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Incidence, risk factors and clinical outcome of multidrug-resistant organisms after heart transplantation

World Journal of Transplantation 2024年第2期14卷 107-118页

作者： Sophia Hatzianastasiou Paraskevas Vlachos Georgios Stravopodis Dimitrios Elaiopoulos Afentra Koukousli Josef Papaparaskevas Themistoklis Chamogeorgakis Kyrillos Papadopoulos Theodora Soulele Despoina Chilidou Kyriaki Kolovou Aggeliki Gkouziouta michail Bonios Stamatios Adamopoulos Stavros Dimopoulos Microbiology Department and Infection Control Office Onassis Cardiac Surgery CenterAthens 17674Greece Heart Transplantation Unit Onassis Cardiac Surgery CenterAthens 17674Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUND Transplant recipients commonly harbor multidrug-resistant organisms(MDROs),as a result of frequent hospital admissions and increased exposure to antimi-crobials and invasive *** To investigate the impact of patient demographic and clinical characteristics on MDRO acquisition,as well as the impact of MDRO acquisition on intensive care unit(ICU)and hospital length of stay,and on ICU mortality and 1-year mortality post heart *** This retrospective cohort study analyzed 98 consecutive heart transplant patients over a ten-year period(2013-2022)in a single transplantation *** was collected regarding MDROs commonly encountered in critical *** Among the 98 transplanted patients(70%male),about a third(32%)acquired or already harbored MDROs upon transplantation(MDRO group),while two thirds did not(MDRO-free group).The prevalent MDROs were Acinetobacter baumannii(14%),Pseudomonas aeruginosa(12%)and Klebsiella pneumoniae(11%).Compared to MDRO-free patients,the MDRO group was characterized by higher body mass index(P=0.002),higher rates of renal failure(P=0.017),primary graft dysfunction(10%vs 4.5%,P=0.001),surgical re-exploration(34%vs 14%,P=0.017),mechanical circulatory support(47%vs 26%P=0.037)and renal replacement therapy(28%vs 9%,P=0.014),as well as longer extracorporeal circulation time(median 210 vs 161 min,P=0.003).The median length of stay was longer in the MDRO group,namely ICU stay was 16 vs 9 d in the MDRO-free group(P=0.001),and hospital stay was 38 vs 28 d(P=0.006),while 1-year mortality was higher(28%vs 7.6%,log-rank-χ2:7.34).CONCLUSION Following heart transplantation,a predominance of Gram-negative MDROs was *** acquisition was associated with higher complication rates,prolonged ICU and total hospital stay,and higher post-transplantation mortality.

关键词： Heart transplantation Multi drug resistant organisms Transplantation complications Transplantation outcome

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Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2689-2701页

作者： Lewis A Hall Duncan Loader Santiago Gouveia Marta Burak James Halle-Smith Peter Labib Moath Alarabiyat Ravi Marudanayagam Bobby V Dasari Keith J Roberts Syed S Raza michail Papamichail David C Bartlett Robert P Sutcliffe Nikolaos A Chatzizacharias Department of Hepatopancreatobiliary Surgery and Liver Transplantation University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152TTUnited Kingdom College of Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Clinical Sciences University of BirminghamBirmingham B152TTUnited Kingdom

BACKGROUND The use of neoadjuvant therapy(NAT)in distal cholangiocarcinoma(dCCA)with regional arterial or extensive venous involvement,is not widely accepted and evidence is *** To synthesise evidence on NAT for dCCA and present the experience of a highvolume tertiary-centre managing dCCA with arterial *** A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received *** patients from 2017 to 2022 who were referred for NAT for dCCA at our centre were retrospectively collected from a prospectively maintained *** characteristics,NAT type,progression to surgery and oncological outcomes were *** Twelve studies were *** definition of“unresectable”locally advanced dCCA was *** studies reported outcomes for 9 patients who received NAT for dCCA with extensive vascular involvement.R0 resection rate ranged between 0 and 100%but without survival benefit in most *** studies considered either NAT in resectable dCCA or inclusive with extrahepatic *** presented case series includes 9 patients(median age 67,IQR 56-74 years,male:female 5:4)referred for NAT for borderline resectable or locally advanced *** patients progressed to surgery and 2 were *** patient died at 14 months with evidence of recurrence at 6 months and the other died at 51 months following recurrence 6 months *** Evidence for benefit of NAT is *** on criteria for uniform definition of resectability for dCCA is *** propose using the established National-Comprehensive-Cancer-Network®criteria for pancreatic ductal adenocarcinoma.

关键词： Cholangiocarcinoma Neoadjuvant therapy Arterial involvement Locally advanced Systematic review

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Single-center experience with Knee+^(TM) augmented reality navigation system in primary total knee arthroplasty

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World Journal of Orthopedics 2024年第3期15卷 247-256页

作者： Evangelos Sakellariou Panagiotis Alevrogiannis Fani Alevrogianni Athanasios Galanis michail Vavourakis Panagiotis Karampinas Panagiotis Gavriil John Vlamis Stavros Alevrogiannis The 3^(rd)Department of Orthopaedic Surgery National&Kapodistrian University of AthensKAT General HospitalAthens 14561Greece The 1^(st)Department of Orthopaedic Surgery National&Kapodistrian University of AthensAttikon General HospitalAthens 14561Greece Department of Anesthesiology KAT General HospitalAthens 14561Greece Department of Robotic Hip&Knee Orthopaedic Surgery Metropolitan General HospitalAthens 14561Greece

BACKGROUND Computer-assisted systems obtained an increased interest in orthopaedic surgery over the last years,as they enhance precision compared to conventional *** expansion of computer assistance is evolving with the employment of augmented ***,the accuracy of augmented reality navigation systems has not been *** To examine the accuracy of component alignment and restoration of the affected limb’s mechanical axis in primary total knee arthroplasty(TKA),utilizing an augmented reality navigation system and to assess whether such systems are conspicuously fruitful for an accomplished knee *** From May 2021 to December 2021,30 patients,25 women and five men,under-went a primary unilateral *** cases were excluded.A preoperative radiographic procedure was performed to evaluate the limb’s axial *** patients were operated on by the same team,without a tourniquet,utilizing three distinct prostheses with the assistance of the Knee+™augmented reality navigation system in every ***,the same radiographic exam protocol was executed to evaluate the implants’position,orientation and coronal plane *** recorded measurements in 3 stages regarding femoral varus and flexion,tibial varus and posterior ***,the expected values from the Augmented Reality system were *** we calculated the same values after each cut and finally,the same measurements were recorded radiolo-gically after the *** statistical analysis,Lin’s concordance correlation coefficient was estimated,while Wilcoxon Signed Rank Test was performed when *** A statistically significant difference was observed regarding mean expected values and radiographic mea-surements for femoral flexion measurements only(Z score=2.67,P value=0.01).Nonetheless,this difference was statistically significantly lower than 1 degree(Z score=-4.21,P value<0.01).In terms of discrepancies in the calculations of

关键词： Augmented reality Orthopedics Total knee arthroplasty Robotics Knee Navigation

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非洲最恐怖的生命禁区一百年里无人敢涉足的达洛尔

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环球人文地理 2024年第5期 96-103页

作者：李理 Vladislav Radek Benot ArtushFoto Lina dinozzaver michail mikhail cheremkin flickr

色彩绚丽的盐层让人称奇，强酸性的湖水腐蚀鞋子，车队时不时被袭击，还曾有游客被撕票……达洛尔深刻诠释了什么叫“越迷人的越危险”。达洛尔位于埃塞俄比亚东北角，被描述成一个鬼城。因为2005年之后，埃塞俄比亚中央统计局的人口报...

色彩绚丽的盐层让人称奇，强酸性的湖水腐蚀鞋子，车队时不时被袭击，还曾有游客被撕票……达洛尔深刻诠释了什么叫“越迷人的越危险”。达洛尔位于埃塞俄比亚东北角，被描述成一个鬼城。因为2005年之后，埃塞俄比亚中央统计局的人口报告中，就已没有此地区的人口数据。这里是世界上最遥远、最荒芜的地区之一，没有学校、没有商店，也没有公路，对外交通除了游客车队，就只有前往该地收集盐块的阿法尔人与骆驼。然而，这里的形势极不稳定，

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Minimizing the risk of small-for-size syndrome after liver surgery

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Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 113-133页

作者： michail Papamichail michail Pizanias NigelD Heaton Department of Hepato-Pancreato-Biliary Surgery Royal Blackburn HospitalBlackburn BB23HHUK Department of General Surgery Whittington HospitalLondon N195NFUK Department of Liver Transplant and Hepato-Pancreato-Biliary Surgery Institute of Liver StudiesKings Health Partners at King’s College Hospital NHS TrustLondon SE59RSUK

Background: Primary and secondary liver tumors are not always amenable to resection due to location and size. Inadequate future liver remnant(FLR) may prevent patients from having a curative resection or may result in increased postoperative morbidity and mortality from complications related to small-forsize syndrome(SFSS). Data sources: This comprehensive review analyzed the principles, mechanism and risk factors associated with SFSS and presented current available options in the evaluation of FLR when planning liver surgery. In addition, it provided a detailed description of specifc modalities that can be used before, during or after surgery, in order to optimize the conditions for a safe resection and minimize the risk of SFSS. Results: Several methods which aim to reduce tumor burden, preserve healthy liver parenchyma, induce hypertrophy of FLR or prevent postoperative complications help minimize the risk of SFSS. Conclusions: With those techniques the indications of radical treatment for patients with liver tumors have signifcantly expanded. The successful outcome depends on appropriate patient selection, the individualization and modifcation of interventions and the right timing of surgery.

关键词： Small-for-size syndrome Liver resection Future liver remnant

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Exploring injury severity of children and adolescents involved in traffic crashes in Greece

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Journal of Traffic and Transportation Engineering(English Edition) 2021年第4期8卷 596-604页

作者： Athanasios Theofilatos Constantinos antoniou George Yannis School of Architecture Building and Civil EngineeringLoughborough UniversityLeicestershire LE113TUUK Department of Civil Geo and Environmental EngineeringTechnical University of MunichMunich 80333Germany Department of Transportation Planning and Engineering School of Civil EngineeringNational Technical University of AthensZografou 15773Greece

For the purpose of exploring the factors affecting injury severity of children and adolescents involved in traffic crashes in Greece,disaggregate crash data including 13,431 involving children and adolescents from all regions of Greece for the period 2006–2015 were *** order to identify factors affecting injury severity and account for potential unobserved heterogeneity,a series of mixed logit models were *** explore and address potential temporal instability of crash-related risk factors,the likelihood ratio test was *** indicated that night crashes,crashes outside urban areas as well as crashes involving bicycles or powered-two-wheelers are associated with higher injury severity of children and ***,crashes involving pedestrians are associated with lower injury severity than head-on collisions and run-off-road collisions with fixed *** and sideswipe crashes also result in lower injury *** likelihood ratio test indicated that crash-related factors are instable when comparing the models utilizing data before and after 2010 *** study contributes to the current knowledge in the field,as to the best of our knowledge this is the first study that addresses unobserved heterogeneity when analyzing child and adolescent injury ***,the findings of this study provide useful insights and could assist in unveiling crash risk factors and prioritize programs and measures to promote road safety of children and adolescents.

关键词： Traffic engineering Traffic crash Injury severity Children Adolescents Unobserved heterogeneity

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A numerical case study on the long-term seismic assessment of reinforced concrete tunnels in corrosive environments

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第3期15卷 551-572页

作者： Maria antoniou Antonios Mantakas Nikolaos Nikitas Raul Fuentes ETH Zurich ZurichSwitzerland National Technical University of Athens AthensGreece University of Leeds LeedsUK RWTH Aachen University AachenGermany

The paper investigates the long-term seismic behaviour of an underground reinforced concrete(RC)metro tunnel in Santiago,Chile,considering the combined effects of chloride-induced corrosion and cumulative,low-amplitude seismic shaking on the structure’s *** soil-tunnel response is evaluated with the aid of transient,nonlinear finite element analysis using a two-dimensional(2D)plane strain numerical model that adopts advanced nonlinear models for the simulation of soil and concrete plasticity and the dynamic stiffness *** effects of corrosion deterioration are demonstrated in terms of time-dependent loss of rebar area and cover concrete stiffness and *** study illustrates the influence of ageing and repeated seismic shaking on lining deformation,crack development,and the modal characteristics of the intact and degrading *** results indicate that multiple lowamplitude events drive the non-degrading RC tunnel beyond its elastic regime without significant structural response consequences.A noticeable impact of corrosion deterioration on the structure’s seismic performance is revealed,increasing with the number and intensity of earthquake *** different tunnel embedment depths are comparatively *** analyses demonstrate larger coseismic section convergence in the case of the deeper tunnel,yet a less pronounced effect of ageing and successive seismic loading compared to the shallow section,which is evident in the RC lining cracks at the end of shaking.

关键词： Tunnels Reinforcement corrosion Ageing Earthquakes Numerical modelling Long-term performance Concrete cracking behaviour

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Spectroscopic investigations on the effect of humic acid on the formation and solubility of secondary solid phases of Ln_2(CO_3)_3

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Journal of Rare Earths 2011年第6期29卷 516-521页

作者： Stella antoniou Ioannis Pashalidis Andre Gessner Michael U Kumke Department of Chemistry University of Cyprus P.O. Box 20537 1678 Nicosia Cyprus Chemistry Department/Physical Chemistry University of Potsdam Karl- Liebknecht-Str. 24-25 14476 Potsdam-Golm Germany

The formation of secondary Ln（III） solid phases （e.g., Nd2（CO3）3 and Sm2（CO3）3） was studied as a function of the humic acid concentration in 0.1 mol/L NaClO4 aqueous solution in the neutral pH range （5–6.5）. The solid phases under investigation were prepared by alkaline precipitation under 100% CO2 atmosphere and characterized by attenuated total reflectance Fourier transform infrared spectroscopy （ATR-FTIR）, X-ray diffraction （XRD）, time-resolved laser fluorescence spectroscopy （TRLFS）, diffuse reflectance ultraviolet-visible （DR-UV-Vis）, Raman spectroscopy, and solubility measurements. The spectroscopic data obtained indicated that Nd2（CO3）3 and Sm2（CO3）3 were stable and remained the solubility limiting solid phases even in the presence of increased humic acid concentration （0.5 g/L） in solution. Upon base addition in the Ln（III）-HA system, decomplexation of the previously formed Ln（III）-humate complexes and precipitation of two distinct phases occurred, the inorganic （Ln2（CO3）3） and the organic phase （HA）, which was adsorbed on the particle surface of the former. Nevertheless, humic acid affected the particle size of the solid phases. Increasing humic acid concentration resulted in decreasing crystallite size of the Nd2（CO3）3 and increasing crystallite size of the Sm2（CO3）3 solid phase, and affected inversely the solubility of the solid phases. However, this impact on the solid phase properties was expected to be of minor relevance regarding the chemical behavior and migration of trivalent lanthanides and actinides in the geosphere.

关键词： lanthanide ions humic acid solid phase solubility Raman TRLFS DR-UV-Vis rare earths

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Coexistence Between Massive MIMO and Radar Communications:Performance Analysis

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Journal of Communications and Information Networks 2023年第1期8卷 37-47页

作者： Mohamed Elfiatoure Hien Quoc Ngo michail Matthaiou Centre for Wireless Innovation(CWI) Queen’s University BelfastBelfast BT39DTUK

Frequency spectrum sharing between radar and communication systems has recently attracted substantial *** consider the coexistence between a massive multiple-input multiple-output(MIMO)downlink system and MIMO radar to enable the operation of these two systems with minimal mutual *** an asymptotic analysis,we show that by using more antennas at the base station(BS),we can improve the performance of massive MIMO,while keeping the interference to the radar system ***,if we use a large number of antennas at the BS and make the transmit power inversely proportional to the number of antennas,we can avoid the interference from the massive MIMO system to the radar system,with no compromise in the performance of the massive MIMO ***-form expressions for the probability of detection of the radar system and the downlink spectral efficiency of the massive MIMO system,are ***,we propose a power allocation scheme which selects the transmit powers at the MIMO radar and BS to maximize the probability of detection for the MIMO ***,the optimal power allocation can be determined in *** results provide valuable insights into the practical coexistence between massive MIMO and radar systems.

关键词： massive MIMO radar-communication coexistence spectrum sharing

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Primary melanoma of the gallbladder: Does it exist? Report of a case and review of the literature

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World Journal of Gastroenterology 2006年第26期12卷 4259-4261页

作者： michail Safioleas Emmanouil Agapitos Konstantinos Kontzoglou michail Stamatakos Panagiotis Safioleas George Mouzopoulos Alkiviadis Kostakis Department of Propedeutic Surgery School of MedicineAthens UniversityLaiko HospitalGreece Depatment of Pathology School of MedicineAthens UniversityGreece Department of General Surgery General Hospital of SpartaGreece

With the occasion of a case of malignant melanoma of the gallbladder, which appeared to be primary, we have reviewed the literature and the result of this research was that primary melanoma of the gallbladder remains a questionable medical entity. Only few cases of both primary and metastatic gallbladder melanoma have been reported so far, and the only agreement is that surgery is the mainstaytreatment. The role of adjuvant chemotherapy, hormonotherapy or immunotherapy for both primary and metastatic disease remains undefined.

关键词： Neoplasms of the gallbladder Gallbladder Metastatic melanoma

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