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Managing Hepatitis C Patients in Greece: A Budget Impact Analysis of Simeprevir plus Pegylated Interferon/Ribavirin Regimen at Early Stages of the Disease

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Health 2017年第11期9卷 1482-1493页

作者： Mary Geitona Hara Kousoulakou Ioannis Goulis Spilios Manolakopoulos Themistoclis Vasiliadis Dimitrios Christodoulou Charalabos Gogos Spyridon Dourakis Ioannis George Koskinas Alexandra Papadokostopoulou aris lathouris George Papatheodoridis University of Peloponnese Corinth Greece aristotle University of Thessaloniki Thessaloniki Greece National and Kapodistrian University of Athens Athens Greece University of Ioannina Ioannina Greece University of Patras Patra Greece Janssen-Cilag Pharmaceutical SACI Athens Greece

Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R) as a treatment option in the early stages of the disease in Greece. Methods: A budget impact tool was developed with a two-year time horizon, which estimated the impact on the Social Insurance Funds (SIFs) of introducing SMV + PR in the management of the early disease stages. Total direct and indirect costs were estimated for each of the following health states: non-cirrhotic chronic Hepatitis C (and within that by fibrosis stage), compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma. Data gaps on treatment algorithms, resource use and productivity losses were covered via an expert panel of eight leading hepatologists. Epidemiology data were taken from the published literature. Unit costs were obtained from the Ministry of Health and SIFs. The perspective was that of the SIF and the cost base year was 2015. Results: The total (direct and indirect) cost per patient per year (excluding cost of antiviral treatment) was estimated at €647, €703, €5,753, €16,313 and €37,237 for non-cirrhotic CHC, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplantation, respectively. The budget impact analysis showed that adding SMV to PR in the early stages of the disease would lead to an increase in the cost of antiviral treatment by €2.03 million. Conclusions: Costs of managing CHC increase dramatically with disease severity. SMV + PR for naive patients at early disease stages has a significant but manageable budget impact, and could prevent high costs in advanced stages.

关键词： Hepatitis C Budget Impact Analysis Simeprevir Greece

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Management of autoimmune hepatitis induced by hepatitis delta virus

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World Journal of Gastroenterology 2024年第8期30卷 799-805页

作者： Eleni Gigi Vasileios Lagopoulos aris Liakos Hepatology Unit The Second Internal Medicine DepartmentAristotle University Medical SchoolHippokrateio General HospitalThessaloniki 54642Greece Department of Surgical AHEPA General Hospital of ThessalonikiThessaloniki 54636Greece Clinical Research and Evidence-Based Medicine Unit Second Medical DepartmentHippokratio General HospitalAristotle University ThessalonikiThessaloniki 54642Greece

Approximately 12-72 million people worldwide are co-infected with hepatitis B virus(HBV)and hepatitis delta virus(HDV).This concurrent infection can lead to several severe outcomes with hepatic disease,such as cirrhosis,fulminant hepatitis,and hepatocellular carcinoma,being the most *** the past few decades,a correlation between viral hepatitis and autoimmune diseases has been ***,autoantibodies have been detected in the serum of patients co-infected with HBV/HDV,and autoimmune features have been ***,to date,very few cases of clinically significant autoimmune hepatitis(AIH)have been reported in patients with HDV infection,mainly in those who have received treatment with pegylated ***,there are some patients with HBV infection and AIH in whom HDV infection is unearthed after receiving treatment with ***,several questions remain unanswered with the challenge to distinguish whether it is autoimmune or“autoimmune-like”hepatitis being the most ***,it remains uncertain whether autoimmunity is induced by HBV or delta ***,we investigated whether the cause of AIH lies in the previous treatment of HDV with pegylated *** pressing issues should be elucidated to clarify whether new antiviral treatments for HDV,such as Bulevirtide or immu-nosuppressive drugs,are more appropriate for the management of patients with HDV and AIH.

关键词： Autoimmune hepatitis Hepatitis delta virus Bulevirtide Prednisolone

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Hidden army within:Harnessing the microbiome to improve cancer treatment outcomes

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World Journal of Clinical Cases 2024年第28期12卷 6159-6164页

作者： Ippokratis Messaritakis Georgios Vougiouklakis Asimina Koulouridi aris P Agouridis Nikolaos Spernovasilis Department of Microbiology German Oncology Center&Yiannoukas Labs LTDBioiatriki GroupLimassol 4108Cyprus Department of Internal Medicine German Oncology CenterLimassol 4108Cyprus Department of Oncology German Oncology CenterLimassol 4108Cyprus School of Medicine European University CyprusNicosia 2404Cyprus Department of Infectious Diseases German Oncology CenterLimassol 4108Cyprus

The gut microbiome has emerged as a critical player in cancer pathogenesis and treatment ***,an imbalance in the gut microbial community,impacts tumor initiation,progression,and therapy *** bacterial species have been associated with either promoting or inhibiting tumor growth,offering potential targets for therapeutic *** gut microbiome in-fluences the efficacy and toxicity of conventional treatments and cutting-edge immunotherapies,highlighting its potential as a therapeutic target in cancer ***,translating microbiome research into clinical practice requires addres-sing challenges such as standardizing methodologies,validating microbial bio-markers,and ensuring ethical ***,we provide a comprehensive overview of the gut microbiome's role in cancer highlighting the need for on-going research,collaboration,and innovation to harness its full potential for im-proving patient outcomes in *** current editorial aims to explore these insights and emphasizes the need for standardized methodologies,validation of microbial biomarkers,and interdisciplinary collaboration to translate microbiome research into clinical ***,it underscores ethical consider-ations and regulatory challenges surrounding the use of microbiome-based ***,this article advocates for ongoing research,collaboration,and innovation to realize the full potential of microbiome-guided oncology in impro-ving patient care and outcomes.

关键词： Gut microbiome Cancer treatment Immunotherapy Microbiome-based interventions Dysbiosis Precision oncology

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A model to standardize safety and quality of care for cupping therapy

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Journal of Integrative Medicine 2021年第4期19卷 327-332页

作者： Riska Siregar aris Setyawan Syahruramdhani Syahruramdhani Lembaga Mitra Sehat Manfaat Relief-Health Partnership SocietySleman 55292Yogyakarta ProvinceIndonesia School of Nursing Institute of Health ScienceSurya Global YogyakartaBantul 55194Yogyakarta ProvinceIndonesia School of Nursing Universitas Muhammadiyah Yogyakarta ProvinceIndonesia

Cupping therapy has historical, traditional and religious value. It is increasingly popular in the field of complementary, alternative and integrative medicine. However, standards for safety and quality of service are absent. Although it is generally considered safe, cupping therapy can cause adverse *** of these events are predictable and preventable. A comprehensive approach to patient eligibility and therapist selection, along with compliance with standard operational procedures is essential to regulate the safety of the practice. Here we discuss a model framework for standardizing safety and quality of care. We recommend that this model be used routinely by cupping therapists and their associations on a nation-wide scale.

关键词： Cupping therapy Safety Theoretical models Practice management

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Experimental determination of Cd2+ adsorption mechanism on low-cost biological waste

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Frontiers of Environmental Science & Engineering 2013年第3期7卷 356-364页

作者： Farhah Amalya ISMAIL Ahmad Zaharin aris Environmental Forensics Research Centre Faculty of Environmental StudiesUniversiti Putra MalaysiaUPM Serdang 43400Malaysia

Carbonate shells have an astonishing ability in the removal of Cd2+in a short time period with emphasis on being a low cost *** the present study,the sorption capacity of carbonate shells was studied for Cd2+in batch *** infuence of different carbonate shell sizes and physico-chemical factors were evaluated and the results were analyzed for its correlation matrices by using Predictive Analytics Software(PASW).The mineralogy state of aqueous solution regarding the saturation index was simulated using PHREEQC to identify the Cd2+uptake *** Cd uptake rates were calculated as well as Ca2+,HCO–3concentration,pH,ambient humidity and temperature were ***2+removal of 91.52%was achieved after 5 h *** adsorption effciencies were signifcantly infuenced by pH as they increased with the increase of pH from acidic solution(5.50 0.02)to slightly alkaline(7.60 0.05).In addition,the mineralogy state of aqueous solution calculated from PHREEQC confrmed that the increment of Ca2+and HCO–3concentrations in solution was attributed to the dissolution of carbonate ***,the ion exchange adsorption mechanism of Cd2+toward Ca2+was identifed as the process involved in Cd2+uptake.

关键词： carbonate shell cadmium heavy metal adsorption mechanism saturation state

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Origin and genomic characteristics of SARS-CoV-2 and its interaction with angiotensin converting enzyme type 2 receptors, focusing on the gastrointestinal tract

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World Journal of Gastroenterology 2020年第41期26卷 6335-6345页

作者： Michail Galanopoulos aris Doukatas Maria Gazouli Department of Gastroenterology 401 General Military Hospital of AthensAthens 11525AttikiGreece Medical Office of Hellenic Army General Staff 401 General Military Hospital of AthensAthens 11525AttikiGreece Laboratory of Biology School of MedicineNational and Kapodistrian University of AthensAthens 11527AttikiGreece

The emergence of coronavirus disease-2019 induced by a newly identified bcoronavirus, namely severe acute respiratory syndrome coronavirus 2(SARSCoV-2) has constituted a public health emergency. Even though it was considered a zoonotic disease, the virus has also spread among humans via respiratory secretions. The expression and distribution of angiotensin converting enzyme type 2(ACE2) in various human organs might also show other possible infection routes. High ACE2 ribonucleic acid expression has been identified in the gastrointestinal tract(GI) indicating its importance as a possible infection pathway of SARS-CoV-2. ACE2 induces viral entry into the host and most importantly has been found to be associated with the function of the gut. Its deficiency has been implicated in several pathologies such as colorectal inflammation. The renin-angiotensin system(RAS) is an essential regulatory cascade operating both at a local tissue level and at the systemic or circulatory level. The RAS may be important in the pathogenesis of chronic liver disease and is associated with the up-regulation of ACE2. Thus, the aim of this review is firstly, the analysis of some important general and genome characteristics of SARS-CoV-2 and secondly, and most importantly, to focus on the utility of ACE2 receptors in both SARS-CoV-2 replication and pathogenesis, especially in the GI tract.

关键词： SARS-CoV-2 COVID-19 Gastrointestinal tract Angiotensin converting enzyme type 2 Angiotensin converting enzyme type 2 receptor Renin-angiotensin system Angiotensin converting enzyme

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Geoaccumulation and distribution of heavy metals in the urban river sediment

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International Journal of Sediment Research 2014年第3期29卷 368-377页

作者： Nur Aliaa SHAFIE Ahmad Zaharin aris Hazzeman Haris Environmental Forensics Research Centre Faculty of Environmental StudiesUniversiti Putra Malaysia43400 UPM SerdangSelangorMalaysia

Current study presents the application of chemometric techniques to comprehend the interrelations among sediment variables whilst identifying the possible pollution source at Langat River,*** sediment samples（0-10 cm）were collected at 22 sampling stations and analyzed for total metals(48Cd,29Cu,30Zn,82Pb),pH,redox potential（Eh）,salinity,electrical conductivity（EC）,loss on ignition（LOI）and cation exchange capacity（CEC）.The principal component analysis（PCA）scrutinized the origin of environmental pollution by various anthropogenic and natural activities:four principal components were obtained with 86.34%（5 cm）and88.34%（10 cm）.Standard,forward and backward stepwise discriminant analysis effectively discriminate 2variables（84.06%）indicating high variation of heavy metals accumulation at both *** cluster analysis accounted for high input of Zn and Pb at LA8,LA 10,LA 11 and LA 12 that mergers three（5 cm）and four（10cm）into *** is consistent with the contamination factor（C1）that shows high Cd（LA 1）and Pb（LA 7,LA 8,LA 10,LA 11 and LA 12）contaminations at *** indicate that Pb and Zn are the most bioavailable metals in the sediment with significant positive linear relationship at both sediment ***,this approach is a good indication of environmental pollution status that transfers new findings on the assessment of heavy metals by interpreting large complex datasets and predicting the fate of heavy metals in the sediment.

关键词： Heavy metals Principal Component Analysis Cluster Analysis River Sediment

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Blocking the PD-1 signal transduction by occupying the phosphorylated ITSM recognition site of SHP-2

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Science China Life Sciences 2024年

作者： Wenjie Li Wenyi Mei Hewei Jiang Jie Wang Xiaoli Li Lina Quan Yanyan Diao Yanni Ma Sisi Fan Zhuwei Xie Mengdie Gong Huan Zhu Dewen Bi Feng Zhang Lei Ma Jian Zhang Yufeng Gao aris Paschalidis Honghuang Lin Fangfang Liu Kangdong Liu Mingliang Ye Zhenjiang Zhao Yajun Duan Zhuo Chen Yufang Xu Weilie Xiao Shengce Tao Lili Zhu Honglin Li Innovation Center for AI and Drug Discovery East China Normal University Shanghai Key Laboratory of New Drug Design School of PharmacyEast China University of Science&Technology Shanghai Center for Systems Biomedicine Key Laboratory of Systems Biomedicine (Ministry of Education)Shanghai Jiao Tong University Lingang Laboratory Key Laboratory of Medicinal Chemistry for Natural Resource Ministry of EducationYunnan Characteristic Plant Extraction LaboratoryYunnan Provincial Center for Research&Development of Natural ProductsState Key Laboratory for Conservation and Utilization of Bio-Resources in YunnanSchool of Pharmacy and School of Chemical Science and TechnologyYunnan University CAS Key Laboratory of Separation Sciences for Analytical Chemistry National Chromatographic R&A CenterDalian Institute of Chemical PhysicsChinese Academy of Sciences Department of Cardiology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of China Department of Infectious Diseases The First Affiliated Hospital of Anhui Medical University Department of Medicine University of Massachusetts Chan Medical School Department of Pathophysiology School of Basic Medical SciencesAcademy of Medical ScienceCollege of MedicineZhengzhou University

Targeting the PD-1/PD-L1 axis with small-molecular inhibitors is a promising approach for immunotherapy. Here, we identify a natural pentacyclic triterpenoid, Pygenic Acid A(PA), as a PD-1 signaling inhibitor. PA exerts anti-tumor activity in hPD-1 knock-in C57BL/6 mice and enhances effector functions of T cells to promote immune responses by disrupting the PD-1 signaling transduction. Furthermore, we identify SHP-2 as the direct molecular target of PA for inhibiting the PD-1 signaling transduction. Subsequently, mechanistic studies suggest that PA binds to a new druggable site in the phosphorylated PD-1 ITSM recognition site of SHP-2, inhibiting the recruitment of SHP-2 by PD-1. Taken together, our findings demonstrate that PA has a potential application in cancer immunotherapy and occupying the phosphorylated ITSM recognition site of SHP-2 may serve as an alternative strategy to develop PD-1 signaling inhibitors. In addition, our success in target recognition provides a paradigm of target identification and confirmation for natural products.

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Current protocols and outcomes of ABO-incompatible kidney transplantation

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World Journal of Transplantation 2020年第7期10卷 191-205页

作者： Maurizio Salvadori aris Tsalouchos Department of Transplantation Renal Unit Careggi University HospitalFlorence 50139Italy Nephrology and Dialysis Unit Saints Cosmas and Damian HospitalPescia 51017Italy

One of the principal obstacles in transplantation from living donors is that approximately 30%are immunologically incompatible because of the presence in the recipient of antibodies directed against the human leukocyte antigen system of the donor or because of the incompatibility of the ABO *** aim of this review is to describe the more recent data from the literature on the different protocols used and the clinical outcomes of ABO-incompatible kidney *** different strategies are used to overcome these barriers:desensitization of the recipient to remove the antibodies and to prevent their rebound after transplantation and the exchange of organs between two or more *** largest part of this review is dedicated to describing the techniques of *** if the first reports of successful renal transplantation between ABO-incompatible pairs have been published by 1980,the number of ABO-incompatible transplants increased substantially in this century because of our improved knowledge of the immune system and the availability of new *** has substantially replaced *** technique of apheresis has improved and more recently a tailored desensitization proved to be the more efficient strategy avoiding an excess of immunosuppression with the related side *** reports document outcomes for such transplantation similar to the outcomes of standard transplantation.

关键词： ABO-incompatible transplants Desensitization strategies Immunological aspects B cell depletion Immunomodulation Apheresis techniques Kidney paired donation

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Therapeutic apheresis in kidney transplantation: An updated review

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World Journal of Transplantation 2019年第6期9卷 103-122页

Therapeutic apheresis is a cornerstone of therapy for several conditions in transplantation medicine and is available in different technical variants. In the setting of kidney transplantation, immunological barriers such as ABO blood group incompatibility and preformed donor-specific antibodies can complicate the outcome of deceased-or living-donor transplantation. Postoperatively,additional problems such as antibody-mediated rejection and a recurrence of primary focal segmental glomerulosclerosis can limit therapeutic success and decrease graft survival. Therapeutic apheresis techniques find application in these issues by separating and selectively removing exchanging or modifying pathogenic material from the patient by an extracorporeal aphaeresis system. The purpose of this review is to describe the available techniques of therapeutic aphaeresis with their specific advantages and disadvantages and examine the evidence supporting the application of therapeutic aphaeresis as an adjunctive therapeutic option to immunosuppressive agents in protocols before and after kidney transplantation.

关键词： Kidney transplantation Therapeutic plasma exchange Double-filtrationplasmapheresis Immunoadsorption Extracorporeal photopheresis Desensitization Antibody-mediated rejection Focal segmental glomerulosclerosis

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