graft losses (14.5%) occurred in the belatacept group (n = 69) versus 26 (37.1%) in the matched CNI group (n = 70) (P = .005). Death-censored graft survival was significantly higher in the belatacept group (P = .001). At 3 years, graft survival was 84.0% in the belatacept group compared with 65.1% in the control group. Continuing CNI was an independent risk factor for graft loss [hazard ratio (HR) 3.46; P < .005]. The incidence of cellular rejection after the conversion was low (4.3% in both groups) and not significantly different between groups (P = .84). Patients switched to belatacept developed significantly less donor-specific antibodies de novo. Belatacept was an independent risk factor for the occurrence of opportunistic infections (HR 4.84; P < .005). CONCLUSION The replacement of CNI with belatacept in patients with decreased allograft function and vascular lesions is associated with an improvement in graft survival and represents a valuable option in a context of organ shortage. Caution should be exercised regarding the increased risk of opportunistic infection.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Marie Matignon
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Antoine Morel
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Lebourg Ludivine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Tristan de Nattes
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Anissa Moktefi
- Department of Pathology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est-Créteil University, Paris, France
| | | | - Charlotte Laurent
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.,INSERM U1096, Normandie Univ, UNIROUEN, Rouen, France
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Apinyankul R, Hui AY, Hwang K, Segovia NA, Amanatullah DF, Huddleston JI, Maloney WJ, Goodman SB. Complications, Implant Survivorships, and Functional Outcomes of Conversion Total Knee Arthroplasty With Prior Hardware. J Arthroplasty 2023; 38:S66-S70.e2. [PMID: 36758842 DOI: 10.1016/j.arth.2023.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND End-stage knee osteoarthritis with retained periarticular hardware is a frequent scenario. Conversion total knee arthroplasty (TKA) leads to excellent outcomes, but poses unique challenges. The evidence supporting retention versus removal of hardware during TKA is controversial. METHODS Patients who underwent TKA with prior hardware between January 2009 and December 2019 were identified. A total of 148 patients underwent TKA with prior hardware. The mean follow-up was 60 months (range, 24-223). Univariate and multivariable analyses were used to study correlations among factors and surgical-related complications, prosthesis failures, and functional outcomes. RESULTS The complication rate was 28 of 148 (18.9%). The use of a quadriceps snips in addition to a medial parapatellar arthrotomy was associated with a higher complication (odds ratio: 20.7, P < .05), implant failures (odds ratio: 13.9, P < .05), and lower the Veterans Rand 12 Mental Score (VR-12 MS) (-14.8, P < .05). Hardware removal versus retention and use of single versus multiple incisions were not associated with complications or prosthesis failures. Removal of all hardware was associated with significantly higher (+7.3, P < .05) VR-12 MS compared to retention of all hardware. CONCLUSIONS TKA with prior hardware was associated with more complications, implant failures, and lower VR-12 MS when a more constrained construct or quadriceps snip was performed. This probably reflects the level of difficulty of the procedure rather than the surgical approach used. Hardware removal or retention was not associated with complications or implant failures; however, removal rather than retention of all prior hardware is associated with increased general health outcomes. LEVEL OF EVIDENCE IV, cohort without control.
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Affiliation(s)
- Rit Apinyankul
- Department of Orthopaedics, Khon Kaen University, Khon Kaen, Thailand
| | - Alexander Y Hui
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Katherine Hwang
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Nicole Alexandriadria Segovia
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Derek F Amanatullah
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - James I Huddleston
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - William J Maloney
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
| | - Stuart B Goodman
- Department of Orthopaedic Surgery, Stanford University Medical Center Outpatient Center, Stanford University School of Medicine, Stanford, California
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Li J, Gong Y, Li J, Fan L. Hydrothermal treatment improves xanthine oxidase inhibitory activity and affects the polyphenol profile of Flos Sophorae Immaturus. J Sci Food Agric 2023; 103:1205-1215. [PMID: 36086816 DOI: 10.1002/jsfa.12215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Flos Sophorae Immaturus (FSI) is rich in polyphenols and a potential uric acid-lowering food. However, the processing of FSI is greatly restricted due to the heat sensitivity and low solubility of polyphenols. In this study, hydrothermal treatment - an effective strategy - was applied to FSI processing. The variation of xanthine oxidase (XO) inhibitory effect and polyphenol composition of FSI during hydrothermal treatment were recorded. RESULTS The XO inhibition rate of FSI increased from 32.42% to 89.00% after hydrothermal treatment at 220 °C for 30 min, as well as total polyphenols (from 0.66 to 1.11 mg mL-1 ) and flavonoids (from 1.21 to 1.58 mg mL-1 ). However, high thermal temperature (>160 °C) and extended thermal time (>90 min) caused the degradation of polyphenols. Rutin, kaempferol-3-O-rutinoside and narcissoside rapidly degraded and converted to quercetin, kaempferol and isorhamnetin when the temperature exceeded 160 °C. The maximum yields of quercetin, kaempferol and isorhamnetin were at 220 °C for 30 min, 90 min and 90 min, respectively. Meanwhile, the conversion kinetics conformed to the first-order model. Interestingly, these newly formed polyphenols possessed better XO inhibitory effects than their derivatives with 3-O-rutinoside. CONCLUSION Polyphenol conversion during hydrothermal treatment was the main reason for enhancing XO inhibitory activity. Therefore, hydrothermal treatment is an appropriate method for improving the XO inhibitory effect of FSI. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Jun Li
- State Key laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- Institute of Food Processing Technology, Guizhou Academy of Agricultural Sciences, Guiyang, China
| | - Yuhong Gong
- State Key laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Jinwei Li
- State Key laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Liuping Fan
- State Key laboratory of Food Science and Technology, Jiangnan University, Wuxi, China
- School of Food Science and Technology, Jiangnan University, Wuxi, China
- Collaborative Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, China
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Colson C, Batrow PL, Dieckmann S, Contu L, Roux CH, Balas L, Vigor C, Fourmaux B, Gautier N, Rochet N, Bernoud-Hubac N, Durand T, Langin D, Klingenspor M, Amri EZ. Effects of Fatty Acid Metabolites on Adipocytes Britening: Role of Thromboxane A2. Cells 2023; 12. [PMID: 36766790 DOI: 10.3390/cells12030446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Obesity is a complex disease highly related to diet and lifestyle and is associated with low amount of thermogenic adipocytes. Therapeutics that regulate brown adipocyte recruitment and activity represent interesting strategies to fight overweight and associated comorbidities. Recent studies suggest a role for several fatty acids and their metabolites, called lipokines, in the control of thermogenesis. The purpose of this work was to analyze the role of several lipokines in the control of brown/brite adipocyte formation. We used a validated human adipocyte model, human multipotent adipose-derived stem cell model (hMADS). In the absence of rosiglitazone, hMADS cells differentiate into white adipocytes, but convert into brite adipocytes upon rosiglitazone or prostacyclin 2 (PGI2) treatment. Gene expression was quantified using RT-qPCR and protein levels were assessed by Western blotting. We show here that lipokines such as 12,13-diHOME, 12-HEPE, 15dPGJ2 and 15dPGJ3 were not able to induce browning of white hMADS adipocytes. However, both fatty acid esters of hydroxy fatty acids (FAHFAs), 9-PAHPA and 9-PAHSA potentiated brown key marker UCP1 mRNA levels. Interestingly, CTA2, the stable analog of thromboxane A2 (TXA2), but not its inactive metabolite TXB2, inhibited the rosiglitazone and PGI2-induced browning of hMADS adipocytes. These results pinpoint TXA2 as a lipokine inhibiting brown adipocyte formation that is antagonized by PGI2. Our data open new horizons in the development of potential therapies based on the control of thromboxane A2/prostacyclin balance to combat obesity and associated metabolic disorders.
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Li H, Sun D, Cao L, Wang B. Efficient conversion of rebaudioside C to steviol by Paenarthrobacter ilicis CR5301. Lett Appl Microbiol 2023; 76:6902085. [PMID: 36688762 DOI: 10.1093/lambio/ovac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/20/2022] [Accepted: 11/10/2022] [Indexed: 01/24/2023]
Abstract
To improve the conversion efficiency of rebaudioside C, this study screened the Paenarthrobacter ilicis CR5301 from soil samples and identified it by 16S rRNA. The conversion experiment proved that P. ilicis CR5301 was capable of converting rebaudioside C. The effects of initial pH, temperature, inoculation amount, and substrate concentration on rebaudioside C conversion rate were investigated. The results showed that the conversion rate of rebaudioside C reached up to 100% when CR5301 was incubated in a conversion medium with an initial pH of 7.0 for 8 h at 28°C and 270 rpm. The conversion time was reduced by at least 16 h compared with previous studies. The conversion product was analyzed and identified as steviol by high performance liquid chromatography, ultra performance liquid chromatography-triple-time of flight mass spectrometer, and Fourier transform infrared spectroscopy methods. In addition, stevioside, rebaudioside A, dulcoside A, and some unknown components in steviol glycosides byproduct were all efficiently converted to steviol. These findings provide an efficient approach to the conversion of rebaudioside C and byproduct to steviol to simplify the subsequent industrial process and improve the reuse value of steviol glycosides.
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Affiliation(s)
- Hongfei Li
- College of Chemistry and Chemical Engineering, Northeast Petroleum University, Daqing City, Heilongjiang 163318, China.,National Coarse Cereals Engineering Research Center, Heilongjiang Bayi Agricultural University, Daqing 163319, China.,Engineering Research Center of Processing and Utilization of Grain By-products, Ministry of Education, Daqing, China
| | - Daqing Sun
- National Coarse Cereals Engineering Research Center, Heilongjiang Bayi Agricultural University, Daqing 163319, China
| | - Longkui Cao
- National Coarse Cereals Engineering Research Center, Heilongjiang Bayi Agricultural University, Daqing 163319, China.,Engineering Research Center of Processing and Utilization of Grain By-products, Ministry of Education, Daqing, China
| | - Baohui Wang
- College of Chemistry and Chemical Engineering, Northeast Petroleum University, Daqing City, Heilongjiang 163318, China
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Mante J, Abam J, Samineni SP, Pötzsch IM, Beal J, Myers CJ. Excel-SBOL Converter: Creating SBOL from Excel Templates and Vice Versa. ACS Synth Biol 2023; 12:340-346. [PMID: 36595709 DOI: 10.1021/acssynbio.2c00521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Standards support synthetic biology research by enabling the exchange of component information. However, using formal representations, such as the Synthetic Biology Open Language (SBOL), typically requires either a thorough understanding of these standards or a suite of tools developed in concurrence with the ontologies. Since these tools may be a barrier for use by many practitioners, the Excel-SBOL Converter was developed to facilitate the use of SBOL and integration into existing workflows. The converter consists of two Python libraries: one that converts Excel templates to SBOL and another that converts SBOL to an Excel workbook. Both libraries can be used either directly or via a SynBioHub plugin.
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Affiliation(s)
- Jeanet Mante
- University of Colorado Boulder, Boulder, Colorado 80309, United States
| | - Julian Abam
- University of Colorado Boulder, Boulder, Colorado 80309, United States
| | - Sai P Samineni
- University of Colorado Boulder, Boulder, Colorado 80309, United States
| | | | - Jacob Beal
- Raytheon BBN Technologies, Cambridge, Massachusetts 02138, United States
| | - Chris J Myers
- University of Colorado Boulder, Boulder, Colorado 80309, United States
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Lapp AS, Merrill LC, Wygant BR, Ashby DS, Bhandarkar AS, Zhang AC, Fuller EJ, Harrison KL, Lambert TN, Talin AA. Room-Temperature Pseudo-Solid-State Iron Fluoride Conversion Battery with High Ionic Conductivity. ACS Appl Mater Interfaces 2023; 15:893-902. [PMID: 36538758 DOI: 10.1021/acsami.2c16332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Li-metal batteries (LMBs) employing conversion cathode materials (e.g., FeF3) are a promising way to prepare inexpensive, environmentally friendly batteries with high energy density. Pseudo-solid-state ionogel separators harness the energy density and safety advantages of solid-state LMBs, while alleviating key drawbacks (e.g., poor ionic conductivity and high interfacial resistance). In this work, a pseudo-solid-state conversion battery (Li-FeF3) is presented that achieves stable, high rate (1.0 mA cm-2) cycling at room temperature. The batteries described herein contain gel-infiltrated FeF3 cathodes prepared by exchanging the ionic liquid in a polymer ionogel with a localized high-concentration electrolyte (LHCE). The LHCE gel merges the benefits of a flexible separator (e.g., adaptation to conversion-related volume changes) with the excellent chemical stability and high ionic conductivity (∼2 mS cm-1 at 25 °C) of an LHCE. The latter property is in contrast to previous solid-state iron fluoride batteries, where poor ionic conductivities necessitated elevated temperatures to realize practical power levels. The stable, room-temperature Li-FeF3 cycling performance obtained with the LHCE gel at high current densities paves the way for exploring a range of architectures including flexible, three-dimensional, and custom shape batteries.
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Affiliation(s)
- Aliya S Lapp
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Laura C Merrill
- Nanoscale Sciences Department, Sandia National Laboratories, 1515 Eubank Blvd. SE, Albuquerque, New Mexico 87123, United States
| | - Bryan R Wygant
- Photovoltaics and Materials Technology Department, Sandia National Laboratories, 1515 Eubank Blvd. SE, Albuquerque, New Mexico 87123, United States
| | - David S Ashby
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Austin S Bhandarkar
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Alan C Zhang
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Elliot J Fuller
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
| | - Katharine L Harrison
- Nanoscale Sciences Department, Sandia National Laboratories, 1515 Eubank Blvd. SE, Albuquerque, New Mexico 87123, United States
| | - Timothy N Lambert
- Photovoltaics and Materials Technology Department, Sandia National Laboratories, 1515 Eubank Blvd. SE, Albuquerque, New Mexico 87123, United States
| | - A Alec Talin
- Materials Physics Department, Sandia National Laboratories, 7011 East Avenue, Livermore, California 94550, United States
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Martínez-Pérez A, Piccoli M, Casoni Pattacini G, Winter DC, Carcoforo P, Celentano V, Chiarugi M, Di Saverio S, Bianchi G, Frontali A, Fuks D, Genova P, Guerrieri M, Kraft M, Lakkis Z, Le Roy B, Micelli Lupinacci R, Milone M, Petri R, Scabini S, Tonini V, Valverde A, Zorcolo L, Ris F, Espin E, de'Angelis N. Conversion to Open Surgery During Minimally Invasive Right Colectomy for Cancer: Results from a Large Multinational European Study. J Laparoendosc Adv Surg Tech A 2023; 33:344-350. [PMID: 36602521 DOI: 10.1089/lap.2022.0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: The risk of conversion to open surgery is inevitably present during any minimally invasive colorectal surgical procedure. Conversions have been associated with adverse postoperative and oncologic outcomes. No previous study has evaluated the specific causes and consequences of conversion during a minimally invasive right colectomy (MIS-RC). Materials and Methods: We analyzed the Minimally invasivE surgery for oncologic Right ColectomY (MERCY) study database including patients who underwent laparoscopic or robotic RC because of colon cancer between 2014 and 2020. Descriptive analyses were performed to determine the different reasons for conversion. Uni- and multivariate logistic regressions were run to identify potential variables associated with this outcome. Cox regression analyses were used to evaluate the impact of conversion on tumor recurrence. Results: Over a total of 1574 MIS-RC, 120 (7.6%) were converted to open surgery. The main reasons for conversion were procedural difficulties related to adherences from previous abdominal surgical procedures (39.2%), or owing to large tumor size or infiltration of adjacent structures (26.7%). Only 16.7% of the conversions were caused by intraoperative medical or surgical complications. Converted patients required longer operative times and developed more postoperative complications, both overall (39.2% versus 27.5%; P = .006) and severe ones (13.3% versus 8.3%; P = .061). Male gender (odds ratio [OR] = 1.89 [95% confidence interval: 1.31-2.71]), obesity (OR = 1.99 [1.4-2.83]), prior abdominal surgery (OR = 1.68 [1.19-2.37]), and pT4 cancers (OR = 4.04 [2.86-5.69]) were independently associated with conversion. Conversion to open surgery was not significantly associated with tumor recurrence (hazard ratios = 1.395 [0.724-2.687]). Conclusions: Although conversion to open surgery during MIS-RC for cancer is associated with worsened postoperative outcomes, it seems not to impact on the oncologic prognosis.
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Affiliation(s)
- Aleix Martínez-Pérez
- Unit of General Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), Créteil, France.,Faculty of Health Sciences, Valencian International University (VIU), Valencia, Spain
| | - Micaela Piccoli
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Gianmaria Casoni Pattacini
- Department of General Surgery, Emergencies and New Technologies, Baggiovara Civil Hospital, Modena, Italy
| | - Des C Winter
- Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland
| | - Paolo Carcoforo
- Department of Surgery, Unit of General Surgery, University Hospital of Ferrara, University of Ferrara, Ferrara, Italy
| | - Valerio Celentano
- Faculty of Medicine, University of Portsmouth, Portsmouth, United Kingdom.,Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Massimo Chiarugi
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Salomone Di Saverio
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Giorgio Bianchi
- Unit of General Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), Créteil, France
| | - Alice Frontali
- Department of General Surgery, Department of Biomedical and Clinical Sciences 'L. Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milan, Italy
| | - David Fuks
- Department of Digestive Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Paris Descartes University, Paris, France
| | - Pietro Genova
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy
| | - Mario Guerrieri
- Department of General Surgery, Università Politecnica Delle Marche, Ancona, Italy
| | - Miquel Kraft
- Unit of Colorectal Surgery, Department of General and Digestive Surgery, University Hospital Vall d'Hebron-Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology-Liver Transplantation Unit, University Hospital of Besançon, Besançon, France
| | - Bertrand Le Roy
- Department of Digestive and Oncologic Surgery, Hospital Nord, CHU Saint-Etienne, Saint-Etienne, France
| | - Renato Micelli Lupinacci
- Department of Digestive, Oncologic and Metabolic Surgery, Ambroise Paré Hospital, AP-HP Paris Saclay University, Boulogne-Billancourt, France
| | - Marco Milone
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - Roberto Petri
- General Surgery Department, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
| | - Stefano Scabini
- General and Oncologic Surgical Unit, Policlinico San Martino, Genova, Italy
| | - Valeria Tonini
- Emergency Surgery Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Alain Valverde
- Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Luigi Zorcolo
- Colon and Rectal Surgery Unit, University of Cagliari, Cagliari, Italy
| | - Frederic Ris
- Division of Abdominal and Transplantation Surgery, Department of Surgery, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Eloy Espin
- Service of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital (AP-HP), Faculty of Medicine, University Paris Cité, Paris, France
| | - Nicola de'Angelis
- Unit of General Surgery, CARE Department, Henri Mondor University Hospital (AP-HP), Créteil, France.,Service of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital (AP-HP), Faculty of Medicine, University Paris Cité, Paris, France
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Lukic S, Krauska A, Yoshida M, Thompson CK. The role of category ambiguity in normal and impaired lexical processing: can you paint without the paint? Front Hum Neurosci 2023; 17:1028378. [PMID: 37213932 PMCID: PMC10192584 DOI: 10.3389/fnhum.2023.1028378] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction Many words are categorially ambiguous and can be used as a verb (to paint) or as a noun (the paint) due to the presence of unpronounced morphology or "zero morphology". On this account, the verb "paint" is derived from the noun "paint" through the addition of a silent category-changing morpheme. Past studies have uncovered the syntactic and semantic properties of these categorially ambiguous words, but no research has been conducted on how people process them during normal or impaired lexical processing. Are these two different uses of "paint" processed in the same way? Does this morphosyntactic structure have an effect on online sentence processing? Methods This study presents two experiments that investigate the effect of morphosyntactic complexity in categorially ambiguous words presented in isolation (experiment 1) and in a sentential context (experiment 2). The first experiment tested the ability to process categorially unambiguous and ambiguous nouns and verbs in 30 healthy older adults and 12 individuals with aphasia, using a forced choice phrasal-completion task, in which individuals choose whether the or to is most compatible with target words. Results Healthy controls and individuals with fluent aphasia all showed: (1) a bias toward the base category in selection rates for the and to, where the was selected more frequently for words identified to be base nouns, and to was selected more frequently for base verbs, and (2) longer reaction times for ambiguous (over unambiguous) words. However, individuals with non-fluent agrammatic aphasia showed a base-category effect only for nouns, with chance performance for verbs. The second experiment, using an eye-tracking while reading paradigm with 56 young healthy adults, showed a reading time slowdown for derived forms (to paint) compared to their base-category counterparts (the paint) in sentence contexts. Discussion These findings suggest that categorially ambiguous words likely share a common root, and are related by zero-derivation, and that impaired access to the base-category (i.e., verbs like to visit) precludes associated morphological processes and therefore the retrieval of the derived-category (i.e., nouns like the visit) in non-fluent agrammatic aphasia. This study provides insights into the theory of zero morphology, and the principles that need to be accounted for in models of the lexicon.
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Affiliation(s)
- Sladjana Lukic
- Department of Communication Sciences and Disorders, Ruth S. Ammon College of Education and Health Sciences, Adelphi University, Garden City, NY, United States
- *Correspondence: Sladjana Lukic,
| | - Alexandra Krauska
- Department of Linguistics, University of Maryland, College Park, College Park, MD, United States
| | - Masaya Yoshida
- Department of Linguistics, Northwestern University, Evanston, IL, United States
| | - Cynthia K. Thompson
- Aphasia and Neurolinguistics Laboratory, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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Hou Q, Zhang B, Luo Y, Wang P, Yang S, Shang P. Predictive Factors for Conversion from Laparoscopic Adrenalectomy to Open Surgery: A 9-Year Review of 911 Cases. J Laparoendosc Adv Surg Tech A 2023; 33:38-43. [PMID: 35617700 DOI: 10.1089/lap.2022.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background: With the development of minimally invasive techniques, laparoscopic adrenalectomy (LA) has become the standard for the treatment of adrenal surgical diseases, but conversion to open adrenalectomy (OA) is also necessary in some cases. The purpose of this study was to investigate the risk factors for conversion from LA to OA. Methods: A retrospective study was performed on 911 patients who were diagnosed with adrenal tumors and underwent LA in the Department of Urology, Second Hospital of Lanzhou University from January 2013 to December 2021. According to the surgical methods, the patients were divided into the laparoscopic group (n = 873) and the conversion group (n = 38). Logistic regression was used to analyze the independent risk factors of conversion, and the logistic regression equation was established to predict the probability of conversion. Results: In this study, 38 patients (4.17%) were converted to open. In the univariate analysis, body mass index (P = .037), tumor side (P < .001), tumor size (P < .001), surgical approach (P < .001), and histological type (P = .006) were significantly associated with conversion. In the multivariate analysis, tumor diameter >7 cm (odds ratio = 2.835, 95% confidence interval 1.096-7.335; P = .032), transabdominal approach (odds ratio = 2.400, 95% confidence interval 1.136-5.074; P = .022), pheochromocytoma (odds ratio = 5.018, 95% confidence interval 1.964-12.822; P = .001), and malignant tumor (odds ratio = 17.781, 95% confidence interval 4.156-76.075; P < .001) were independent risk factors for transition opening. The logistic regression equation showed good power to predict conversion. Conclusion: Tumor size, surgical approach, and histological type were predictive factors for conversion from a laparoscopic to an open procedure. Preoperative evaluation of these characteristics is of great value for clinicians to evaluate the risk of conversion and make a surgical plan. It can not only reduce the conversion rate but also help to improve the intraoperative situation and shorten the length of hospital stays.
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Affiliation(s)
- Qian Hou
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Biao Zhang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Yao Luo
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Pengyuan Wang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Shujun Yang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Panfeng Shang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China
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Beider N. Religious residue: The impact of childhood religious socialization on the religiosity of nones in France, Germany, Great Britain, and Sweden. Br J Sociol 2023; 74:50-69. [PMID: 36300574 PMCID: PMC10092140 DOI: 10.1111/1468-4446.12982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/11/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
One of the distinguishing features of religious life in Western Europe in recent decades has been the sharp increase in the proportion of people who identify as unaffiliated with any religious tradition (religious nones). Non-affiliation entails a rejection of religious belonging, not the absence of all religious belief and practice; yet the determinants of religiosity among nones have not been fully explored. Drawing on data from the 1998-2018 ISSP surveys in four West European countries (France, Germany, Great Britain, and Sweden), I test the impact of childhood religious socialization on the religiosity of unaffiliated adults by comparing lifelong nones, who were never religiously affiliated, with disaffiliates, who were raised within a religious tradition and have since exited organized religious life. Disaffiliates are consistently more religious than lifelong nones due to religious residue from childhood, with greater residue found among those who were more religiously committed as children. Religious decline among the unaffiliated over time, combined with the increasing proportion of lifelong nones and second-generation lifelong nones who lack even an inherited, minimal religious residue, suggest that secularization will gather momentum.
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Yan Q, Hu W, Tian Y, Li X, Yu Y, Li X, Feng B. Probiotics intervention in preventing conversion of impaired glucose tolerance to diabetes: The PPDP follow-on study. Front Endocrinol (Lausanne) 2023; 14:1113611. [PMID: 36875472 PMCID: PMC9982119 DOI: 10.3389/fendo.2023.1113611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVES The purpose of this study was to assess the incidence of type 2 diabetes mellitus (T2DM) after 6 years in patients with IGT who received early probiotic intervention in the Probiotics Prevention Diabetes Program (PPDP) trial. METHODS 77 patients with IGT in the PPDP trial were randomized to either probiotic or placebo. After the completion of the trial, 39 non-T2DM patients were invited to follow up glucose metabolism after the next 4 years. The incidence of T2DM in each group was assessed using Kaplan-Meier analysis. The 16S rDNA sequencing technology was used to analyze gut microbiota's structural composition and abundance changes between the groups. RESULTS The cumulative incidence of T2DM was 59.1% with probiotic treatment versus 54.5% with placebo within 6 years, there was no significant difference in the risk of developing T2DM between the two groups (P=0.674). CONCLUSIONS Supplemental probiotic therapy does not reduce the risk of IGT conversion to T2DM. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn/showproj.aspx?proj=5543, identifier ChiCTR-TRC-13004024.
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Affiliation(s)
- Qun Yan
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Weiting Hu
- The Second Clinical Medical College, Shanxi Medical University, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yan Tian
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xu Li
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuan Yu
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xing Li
- The Second Clinical Medical College, Shanxi Medical University, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Bo Feng
- Department of Endocrinology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Bo Feng,
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Bernardes C, Lima M, Duro D, Silva-Spínola A, Durães J, Tábuas-Pereira M, Baldeiras I, Freitas S, Santana I. Montreal Cognitive Assessment in Mild Cognitive Impairment: Relationship with Cerebrospinal Fluid Biomarkers and Conversion to Dementia. J Alzheimers Dis 2023; 96:1173-1182. [PMID: 37927268 DOI: 10.3233/jad-230916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is considered a prodromal state of dementia. Abnormal values of cerebrospinal fluid Alzheimer's disease biomarkers (CSF-AD-b) have been associated with a higher risk of conversion to dementia (due to Alzheimer's disease), but studies evaluating the ability of Montreal Cognitive Assessment (MoCA) in this task are lacking. OBJECTIVE This study aims to investigate the relationship between MoCA and CSF-AD-b, as well as the ability of those tools to predict conversion to dementia. METHODS Taking advantage of our MCI cohort with biological characterization on longitudinal follow-up (180 patients followed for 62.6 months during which 41.3% converted), we computed MoCA and MMSE z-scores, using Portuguese normative data. The performance in MoCA z-score was correlated with CSF-AD-b and the relative time to conversion and risk according to baseline characteristics were analyzed using Kaplan-Meier analysis and Cox regression models. RESULTS MoCA z-scores were correlated with Aβ42 (p = 0.026), t-tau (p = 0.033), and p-tau (p = 0.01). Impaired MMSE (p < 0.001) and MoCA z-scores (p = 0.019), decreased Aβ42 (p < 0.001) and increased t-tau (p < 0.001) and p-tau (p < 0.001) were associated with shorter estimated time of conversion. Aβ42 (p < 0.001) and MMSE z-scores (p = 0.029) were independent predictors of conversion. For those with at least 9 years of education, MoCA z-score (p = 0.004) (but not MMSE) was an independent predictor of conversion as well as Aβ42. CONCLUSIONS This study confirms the role of CSF-AD-b, namely Aβ42, in predicting conversion from MCI to dementia and suggests the utility of MoCA in predicting conversion in highly educated subjects, supporting its use in the evaluation of MCI patients.
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Affiliation(s)
- Catarina Bernardes
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Marisa Lima
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
| | - Diana Duro
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
| | - Anuschka Silva-Spínola
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Centre for Informatics and Systems, Department of Informatics Engineering, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Durães
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Tábuas-Pereira
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Inês Baldeiras
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sandra Freitas
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Coimbra University Hospital Centre, Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Centre for Informatics and Systems, Department of Informatics Engineering, University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Stav M, Matatov Y, Hoffmann D, Heesen P, Gliesche V, Binyamin Y, Ioscovich A, Eidelman LA, Orbach-Zinger S. Incidence of conversion to general anaesthesia and need for intravenous supplementation in parturients undergoing caesarean section under spinal anaesthesia: A retrospective observational study. Acta Anaesthesiol Scand 2023; 67:29-35. [PMID: 36056463 DOI: 10.1111/aas.14146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Conversion from spinal anaesthesia to general anaesthesia (GA) was shown to be associated with more complications. It has been postulated that spinal injection of a low dose of local anaesthetic is a risk factor. We aimed to discover the rate of conversion from spinal anaesthesia to GA in women who received at least 10 mg heavy bupivacaine and opioids and assess its risk factors. METHODS All women that underwent spinal anaesthesia for caesarean section from 1 January 2017 to 31 December 2020 were included in this analysis. Spinal anaesthesia was performed according to department protocol using heavy bupivacaine 0.5% 10-13 mg, fentanyl 20 μg, and morphine 0.1 mg. We examined rate of conversion from spinal anaesthesia to GA and rate of need for analgesia/sedation. RESULTS There were 1.7% of women that required conversion to GA. Bupivacaine dose (OR 0.54 [95% CI 0.38 to 0.75], p < 0.001), surgery time (OR 1.03 [95% CI 1.02 to 1.04], p < 0.001), emergency caesarean section (OR 1.06 [95% CI 1.16 to 3.76], p = 0.015), and postpartum haemorrhage (OR 5.96 [95% CI 1.09 to 25.18], p = 0.025) were independent predictors of need for conversion to GA. Of the women who had CS under spinal anaesthesia, 4.1% of parturients required intraoperative analgesics/sedatives and 9.1% required anxiolysis. CONCLUSIONS A small proportion of women required conversion to GA. This conversion occurred especially with emergency caesarean section and when low spinal bupivacaine doses were used.
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Affiliation(s)
- Michael Stav
- Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Yuri Matatov
- Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Dana Hoffmann
- Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Yair Binyamin
- Department of Anesthesiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Soroka University Medical Center, Beer Sheva, Israel
| | - Alexander Ioscovich
- Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, Affiliated with the Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Leonid A Eidelman
- Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Orbach-Zinger
- Department of Anaesthesia, Beilinson Hospital, Petach Tikvah, and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel
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DeCoffe LJR, Conran DN, Bauch TD, Ross MG, Kaputa DS, Salvaggio C. Initial Performance Analysis of the At-Altitude Radiance Ratio Method for Reflectance Conversion of Hyperspectral Remote Sensing Data. Sensors (Basel) 2022; 23:320. [PMID: 36616918 PMCID: PMC9823536 DOI: 10.3390/s23010320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/15/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
In remote sensing, the conversion of at-sensor radiance to surface reflectance for each pixel in a scene is an essential component of many analysis tasks. The empirical line method (ELM) is the most used technique among remote sensing practitioners due to its reliability and production of accurate reflectance measurements. However, the at-altitude radiance ratio (AARR), a more recently proposed methodology, is attractive as it allows reflectance conversion to be carried out in real time throughout data collection, does not require calibrated samples of pre-measured reflectance to be placed in scene, and can account for changes in illumination conditions. The benefits of AARR can substantially reduce the level of effort required for collection setup and subsequent data analysis, and provide a means for large-scale automation of remote sensing data collection, even in atypical flight conditions. In this study, an onboard, downwelling irradiance spectrometer integrated onto a small unmanned aircraft system (sUAS) is utilized to characterize the performance of AARR-generated reflectance from hyperspectral radiance data under a variety of challenging illumination conditions. The observed error introduced by AARR is often on par with ELM and acceptable depending on the application requirements and natural variation in the reflectance of the targets of interest. Additionally, a number of radiometric and atmospheric corrections are proposed that could increase the accuracy of the method in future trials, warranting further research.
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Affiliation(s)
- Luke J. R. DeCoffe
- Digital Imaging and Remote Sensing Laboratory, Chester F. Carlson Center for Imaging Science, College of Science, Rochester Institute of Technology, 54 Lomb Memorial Drive, Rochester, NY 14623, USA
| | - David N. Conran
- Digital Imaging and Remote Sensing Laboratory, Chester F. Carlson Center for Imaging Science, College of Science, Rochester Institute of Technology, 54 Lomb Memorial Drive, Rochester, NY 14623, USA
| | - Timothy D. Bauch
- Digital Imaging and Remote Sensing Laboratory, Chester F. Carlson Center for Imaging Science, College of Science, Rochester Institute of Technology, 54 Lomb Memorial Drive, Rochester, NY 14623, USA
| | - Micah G. Ross
- Digital Imaging and Remote Sensing Laboratory, Chester F. Carlson Center for Imaging Science, College of Science, Rochester Institute of Technology, 54 Lomb Memorial Drive, Rochester, NY 14623, USA
| | - Daniel S. Kaputa
- Department of Electrical and Computer Engineering Technology, College of Engineering Technology, Rochester Institute of Technology, 15 Lomb Memorial Drive, Rochester, NY 14623, USA
| | - Carl Salvaggio
- Digital Imaging and Remote Sensing Laboratory, Chester F. Carlson Center for Imaging Science, College of Science, Rochester Institute of Technology, 54 Lomb Memorial Drive, Rochester, NY 14623, USA
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