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Intralesional steroid is beneficial in benign refractory esophageal strictures:A meta-analysis

World Journal of Gastroenterology 2018年第21期24卷 2311-2319页

作者： László Szapáry Benedek Tinusz Nelli Farkas Katalin Márta Lajos Szakó Agnes Meczker Roland Hágendorn Judit Bajor Aron Vincze Zoltan Gyongyi alexandra mikó Dezso Csupor Péter Hegyi Balint Eross Institute for Translational Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Institute of Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Gastroenterology First Department of MedicineMedical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy Faculty of PharmacyUniversity of SzegedSzeged 6720Hungary

AIM To analyze the effect of intralesional steroid injections in addition to endoscopic dilation of benign refractory esophageal *** A comprehensive search was performed in three databases from inception to 10 April 2017 to identify trials, comparing the efficacy of endoscopic dilation to dilation combined with intralesional steroid injections. Following the data extraction, meta-analytical calculations were performed on measures of outcome by the randomeffects method of Der Simonian and Laird. Heterogeneity of the studies was tested by Cochrane's Q and I^2 statistics. Risk of quality and bias was assessed by the Newcastle Ottawa Scale and JADAD assessment *** Eleven articles were identified suitable for analyses, involving 343 patients, 235 cases and 229 controls in total. Four studies used crossover design with 121 subjects enrolled. The periodic dilation index(PDI) was comparable in 4 studies, where the pooled result showed a significant improvement of PDI in the steroid group(MD:-1.12 dilation/month, 95% CI:-1.99 to -0.25 P = 0.012; I^2 = 74.4%). The total number of repeat dilations(TNRD) was comparable in 5 studies and showed a non-significant decrease(MD:-1.17, 95%CI:-0.24-0.05, P = 0.057; I^2 = 0), while the dysphagia score(DS) was comparable in 5 studies and did not improve(SMD: 0.35, 95%CI:-0.38, 1.08, P = 0.351; I^2 = 83.98%) after intralesional steroid *** Intralesional steroid injection increases the time between endoscopic dilations of benign refractory esophageal strictures. However, its potential role needs further research.

关键词： Intralesional steroid Meta-analysis Benign refractory esophageal stricture Dilation

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Restoration of energy level in the early phase of acute pediatric pancreatitis

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World Journal of Gastroenterology 2017年第6期23卷 957-963页

作者： Dóra Mosztbacher Nelli Farkas Margit Solymár Gabriella Pár Judit Bajor ákos Szucs József Czimmer Katalin Márta alexandra mikó Zoltán Rumbus Péter Varjú Péter Hegyi Andrea Párniczky First Department of Pediatrics Semmelweis University Institute for Translational Medicine University of Pécs Institute for Bioanalyses University of Pécs Department of Gastroenterology First Department of MedicineUniversity of Pécs Department of Translational Medicine First Department of MedicineUniversity of Pécs First Department of Surgery Semmelweis University Hungarian Academy of Sciences-University of Szeged Momentum Gastroenterology Multidisciplinary Research Group Heim Pál Children’s Hospital

Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP. In this minireview, our aim was to systematically analyse the literature on the treatmentof acute pediatric pancreatitis. The preferred reporting items for systematic review(PRISMA-P) were followed, and the question was drafted based on participants, intervention, comparison and outcomes: P: patients under the age of twenty-one suffering from acute pancreatitis; I: early enteral nutrition (per os and nasogastric- or nasojejunal tube started within 48 h); C: nil per os therapy; O: length of hospitalization, need for treatment at an intensive care unit, development of severe AP, lung injury (including lung oedema and pleural effusion), white blood cell count and pain score on admission. Altogether, 632 articles (Pub Med: 131; EMBASE: 501) were found. After detailed screening of eligible papers, five of them met inclusion criteria. Only retrospective clinical trials were available. Due to insufficient information from the authors, it was only possible to address length of hospitalization as an outcome of the study. Our mini-meta-analysis showed that early enteral nutrition significantly(SD = 0.806, P = 0.034) decreases length of hospitalization compared with nil per os diet in acute pediatric pancreatitis. In this minireview, we clearly show that early enteral nutrition, started within 24-48 h, is beneficial in acute pediatric pancreatitis. Prospective studies and better pres

关键词： pediatric pancreatitis enteral nutrition nil per os diet ATP restoration length of hospitalization

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Chronic kidney disease severely deteriorates the outcome of gastrointestinal bleeding: A meta-analysis

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World Journal of Gastroenterology 2017年第47期23卷 8415-8425页

作者： Roland Hágendorn Nelli Farkas Aron Vincze Zoltán Gyongyi Dezso Csupor Judit Bajor Bálint Eross Péter Csécsei Andrea Vasas Zsolt Szakács László Szapáry Péter Hegyi alexandra mikó Department of Gastroenterology First Department of MedicineUniversity of Pécs Institute of Bioanalysis University of Pécs Department of Public Health Medicine University of Pécs Department of Pharmacognosy Faculty of PharmacyUniversity of Szeged Institute for Translational Medicine University of Pécs Department of Neurology University of Pécs

AIM To understand the influence of chronic kidney disease(CKD) on mortality, need for transfusion and rebleeding in gastrointestinal(GI) bleeding *** A systematic search was conducted in three databases for studies on GI bleeding patients with CKD or endstage renal disease(ESRD) with data on outcomes of mortality, transfusion requirement, rebleeding rate and length of hospitalization(LOH). Calculations were performed with Comprehensive Meta-Analysis software using the random effects model. Heterogeneity was tested by using Cochrane's Q and I2 statistics. Mean difference(MD) and OR(odds ratio) were ***1063 articles(EMBASE: 589; PubM ed: 459; Cochrane: 15) were found in total. 5 retrospective articles and 1 prospective study were available for analysis. These 6 articles contained data on 406035 patients, of whom 51315 had impaired renal function. The analysis showed a higher mortality in the CKD group(OR = 1.786, 95%CI: 1.689-1.888, P < 0.001) and the ESRD group(OR = 2.530, 95%CI: 1.386-4.616, P = 0.002), and a rebleeding rate(OR = 2.510, 95%CI: 1.521-4.144, P < 0.001) in patients with impaired renal function. CKD patients required more unit red blood cell transfusion(MD = 1.863, 95%CI: 0.812-2.915, P < 0.001) and spent more time in hospital(MD = 13.245, 95%CI: 6.886-19.623, P < 0.001) than the *** ESRD increases mortality, need for transfusion, rebleeding rate and LOH among GI bleeding patients. Prospective patient registries and observational clinical trials are crucially needed.

关键词： Gastrointestinal bleeding Chronic kidney disease Mortality Blood transfusion Rebleeding

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Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis

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World Journal of Gastroenterology 2019年第6期25卷 729-743页

作者： Dalma Dobszai Péter Mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross alexandra mikó Lajos Szakó Agnes Meczker Roland Hágendorn Katalin Márta Andrea Szentesi Péter Hegyi on behalf of the Hungarian Pancreatic Study Group Institute for Translational Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Clinical Medicine Doctoral School University of SzegedSzeged 6720Hungary Institute for Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy University of SzegedSzeged 6720Hungary Division of Gastroenterology First Department of MedicineUniversity of PécsMedical SchoolPécs 7624Hungary János Szentágothai Research Center University of PécsPécs 7624 Hungary MTA-SZTE Momentum Translational Gastroenterology Research Group University of SzegedSzeged 6720Hungary 不详

BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the *** To quantify the association between subgroups of BMI and the severity and mortality of *** A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number *** A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P < 0.001). Importantly,the mean BMI of patients with severe AP is higher than that of the non-severe group(MD = 1.79, 95%CI: 0.89-2.70, P < 0.001). As regards mortality, death rates among AP patients are the highest in the underweight and obese subgroups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality

关键词： Acute pancreatitis Body-mass index Obesity Severity Mortality Prognostic Meta-analysis

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On optimal control at the onset of a new viral outbreak

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Infectious Disease Modelling 2024年第4期9卷 995-1006页

作者： alexandra Smirnova Xiaojing Ye Department of Mathematics&Statistics Georgia State UniversityAtlantaUSA

We propose a versatile model with a flexible choice of control for an early-pandemic outbreak prevention when vaccine/drug is not yet *** that stage,control is often limited to non-medical interventions like social distancing and other behavioral *** the SIR optimal control problem,we show that the running cost of control satisfying mild,practically justified conditions generates an optimal strategy,u(t),t∈[0,T],that is sustainable up until some moment τ∈[0,T).However,for any t∈[τ,T],the function u(t)will decline as t approaches T,which may cause the number of newly infected people to ***,the window from 0 to τ is the time for public health officials to prepare alternative mitigation measures,such as vaccines,testing,antiviral medications,and *** addition to theoretical study,we develop a fast and stable computational method for solving the proposed optimal control *** efficiency of the new method is illustrated with numerical examples of optimal control trajectories for various cost functions and *** results provide a comprehensive demonstration of the effects of control on the epidemic spread and mitigation expenses,which can serve as invaluable references for public health officials.

关键词： Epidemiology Compartmental model Transmission dynamic Optimal control

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Reconstruction of incidence reporting rate for SARS-CoV-2 Delta variant of COVID-19 pandemic in the US

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Infectious Disease Modelling 2024年第1期9卷 70-83页

作者： alexandra Smirnova Mona Baroonian Department of Mathematics&Statistics Georgia State UniversityAtlantaUSA

In recent years,advanced regularization techniques have emerged as a powerful tool aimed at stable estimation of infectious disease parameters that are crucial for future projections,prevention,and *** other system parameters,i.e.,incubation and recovery rates,the case reporting rate,Ψ,and the time-dependent effective reproduction number,R_(e)t,are directly influenced by a large number of factors making it impossible to pre-estimate these parameters in any meaningful *** this study,we propose a novel iteratively-regularized trust-region optimization algorithm,combined with SuSvIuIvRD compartmental model,for stable reconstruction ofΨand R_(e)t from reported epidemic data on vaccination percentages,incidence cases,and daily *** innovative regularization procedure exploits(and takes full advantage of)a unique structure of the Jacobian and Hessian approximation for the nonlinear observation *** proposed inversion method is thoroughly tested with synthetic and real SARS-CoV-2 Delta variant data for different regions in the United States of America from July 9,2021,to November 25,*** study shows that case reporting rate during the Delta wave of COVID-19 pandemic in the US is between 12%and 37%,with most states being in the range from 15%to 25%.This confirms earlier accounts on considerable under-reporting of COVID-19 cases due to the impact of”silent spreaders”and the limitations of testing.

关键词： Epidemiology Incidence reporting rate Compartmental model Transmission dynamic Regularization algorithm

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Assistive Robotics for Upper Limb Physical Rehabilitation:A Systematic Review and Future Prospects

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Chinese Journal of Mechanical Engineering 2024年第4期37卷 50-73页

作者： Andrés Guatibonza Leonardo Solaque alexandra Velasco Lina Peñuela Department of Engineering Mechatronics EngineeringMilitar Nueva Granada UniversityBogotá1101111Colombia

Physical assistive robotics are oriented to support and improve functional capacities of *** physical rehabilitation,robots are indeed useful for functional recovery of affected ***,there are still open questions related to technological *** work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature *** from the last six years,conducted between August 2020 and May 2021,was *** methodology for the literature search and a bibliometric analysis of the metadata are *** a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were *** an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is *** review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical *** literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.

关键词： Upper limb Rehabilitation Assistive robotics Human-machine interaction Robotic systems Virtual reality Rehabilitation monitoring

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Role of practice standardization in outcome optimization for CDH

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World Journal of Pediatric Surgery 2024年第2期7卷 110-118页

作者： alexandra Dimmer Robert Baird Pramod Puligandla Harvey E.Beardmore Division of Pediatric Surgery Department of Pediatric SurgeryMontreal Children's HospitalMontrealQuebecCanada Division of Pediatric General and Thoracic Surgery British Columbia Children's HospitalVancouverBritish ColumbiaCanada Harvey E.Beardmore Department of Pediatric Surgery McGill UniversityMontrealQuebecCanada

Standardization of care seeks to improve patient outcomes and healthcare delivery by reducing unwanted variations in care as well as promoting the efficient and effective use of healthcare *** are many types of standardization,with clinical practice guidelines(CPGs),based on a stringent assessment of evidence and expert consensus,being the hallmark of high-quality *** article outlines the history of CPGs,their benefits and shortcomings,with a specific focus on standardization efforts as it relates to congenital diaphragmatic hernia management.

关键词： congenital clinical shortcomings

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Elevation transition of aquatic insects closely matches a thermal feature in the Yungas of Northwestern Argentina

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Journal of Mountain Science 2024年第2期21卷 433-448页

作者： alexandra BUITRAGO-GUACANAME Carlos MOLINERI Andrés LIRA-NORIEGA Daniel Andrés DOS SANTOS Neotropical Biodiversity Institute(CONICET-UNT) UNT-DomesHorco Molle S/N4107 TucumánArgentina CONACYT Research Fellow Network of Advanced Molecular StudiesInstitute of Ecology A.COld Road to Coatepec 351El HayaCP 91073XalapaVeracruzMexico Biostatistics Chair Faculty of Natural Sciences and IMLNational University of TucumánSan Miguel de TucumánMiguel Lillo 2054000 TucumánArgentina

Temperature is a key factor that shapes the distribution of *** knowledge about how species respond to temperature is relevant to devise strategies for addressing the impacts of climate *** insects are particularly vulnerable to climate change,yet there is still much to learn about their ecology and *** the Yungas ecoregion of Northwestern Argentina,cold-and warm-adapted species of the orders Ephemeroptera,Plecoptera,and Trichoptera(EPT)are segregated by *** modeled the ecological niche of South American EPT species in this region using available data and projected their potential distribution in geographic *** were grouped based on their ecogeographic similarity,and we analyzed their replacement pattern along elevation gradients,focusing on the ecotone where opposing thermal preferences *** this interface,we identified critical points where the combined incidence of cold and warm assemblages maximizes,indicating a significant transition *** found that the Montane Cloud Forest holds the interface,with a particularly greater suitability at its lower *** main axis of the interface runs in a N-S direction and falls between 14°C-16°C mean annual *** probability of a particular location within a basin being classified as part of the interface increases as Kira’s warmth index approaches a score around *** the interface is critical for defining the thermal limits of species distribution and designing biomonitoring *** in the location of thermal constants related to mountainous ecotones may cause vertical displacement of aquatic insects and vegetation *** have recognized significant temperature thresholds that serve as indicators of suitability for the *** global warming is anticipated to shift these indicators,we suggest using them to monitor the imprints of climate change on mountain ecosystems.

关键词： Austral Yungas Ecological Niche Model Ephemeroptera Kira’s warmth index Plecoptera Trichoptera

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Development and characterization of 3D-printed electroconductive pHEMA-co-MAA NP-laden hydrogels for tissue engineering

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Bio-Design and Manufacturing 2024年第3期7卷 262-276页

作者： Sara De Nitto Aleksandra Serafin alexandra Karadimou Achim Schmalenberger John J.EMulvihill Maurice N.Collins DIBRIS Polytechnic Inter-School Section University of Genoa16126 GenoaItaly School of Engineering Bernal InstituteUniversity of LimerickLimerick V94 T9PXIreland School of Natural Sciences Department of Biological SciencesUniversity of LimerickLimerick V94 T9PXIreland Health Research Institute University of LimerickLimerick V94 T9PXIreland AMBER University of LimerickLimerick V94 T9PXIreland

Tissue engineering(TE)continues to be widely explored as a potential solution to meet critical clinical needs for diseased tissue replacement and tissue *** this study,we developed a poly(2-hydroxyethyl methacrylate-co-methacrylic acid)(pHEMA-co-MAA)based hydrogel loaded with newly synthesized conductive poly(3,4-ethylene-dioxythiophene)(PEDOT)and polypyrrole(PPy)nanoparticles(NPs),and subsequently processed these hydrogels into tissue engineered constructs via three-dimensional(3D)*** presence of the NPs was critical as they altered the rheological properties during ***,all samples exhibited suitable shear thinning properties,allowing for the development of an optimized processing window for 3D *** were 3D printed into pre-determined disk-shaped configurations of 2 and 10 mm in height and diameter,*** observed that the NPs disrupted the gel crosslinking efficiencies,leading to shorter degradation times and compressive mechanical properties ranging between 450 and 550 *** conductivity of the printed hydrogels increased along with the NP concentration to(5.10±0.37)×10^(−7)S/*** vitro studies with cortical astrocyte cell cultures demonstrated that exposure to the pHEMA-co-MAA NP hydrogels yielded high cellular viability and proliferation ***,hydrogel antimicrobial studies with staphylococcus epidermidis bacteria revealed that the developed hydrogels affected bacterial *** together,these materials show promise for various TE strategies.

关键词： Conductive nanoparticles Hydroxyethyl methacrylate(HEMA) Ultraviolet(UV)polymerization 3D printing

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