BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and conf...BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis.However,there is a paucity of data regarding the imaging assessment of these lesions.AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.METHODS This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers.All cases with postoperative histology of SPN were included in the study.Data collected included clinical,biochemical,histological and EUS characteristics.RESULTS One hundred and six patients with the diagnosis of SPN were included.The mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic morphology.Calcification was observed in only 4(3.8%)cases.Main pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)cases.One patient demonstrated a double duct sign at presentation.Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern.EUS guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)cases.Ninety-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all cases.During the 2-year follow-up period,no recurrence was observed.CON展开更多
In order to design Sustainable Land Management(SLM)plans or interventions it is important to understand the land use change and subsequent impacts.The basic aim of this study was to assess the impact of land use land ...In order to design Sustainable Land Management(SLM)plans or interventions it is important to understand the land use change and subsequent impacts.The basic aim of this study was to assess the impact of land use land cover(LULC)change on soil physico-chemical properties and nutrients loss under different land use/land cover changes within Miandam watershed of Swat valley,Pakistan.The study area was divided into three major types on the basis LULC type(Dense forest,Moderate forest and Agriculture land).A total of 81 soil samples were collected from the study area(27 from each land use)through stratified random sampling and were transferred to the laboratory.The prepared soil samples were then tested for various physico-chemical properties such as pH,electrical conductivity,contents of organic matter,organic carbon,sand,silt,clay,nitrogen,phosphorus,potassium,iron,copper and zinc.Results showed that LULC significantly affected all soil parameters except electrical conductivity and potassium.For all the nutrients assessed,the enrichment ratio was greater than 1 which showed that the most fertile layer of the soil in the cropped areas was transported through soil erosion.In this study,time-series satellite images were used to determine the spatiotemporal changes in the LULC of Miandam valley of Swat,Pakistan,and the possible effect of LULC on soil properties was reported.The information generated on the soil properties as indicators of soil health could be used to inform the stakeholders about the effect of LULC change in the study area.Multi-temporal image acquired by Landsat sensors for the year 2018 was used for quantifying changes in the study area.The Landsat images for the year 2018 were classified into six land cover/land use classes.The increase in agricultural activities caused an increase in the land farming areas which led to an increase in the rate of deforestation in the valley.Thus,the present study results reveal that the use of the soil for agriculture instead of keeping them naturally or in other wor展开更多
This paper concerns the study of the influence of the proportion of plastic from polyethylene, on the yields of gas emissions during the combustion of the mixture of “millet stalks and polyethylene plastic bags”, in...This paper concerns the study of the influence of the proportion of plastic from polyethylene, on the yields of gas emissions during the combustion of the mixture of “millet stalks and polyethylene plastic bags”, in a prototype of kiln of potters. During these investigations, we looked at the rate of residual oxygen (O2) and emissions of carbon dioxide (CO2) and nitrogen monoxide (NO), as a function of primary air flow (Q1) and secondary airflow (Q2). The potter’s kilns are considered those fueled by natural air flow. The primary air flows ranging from 45 to 85 Nm3?h 1 and secondary air flows from 20 to 60 Nm3?h 1. To conduct this numerical study, the model used is “reactor” based on the code CHEMKIN II. The modeled area is composed into a multitude of perfectly stirred reactors (PSR) and the kinetic model has 893 species and 113 reversible chemical reactions. The results show that in our test conditions, the increasing of the rate of plastic in the mixture produces a decrease of the residual oxygen content, due to higher oxygen consumption regardless of the airflow. The CO2 emissions are an increasing function of the rate of plastic (polyethylene) in the fuel mixture. Finally, NO emissions are increasing functions of the mass of plastic for a proportions less than or equal to 20%, and are essentially controlled by the temperature of the reactional medium.展开更多
Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions;less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic...Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions;less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke.Methods Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007.Haematocrit values within 24 hours of admission were classified as≤27%,28%-32%,33%-37%,38%-42%,43%-47% or≥48%.Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital,30-day,6-month and 1-year mortality,adjusting for age,medical comorbidities,modified Acute Physiology and Chronic Health Evaluation-III and stroke severity.Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates.results Among n=3750 patients included in the analysis,the haematocrit values were≤27%in 2.1%(n=78),28%-32% in 6.2%(n=234),33%-37%in 17.9%(n=670),38%-42% in 36.4%(n=1366),43%-47% in 28.2%(n=1059)and≥48% in 9.1%(n=343).Patients with haematocrit≤27%,compared with patients in the 38%-42% range,were more likely to have died across all follow-up intervals,with statistically significant adjusted ORs(aORs)ranging from 2.5 to 3.5.Patients with polycythaemia(ie,haematocrit≥48%)were at increased risk of in-hospital mortality(aOR=2.9;95%CI 1.4 to 6.0),compared with patients with mid-range admission haematocrits.Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis.Impact factors in the 1-year mortality model were 0.46(severe anaemia),0.06(cancer)and 0.018(heart disease).Conclusions Anaemia is independently associated with an increased risk of death throughout the first year post stroke;high haematocrit is associated with early poststroke mortality.Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease.These data cannot address the qu展开更多
文摘BACKGROUND Solid pseudopapillary neoplasm(SPN)is an uncommon pathology of the pancreas with unpredictable malignant potential.Endoscopic ultrasound(EUS)assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis.However,there is a paucity of data regarding the imaging assessment of these lesions.AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.METHODS This was an international,multicenter,retrospective,observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers.All cases with postoperative histology of SPN were included in the study.Data collected included clinical,biochemical,histological and EUS characteristics.RESULTS One hundred and six patients with the diagnosis of SPN were included.The mean age was 26 years(range 9 to 70 years),with female predominance(89.6%).The most frequent clinical presentation was abdominal pain(80/106;75.5%).The mean diameter of the lesion was 53.7 mm(range 15 to 130 mm),with the slight predominant location in the head of the pancreas(44/106;41.5%).The majority of lesions presented with solid imaging features(59/106;55.7%)although 33.0%(35/106)had mixed solid/cystic characteristics and 11.3%(12/106)had cystic morphology.Calcification was observed in only 4(3.8%)cases.Main pancreatic duct dilation was uncommon,evident in only 2 cases(1.9%),whilst common bile duct dilation was observed in 5(11.3%)cases.One patient demonstrated a double duct sign at presentation.Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern.EUS guided biopsy was performed using three different types of needles:Fine needle aspiration(67/106;63.2%),fine needle biopsy(37/106;34.9%),and Sonar Trucut(2/106;1.9%).The diagnosis was conclusive in 103(97.2%)cases.Ninety-seven patients were treated surgically(91.5%)and the post-surgical SPN diagnosis was confirmed in all cases.During the 2-year follow-up period,no recurrence was observed.CON
文摘In order to design Sustainable Land Management(SLM)plans or interventions it is important to understand the land use change and subsequent impacts.The basic aim of this study was to assess the impact of land use land cover(LULC)change on soil physico-chemical properties and nutrients loss under different land use/land cover changes within Miandam watershed of Swat valley,Pakistan.The study area was divided into three major types on the basis LULC type(Dense forest,Moderate forest and Agriculture land).A total of 81 soil samples were collected from the study area(27 from each land use)through stratified random sampling and were transferred to the laboratory.The prepared soil samples were then tested for various physico-chemical properties such as pH,electrical conductivity,contents of organic matter,organic carbon,sand,silt,clay,nitrogen,phosphorus,potassium,iron,copper and zinc.Results showed that LULC significantly affected all soil parameters except electrical conductivity and potassium.For all the nutrients assessed,the enrichment ratio was greater than 1 which showed that the most fertile layer of the soil in the cropped areas was transported through soil erosion.In this study,time-series satellite images were used to determine the spatiotemporal changes in the LULC of Miandam valley of Swat,Pakistan,and the possible effect of LULC on soil properties was reported.The information generated on the soil properties as indicators of soil health could be used to inform the stakeholders about the effect of LULC change in the study area.Multi-temporal image acquired by Landsat sensors for the year 2018 was used for quantifying changes in the study area.The Landsat images for the year 2018 were classified into six land cover/land use classes.The increase in agricultural activities caused an increase in the land farming areas which led to an increase in the rate of deforestation in the valley.Thus,the present study results reveal that the use of the soil for agriculture instead of keeping them naturally or in other wor
文摘This paper concerns the study of the influence of the proportion of plastic from polyethylene, on the yields of gas emissions during the combustion of the mixture of “millet stalks and polyethylene plastic bags”, in a prototype of kiln of potters. During these investigations, we looked at the rate of residual oxygen (O2) and emissions of carbon dioxide (CO2) and nitrogen monoxide (NO), as a function of primary air flow (Q1) and secondary airflow (Q2). The potter’s kilns are considered those fueled by natural air flow. The primary air flows ranging from 45 to 85 Nm3?h 1 and secondary air flows from 20 to 60 Nm3?h 1. To conduct this numerical study, the model used is “reactor” based on the code CHEMKIN II. The modeled area is composed into a multitude of perfectly stirred reactors (PSR) and the kinetic model has 893 species and 113 reversible chemical reactions. The results show that in our test conditions, the increasing of the rate of plastic in the mixture produces a decrease of the residual oxygen content, due to higher oxygen consumption regardless of the airflow. The CO2 emissions are an increasing function of the rate of plastic (polyethylene) in the fuel mixture. Finally, NO emissions are increasing functions of the mass of plastic for a proportions less than or equal to 20%, and are essentially controlled by the temperature of the reactional medium.
基金This work was supported by the Department of Veterans Affairs,VHA,Office of Quality and Performance,and Health Services Research&Development Service Quality Enhancement Research Initiative Service Directed Project 12-178 and Career Development Award 11-262,and the Department of Veterans Affairs,Health Services Research&Development,Stroke Quality Enhancement Research Initiative(QUERI)Rapid Response Project 09-184.The views expressed in this article are those of the authors and do not necessarily represent the view of the Department of Veterans Affairs.
文摘Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions;less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke.Methods Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007.Haematocrit values within 24 hours of admission were classified as≤27%,28%-32%,33%-37%,38%-42%,43%-47% or≥48%.Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital,30-day,6-month and 1-year mortality,adjusting for age,medical comorbidities,modified Acute Physiology and Chronic Health Evaluation-III and stroke severity.Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates.results Among n=3750 patients included in the analysis,the haematocrit values were≤27%in 2.1%(n=78),28%-32% in 6.2%(n=234),33%-37%in 17.9%(n=670),38%-42% in 36.4%(n=1366),43%-47% in 28.2%(n=1059)and≥48% in 9.1%(n=343).Patients with haematocrit≤27%,compared with patients in the 38%-42% range,were more likely to have died across all follow-up intervals,with statistically significant adjusted ORs(aORs)ranging from 2.5 to 3.5.Patients with polycythaemia(ie,haematocrit≥48%)were at increased risk of in-hospital mortality(aOR=2.9;95%CI 1.4 to 6.0),compared with patients with mid-range admission haematocrits.Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis.Impact factors in the 1-year mortality model were 0.46(severe anaemia),0.06(cancer)and 0.018(heart disease).Conclusions Anaemia is independently associated with an increased risk of death throughout the first year post stroke;high haematocrit is associated with early poststroke mortality.Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease.These data cannot address the qu
