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Natural history of children with mild Crohn’s disease

World Journal of Gastroenterology 2019年第30期25卷 4235-4245页

作者： Yamini Sharma athos bousvaros Enju Liu Julia Bender Stern Department of Gastroenterology and Hepatology Inflammatory Bowel Disease Center Boston Children’s Hospital

BACKGROUND There is a small and poorly studied population of patients with mild and limited Crohn’s disease(CD),who either spontaneously enter remission and can discontinue therapy,or be maintained on milder anti-inflammatory *** To identify a group of children with mild CD who were not escalated to immunomodulators(azathioprine,mercaptopurine,or methotrexate)or biologics(infliximab or adalimumab)within the first two years after their Crohn’s diagnosis and outline the natural history and phenotypic features of these *** In a retrospective chart review of the inflammatory bowel disease database at Boston Children’s Hospital we reviewed all the mild CD patient’s clinic visits,laboratory studies,and procedures for the duration of time they were followed at the *** were included if they had clear diagnosis of Crohn’s disease,and they were not escalated to immunosuppressive therapies for at least 2 years after the date of *** mild CD patients were compared to controls diagnosed at a similar time,that were treated with immunomodulators or *** that was abstracted included:Age at diagnosis,sex,disease location utilizing the Paris classification,medical treatment,surgical treatment,endoscopic findings,histology,and *** also analyzed differences in the phenotypic features between those with mild CD and those with moderate to severe *** Out of 1205 patients with CD diagnosed between 1990 and 2013,we identified 29 patients that met the inclusion criteria,and they were matched with 58 *** were no significant differences between the disease behaviors at presentation,with approximately 90%of patients in each group having inflammatory ***,patients with mild disease were more likely to have disease limited to the colon(31%vs 12%,P=0.03).In contrast,patients with moderate to severe disease(aka control group)were more likely to have ileocolonic disease(70%vs 45%in the mild grou

关键词： Crohn’s disease Colitis Aminosalicylates Antibiotics Immunosuppression Inflammatory bowel disease Child Pediatric

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Correlation of endoscopic disease severity with pediatric ulcerative colitis activity index score in children and young adults with ulcerative colitis

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World Journal of Gastroenterology 2017年第18期23卷 3322-3329页

作者： Basavaraj Kerur Heather J Litman Julia Bender Stern Sarah Weber Jenifer R Lightdale Paul A Rufo athos bousvaros Pediatric Gastroenterology Hasbro Children's Hospital Corrona LLC Southborough Inflammatory Bowel Disease Center Children's Hospital Boston Division of Pediatric Gastroenterology UMass Memorial Medical CenterUniversity Campus Worcester

To investigate of pediatric ulcerative colitis activity index (PUCAI) in ulcerative colitis correlate with mucosal inflammation and endoscopic assessment of disease activity (Mayo endoscopic score).METHODSWe reviewed charts from ulcerative colitis patients who had undergone both colonoscopy over 3 years. Clinical assessment of disease severity within 35 d (either before or after) the colonoscopy were included. Patients were excluded if they had significant therapeutic interventions (such as the start of corticosteroids or immunosuppressive agents) between the colonoscopy and the clinical assessment. Mayo endoscopic score of the rectum and sigmoid were done by two gastroenterologists. Inter-observer variability in Mayo score was *** identified 99 patients (53% female, 74% pancolitis) that met inclusion criteria. The indications for colonoscopy included ongoing disease activity (62%), consideration of medication change (10%), assessment of medication efficacy (14%), and cancer screening (14%). Based on PUCAI scores, 33% of patients were in remission, 39% had mild disease, 23% had moderate disease, and 4% had severe disease. There was “moderate-substantial” agreement between the two reviewers in assessing rectal Mayo scores (kappa = 0.54, 95%CI: 0.41-0.68).CONCLUSIONEndoscopic disease severity (Mayo score) assessed by reviewing photographs of pediatric colonoscopy has moderate inter-rater reliability, and agreement was less robust in assessing patients with mild disease activity. Endoscopic disease severity generally correlates with clinical disease severity as measured by PUCAI score. However, children with inflamed colons can have significant variation in their reported clinical symptoms. Thus, assessment of both clinical symptoms and endoscopic disease severity may be required in future clinical studies.

关键词： Ulcerative colitis Pediatric ulcerative colitis activity index Mayo score

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The response to vedolizumab in chronic granulomatous disease-related inflammatory bowel disease

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Gastroenterology Report 2020年第5期8卷 404-406,I0003页

作者： Natasha Kamal Beatriz Marciano Bryan Curtin Anna Strongin Suk See DeRavin athos bousvaros Christopher Koh Harry L.Malech Steven M.Holland Christa Zerbe Theo Heller Digestive Disease Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA Laboratory of Host Defenses National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMDUSA Division of Gastroenterology Hepatology and NutritionBoston Children’s HospitalBostonMAUSA Liver Disease Branch National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaMDUSA Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMDUSA

Introduction Chronic granulomatous disease(CGD)is a rare immunodeficiency affecting approximately 1 in 200,000 people[1].Patients with CGD are unable to produce normal amounts of neutrophil superoxide and other phagocyte reactive oxygen *** a result,phagocytes have decreased microbicidal activity and patients develop recurrent bacterial and fungal infections.

关键词：慢性肉芽肿单抗治疗炎症性肠病 immunodeficiency

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Remote sensing heritage in a petabyte-scale:satellite data and heritage Earth Engine©applications

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International Journal of Digital Earth 2017年第1期10卷 85-102页

作者： athos Agapiou Remote Sensing and Geo-Environment Laboratory Eratosthenes Research CentreDepartment of Civil Engineering and GeomaticsCyprus University of TechnologyLimassolCyprus

This paper aims to demonstrate results and considerations regarding the use of remote sensing big data for archaeological and Cultural Heritage management large scale *** this purpose,the Earth Engine©developed by Google©was *** Engine©provides a robust and expandable cloud platform where several freely distributed remote sensing big data,such as Landsat,can be accessed,analysed and *** different applications are presented here as follows:the first one is based on the evaluation of multi-temporal Landsat series datasets for the detection of buried Neolithic tells(‘magoules’)in the area of Thessaly,in Greece using linear orthogonal *** second case exploits European scale multi-temporal DMSP-OLS Nighttime Lights Time Series to visualize the impact of urban sprawl in the vicinity of UNESCO World Heritage sites and *** applications highlight the considerable opportunities that big data can offer to the fields of archaeology and Cultural Heritage,while the studies also demonstrate the great challenges that still are needed to be overcome in order to make the exploitation of big data process manageable and fruitful for future applications.

关键词： Big data remote sensing archaeology cultural heritage Earth Engine orthogonal equations urban sprawl

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Exploring natural and anthropogenic risk for cultural heritage in Cyprus using remote sensing and GIS

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International Journal of Digital Earth 2013年第2期6卷 115-142页

作者： Diofantos Hadjimitsis athos Agapiou Dimitrios Alexakis Apostolos Sarris Department of Civil Engineering and Geomatics Faculty of Engineering and TechnologyCyprus University of TechnologyCyprusGreece Institute for Mediterranean Studies?FORTH Laboratory of Geophysical-Satellite Remote Sensing&Archaeo-EnvironmentRethymnoGreece

On site observation is the most common way of monitoring cultural heritage sites and monuments in ***,this procedure that includes data collection,periodical observations,and multivariate risk assessment analysis is difficult to accomplish with the traditional practices and methods since it is time consuming and ***,many archaeological sites and monuments are located at inaccessible areas,far away from the main road network and urban *** remote sensing and Geographical Information Systems(GIS)can successfully confront this problem by providing the scientists with integrated monitoring of the study areas and the unique advantage to store and manipulate a large amount of spatial and attribute data *** the monitoring and identification of several natural and anthropogenic hazards in the vicinity of the cultural heritage sites in Cyprus,seems to be one of the main priorities of its governmental and municipal *** study aims to integrate both satellite remote sensing techniques and GIS in a multidisciplinary approach,for monitoring anthropogenic and natural hazards with the use of archived and up-to-date multitemporal remotely sensed images in the study area,namely in areas nearby cultural heritage sites and monuments in *** this study anthropogenic hazards include urbanisation and extended land use changes in the surroundings of archaeological sites and natural hazards concern seismicity and sea erosion.

关键词： monitoring natural risk anthropogenic risk satellite images cultural heritage conservation geographical information systems

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Spectral sensitivity of ALOS, ASTER, IKONOS, LANDSAT and SPOT satellite imagery intended for the detection of archaeological crop marks

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International Journal of Digital Earth 2014年第5期7卷 351-372页

作者： athos Agapiou Dimitrios D.Alexakis Diofantos G.Hadjimitsis Department of Civil Engineering and Geomatics Cyprus University of TechnologyLimassolCyprus

This study compares the spectral sensitivity of remotely sensed satellite images,used for the detection of archaeological *** comparison was based on the relative spectral response(RSR)Filters of each *** signatures profiles were obtained using the GER-1500 field spectroradiometer under clear sky conditions for eight different *** field spectral signature curves were simulated to ALOS,ASTER,IKONOS,Landsat 7-ETM-,Landsat 4-TM,Landsat 5-TM and SPOT *** and near infrared(NIR)bandwidth reflectance were re-calculated to each one of these sensors using appropriate RSR ***,the normalised difference vegetation index(NDVI)and simple ratio(SR)vegetation profiles were analysed in order to evaluate their sensitivity to sensors spectral *** results have shown that IKONOS RSR filters can better distinguish buried archaeological remains as a result of difference in healthy and stress vegetation(approximately 18%difference in reflectance of the red and NIR band and nearly 0.07 to the NDVI profile).In comparison,all the other sensors showed similar results and *** difference of IKONOS sensor might be a result of its spectral characteristics(bandwidths and RSR filters)since they are different from the rest of sensors compared in this study.

关键词： RSR filters spectral sensitivity archaeological remains crop mark detection spectroscopy

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Intestinal microbiome analysis demonstrates azithromycin post-treatment effects improve when combined with lactulose

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World Journal of Pediatrics 2020年第2期16卷 168-176页

作者： Elpiniki Nikolaou Elena Kamilari Dragana Savkov Artemy Sergeev Irina Zakharova Paris Vogazianos Marios Tomazou athos Antoniades Christos Shammas Genetics Department AVVA Pharmaceuticals Ltd23A Spyrou Kyprianou4001 LimassolCyprus Research and Development MC Development LLCMoscowRussia Russian Medical Academy of Continuing Professional Education MoscowRussia Stremble Ventures Ltd LimassolCyprus

Background Next-generation sequencing has revolutionized our perspective on the gut microbiome composition,revealing the true extent of the adverse effects of *** impact of antibiotic treatment on gut microbiota must be considered and researched to provide grounds for establishing new treatment strategies that are less devastating on commensal *** study investigates the impact on gut microbiome when a commonly used antibiotic,azithromycin is administered,as well as uncovers the benefits induced when it is used in combination with lactulose,a prebiotic known to enhance the proliferation of commensal *** 16S rRNA gene sequencing analysis of stool samples obtained from 87 children treated with azithromycin in combination with or without lactulose have been ***'s gut microbial profile was established at the pre-and post-treatment *** Azithromycin caused an increase in the relative abundance of opportunistic pathogens such as Streptococcus that was evident 60 days after *** few days after treatment,children who also received lactulose started to show a higher relative abundance of saccharolytic bacteria such as Lactobacillus,Enterococcus,Anaerostipes,Blautia and Roseburia,providing a protective role against opportunistic *** addition,azithromycin-prebiotic combination was able to provide a phylogenetic profile more similar to the pre-treatment *** It is suggested that during azithromycin treatment,lactulose is able to reinstate the microbiome equilibrium much faster as it promotes saccharolytic microbes and provides a homeostatic effect that minimizes the opportunistic pathogen colonization.

关键词： Antibiotics Azithromycin Lactulose Microbiome Prebiotics

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Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

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Current Urology 2022年第1期16卷 44-49页

作者： Maria Satchi athos Katelaris Martina Smekal Hussain M.Alnajjar Asif Muneer Department of Urology Institute of AndrologyUniversity College London Hospitals NHS TrustLondonW1G 8PHUK NIHR Biomedical Research Centre University College London HospitalsLondonUK Division of Surgery and Interventional Science University College LondonLondonUK

Background:Hematospermia,although often found to be a benign condition,can be an alarming ***,patients undergo multiple investigations with no current standardized pathway based on data from large *** aim of this study was to evaluate the incidence of an underlying pathology and the value of diagnostic investigations performed in patients presenting with *** and methods:A retrospective review of 393 consecutive men who underwent investigations for hematospermia was performed in a single tertiary *** demographics,radiological and microbiological results were recorded together with symptoms of concomitant hematuria and clinical ***:In this cohort,the overall prostate cancer detection rate was 5.3%and 7.2%in the≥40 years *** patient was diagnosed with testicular seminoma detected on scrotal ultrasound scan and one with G1pTa urothelial carcinoma of the bladder detected on flexible *** addition,5.6%of patients were found to have a significant benign pathology for which intervention was proposed.A total of 288 patients underwent a transrectal ultrasound scan and 58.7%(n=169)of these patients were found to have a positive *** hundred ten patients underwent a multiparametric magnetic resonance imaging and 73.6%(n=81)had a positive ***:Apart from transrectal ultrasound and multiparametric magnetic resonance imaging,the remaining investigations have a low diagnostic *** cancer detection was 5.3%;7.2%in the≥40 years group,and two further patients were diagnosed with testicular and bladder *** on our results,we propose an algorithm for the management of hematospermia to limit unnecessary investigations with the majority requiring reassurance.

关键词： Differential diagnosis Ejaculation Hematospermia Male Prostatic neoplasm

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Assessment of water-induced soil erosion as a threat to cultural heritage sites:the case of Chania prefecture,Crete Island,Greece

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Big Earth Data 2022年第4期6卷 561-579页

作者： Christos Polykretis Dimitrios D.Alexakis Manolis G.Grillakis athos Agapiou Branka Cuca Nikos Papadopoulos Apostolos Sarris Laboratory of Geophysical-Satellite Remote Sensing and Archaeo-environment(Geosat ReSeArch) Institute for Mediterranean StudiesFoundation for Research and Technology-HellasCreteGreece School of Environmental Engineering Technical University of CreteChaniaCreteGreece Department of Civil Engineering and Geomatics Cyprus University of TechnologyLimassolCyprus Department of Architecture Built Environment and Construction EngineeringMilanItaly Digital Humanities Geoinformatics Lab Archaeological Research UnitDepartment of History and ArchaeologyUniversity of CyprusNicosiaCyprus

Among the environmental threats,the intensification of natural hazards,such as soil erosion may threaten the integrity and value of cultural heritage *** this framework,the present study’s main objective was to identify archaeological sites susceptible by soil erosion,taking the case study of Chania prefecture in Crete *** sensed and other available geospatial datasets were analyzed in a GIS-based empirical model,namely Unit Stream Power Erosion and Deposition(USPED),to estimate the average annual soil loss and deposition rates due to waterinduced erosion in the study *** resultant erosion map was then intersected with the locations and surrounding zones of the known archaeological sites for identifying the sites and the portions of their vicinity being at *** results revealed that Chania prefecture and its cultural heritage are significantly affected by both soil loss and deposition *** the two processes,soil loss was found to be more intensive,influencing a larger part of the prefecture(especially to the west)as well as a higher amount of archaeological *** extreme and high soil loss classes were also detected to cover the most considerable portion of the sites’surrounding *** identification of the archaeological sites being most exposed to soil erosion hazard can constitute a basis for cultural heritage managers in order to take preventive preserva-tion measures and develop specific risk mitigation strategies.

关键词： Cultural heritage soil erosion USPED model GIS Crete

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Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula:A new variant of “Bouveret’s syndrome”

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World Journal of Gastroenterology 2008年第1期14卷 125-128页

作者： Dimitry Arioli Ivo Venturini Michele Masetti Elisa Romagnoli Antonella Scarcelli Pietro Ballesini athos Borghi Alessandro Barberini Vincenzo Spina Mario De Santis Fabrizio Di Benedetto Giorgio Enrico Gerunda Maria Luisa Zeneroli Medicina Interna Ⅱ Department of Medicine and Medical Specialties Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy Liver and Multivisceral Transplant Center Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy Gastrointestinal Unit Department of Medicine and Medical Specialties Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy Department of Radiology and Liver and Multivisceral Transplant Center Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy

Bouveret's syndrome, defined as gastric outlet obstruction due to a large gallstone, is still one of the most dramatic biliary gallstone complications. Although new radiological and endoscopic techniques have made pre-surgical diagnosis possible in most cases and the death rate has dropped dramatically, "one-stage surgery" (biliary surgery carried out at the same time as the removal of the gut obstruction) should be still considered as the gold standard for the treatment of gallstone *** this case, partial gastric outlet obstruction resulted in an atypical and insidious clinical presentation that allowed us to perform the conventional one-stage laparatomic procedure that completely solved the problem, thus avoiding any further complications.

关键词： Bouveret's Syndrome Biliary gallstone Gastric outlet obstruction Biliary surgery

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