Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.
Kashani, Arash;Holman, Benjamin William Behrens;Nichols, Peter David;Malau-Aduli, Aduli Enoch Othniel
Journal of Animal Science and Technology
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v.57
no.3
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pp.8.1-8.8
/
2015
Background: The demand for healthy, lean and consistent meat products containing low saturated fatty acid content and high quality polyunsaturated fatty acids (PUFA), especially long-chain (${\geq}C_{20}$) omega-3 PUFA, has increased in recent times. Fat deposition is altered by both the genetic background and dietary supplements, and this study aimed to assess the effect of dietary Spirulina supplementation levels on the mRNA expression patterns of genes controlling lipid metabolism in the subcutaneous adipose tissue (SAT) and Longissimus dorsi (ld) muscle of Australian crossbred sheep. Methods: Twenty-four weaned lambs belonging to four breeds under the same management conditions were maintained on ryegrass pasture and fed three levels of Spirulina supplement (control, low and high). In terms of nutrient composition, Spirulina is a nutrient-rich supplement that contains all essential amino acids, vitamins and minerals. It also is a rich source of carotenoids and fatty acids, especially gamma-linolenic acid (GLA) that infer health benefits. After slaughter, subcutaneous adipose tissue (SAT) and ld samples were subjected to mRNA extraction and reverse transcription using quantitative polymerase chain reaction (RT-qPCR) to assess the mRNA expression levels of the Aralkylamine N-acetyltransferase (AANAT), Adrenergic beta-3 receptor (ADRB3), B-cell translocation gene 2 (BTG2) and Fatty acid synthase (FASN) genes, which are associated with lipid metabolism. Results: Both low and high Spirulina supplementation levels strongly up-regulated the transcription of all the selected genes in both SAT and ld tissues (mostly in the subcutaneous adipose), but sheep breed and sex did not influence the gene expression patterns in these tissues. Conclusions: The evidence indicates that high Spirulina supplementation level resulted in a decrease in intramuscular fat content in Australian purebred and crossbred sheep due to the enhanced production of melatonin in sheep muscle tissues and strong up-regulation of mRNA expression of BTG2 in SAT which negatively affected fat deposition. In contrast, low Spirulina supplementation level strongly up-regulated the ADRB3 and FASN genes responsible for fat production. These findings are consistent with the observed phenotypic data suggesting that low Spirulina supplementation level can increase lamb production, with higher long-chain PUFA content.
Zuh, Cephas Kwesi;Abobi, Seth Mensah;Campion, Benjamin Betey
Fisheries and Aquatic Sciences
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v.22
no.12
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pp.31.1-31.12
/
2019
Background: The black-chinned tilapia, Sarotherodon melanotheron, is the most abundant fish species in the Nakwa (an open lagoon) and Brenu (a closed lagoon) in the Central Region of Ghana. Aspects of the life history characteristics and the ecology of the fish populations in both lagoons were studied to assess the bio-ecological status of this important resource. Methods: Fish samples were obtained from fishermen that fish on the Nakwa and Brenu lagoons using cast, drag and gill nets. The age of the fish was assessed from otoliths analysis and its growth modelled following the von Bertalanffy growth function. Morphometric characteristics of the fish populations were analysed using power regression and ANOVA for parameters comparisons, and Student's t test to determine whether species grew isometrically. The percentage occurrence method was used to analyse the stomach contents of the fish. Results: A total of 382 fish samples from both lagoons were measured, comprising 209 from Nakwa lagoon and 176 from Brenu lagoon. The size and weight of fish samples ranged between 3.9-11.5 cm total length and 1.0-27.3 g for Nakwa Lagoon and 5.6-12.8 cm total length and 3.2-29.8 g for the Brenu Lagoon. The estimated von Bertalanffy growth parameters were L∞ = 12.04 cm and K = 2.76/year for the Nakwa Lagoon samples and L∞ = 13.44 cm and K = 3.27/year for Brenu Lagoon samples. Daily otolith incremental rate ranged from 0.01-0.03 mm per day to 0.01-0.02 mm per day for Nakwa and Brenu lagoons, respectively. Stomach content analysis of the fish samples revealed that the species are planktivorous and the range of food varied between the lagoons. Green algae were the most prevalent food item in the stomachs of the fish samples from Nakwa with the frequency of 69% whilst diatoms (80.5%) were most prevalent phytoplanktonic food item for the fish in Brenu lagoon. Conclusions: The estimates of asymptotic length for the species in both lagoons are close to known values of the species length at first sexual maturity and points to intensive fishing pressure. As a consequence, a comprehensive sample-based survey is required in both lagoons to derive estimates of management reference points. The results of the stomach content analysis are beneficial to the construction of diet matrix for ecosystem models of the two systems.
Hongu, Nobuko;Pope, Benjamin T.;Bilgic, Pelin;Orr, Barron J.;Suzuki, Asuka;Kim, Angela Sarah;Merchant, Nirav C.;Roe, Denise J.
Nutrition Research and Practice
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v.9
no.2
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pp.207-212
/
2015
BACKGROUND/OBJECTIVES: The Recaller app was developed to help individuals record their food intakes. This pilot study evaluated the usability of this new food picture application (app), which operates on a smartphone with an embedded camera and Internet capability. SUBJECTS/METHODS: Adults aged 19 to 28 years (23 males and 22 females) were assigned to use the Recaller app on six designated, nonconsecutive days in order to capture an image of each meal and snack before and after eating. The images were automatically time-stamped and uploaded by the app to the Recaller website. A trained nutritionist administered a 24-hour dietary recall interview 1 day after food images were taken. Participants' opinions of the Recaller app and its usability were determined by a follow-up survey. As an evaluation indicator of usability, the number of images taken was analyzed and multivariate Poisson regression used to model the factors determining the number of images sent. RESULTS: A total of 3,315 food images were uploaded throughout the study period. The median number of images taken per day was nine for males and 13 for females. The survey showed that the Recaller app was easy to use, and 50% of the participants would consider using the app daily. Predictors of a higher number of images were as follows: greater interval (hours) between the first and last food images sent, weekend, and female. CONCLUSIONS: The results of this pilot study provide valuable information for understanding the usability of the Recaller smartphone food picture app as well as other similarly designed apps. This study provides a model for assisting nutrition educators in their collection of food intake information by using tools available on smartphones. This innovative approach has the potential to improve recall of foods eaten and monitoring of dietary intake in nutritional studies.
Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.
Lee, Hye-Jeong;Kim, Ji Young;Park, Ji Eun;Yoon, Yong-Dal;Tsang, Benjamin K.;Kim, Jong-Min
Development and Reproduction
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v.20
no.4
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pp.315-329
/
2016
Fas ligand (FasL) and its receptor Fas have been implicated in granulosa cell apoptosis during follicular atresia. Although interferon-gamma (IFN-${\gamma}$) is believed to be involved in the regulation Fas expression in differentiated granulosa or granulosa-luteal cells, the expression of this cytokine and its role in the regulation of the granulosa cell Fas/FasL system and apoptosis during follicular maturation have not been thoroughly investigated. In the present study, we have examined the presence of IFN-${\gamma}$ in ovarian follicles at different stage of development by immunohistochemistry and related their relative intensities with follicular expression of Fas and FasL, and with differences in granulosa cell sensitivity to Fas activation by exogenous agonistic Anti-Fas monoclonal antibody (Fas mAb). Although IFN-${\gamma}$ immunostaining was detectable in oocyte and granulosa cells in antral follicles, most intense immunoreactivity for the cytokine was observed in these cells of preantral follicles. Intense immunoreactivity for IFN-${\gamma}$ was most evident in granulosa cells of atretic early antral follicles where increased Fas and FasL expression and apoptosis were also observed. Whereas low concentrations of IFN-${\gamma}$ (10-100 U/mL) significantly increased Fas expression in undifferentiated granulosa cells (from preantral or very early antral follicles) in vitro, very higher concentrations (${\geq}1,000U/mL$) were required to up-regulate of Fas in differentiated cells isolated from eCG-primed (antral) follicles. Addition of agonistic Fas mAb to cultures of granulosa cells at the two stages of differentiation and pretreated with IFN-${\gamma}$ (100 U/mL) elicited morphological and biochemical apoptotic features which were more prominent in cells not previously exposed to the gonadotropin in vivo. These findings suggested that IFN-${\gamma}$ is an important physiologic intra-ovarian regulator of follicular atresia and plays a pivotal role in regulation of expression of Fas receptor and subsequent apoptotic response in undifferentiated (or poorly differentiated) granulosa cells at an early (penultimate) stage of follicular development.
This research proposes a suitable classification and analysis standard for digital exhibition to analyze digital exhibition. Through the previous studies on digital exhibition classification, the necessity of the new standard is suggested and the analysis standard which can be easily applied to the change of concept and form of the newly emerging digital exhibition is established. Digital exhibition should take into account the elements of audience participation that naturally arise from exhibition planning and interactive storytelling format. Classification and analysis of existing digital exhibition spaces are conceptual classification based on keywords. This is because traditional exhibition methodology has been applied in the process of classifying exhibitions and works. However, in digital exhibitions, the interactive aspect between exhibition space, works, and visitors become so important that it is necessary to perform a performative classification between the works and the audience in the digital exhibition. Accordingly, the way of participating directly or indirectly in the exhibition classification should be considered based on what the audience feel. In this research, the interpretation of the classification and composition of the exhibition is based on Benjamin's argument which the classification of the sensory experience of the audience and 'Aktualisierung' closely related to the interaction with the audience. We also present analysis standard for digital exhibition according to the structure of the art exhibition narrative based on the narrative structure of Chatman. This classification methodology will provide the exhibition information in a way that can be easily understood by the visitors and it will be a precedent research that secures the expansion and accessibility of the digital exhibition.
Animation is showing the highest record in entertainment around the world and writing the history of 3D animation again. The image contents effect thanks to the proper introduction of the state-of-art digital technology, which is one of the causes of the outstanding entertainment and the factual reproduction of the images, provided an opportunity to transmit the meaning of image aesthetics, which is a virtual reality and image reproduction through the reality realization of photo medium, and to reinterpret the boundary of virtual reality. Especially, the development of digital contents technology due to scientific technologies demolishes the boundary of virtual reality and reality and creates the effect of making viewers be absorbed by realizing the virtual reality by means of 3D reality images which highlight the special characteristic of photos. The aspect of the contents technology and image aesthetics which can be interpreted in a view point beyond the existing concept of reality is found in the aura theory of Benjamin and in the Simulacres of Baudrillard. The 3D image by photo-reality herein presents various suggestions in the aspect of real existence of spatial expression, the meaning creation process of reality, the existence value of virtual images.
In this essay, I examine the interactions of chronotopes in the narrative of Gangnam Blues, a film written and directed by Yu Ha and released in 2015. Bakhtin's chronotope, the connectedness of temporal and spatial relationships in literary narratives, provides the background for the representability of events and becomes the organizing center for the events. Each chronotope offers a different way of acting, interacting and understanding experience, and chronotopes can interact with each other in a single text or between the reader and the represented world. Gangnam Blues is a gangster movie, first of all, showing an individual's illusion of an unlimited possibility for achieving wealth and power. At the same time, the film describes the government's project to transform Gangam, a rural area in the south of the Han, into a new downtown and residential area for Seoul. As the world in the narrative and the world of the author or the reader are all chronotopic, we can see the interactions of chronotopes between the narrative of an individual and the historical narrative, as well as between the narrative about the beginning of Gangnam and the audience's perception of the present Gangnam. In this film, the main character's ambition is shown as part of the social desire for rapid economic achievements in the 1970s, along with high social mobility. The social desire can be explained as envy, as it is fueled by social comparisons and competitions. The main character's pursuit of money and power through the possession of Gangnam land overlaps with the envious desire for the present Gangnam shared by many. The individual's exceptional ambition and violence are not fully examined in this text. Moreover, the film's dependence on the feelings of envy to represent the individual's choice and violence can be a symptom of the lack of critical distance from social desire and envy.
Social TV users and content are increasing day by day. The main purpose was to study the motivation for social television users, but I felt the need to analyze the potential psychological impact of users in various content. This study analyzed the impact on psychological well-being due to the interaction and viewing satisfaction by the object relations theory factors of social TV user in Korea. A survey was conducted on students of N university, ordinary university, and ordinary people who have experience using social TV to prove the observations or experiments of empirical facts in this study. Research result, First, Nonalienation have been have a positive effect on interaction and viewing satisfaction. Second, stable attachment have been have a positive effect on interaction. Third, social competence have been have a positive effect on interaction. Fourth, interaction have been have a positive effect on viewing satisfaction and psychological well-being. Fifth viewing satisfaction have been have a positive effect on Psychological well-being. Through this, This will contribute to the development of subdivided content and user-customized services for social television, and it is necessary to reconfigure and study various events that may occur between users in the future.
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