Total pancreatectomy with islet autotransplantation (TPIAT) is used to treat debilitating chronic pancreatitis (CP) and acute recurrent pancreatitis (ARP) that has failed medical and endoscopic therapy. We performed a retrospective review of TPIAT patients at a free-standing children's hospital to evaluate perioperative outcomes.Twenty patients (median age 13, 65% female) underwent TPIAT (2015 through 2017).Of the 20 patients, 95% had CP and 1 patient (5%) had ARP alone. Seventy-five percent of the patients had a pancreatitis-associated genetic mutation; 40% had pancreas divisum. The median surgical time was 757 (IQR 657 to 835) minutes. Median islet equivalents per kg of body weight (IEQ/kg) were 6404 (IQR 5018 to 7554). At 90 days postoperatively vs preoperatively, significantly fewer patients were

Use of solar energy to convert the greenhouse gas CO2 into useful chemicals or fuels could not only reduce the accumulation of CO2 in the atmosphere but also provide a solution to sustainable energy development. There has been much interest in understanding the mechanistic role of graphene when added to semiconductor nanostructures to reduce CO2 because of the observation of enhanced photocatalytic activities in recent experiments. In this work, we investigate the adsorption and single-electron activation of CO2 on ZnO nanoclusters with and without a modified graphene support using a first-principles approach, with a special focus on the effect of the support. The formation of the CO2 – anion is identified under simulated photoexcitation conditions and is energetically more favorable than for previously studied oxide photocatalysts. The calculated results suggest that single-heteroatom doping in graphene has a significant impact on the catalytic activity of ZnO. The electronic coupling between the support and the semiconductor cluster plays a critical role in the activation of CO2 on the supported ZnO cluster. n-type doping helps to retain the photoexcited electron on ZnO and facilitates CO2 reduction on ZnO, whereas p-type doping enhances charge transfer from the photoexcited ZnO to graphene and would be useful for reductions occurring on graphene.

Nationwide databases have implicated an increased incidence of renal cell carcinoma (RCC). The Pennsylvania (PA) Cancer Registry was queried to better define incidence, geographic distribution, and statewide trends of new RCC cases over a 27-year period. JoinPoint Trend Analysis Software modeled average annual percent changes (APCs) in age-adjusted rates (AAR). Maps plotting county-level incidence rates and stage distribution of disease across the state in 5-year time intervals were created using R 4.0.2 software. Overall, 59,628 cases of RCC were recorded in PA from 1990 to 2017. Eighty six percent of patients were >50 years of age, 61% were males, and 89% were Caucasian. Stage distribution using the SEER staging system included 64% local, 17% regional, and 16% distant. Over the study interval, AAR of all RCC cases increased from 9.9 to 18.0 patients per 100,000 population with an APC of 2.3% (p < 0.01). AAR of local disease increased from 5.4 to 12.7 patients per 100,000 population with an APC of 3.2% (p < 0.01). AAR of regional disease also increased from 1.9 to 2.9 patients per 100,000 population with an APC of 1.0% (p = 0.01). Younger patients (<50 years) had a greater rate of increase than older counterparts (APC 3.8% vs. 2.0%, p < 0.05). Geospatial investigation of new RCC cases noted certain geographic concentrations of greater disease incidence. The incidence of RCC in PA has increased over the past 27 years in PA. One-third of the cases are regional or metastatic at presentation and rates of increase were most notable in younger patients.

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