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Effects on physiologic measures of appetite from intragastric balloon and endoscopic sleeve gastroplasty: results of a prospective study

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Chinese Medical Journal 2022年第10期135卷 1234-1241页

作者： babusai Rapaka Daniel B.Maselli Gontrand Lopez-Nava Inmaculada bautista-Castano Reem Matar Veeravich Jaruvongvanich Eric J.Vargas Andrew C.Storm Andres Acosta barham K.Abu Dayyeh Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905USA Madrid Sanchinarro University Hospital MadridSpain

background: Endoscopic bariatric therapies can help address widening management gaps in obesity. Their ability to facilitate weight loss is largely tied to influences on appetite through perturbations of gastric emptying and accommodation. As these tools gain traction in obesity therapy, their physiologic underpinnings require exploration, which may enhance efficacy, tolerance, and patient-tailored care.Methods: We prospectively assessed consecutive subjects with fluid-filled intragastric balloons (IGbs) (n = 18) placed between October 2016 and June 2017 or underwent endoscopic sleeve gastroplasty (ESG) (n = 23) from March 2018 to June 2018. Patients underwent physiologic appraisal at 3 months with13C-spirulina-based gastric emptying breath test to determine time to half emptying (T50), as well as maximum tolerated volume (MTV) of a standard nutrient drink test. Changes in T50 and MTV at 3 months were compared with percent total body weight loss (%TbWL) at 3 and 6 months using best-fit linear regression.Results: The change in T50 at 3 months correlated with %TbWL at 3 months for IGb (P = 0.01) and ESG (P = 0.01) but with greater impact on %TbWL in IGb compared to ESG (R2 = 0.42vs. 0.26). Change in T50 at 3 months was predictive of weight loss at 6 months for IGb (P = 0.01) but not ESG (P = 0.11). ESG was associated with greater decrease in MTV compared to IGb (340.25 ± 297.97 mLvs. 183.00 ± 217.13 mL,P = 0.08), indicting an enhanced effect on satiation through decreased gastric accommodation. Changes in MTV at 3 months did not correlate with %TbWL for either IGb (P = 0.26) or ESG (P = 0.49) but trended toward significance for predicting %TbWL at 6 months for ESG (P = 0.06) but not IGb (P = 0.19).Conclusion: IGb and ESG both induce weight loss but likely through distinct gastric motor function phenotypes, and gastric emptying may predict future weight loss in patients with IGb.

关键词： Intragastric balloon Endoscopic sleeve gastroplasty Gastric emptying Gastric accommodation Obesity

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How to establish an endoscopic bariatric practice

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World Journal of Gastrointestinal Endoscopy 2024年第4期16卷 178-186页

作者： Daniel B.Maselli Lauren L Donnangelo brian Coan Christopher E McGowan Clinical Research True You Weight LossAtlantaGA 30342United States Clinical Research True You Weight LossCaryNC 27513United States

Obesity is a chronic,progressive,and relapsing disease of excess adiposity that contributes to more than two hundred medical conditions and is projected to affect more than half the adult population of the United States by the year 2030.Given the limited penetrance of traditional bariatric surgery,as well as the cost and adherence barriers to anti-obesity medications,there is growing interest in the rapidly evolving field of endoscopic bariatric therapies(EbTs).EbTs are minimally invasive,same-day,per-oral endoscopic procedures and include endoscopic sleeve gastroplasty,intragastric balloons,and endoscopic bariatric revisional procedures.This field represents an exciting and innovative subspe-cialty within gastroenterology.However,building a successful endoscopic bariatric practice requires intentional,coordinated,and sustained efforts to overcome the numerous obstacles to entry.Common barriers include acquisition of the technical and cognitive skillset,practice limitations including the availability of nutrition counseling,facility capabilities,direct-to-consumer marketing,and financial pressures such as facility and anesthesia fees.As the highest-volume center for metabolic and bariatric endoscopy in the United States,we provide insights into successfully establishing an endoscopic bariatric program.

关键词： Obesity Endoscopic bariatric therapies bariatric endoscopy Endoscopic sleeve gastroplasty Intragastric balloon Practice management

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Transoral outlet reduction:Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice

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World Journal of Gastrointestinal Endoscopy 2023年第10期15卷 602-613页

作者： Daniel B.Maselli Vibhu Chittajallu Chase Wooley Areebah Waseem daniel Lee Michelle Secic Lauren LDonnangelo brian Coan Christopher E McGowan Clinical Research True You Weight LossAtlantaGA 30342United States Department of Gastroenterology and Hepatology University Hospitals Cleveland Medical CenterClevelandOH 44106United States Clinical Research True You Weight LossCaryNC 27513United States Secic Statistical Consulting ClevelandOH 44106United States

bACKGROUND Transoral outlet reduction(TORe)is a minimally invasive endoscopic revision of Roux-en-Y gastric bypass(RYGb)for weight recurrence;however,little has been published on its clinical implementation in the community setting.AIM To characterize the safety and efficacy of TORe in the community setting for adults with weight recurrence after RYGb.METHODS This is a retrospective cohort study of argon plasma coagulation and purse-string suturing for gastric outlet reduction in consecutive adults with weight recurrence after RYGb at a single community center from September 2020 to September 2022.Patients were provided longitudinal nutritional support via virtual visits.The primary outcome was total body weight loss(TbWL)at twelve months from TORe.Secondary outcomes included TbWL at three months and six months;excess weight loss(EWL)at three,six,and twelve months;twelve-month TbWL by obesity class;predictors of twelve-month TbWL;rates of post-TORe stenosis;and serious adverse events(SAE).Outcomes were reported with descriptive statistics.RESULTS Two hundred eighty-four adults(91.9%female,age 51.3 years,body mass index 39.3 kg/m^(2))underwent TORe an average of 13.3 years after RYGb.Median pre-and post-TORe outlet diameter was 35 mm and 8 mm,respectively.TbWL was 11.7%±4.6%at three months,14.3%±6.3%at six months,and 17.3%±7.9%at twelve months.EWL was 38.4%±28.2%at three months,46.5%±35.4%at six months,and 53.5%±39.2%at twelve months.The number of follow-up visits attended was the strongest predictor of TbWL at twelve months(R^(2)=0.0139,P=0.0005).Outlet stenosis occurred in 11 patients(3.9%)and was successfully managed with endoscopic dilation.There was one instance of post-procedural nausea requiring overnight observation(SAE rate 0.4%).CONCLUSION When performed by an experienced endoscopist and combined with longitudinal nutritional support,purse-string TORe is safe and effective in the community setting for adults with weight recurrence after RYGb.

关键词： Transoral outlet reduction Purse-string Roux-en-Y gastric bypass Obesity Endoscopic revision Weight recurrence Gastrojejunal anastomosis

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Mechanical circulatory support in cardiogenic shock and post-myocardial infarction mechanical complications

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Journal of Geriatric Cardiology 2022年第2期19卷 130-136页

作者： daniel Rob Jan bělohlávek nd Department of Medicine-Department of Cardiovascular Medicine First Faculty of MedicineCharles University and General University HospitalPragueCzech Republic

Despite advanced therapies,the mortality of patients with myocardial infarction(MI)complicated by cardiogenic shock(CS)remains around 50%.Mechanical complications of MI are rare nowadays but associated with high mortality in patients who present with CS.Different treatment strategies and mechanical circulatory support(MCS)devices have been increasingly used to improve the grim prognosis of refractory CS.This article discusses current evidence regarding the use of MCS in MI complicated by CS,ventricular septal rupture,free wall rupture and acute mitral regurgitation.Device selection should be tailored according to the cause and severity of CS.Early MCS initiation and multidisciplinary team cooperation is mandatory for good results.MCS associated bleeding remains a major complication and an obstacle to better outcomes.Ongoing prospective randomized trials will improve current knowledge regarding MCS indications,timing,and patient selection in the coming years.

关键词： mortality infarction rupture

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基于随机暴雨移置方法的城市设计暴雨分析

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水科学进展 2020年第4期31卷 583-591页

作者：周正正刘曙光 daniel b Wright 同济大学水利工程系上海200092 Department of Civil and Environmental Engineering University of WisconsinMadison WI 53706USA

城市地区暴雨洪灾发生频繁,合理计算设计暴雨是解决城市洪涝的重要前提。采用随机暴雨移置方法(Stochastic Storm Transposition,SST),设定暴雨移置区并提取出暴雨目录,通过区域性概率重采样与暴雨空间变换相结合的方式进行降雨频率分析... 详细信息

城市地区暴雨洪灾发生频繁,合理计算设计暴雨是解决城市洪涝的重要前提。采用随机暴雨移置方法(Stochastic Storm Transposition,SST),设定暴雨移置区并提取出暴雨目录,通过区域性概率重采样与暴雨空间变换相结合的方式进行降雨频率分析,估计本地化的极端暴雨频率。以上海地区为例,研究发现暴雨移置区内暴雨分布具有空间异质性,暴雨随机移置概率不均,计算得到的设计暴雨方案包含了降雨时空分布信息,在不同重现期下设计暴雨的时空结构存在变异性,说明传统方法中采用的简化雨型和均一化空间分布假设会增加设计暴雨的不确定性。

关键词：设计暴雨随机暴雨移置法城市流域上海市

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Iron regulatory protein 1: the deadly switch of ferroptosis

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Neural Regeneration Research 2024年第3期19卷 477-478页

作者： daniel A.bórquez Pamela J.Urrutia Center for biomedical Research Faculty of MedicineUniversidad Diego PortalesSantiagoChile Institute of Nutrition&Food Technology(INTA) Universidad de ChileSantiagoChile Geroscience Center for brain Health and Metabolism SantiagoChile

Ferroptosis,an iron-dependent cell death:Ferroptosis is a type of regulated necrosis,characterized by redox-active iron accumulation and increased free radical production derived by Fenton chemistry,that triggers oxidation of polyunsaturated fatty acids in phospholipids,loss of cellular membranes integrity,and leakage of intracellular contents.

关键词： integrity switch Iron

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Iron,the endolysosomal system and neuroinflammation:a matter of balance

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Neural Regeneration Research 2022年第5期17卷 1003-1004页

作者： daniel A.bórquez Pamela J.Urrutia Marco T.Núñez Center for biomedical Research Faculty of MedicineUniversidad Diego PortalesSantiagoChile Department of biology Faculty of SciencesUniversidad de ChileSantiagoChile

Iron accumulation and neuroinflammation are cardinal features of many neurodegenerative diseases(Urrutia et al.,2021).However,the hierarchy in the pathogenic mechanisms and the molecular connections between these proc... 详细信息

关键词： Iron system showing

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Design of synthetic materials for intracellular delivery of RNAs： From siRNA-mediated gene silencing to CRISPR/Cas gene editing

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Nano Research 2018年第10期11卷 5310-5337页

作者： Jason b. Miller daniel J. Siegwart Simmons Comprehensive Cancer Center University of Texas Southwestern Medical Center Dallas TX 75390 USA Department of biochemistry University of Texas Southwestern Medical Center Dallas TX 75390 USA

Ribonucleic acids （RNAs） possess great therapeutic potential and can be used to treat a variety of diseases. The unique biophysical properties of RNAs, such as high molecular weight, negative charge, hydrophilicity, low stability, and potential immunogenicity, require chemical modification and development of carriers to enable intracellular delivery of RNAs for clinical use. A variety of nanornaterials have been developed for the effective in vivo delivery of short/ small RNAs, messenger RNAs, and RNAs required for gene editing technologies including clustered regularly interspaced palindromic repeat （CRISPR）/Cas. This review outlines the challenges of delivering RNA therapeutics, explores the chemical synthesis of RNA modifications and carriers, and describes the efforts to design nanomaterials that can be used for a variety of clinical indications.

关键词： nucleic acid therapeutics nanoparticles synthetic nanomaterials RNA interference （RNAi） messenger RNA （mRNA） clustered regularly inter-spaced palindromic repeat（CRISPR）/Cas

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Contributors’enrollment in collaborative online communities:the case of OpenStreetMap

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Geo-Spatial Information Science 2017年第3期20卷 282-295页

作者： daniel bégin Rodolphe Devillers Stéphane Roche Department of Geography Memorial University of NewfoundlandSt.John’sCanada Centre de Recherche en Géomatique UniversitéLavalQuébecCanada

The number of people registering in an online community depends on two main factors:interest in,and awareness of,the project.Registering to a project does not,however,imply contributing to it,as lacking the knowledge and skills can be a barrier to participation.In order to identify the nature of events that might have facilitated or hindered enrollments in the OpenStreetMap(OSM)project over time,we analyzed the correlations between the number of new participants and the events that dotted its history.Four different metrics were defined to characterize participants’behaviors:the daily number of registrations,the daily number of participants that made a first contribution,the delays between contributors’registration and their first edits,and a daily contribution ratio built from the number of new contributors and the number of new registered members.Time series analyses were used to identify trends,and outstanding variations of the number of participants.An inventory of events that took place along the OSM project’s history was created and appreciable variations of the metrics have been linked to events that seemed to be meaningful.Although a correlation does not imply causality,many of the explanations these correlations suggest are supported by the results of other studies,either directly or indirectly.For instance,when considering the time participants spend as“lurker”,as well as on the nature of the contribution of early participants.In other cases,they suggest new explanations for the origin of the spam accounts that affect registration statistics,or the decline in the proportion of registered members who actually become contributors.

关键词： OpenStreetMap(OSM) contributors lurkers participation knowledge motivation

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Olfactory outcomes in the management of aspirin exacerbated respiratory disease related chronic rhinosinusitis

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第4期6卷 207-213页

作者： daniel b.Spielman Jonathan Overdevest David A.Gudis Departm ent of Otolaryngology-Head and Neck Surgery Columbia University Medical CenterNew YorkNY10032USA

Patients with aspirin exacerbated respiratory disease(AERD)experience a severe and recalcitrant form of chronic rhinosinusitis with nasal polyposis(CRSwNP)and asthma,which are exacerbated by aspirin/NSAID ingestion.As compared with aspirin-tolerant CRSwNP,patients with AERD experience more severe olfactory dysfunction,which is one of the key contributors to the observed decrease in quality of life(QOL)in this disease.The objective of this paper is to review the published olfactory outcomes observed with various treatment modalities.

关键词： Aspirin exacerbated respiratory disease AERD Samter’s Triad Olfaction hyposmia Endoscopic sinus surgery Aspirin desensitization NSAID

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