Prediction of Discharge Status and Readmissions after Resection of Intradural Spinal Tumors

Michael C. Jin,Allen L. Ho,Austin Y. Feng,Zachary A. Medress,Arjun V. Pendharkar,Paymon Rezaii,John K. Ratliff,Atman M. Desai 대한척추신경외과학회 2022 Neurospine Vol.19 No.1

Objective: Intradural spinal tumors are uncommon and while associations between clinical characteristics and surgical outcomes have been explored, there remains a paucity of literature unifying diverse predictors into an integrated risk model. To predict postresection outcomes for patients with spinal tumors. Methods: IBM MarketScan Claims Database was queried for adult patients receiving surgery for intradural tumors between 2007 and 2016. Primary outcomes-of-interest were nonhome discharge and 90-day postdischarge readmissions. Secondary outcomes included hospitalization duration and postoperative complications. Risk modeling was developed using a regularized logistic regression framework (LASSO, least absolute shrinkage and selection operator) and validated in a withheld subset. Results: A total of 5,060 adult patients were included. Most surgeries utilized a posterior approach (n = 5,023, 99.3%) and tumors were most commonly found in the thoracic region (n = 1,941, 38.4%), followed by the lumbar (n = 1,781, 35.2%) and cervical (n = 1,294, 25.6%) regions. Compared to models using only tumor-specific or patient-specific features, our integrated models demonstrated better discrimination (area under the curve [AUC] [nonhome discharge] = 0.786; AUC [90-day readmissions] = 0.693) and accuracy (Brier score [nonhome discharge] = 0.155; Brier score [90-day readmissions] = 0.093). Compared to those predicted to be lowest risk, patients predicted to be highest-risk for nonhome discharge required continued care 16.3 times more frequently (64.5% vs. 3.9%). Similarly, patients predicted to be at highest risk for postdischarge readmissions were readmitted 7.3 times as often as those predicted to be at lowest risk (32.6% vs. 4.4%). Conclusion: Using a diverse set of clinical characteristics spanning tumor-, patient-, and hospitalization-derived data, we developed and validated risk models integrating diverse clinical data for predicting nonhome discharge and postdischarge readmissions.

Measuring the competition between bimolecular charge recombination and charge transport in organic solar cells under operating conditions

Heiber, Michael C.,Okubo, Takashi,Ko, Seo-Jin,Luginbuhl, Benjamin R.,Ran, Niva A.,Wang, Ming,Wang, Hengbin,Uddin, Mohammad Afsar,Woo, Han Young,Bazan, Guillermo C.,Nguyen, Thuc-Quyen The Royal Society of Chemistry 2018 ENERGY AND ENVIRONMENTAL SCIENCE Vol.11 No.10

<P>The rational design of new high performance materials for organic photovoltaic (OPV) applications is largely inhibited by a lack of design rules for materials that have slow bimolecular charge recombination. Due to the complex device physics present in OPVs, rigorous and reliable measurement techniques for charge transport and charge recombination are needed to construct improved physical models that can guide materials development and discovery. Here, we develop a new technique called impedance-photocurrent device analysis (IPDA) to quantitatively characterize the competition between charge extraction and charge recombination under steady state operational conditions. The measurements are performed on actual lab scale solar cells, have mild equipment requirements, and can be integrated into normal device fabrication and testing workflows. We perform IPDA tests on a broad set of devices with varying polymer:fullerene blend chemistry and processing conditions. Results from the IPDA technique exhibit significantly improved reliability and self-consistency compared to the open-circuit voltage decay technique (OCVD). IPDA measurements also reveal a significant negative electric field dependence of the bimolecular recombination coefficient in high fill factor devices, a finding which is inaccessible to most other common techniques and indicates that many of these techniques may overestimate the value that is most relevant for describing device performance. Future work utilizing IPDA to build structure-property relationships for bimolecular recombination will lead to enhanced design rules for creating efficient OPVs that are suitable for commercialization.</P>

The use of poly-cation oxides to lower the temperature of two-step thermochemical water splitting

Zhai, Shang,Rojas, Jimmy,Ahlborg, Nadia,Lim, Kipil,Toney, Michael F.,Jin, Hyungyu,Chueh, William C.,Majumdar, Arun The Royal Society of Chemistry 2018 ENERGY AND ENVIRONMENTAL SCIENCE Vol.11 No.8

<P>We report the discovery of a new class of oxides - poly-cation oxides (PCOs) - that consist of multiple cations and can thermochemically split water in a two-step cycle to produce hydrogen (H2) and oxygen (O2). Specifically, we demonstrate H2 yields of 10.1 ± 0.5 mL-H2 per g and 1.4 ± 0.5 mL-H2 per g from (FeMgCoNi)Ox (<I>x</I> ≈ 1.2) with thermal reduction temperatures of 1300 °C and 1100 °C, respectively, and also with background H2 during the water splitting step. Remarkably, these capacities are mostly higher than those from measurements and thermodynamic analysis of state-of-the-art materials such as (substituted) ceria and spinel ferrites. Such high-performance two-step cycles ≤1100 °C are practically relevant for today's chemical infrastructure at large scale, which relies almost exclusively on thermochemical transformations in this temperature regime. It is likely that PCOs with complex cation compositions will offer new opportunities for both fundamental investigations of redox thermochemistry as well as scalable H2 production using infrastructure-compatible chemical systems.</P>

Outcomes of Infected versus Symptomatic Sterile Walled-Off Pancreatic Necrosis Treated with a Minimally Invasive Therapy

( Jong Jin Hyun ),( Nadav Sahar ),( Anand Singla ),( Andrew S Ross ),( Shayan S Irani ),( S Ian Gan ),( Michael C Larsen ),( Richard A Kozare ),( Michael Gluck ) 대한소화기학회 2019 Gut and Liver Vol.13 No.2

Background/Aims: Acute pancreatitis complicated by walled-off necrosis (WON) is associated with high morbidity and mortality, and if infected, typically necessitates intervention. Clinical outcomes of infected WON have been described as poorer than those of symptomatic sterile WON. With the evolution of minimally invasive therapy, we sought to compare outcomes of infected to symptomatic sterile WON. Methods: We performed a retrospective cohort study examining patients who were undergoing dual-modality drainage as minimally invasive therapy for WON at a high-volume tertiary pancreatic center. The main outcome measures included mortality with a drain in place, length of hospital stay, admission to intensive care unit, and development of pancreatic fistulae. Results: Of the 211 patients in our analysis, 98 had infected WON. The overall mortality rate was 2.4%. Patients with infected WON trended toward higher mortality although not statistically significant (4.1% vs 0.9%, p=0.19). Patients with infected WON had longer length of hospitalization (29.8 days vs 17.3 days, p<0.01), and developed more spontaneous pancreatic fistulae (23.5% vs 7.8%, p<0.01). Multivariate analysis showed that infected WON was associated with higher odds of spontaneous pancreatic fistula formation (odds ratio, 2.65; 95% confidence interval, 1.20 to 5.85). Conclusions: This study confirms that infected WON has worse outcomes than sterile WON but also demonstrates that WON, once considered a significant cause of death, can be treated with good outcomes using minimally invasive therapy. (Gut Liver 2019;13:215-222)

Piperlongumine decreases cell proliferation and the expression of cell cycle-associated proteins by inhibiting Akt pathway in human lung cancer cells

Seok, Jin Sil,Jeong, Chang Hee,Petriello, Michael C.,Seo, Han Geuk,Yoo, Hyunjin,Hong, Kwonho,Han, Sung Gu Elsevier 2018 Food and chemical toxicology Vol.111 No.-

<P><B>Abstract</B></P> <P>Piperlongumine (PL) is an alkaloid of a pepper plant found in Southeast Asia. PL is known to induce selective toxicity towards a variety of cancer cell types. To explore the possible anti-lung cancer effects of PL, A549 cells were treated with PL (0–40 μM) for 24 h. Alterations in the expression of cell cycle-associated proteins (cyclin D1, cyclin-dependent kinase 4 (CDK4), CDK6 and retinoblastoma (Rb)) and intracellular signaling molecules (extracellular signal receptor-activated kinase 1/2 (ERK1/2), Akt, p38 and nuclear factor-κB (NF-κB)) were examined in cells following treatment of PL using Western blot analysis. Results showed that proliferation of cells were significantly decreased by PL in a dose-dependent manner. Flow cytometry results demonstrated increased number of cells in G1 phase in PL (40 μM)-treated group. Reactive oxygen species was significantly increased in cells treated with PL at 20–40 μM. The expression of cyclin D1, CDK4, CDK6 and p-Rb were markedly decreased in cells treated with PL at 40 μM. Treatment of cells with PL suppressed phosphorylation of Akt but increased ERK1/2 phosphorylation. Treatment of PL significantly decreased nuclear translocation of NF-κB p65 in cells. These results suggest that PL possesses antiproliferative properties in A549 cells.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Piperlongumine decreases proliferation of A549 cells. </LI> <LI> The mechanism is through ROS generation and downregulated Akt pathway. </LI> <LI> Piperlongumine decreases protein expression of cycle-associated proteins. </LI> </UL> </P>

Electron delocalization and charge mobility as a function of reduction in a metal–organic framework

Aubrey, Michael L.,Wiers, Brian M.,Andrews, Sean C.,Sakurai, Tsuneaki,Reyes-Lillo, Sebastian E.,Hamed, Samia M.,Yu, Chung-Jui,Darago, Lucy E.,Mason, Jarad A.,Baeg, Jin-Ook,Grandjean, Fernande,Long, Ga Nature Publishing Group UK 2018 Nature Materials Vol.17 No.7

<P>Conductive metal-organic frameworks are an emerging class of three-dimensional architectures with degrees of modularity, synthetic flexibility and structural predictability that are unprecedented in other porous materials. However, engendering long-range charge delocalization and establishing synthetic strategies that are broadly applicable to the diverse range of structures encountered for this class of materials remain challenging. Here, we report the synthesis of KxFe2(BDP)(3) (0 <= x <= 2; BDP2- =1,4-benzenedipyrazolate), which exhibits full charge delocalization within the parent framework and charge mobilities comparable to technologically relevant polymers and ceramics. Through a battery of spectroscopic methods, computational techniques and single-microcrystal field-effect transistor measurements, we demonstrate that fractional reduction of Fe-2(BDP)(3) results in a metal-organic framework that displays a nearly 10,000-fold enhancement in conductivity along a single crystallographic axis. The attainment of such properties in a KxFe2(BDP)(3) field-effect transistor represents the realization of a general synthetic strategy for the creation of new porous conductor-based devices.</P>

Incidence and Significance of Biliary Stricture in Chronic Pancreatitis Patients Undergoing Extracorporeal Shock Wave Lithotripsy for Obstructing Pancreatic Duct Stones

( Jong Jin Hyun ),( Shayan S. Irani ),( Andrew S. Ross ),( Michael C. Larsen ),( Michael Gluck ),( Richard A. Kozarek ) 대한소화기학회 2021 Gut and Liver Vol.15 No.1

Background/Aims: This study assessed the significance of biliary stricture in symptomatic chronic pancreatitis patients requiring extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde cholangiopancreatography (ERCP) to remove obstructing pancreatic calculi. Methods: A total of 97 patients underwent ESWL followed by ERCP to remove pancreatic calculi between October 2014 and October 2017 at Virginia Mason Medical Center. Significant biliary stricture (SBS) was defined as a stricture with upstream dilation on computed tomography scan or magnetic resonance cholangiopancreatography scans accompanied by cholestasis and/or cholangitis. SBS was initially managed by either a plastic stent or fully covered self-expandable metallic stent (fcSEMS). If the stricture did not resolve, the stent was replaced with either multiple plastic stents or another fcSEMS. Data were collected by retrospectively reviewing the medical records. Results: Biliary strictures were noted in approximately one-third of patients (34/97, 35%) undergoing ESWL for pancreatic calculi. Approximately one-third of the biliary strictures (11/34, 32%) were SBS. Pseudocysts were more frequently found in those with SBS (36% vs 8%, p=0.02), and all pseudocysts in the SBS group were located in the pancreatic head. The initial stricture resolution rates with fcSEMSs and plastic prostheses were 75% and 29%, respectively. The overall success rate for stricture resolution was 73% (8/11), and the recurrence rate after initial stricture resolution was 25% (2/8). Conclusions: Although periductal fibrosis is the main mechanism underlying biliary stricture development in chronic pancreatitis, inflammation induced by obstructing pancreatic calculi, including pseudocysts, is an important contributing factor to SBS formation during the acute phase. (Gut Liver 2021;15:128-134)

Sonication-assisted water extract of Dendronephthya gigantea exhibits anti-fine dust effects; suppression of MAPK phosphorylation in Raw 264.7 macrophages

Mihidukulasuriya Jude Michael,Dineth Pramuditha Nagahawatta,Nisansala Madushani Liyanage,Henarath Hetthi Arachchilage C,Rajasinghe Peli Gedara Sewwand,Hyo-Geun Lee,Sang-Woon Lee,You-Jin Jeon 한국식품영양과학회 2022 한국식품영양과학회 학술대회발표집 Vol.2022 No.10

OGLE-2019-BLG-0362Lb: A Super-Jovian-Mass Planet around A Low-Mass Star

정선주,Jennifer C. Yee,Andrej Udalski,Andrew Gould,Michael D. Albrow,정연길,황규하,CHEONGHOHAN,Yoon-Hyun Ryu,신인구,Yossi Shvartzvald,Weicheng Zang,차상목,Dong Jin Kim,김승리,이충욱,Dong-Joo Lee,이용석,Byeong-Gon Park,Richar 한국천문학회 2022 Journal of The Korean Astronomical Society Vol.55 No.4

We present the analysis of a planetary microlensing event OGLE-2019-BLG-0362 with a short-duration anomaly (~0.4 days) near the peak of the light curve, which is caused by the resonant caustic. The event has a severe degeneracy with $\delcs = 0.9$ between the close and the wide binary lens models both with planet-host mass ratio $q \simeq 0.007$. We measure the angular Einstein radius but not the microlens parallax, and thus we perform a Bayesian analysis to estimate the physical parameters of the lens. We find that the OGLE-2019-BLG-0362L system is a super-Jovian-mass planet $M_{\rm p}=3.26^{+0.83}_{-0.58}~M_{\rm J}$ orbiting an M dwarf $M_{\rm h}=0.42^{+0.34}_{-0.23}~M_{\odot}$ at a distance $D_{\rm L} =5.83^{+1.04}_{-1.55}$ kpc. The projected star-planet separation is $a_{\perp} = 2.18^{+0.58}_{-0.72}~{\rm AU}$, which indicates that the planet lies beyond the snow line of the host star.

Mortality among Pesticide Applicators Exposed to Chlorpyrifos in the Agricultural Health Study

Lee, Won Jin,Alavanja, Michael C.R.,Hoppin, Jane A.,Rusiecki, Jennifer A.,Kamel, Freya,Blair, Aaron,Sandler, Dale P. U.S. Dept. of Health, Education, and Welfare, Publ 2007 Environmental health perspectives Vol. No.

<P><B>Background</B></P><P>Chlorpyrifos is one of the most widely used organophosphate insecticides in the United States. Although the toxicity of chlorpyrifos has been extensively studied in animals, the epidemiologic data are limited.</P><P><B>Objective</B></P><P>To evaluate whether agricultural chlorpyrifos exposure was associated with mortality, we examined deaths among pesticide applicators in the Agricultural Health Study, a prospective study of licensed pesticide applicators in Iowa and North Carolina.</P><P><B>Methods</B></P><P>A total of 55,071 pesticide applicators were included in this analysis. Detailed pesticide exposure data and other information were obtained from self-administered questionnaires completed at the time of enrollment (1993–1997). Lifetime chlorpyrifos use was divided into tertiles. Poisson regression analysis was used to evaluate the exposure–response relationships between chlorpyrifos use and causes of death after adjustment for potential confounders.</P><P><B>Results</B></P><P>A total of 1,851 deaths (588 among chlorpyrifos users) were observed during the study period, 1993–2001. The relative risk (RR) of death from all causes combined among applicators exposed to chlorpyrifos was slightly lower than that for nonexposed applicators (RR = 0.90; 95% confidence interval, 0.81–1.01). For most causes of death analyzed, there was no evidence of an exposure–response relationship. However, the relative risks for mortality from suicide and non-motor-vehicle accidents were increased 2-fold in the highest category of chlorpyrifos exposure days.</P><P><B>Conclusions</B></P><P>Our findings of a possible association between chlorpyrifos use and external causes of death were based on small numbers. However, the findings may reflect a link between chlorpyrifos and depression or other neurobehavioral symptoms that deserves further evaluation.</P>