| 1. |
- Asbun, H.J., et al.
(författare)
-
The Miami International Evidence-based Guidelines on Minimally Invasive Pancreas Resection
- 2020
-
Ingår i: Annals of Surgery. - : Lippincott Williams and Wilkins. - 0003-4932 .- 1528-1140. ; 271:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to develop and externally validate the first evidence-based guidelines on minimally invasive pancreas resection (MIPR) before and during the International Evidence-based Guidelines on Minimally Invasive Pancreas Resection (IG-MIPR) meeting in Miami (March 2019).Summary Background Data: MIPR has seen rapid development in the past decade. Promising outcomes have been reported by early adopters from high-volume centers. Subsequently, multicenter series as well as randomized controlled trials were reported; however, guidelines for clinical practice were lacking. Methods: The Scottisch Intercollegiate Guidelines Network (SIGN) methodology was used, incorporating these 4 items: systematic reviews using PubMed, Embase, and Cochrane databases to answer clinical questions, whenever possible in PICO style, the GRADE approach for assessment of the quality of evidence, the Delphi method for establishing consensus on the developed recommendations, and the AGREE-II instrument for the assessment of guideline quality and external validation. The current guidelines are cosponsored by the International Hepato-Pancreato-Biliary Association, the Americas Hepato-Pancreato-Biliary Association, the Asian-Pacific Hepato-Pancreato-Biliary Association, the European-African Hepato-Pancreato-Biliary Association, the European Association for Endoscopic Surgery, Pancreas Club, the Society of American Gastrointestinal and Endoscopic Surgery, the Society for Surgery of the Alimentary Tract, and the Society of Surgical Oncology. Results: After screening 16,069 titles, 694 studies were reviewed, and 291 were included. The final 28 recommendations covered 6 topics; laparoscopic and robotic distal pancreatectomy, central pancreatectomy, pancreatoduodenectomy, as well as patient selection, training, learning curve, and minimal annual center volume required to obtain optimal outcomes and patient safety.Conclusion: The IG-MIPR using SIGN methodology give guidance to surgeons, hospital administrators, patients, and medical societies on the use and outcome of MIPR as well as the approach to be taken regarding this challenging type of surgery. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Hrdina, Amy, et al.
(författare)
-
The role of coarse aerosol particles as a sink of HNO3 in wintertime pollution events in the Salt Lake Valley
- 2021
-
Ingår i: Atmospheric Chemistry and Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 21:10, s. 8111-8126
-
Tidskriftsartikel (refereegranskat)abstract
- Wintertime ammonium nitrate (NH4NO3) pollution events burden urban mountain basins around the globe. In the Salt Lake Valley of Utah in the United States, such pollution events are often driven by the formation of persistent cold-air pools (PCAPs) that trap emissions near the surface for several consecutive days. As a result, secondary pollutants including fine particulate matter less than 2.5 um in diameter (PM2:5), largely in the form of NH4NO3, build up during these events and lead to severe haze. As part of an extensive measurement campaign to understand the chemical processes underlying PM2:5 formation, the 2017 Utah Winter Fine Particulate Study, water-soluble trace gases and PM2:5 constituents were continuously monitored using the ambient ion monitoring ion chromatograph (AIM-IC) system at the University of Utah campus. Gas-phase NH3, HNO3, HCl, and SO2 along with particulate NHC 4 , NaC, KC, Mg2C, Ca2C, NO3 , Cl, and SO2 4 were measured from 21 January to 21 February 2017. During the two PCAP events captured, the fine particulate matter was dominated by secondary NH4NO3. The comparison of total nitrate (HNO3 CPM2:5 NO3 ) and total NHx (NH3 CPM2:5 NHC 4 ) showed NHx was in excess during both pollution events. However, chemical composition analysis of the snowpack during the first PCAP event revealed that the total concentration of deposited NO3 was nearly 3 times greater than that of deposited NHC 4 . Daily snow composition measurements showed a strong correlation between NO3 and Ca2C in the snowpack. The presence of non-volatile salts (NaC, Ca2C, and Mg2C), which are frequently associated with coarse-mode dust, was also detected in PM2:5 by the AIM-IC during the two PCAP events, accounting for roughly 5% of total mass loading. The presence of a significant particle mass and surface area in the coarse mode during the first PCAP event was indicated by size-resolved particle measurements from an aerodynamic particle sizer. Taken together, these observations imply that atmospheric measurements of the gas-phase and fine-mode particle nitrate may not represent the total burden of nitrate in the atmosphere, implying a potentially significant role for uptake by coarse-mode dust. Using the NO3 :NHC 4 ratio observed in the snowpack to estimate the proportion of atmospheric nitrate present in the coarse mode, we estimate that the amount of secondary NH4NO3 could double in the absence of the coarse-mode sink. The underestimation of total nitrate indicates an incomplete account of the total oxidant production during PCAP events. The ability of coarse particles to permanently remove HNO3 and influence PM2:5 formation is discussed using information about particle composition and size distribution.
|
|
