AIM： To determine the rates of success and complications of precut biliary sphincterotomy （PBS） based on prior experience and to compare the complication rates between PBS and standard endoscopic sphincterotomy （E...AIM： To determine the rates of success and complications of precut biliary sphincterotomy （PBS） based on prior experience and to compare the complication rates between PBS and standard endoscopic sphincterotomy （ES）. METHODS： A retrospective evaluation of prospectively collected non-randomized data at an academic tertiary referral center, The study included all patients in an eight-year period who underwent PBS and ES by a single endoscopist who had no formal training in PBS. The main outcorne measures of the study were success and complications of PBS with a comparison to complications of ES.RESULTS： A total of 2939 endoscopic retrograde chola ngiopancreatographies （ERCPs） were performed during the study period, including 818 （28%） ES and 150 （5%） PBS procedures. Selective biliary cannulation via PBS was successful at the first attempt in 75% of the patients. Cannulation was achieved in an additional 13% of the patients at a subsequent attempt （total 87%）. Complication rate from PBS was 45% higher than ES, but did not differ significantly [7% （10/50） vs 5% （38/818）, P = 0.29]. None of the complications from PBS was severe. A significant trend towards increasing success existed with regard to the endoscopist＇s first attempt at precut （P = 0.0393, Cochran-Armitage exact test for trend, Z = -1.7588）. CONCLUSION： Despite the lack of specific training in this technique, PBS was performed with a high success rate and a complication rate similar to or less than reports from other experienced centers. These results suggest that endoscopic experience and perhaps innate endoscopic skill may play an important role in the outcome of this procedure.展开更多
The Global boundary Stratotype Section and Point （GSSP） for the base of the Drumian Stage （Cambrian Series 3） is defined at the base of a limestone （calcisiltite） layer 62 m above the base of the Wheeler Formati...The Global boundary Stratotype Section and Point （GSSP） for the base of the Drumian Stage （Cambrian Series 3） is defined at the base of a limestone （calcisiltite） layer 62 m above the base of the Wheeler Formation in the Stratotype Ridge section, Drum Mountains, Utah, USA. The GSSP level contains the lowest occurrence of the cosmopolitan agnostoid trilobite Ptychagnostus atavus （base of the P. atavus Zone）. Secondary global markers near the base of the stage include the DICE negative δ^13C excursion, the onset of a long monotonic ^87Sr/^86Sr isotopic shift, and the transgressive phase of a eustatic event. Faunal turnovers close to the base of the Drumian Stage are recognized as the base of the Bolaspidella Zone （polymerid trilobites） in Laurentia, the historic base of the Floran Stage in Australia, the base of the Dorypyge richthofeni Zone （polymerid trilobites） in South China, and the base of the Gapparodus bisulcatus-Westergaardodina brevidens Assemblage-zone （conodonts） in Baltica and South China. The last occurrence of the cosmopolitan trilobite Ptychagnostus gibbus occurs in the lower part of the Drumian Stage, and the base of the Hydrocephalus hicksii Zone （polymerid trilobites） as used in Siberia and Baltica occurs near the base of the stage.展开更多
This article presents the fabrication and characterization of poly dimethylsiloxane/carbon nanofiber(CNF)-based nanocomposites.Although silica and carbon nanoparticles have been traditionally used to reinforce mechani...This article presents the fabrication and characterization of poly dimethylsiloxane/carbon nanofiber(CNF)-based nanocomposites.Although silica and carbon nanoparticles have been traditionally used to reinforce mechanical properties in PDMS matrix nanocom-posites,this article focuses on understanding their impacts on electrical and thermal properties.By adjusting both the silica and CNF concentrations,12 different nanocomposite formulations were studied,and the thermal and electrical properties of these materials were experimentally characterized.The developed nano-composites were prepared using a solvent-assisted method pro-viding uniform dispersion of the CNFs in the polymer matrix.Scanning electron microscopy was employed to determine the dispersion of the CNFs at different length scales.The thermal properties,such as thermal stability and thermal diffusivity,of the developed nanocomposites were studied using thermogravi-metirc and laser flash techniques.Furthermore,the electrical volume conductivity of each type of nanocomposite was tested using the four-probe method to eliminate the effects of contact electrical resistance during measurement.Experimental results showed that both CNFs and silica were able to impact on the overall properties of the synthesized PDMS/CNF nanocomposites.The developed nanocomposites have the potential to be applied to the development of new load sensors in the future.展开更多
This paper aims to explore the concept of wellbeing from an individual＇s perspective. Current indicators of wellbeing [including economic indicators such as Gross Domestic Product （GDP）] are static indicators--they...This paper aims to explore the concept of wellbeing from an individual＇s perspective. Current indicators of wellbeing [including economic indicators such as Gross Domestic Product （GDP）] are static indicators--they take into account issues as they are in a given period of time such as the current year. However, these indicators fail to measure the sense of wellbeing felt by an individual over a lifetime, and therefore could miss important issues of relevance when developing policy and other interventions to improve wellbeing. Various wellbeing indicators for the OK over the period of 1945-2013 are explored. These indicators are used to develop a ＂lifetime wellbeing＂ measure. The indicators are grouped and predictions of indicators into the future are made. The data show that some indicators have peaked and are now in decline. Therefore, under a certain choice of indicators and weightings, it is possible to maximise wellbeing over a person＇s lifetime meaning, there may have been an optimum year in which to be born.展开更多
Thymidine kinase 1 (TK1) is a well-studied cancer biomarker. It is commonly found upregulated in the serum of cancer patients, and its levels correlate with stage and grade, disease progression, and prognosis. It has ...Thymidine kinase 1 (TK1) is a well-studied cancer biomarker. It is commonly found upregulated in the serum of cancer patients, and its levels correlate with stage and grade, disease progression, and prognosis. It has recently been reported that TK1 localizes on the plasma cell membrane of hematological and solid malignancies, and not on the membrane of normal healthy cells, and while on the membrane, TK1 has enzymatic activity. However, the function of TK1 on the surface membrane is not well understood. Here, we hypothesize that it may have a role in tumor invasion and migration. It has been shown that TK1 expression levels positively correlate with epithelia to mesenchymal transition (EMT) markers in patients with breast cancer as they progress from HER2+ to triple negative breast cancer. In this study, we silenced TK1 expression by siRNA and show that TK1’s membrane expression is significantly downregulated at 60 hours post transfection. Using a Matrigel-based quantitative invasion assay, we measured cell invasion potential in cells either expressing or lacking TK1 on their membrane and found that cells that lack TK1 on their membrane exhibit decreased invasion potential. These results suggest that TK1’s presence on the membrane may play a role in invasion and cell migration in cancer.展开更多
Sentinel lymph node （SLN） biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic mal...Sentinel lymph node （SLN） biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic malignancies has been studied extensively over the past decade. We review the current literature on SLN dissection in vulvar, endometrial and cervical cancers. Large, well-designed trials in each of the three types of cancer have demonstrated high sensitivity and low false-negative rates when SLN biopsy is performed in the correct patients and with an appropriate technical approach. In all of these cases the addition of ultra-staging to conventional pathology yields increased detection of micrometastatic disease. Biopsy of the sentinel nodes is feasible and safe in early vulvar malignancies, with multiple studies describing low recurrence rates in those women who have with negative SLNs. There does not appear to be a survival benefit to lymphadenectomy over SLN biopsy and quality of life is improved in women undergoing SLN biopsy. Optimal treatment strategies for women with positive nodal biopsies, particularly in cases with micrometastatic disease, remain unclear. Multiple large studies investigating the utility of SLN biopsy in endometrial malignancy have found that sentinel nodal status is a reliable predictor of metastases in women with low-risk disease. Prospective studies are ongoing and suggest sentinel nodal detection may soon become widely accepted as an alternative standard of care for select cases of endometrial cancer. In cervical cancer, SLN biopsy is accurate for diagnosing metastatic disease in early stage tumors （≤ 2 cm diameter or stage ≤ IB2） where the risk of metastasis is low. It is unknown if women who undergo SLN biopsy alone will have different survival outcomes than women who undergo complete lymphadenectomy in these cases. In a specific population of women with vulvar cancer, SLN dissection is an effective and safe alternative to complete dissection. It can be offered 展开更多
文摘AIM： To determine the rates of success and complications of precut biliary sphincterotomy （PBS） based on prior experience and to compare the complication rates between PBS and standard endoscopic sphincterotomy （ES）. METHODS： A retrospective evaluation of prospectively collected non-randomized data at an academic tertiary referral center, The study included all patients in an eight-year period who underwent PBS and ES by a single endoscopist who had no formal training in PBS. The main outcorne measures of the study were success and complications of PBS with a comparison to complications of ES.RESULTS： A total of 2939 endoscopic retrograde chola ngiopancreatographies （ERCPs） were performed during the study period, including 818 （28%） ES and 150 （5%） PBS procedures. Selective biliary cannulation via PBS was successful at the first attempt in 75% of the patients. Cannulation was achieved in an additional 13% of the patients at a subsequent attempt （total 87%）. Complication rate from PBS was 45% higher than ES, but did not differ significantly [7% （10/50） vs 5% （38/818）, P = 0.29]. None of the complications from PBS was severe. A significant trend towards increasing success existed with regard to the endoscopist＇s first attempt at precut （P = 0.0393, Cochran-Armitage exact test for trend, Z = -1.7588）. CONCLUSION： Despite the lack of specific training in this technique, PBS was performed with a high success rate and a complication rate similar to or less than reports from other experienced centers. These results suggest that endoscopic experience and perhaps innate endoscopic skill may play an important role in the outcome of this procedure.
基金We would like to thank all the people, including members of the ISCS, involved in the process of defining the base of the Drumian for stimulating discussion and scientific support. J.G. 0gg thoroughly reviewed the final GSSP proposal. A.M. English and L.A. Ford assisted with assembly of the final illustrations. This work was supported in part by a grant from the U.S. National Science Foundation （EAR-0106883） to Babcock.
文摘The Global boundary Stratotype Section and Point （GSSP） for the base of the Drumian Stage （Cambrian Series 3） is defined at the base of a limestone （calcisiltite） layer 62 m above the base of the Wheeler Formation in the Stratotype Ridge section, Drum Mountains, Utah, USA. The GSSP level contains the lowest occurrence of the cosmopolitan agnostoid trilobite Ptychagnostus atavus （base of the P. atavus Zone）. Secondary global markers near the base of the stage include the DICE negative δ^13C excursion, the onset of a long monotonic ^87Sr/^86Sr isotopic shift, and the transgressive phase of a eustatic event. Faunal turnovers close to the base of the Drumian Stage are recognized as the base of the Bolaspidella Zone （polymerid trilobites） in Laurentia, the historic base of the Floran Stage in Australia, the base of the Dorypyge richthofeni Zone （polymerid trilobites） in South China, and the base of the Gapparodus bisulcatus-Westergaardodina brevidens Assemblage-zone （conodonts） in Baltica and South China. The last occurrence of the cosmopolitan trilobite Ptychagnostus gibbus occurs in the lower part of the Drumian Stage, and the base of the Hydrocephalus hicksii Zone （polymerid trilobites） as used in Siberia and Baltica occurs near the base of the stage.
文摘This article presents the fabrication and characterization of poly dimethylsiloxane/carbon nanofiber(CNF)-based nanocomposites.Although silica and carbon nanoparticles have been traditionally used to reinforce mechanical properties in PDMS matrix nanocom-posites,this article focuses on understanding their impacts on electrical and thermal properties.By adjusting both the silica and CNF concentrations,12 different nanocomposite formulations were studied,and the thermal and electrical properties of these materials were experimentally characterized.The developed nano-composites were prepared using a solvent-assisted method pro-viding uniform dispersion of the CNFs in the polymer matrix.Scanning electron microscopy was employed to determine the dispersion of the CNFs at different length scales.The thermal properties,such as thermal stability and thermal diffusivity,of the developed nanocomposites were studied using thermogravi-metirc and laser flash techniques.Furthermore,the electrical volume conductivity of each type of nanocomposite was tested using the four-probe method to eliminate the effects of contact electrical resistance during measurement.Experimental results showed that both CNFs and silica were able to impact on the overall properties of the synthesized PDMS/CNF nanocomposites.The developed nanocomposites have the potential to be applied to the development of new load sensors in the future.
文摘This paper aims to explore the concept of wellbeing from an individual＇s perspective. Current indicators of wellbeing [including economic indicators such as Gross Domestic Product （GDP）] are static indicators--they take into account issues as they are in a given period of time such as the current year. However, these indicators fail to measure the sense of wellbeing felt by an individual over a lifetime, and therefore could miss important issues of relevance when developing policy and other interventions to improve wellbeing. Various wellbeing indicators for the OK over the period of 1945-2013 are explored. These indicators are used to develop a ＂lifetime wellbeing＂ measure. The indicators are grouped and predictions of indicators into the future are made. The data show that some indicators have peaked and are now in decline. Therefore, under a certain choice of indicators and weightings, it is possible to maximise wellbeing over a person＇s lifetime meaning, there may have been an optimum year in which to be born.
文摘Thymidine kinase 1 (TK1) is a well-studied cancer biomarker. It is commonly found upregulated in the serum of cancer patients, and its levels correlate with stage and grade, disease progression, and prognosis. It has recently been reported that TK1 localizes on the plasma cell membrane of hematological and solid malignancies, and not on the membrane of normal healthy cells, and while on the membrane, TK1 has enzymatic activity. However, the function of TK1 on the surface membrane is not well understood. Here, we hypothesize that it may have a role in tumor invasion and migration. It has been shown that TK1 expression levels positively correlate with epithelia to mesenchymal transition (EMT) markers in patients with breast cancer as they progress from HER2+ to triple negative breast cancer. In this study, we silenced TK1 expression by siRNA and show that TK1’s membrane expression is significantly downregulated at 60 hours post transfection. Using a Matrigel-based quantitative invasion assay, we measured cell invasion potential in cells either expressing or lacking TK1 on their membrane and found that cells that lack TK1 on their membrane exhibit decreased invasion potential. These results suggest that TK1’s presence on the membrane may play a role in invasion and cell migration in cancer.
文摘Sentinel lymph node （SLN） biopsies are a sensitive tool in evaluating lymph nodes for multiple cancers, and in some diseases they decrease morbidity in both the short- and long-term. SLN detection in gynecologic malignancies has been studied extensively over the past decade. We review the current literature on SLN dissection in vulvar, endometrial and cervical cancers. Large, well-designed trials in each of the three types of cancer have demonstrated high sensitivity and low false-negative rates when SLN biopsy is performed in the correct patients and with an appropriate technical approach. In all of these cases the addition of ultra-staging to conventional pathology yields increased detection of micrometastatic disease. Biopsy of the sentinel nodes is feasible and safe in early vulvar malignancies, with multiple studies describing low recurrence rates in those women who have with negative SLNs. There does not appear to be a survival benefit to lymphadenectomy over SLN biopsy and quality of life is improved in women undergoing SLN biopsy. Optimal treatment strategies for women with positive nodal biopsies, particularly in cases with micrometastatic disease, remain unclear. Multiple large studies investigating the utility of SLN biopsy in endometrial malignancy have found that sentinel nodal status is a reliable predictor of metastases in women with low-risk disease. Prospective studies are ongoing and suggest sentinel nodal detection may soon become widely accepted as an alternative standard of care for select cases of endometrial cancer. In cervical cancer, SLN biopsy is accurate for diagnosing metastatic disease in early stage tumors （≤ 2 cm diameter or stage ≤ IB2） where the risk of metastasis is low. It is unknown if women who undergo SLN biopsy alone will have different survival outcomes than women who undergo complete lymphadenectomy in these cases. In a specific population of women with vulvar cancer, SLN dissection is an effective and safe alternative to complete dissection. It can be offered
