AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonosco...AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307,200 pixel) and 150 HDC (792,576 pixels) in a community teaching hospital.RESULTS:A total of 900 colonoscopies were evaluated (mean age 56,46.8% men),450 with each resolution.Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P=0.42).There was no significant difference between the overall number of polyps,HDC (397) and SDC (410),detected among all patients examined,(P=0.73).One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P=0.82).There was no significant difference between HDC (M=0.41) and SDC (M=0.42) regarding adenomatous polyp (P=0.88) or advanced adenoma (P=0.56) detection rate among all patients examined.CONCLUSION:HDC did not improve yield of adenomatous polyp,advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.展开更多
Background： The parent-to-child influences can be adaptive and contribute to the optimal psychological well-being and positive perception of the athlete. Contrary to the healthy parental involvement, a family can als...Background： The parent-to-child influences can be adaptive and contribute to the optimal psychological well-being and positive perception of the athlete. Contrary to the healthy parental involvement, a family can also have negative effects on an athlete development. The purpose of this study was to determine gender, father involvement, and mother involvement differences in the psychological profiles of collegiate freshmen athletes as measured by perfectionism, physical self-concept, and psychological well-being. Methods： Eighty-two male and 73 female collegiate freshmen responded to self-reported measures of family involvement, perfectionism, physical self-concept, and psychological well-being. Three separate 2 x 2 x 2 （gender x mother involvement x father involvement） factorial multivariate analysis of variance （MANOVAs） were carried out on the respective subscales from the reported measures. Results： There were significant differences for gender as well as father involvement in perfectionism （p 〈 0.01）. Freshmen females had lower concern over mistakes, and greater levels of organization as well as planfulness than males. Furthermore, freshmen athletes with high involved fathers showed greater levels of high standards for others as well as organization. Conclusion： Father involvement and mother involvement impact perfectionism, physical self-concept, and psychological well-being. perspective. extends through the freshmen year in college as shown in the athletes＇ Future research should develop better measures and utilize a family systems Copyright @ 2012, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved展开更多
Study Objective: Establish complications and risk factors that are associated with blind tube insertion, evaluate the validity of correct placement verification methods, establish the rationales supporting its employm...Study Objective: Establish complications and risk factors that are associated with blind tube insertion, evaluate the validity of correct placement verification methods, establish the rationales supporting its employment by anesthesia providers, and describe various deployment facilitators described in current literature. Measurements: An exhaustive literature review of the databases Medline, CINAHL, Cochrane Collaboration, Scopus, and Google Scholar was performed applying the search terms “gastric tube”, “complications”, “decompression”, “blind insertion”, “perioperative”, “intraoperative” in various order sequences. A five-year limit was applied to limit the number and timeliness of articles selected. Main Results: Patients are exposed to potentially serious morbidity and mortality from blindly inserted gastric tubes. Risk factors associated with malposition include blind insertion, the presence of endotracheal tubes, altered sensorium, and previous tube misplacements. Pulmonary aspiration risk prevention remains the only indication for anesthesia-related intraoperative use. There are no singularly effective tools that predict or verify the proper placement of blindly inserted gastric tubes. Current placement facilitation techniques are perpetuated through anecdotal experience and technique variability warrants further study. Conclusion: In the absence of aspiration risk factors or the need for surgical decompression in ASA classification I & II patients, a moratorium should be instituted on the elective use of gastric tubes.展开更多
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease in the United States and globally.The currently understood model of pathogenesis consists of a‘multiple hit’hypothesis in w...BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease in the United States and globally.The currently understood model of pathogenesis consists of a‘multiple hit’hypothesis in which environmental and genetic factors contribute to hepatic inflammation and injury.AIM To examine the genetic expression of NAFLD and non-alcoholic steatohepatitis(NASH)tissue samples to identify common pathways that contribute to NAFLD and NASH pathogenesis.METHODS We employed the Search Tag Analyze Resource for Gene Expression Omnibus platform to search the The National Center for Biotechnology Information Gene Expression Omnibus to elucidate NAFLD and NASH pathology.For NAFLD,we conducted meta-analysis of data from 58 NAFLD liver biopsies and 60 healthy liver biopsies;for NASH,we analyzed 187 NASH liver biopsies and 154 healthy liver biopsies.RESULTS Our results from the NAFLD analysis reinforce the role of altered metabolism,inflammation,and cell survival in pathogenesis and support recently described contributors to disease activity,such as altered androgen and long non-coding RNA activity.The top upstream regulator was found to be sterol regulatory element binding transcription factor 1(SREBF1),a transcription factor involved in lipid homeostasis.Downstream of SREBF1,we observed upregulation in CXCL10,HMGCR,HMGCS1,fatty acid binding protein 5,paternally expressed imprinted gene 10,and downregulation of sex hormone-binding globulin and insulin-like growth factor 1.These molecular changes reflect low-grade inflammation secondary to accumulation of fatty acids in the liver.Our results from the NASH analysis emphasized the role of cholesterol in pathogenesis.Top canonical pathways,disease networks,and disease functions were related to cholesterol synthesis,lipid metabolism,adipogenesis,and metabolic disease.Top upstream regulators included proinflammatory cytokines tumor necrosis factor and IL1B,PDGF BB,and beta-estradiol.Inhibition of beta-estradiol was shown to be related to derangement of several cellular downstream processes including metabolism,extracellular matrix deposition,and tumor suppression.Lastly,we found riciribine(an AKT inhibitor)and ZSTK-474(a PI3K inhibitor)as potential drugs that targeted the differential gene expression in our dataset.CONCLUSION In this study we describe several molecular processes that may correlate with NAFLD disease and progression.We also identified ricirbine and ZSTK-474 as potential therapy.展开更多
BACKGROUND Hepatitis B virus(HBV) is a cause of hepatocellular carcinoma(HCC). Interestingly, this process is not necessarily mediated through cirrhosis and may in fact involve oncogenic processes. Prior studies have ...BACKGROUND Hepatitis B virus(HBV) is a cause of hepatocellular carcinoma(HCC). Interestingly, this process is not necessarily mediated through cirrhosis and may in fact involve oncogenic processes. Prior studies have suggested specific oncogenic gene expression pathways were affected by viral regulatory proteins. Thus, identifying these genes and associated pathways could highlight predictive factors for HCC transformation and has implications in early diagnosis and treatment.AIM To elucidate HBV oncogenesis in HCC and identify potential therapeutic targets.METHODS We employed our Search, Tag, Analyze, Resource platform to conduct a meta-analysis of public data from National Center for Biotechnology Information’s Gene Expression Omnibus. We performed meta-analysis consisting of 155 tumor samples compared against 185 adjacent nontumor samples and analyzed results with ingenuity pathway analysis.RESULTS Our analysis revealed liver X receptors/retinoid X receptor(RXR) activation and farnesoid X receptor/RXR activation as top canonical pathways amongst others. Top upstream regulators identified included the Ras family gene rab-like protein 6(RABL6). The role of RABL6 in oncogenesis is beginning to unfold but its specific role in HBV-related HCC remains undefined. Our causal analysis suggests RABL6 mediates pathogenesis of HBV-related HCC through promotion of genes related to cell division, epigenetic regulation, and Akt signaling. We conducted survival analysis that demonstrated increased mortality with higher RABL6 expression. Additionally, homeobox A10(HOXA10) was a top upstream regulator and was strongly upregulated in our analysis. HOXA10 has recently been demonstrated to contribute to HCC pathogenesis in vitro. Our causal analysis suggests an in vivo role through downregulation of tumor suppressors and other mechanisms.CONCLUSION This meta-analysis describes possible roles of RABL6 and HOXA10 in the pathogenesis of HBV-related HCC. RABL6 and HOXA10 represent potential therapeutic targets and warrant further investigation.展开更多
Nasotracheal intubation (NTI) is the most widely used method to establish an airway during anesthesia for oral surgery. It has the advantage of providing exceptional accessibility and optimal working conditions in the...Nasotracheal intubation (NTI) is the most widely used method to establish an airway during anesthesia for oral surgery. It has the advantage of providing exceptional accessibility and optimal working conditions in the oral cavity for surgeons. Anesthesia providers are highly trained in managing and securing the airway. Because the oral intubation route is the most widely used technique for securing the airway, nasal intubation can be cumbersome for anesthetists who do not routinely perform this skill. Moreover, anesthesia providers who do not routinely perform NTI may feel apprehension out of concern for nasopharyngeal bleeding and trauma. The number of dental and oromaxillofacial procedures requiring nasal intubation has been steadily growing annually. Although NTI is generally safe, it still presents a risk for complications. The purpose of this literature review was to examine current literature and evidence-based practices of NTI to determine whether the use of a catheter-guided technique will improve patient care outcomes by way of decreased trauma to the airway compared to current clinical practices. The goal of this review is to recommend the use of a catheter-guided technique for NTI as the preferred method for securing the airway during oral surgery as it is less traumatizing to the airway than conventional methods.展开更多
College students experience great stress due to many factors,such as an uncertain future,academic responsibilities,and pressures imposed by social communication.Many institutions of higher education are focusing on ho...College students experience great stress due to many factors,such as an uncertain future,academic responsibilities,and pressures imposed by social communication.Many institutions of higher education are focusing on how to mediate stressful situations and increase the subjective well-being(SWB)of students to sustain a lifestyle focused on wellness.The online survey used for this study focused on testing an exploratory SWB model by implementing partial least squares structural equation modeling(PLS-SEM)techniques.The participants were 470 college-aged students enrolled in seven different institutions in six cities across China.Findings yielded a good model fit(the Standardized Root Mean Squared Residual[SRMR]=.054)with the validity of manifest variables,reliability of the latent variables(LVs),and overall SWB model indicating moderate predictiveness(GoF R^(2)=.476)by the LVs.Additionally,all of the direct path coefficients and indirect path coefficients that consisted of four partial mediators and one full mediator yielded statistically significant results via bootstrapping.Furthermore,path coefficients for utilization of emotion to life satisfaction for the cognitive exercise group were significantly higher than for the non-cognitive exercise group.The findings illustrated a good model fit for an exploratory SWB model that can predict an individual’s SWB,and cognitive and non-cognitive exercises had different effects on the individuals’SWB.展开更多
Transmission of plant viruses by phytophagous hemipteran insects encompasses complex interactions underlying a continuum of processes involved in virus acquisition, retention and inoculation combined with vector feedi...Transmission of plant viruses by phytophagous hemipteran insects encompasses complex interactions underlying a continuum of processes involved in virus acquisition, retention and inoculation combined with vector feeding behavior. Here, we investigated the effects of dietary pH on whitefly （Bemisia tabaci） feeding behavior and release of Lettuce infectious yellows virus （LIYV） virions retained in the vector＇s foregut. Electrical penetration graph analysis revealed that variables associated with whitefly probing and ingestion did not differ significantly in pH （4, 7.4, and 9） adjusted artificial diets. To investigate virus retention and release, whiteflies allowed to acquire LIYV virions in a pH 7.4 artificial diet were fed pH 4, 7.4, or 9 virion-free artificial （clearing） diets. Immunofluorescent localization analyses indicated that virions remained bound to the foreguts of approximately 20%-24% of vectors after they fed on each of the 3 pH- adjusted clearing diets. When RNA preparations from the clearing diets were analyzed by reverse transcription （RT） nested-PCR and, in some cases, real-time qPCR, successful amplification of LIYV-specific sequence was infrequent but consistently repeatable for the pH 7.4 diet but never observed for the pH 4 and 9 diets, suggesting a weak pH-dependent effect for virion release. Viruliferous vectors that fed on each of the 3 pH-adjusted clearing diets transmitted LIYV to virus-free plants. These results suggest that changes in pH values alone in artificial diet do not result in observable changes in whitefly feeding behaviors, an observation that marks a first in the feeding of artificial diet by whitefly vectors; and that there is a potential causal and contingent relationship between the pH in artificial diet and the release/inoculation of foregut bound virions.展开更多
基金Supported by Cleveland Clinic Florida Institution Review Committee
文摘AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307,200 pixel) and 150 HDC (792,576 pixels) in a community teaching hospital.RESULTS:A total of 900 colonoscopies were evaluated (mean age 56,46.8% men),450 with each resolution.Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P=0.42).There was no significant difference between the overall number of polyps,HDC (397) and SDC (410),detected among all patients examined,(P=0.73).One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P=0.82).There was no significant difference between HDC (M=0.41) and SDC (M=0.42) regarding adenomatous polyp (P=0.88) or advanced adenoma (P=0.56) detection rate among all patients examined.CONCLUSION:HDC did not improve yield of adenomatous polyp,advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.
文摘Background： The parent-to-child influences can be adaptive and contribute to the optimal psychological well-being and positive perception of the athlete. Contrary to the healthy parental involvement, a family can also have negative effects on an athlete development. The purpose of this study was to determine gender, father involvement, and mother involvement differences in the psychological profiles of collegiate freshmen athletes as measured by perfectionism, physical self-concept, and psychological well-being. Methods： Eighty-two male and 73 female collegiate freshmen responded to self-reported measures of family involvement, perfectionism, physical self-concept, and psychological well-being. Three separate 2 x 2 x 2 （gender x mother involvement x father involvement） factorial multivariate analysis of variance （MANOVAs） were carried out on the respective subscales from the reported measures. Results： There were significant differences for gender as well as father involvement in perfectionism （p 〈 0.01）. Freshmen females had lower concern over mistakes, and greater levels of organization as well as planfulness than males. Furthermore, freshmen athletes with high involved fathers showed greater levels of high standards for others as well as organization. Conclusion： Father involvement and mother involvement impact perfectionism, physical self-concept, and psychological well-being. perspective. extends through the freshmen year in college as shown in the athletes＇ Future research should develop better measures and utilize a family systems Copyright @ 2012, Shanghai University of Sport. Production and hosting by Elsevier B.V. All rights reserved
文摘Study Objective: Establish complications and risk factors that are associated with blind tube insertion, evaluate the validity of correct placement verification methods, establish the rationales supporting its employment by anesthesia providers, and describe various deployment facilitators described in current literature. Measurements: An exhaustive literature review of the databases Medline, CINAHL, Cochrane Collaboration, Scopus, and Google Scholar was performed applying the search terms “gastric tube”, “complications”, “decompression”, “blind insertion”, “perioperative”, “intraoperative” in various order sequences. A five-year limit was applied to limit the number and timeliness of articles selected. Main Results: Patients are exposed to potentially serious morbidity and mortality from blindly inserted gastric tubes. Risk factors associated with malposition include blind insertion, the presence of endotracheal tubes, altered sensorium, and previous tube misplacements. Pulmonary aspiration risk prevention remains the only indication for anesthesia-related intraoperative use. There are no singularly effective tools that predict or verify the proper placement of blindly inserted gastric tubes. Current placement facilitation techniques are perpetuated through anecdotal experience and technique variability warrants further study. Conclusion: In the absence of aspiration risk factors or the need for surgical decompression in ASA classification I & II patients, a moratorium should be instituted on the elective use of gastric tubes.
文摘BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common chronic liver disease in the United States and globally.The currently understood model of pathogenesis consists of a‘multiple hit’hypothesis in which environmental and genetic factors contribute to hepatic inflammation and injury.AIM To examine the genetic expression of NAFLD and non-alcoholic steatohepatitis(NASH)tissue samples to identify common pathways that contribute to NAFLD and NASH pathogenesis.METHODS We employed the Search Tag Analyze Resource for Gene Expression Omnibus platform to search the The National Center for Biotechnology Information Gene Expression Omnibus to elucidate NAFLD and NASH pathology.For NAFLD,we conducted meta-analysis of data from 58 NAFLD liver biopsies and 60 healthy liver biopsies;for NASH,we analyzed 187 NASH liver biopsies and 154 healthy liver biopsies.RESULTS Our results from the NAFLD analysis reinforce the role of altered metabolism,inflammation,and cell survival in pathogenesis and support recently described contributors to disease activity,such as altered androgen and long non-coding RNA activity.The top upstream regulator was found to be sterol regulatory element binding transcription factor 1(SREBF1),a transcription factor involved in lipid homeostasis.Downstream of SREBF1,we observed upregulation in CXCL10,HMGCR,HMGCS1,fatty acid binding protein 5,paternally expressed imprinted gene 10,and downregulation of sex hormone-binding globulin and insulin-like growth factor 1.These molecular changes reflect low-grade inflammation secondary to accumulation of fatty acids in the liver.Our results from the NASH analysis emphasized the role of cholesterol in pathogenesis.Top canonical pathways,disease networks,and disease functions were related to cholesterol synthesis,lipid metabolism,adipogenesis,and metabolic disease.Top upstream regulators included proinflammatory cytokines tumor necrosis factor and IL1B,PDGF BB,and beta-estradiol.Inhibition of beta-estradiol was shown to be related to derangement of several cellular downstream processes including metabolism,extracellular matrix deposition,and tumor suppression.Lastly,we found riciribine(an AKT inhibitor)and ZSTK-474(a PI3K inhibitor)as potential drugs that targeted the differential gene expression in our dataset.CONCLUSION In this study we describe several molecular processes that may correlate with NAFLD disease and progression.We also identified ricirbine and ZSTK-474 as potential therapy.
文摘BACKGROUND Hepatitis B virus(HBV) is a cause of hepatocellular carcinoma(HCC). Interestingly, this process is not necessarily mediated through cirrhosis and may in fact involve oncogenic processes. Prior studies have suggested specific oncogenic gene expression pathways were affected by viral regulatory proteins. Thus, identifying these genes and associated pathways could highlight predictive factors for HCC transformation and has implications in early diagnosis and treatment.AIM To elucidate HBV oncogenesis in HCC and identify potential therapeutic targets.METHODS We employed our Search, Tag, Analyze, Resource platform to conduct a meta-analysis of public data from National Center for Biotechnology Information’s Gene Expression Omnibus. We performed meta-analysis consisting of 155 tumor samples compared against 185 adjacent nontumor samples and analyzed results with ingenuity pathway analysis.RESULTS Our analysis revealed liver X receptors/retinoid X receptor(RXR) activation and farnesoid X receptor/RXR activation as top canonical pathways amongst others. Top upstream regulators identified included the Ras family gene rab-like protein 6(RABL6). The role of RABL6 in oncogenesis is beginning to unfold but its specific role in HBV-related HCC remains undefined. Our causal analysis suggests RABL6 mediates pathogenesis of HBV-related HCC through promotion of genes related to cell division, epigenetic regulation, and Akt signaling. We conducted survival analysis that demonstrated increased mortality with higher RABL6 expression. Additionally, homeobox A10(HOXA10) was a top upstream regulator and was strongly upregulated in our analysis. HOXA10 has recently been demonstrated to contribute to HCC pathogenesis in vitro. Our causal analysis suggests an in vivo role through downregulation of tumor suppressors and other mechanisms.CONCLUSION This meta-analysis describes possible roles of RABL6 and HOXA10 in the pathogenesis of HBV-related HCC. RABL6 and HOXA10 represent potential therapeutic targets and warrant further investigation.
文摘Nasotracheal intubation (NTI) is the most widely used method to establish an airway during anesthesia for oral surgery. It has the advantage of providing exceptional accessibility and optimal working conditions in the oral cavity for surgeons. Anesthesia providers are highly trained in managing and securing the airway. Because the oral intubation route is the most widely used technique for securing the airway, nasal intubation can be cumbersome for anesthetists who do not routinely perform this skill. Moreover, anesthesia providers who do not routinely perform NTI may feel apprehension out of concern for nasopharyngeal bleeding and trauma. The number of dental and oromaxillofacial procedures requiring nasal intubation has been steadily growing annually. Although NTI is generally safe, it still presents a risk for complications. The purpose of this literature review was to examine current literature and evidence-based practices of NTI to determine whether the use of a catheter-guided technique will improve patient care outcomes by way of decreased trauma to the airway compared to current clinical practices. The goal of this review is to recommend the use of a catheter-guided technique for NTI as the preferred method for securing the airway during oral surgery as it is less traumatizing to the airway than conventional methods.
文摘College students experience great stress due to many factors,such as an uncertain future,academic responsibilities,and pressures imposed by social communication.Many institutions of higher education are focusing on how to mediate stressful situations and increase the subjective well-being(SWB)of students to sustain a lifestyle focused on wellness.The online survey used for this study focused on testing an exploratory SWB model by implementing partial least squares structural equation modeling(PLS-SEM)techniques.The participants were 470 college-aged students enrolled in seven different institutions in six cities across China.Findings yielded a good model fit(the Standardized Root Mean Squared Residual[SRMR]=.054)with the validity of manifest variables,reliability of the latent variables(LVs),and overall SWB model indicating moderate predictiveness(GoF R^(2)=.476)by the LVs.Additionally,all of the direct path coefficients and indirect path coefficients that consisted of four partial mediators and one full mediator yielded statistically significant results via bootstrapping.Furthermore,path coefficients for utilization of emotion to life satisfaction for the cognitive exercise group were significantly higher than for the non-cognitive exercise group.The findings illustrated a good model fit for an exploratory SWB model that can predict an individual’s SWB,and cognitive and non-cognitive exercises had different effects on the individuals’SWB.
文摘Transmission of plant viruses by phytophagous hemipteran insects encompasses complex interactions underlying a continuum of processes involved in virus acquisition, retention and inoculation combined with vector feeding behavior. Here, we investigated the effects of dietary pH on whitefly （Bemisia tabaci） feeding behavior and release of Lettuce infectious yellows virus （LIYV） virions retained in the vector＇s foregut. Electrical penetration graph analysis revealed that variables associated with whitefly probing and ingestion did not differ significantly in pH （4, 7.4, and 9） adjusted artificial diets. To investigate virus retention and release, whiteflies allowed to acquire LIYV virions in a pH 7.4 artificial diet were fed pH 4, 7.4, or 9 virion-free artificial （clearing） diets. Immunofluorescent localization analyses indicated that virions remained bound to the foreguts of approximately 20%-24% of vectors after they fed on each of the 3 pH- adjusted clearing diets. When RNA preparations from the clearing diets were analyzed by reverse transcription （RT） nested-PCR and, in some cases, real-time qPCR, successful amplification of LIYV-specific sequence was infrequent but consistently repeatable for the pH 7.4 diet but never observed for the pH 4 and 9 diets, suggesting a weak pH-dependent effect for virion release. Viruliferous vectors that fed on each of the 3 pH-adjusted clearing diets transmitted LIYV to virus-free plants. These results suggest that changes in pH values alone in artificial diet do not result in observable changes in whitefly feeding behaviors, an observation that marks a first in the feeding of artificial diet by whitefly vectors; and that there is a potential causal and contingent relationship between the pH in artificial diet and the release/inoculation of foregut bound virions.
