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Endoscopic submucosal dissection training with pig models in a Western country

World Journal of Gastroenterology 2010年第23期16卷 2895-2900页

作者： Adolfo parra-Blanco María Rosa Arnau david nicolás-pérez Antonio Z Gimeno-García nicolás González Juan A Díaz-Acosta Alejandro Jiménez Enrique Quintero Department of Gastroenterology University Hospital of the Canary Islands Ofra s/n Endoscopy Unit Department of GastroenterologyAsturias Central University HospitalCelestino Villamil s/n Research Animal Laboratory Ofra s/nLa Laguna University Department of Gastroenterology Montevideo Clinic HospitalAvda Italia s/n Research Unit University Hospital of the Canary IslandsOfra s/n

AIM:To test a strategy for endoscopic submucosal dissection(EsD) training in animal models designed to overcome the initial learning ***:EsD was attempted in ex vivo and in vivo pig *** EsD procedures were attempted in the esophagus(n=9) or the stomach(n=21).The ex vivo model was used until initial competence was *** the in vivo model,several EsD procedures were performed in up to 3 *** following variables were analyzed:specimen size,complete and en bloc resection rate,time for circumferential incision,time for submucosal dissection,total EsD duration,and ***:Complete resection was achieved in 28 cases(en bloc 27);2 could not be completed(one perforation,one technical diff iculty).The mean ± sD time for circumferential incision was 36.2±16.8 min(range:8-87 min),and the mean±sD time for submucosal dissection was 45.1±35.7 min(range:9-196 min).The mean±sD size of the resected specimens was 45.2±17.8 *** mean±sD total resection time was signif icantly increased for the gastric cases performed in the f irst half of the study(n=13) than in the second half(n=8)(98.9±62.4 min vs 61.7±17.6 min,p=0.04),although the specimen size did not ***:Training in animal models could help endoscopists overcome the learning curve before starting EsD in humans.

关键词： Endoscopic submucosal dissection Training Animal model

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Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy

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World Journal of Gastroenterology 2009年第42期15卷 5266-5273页

作者： Adolfo parra-Blanco Alejandro Jiménez Bjrn Rembacken nicolás González david nicolás-pérez Antonio Z Gimeno-García Marta Carrillo-palau Takahisa Matsuda Enrique Quintero Department of Gastroenterology University Hospital of the Canary Islandsc/Ofra s/nLa Laguna 38320TenerifeSpain Department of Gastroenterology Hospital Universitario Central de AsturiasCelestino Villamil s/n33006 OviedoPrincipado de AsturiasSpain Research Unit University Hospital of the Canary Islandsc/Ofra s/nLa Laguna 38320TenerifeSpain Centre for Digestive Diseases The General Infirmary at LeedsGreat George StLeedsLS1 3EXUnited Kingdom Department of Gastroenterology Hospital de Clínicas de MontevideoAvda.Italia s/nMontevideo 11600Uruguay Division of Endoscopy National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyo 104-0045Japan

AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in ***:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were ***:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white *** mucosal surface was best assessed using filter ***,the views obtained were not rated significantly better than those observed with white *** "gold standard",indigo carmine(IC) dye,was found to be superior to both white light and filter *** 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained *** assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light *** the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white ***:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE.

关键词： Colonoscopy Computed virtual chromoendoscopy Fujinon intelligent chromoendoscopy Magnifying colonoscopy polyp diagnosis

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The timing of bowel preparation before colonoscopy determines the quality of cleansing,and is a significant factor contributing to the detection of flat lesions:A randomized study

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World Journal of Gastroenterology 2006年第38期12卷 6161-6166页

作者： Adolfo parra-Blanco david nicolás-pérez Antonio Gimeno-García Begoa Grosso Alejandro Jiménez Juan Ortega Enrique Quintero Department of Gastroenterology Hospital Universitario de Canarias La Laguna 38109 Santa Cruz de Tenerife Spain Research Unit Hospital Universitario de Canarias La Laguna 38109 Santa Cruz de Tenerife Spain

AIM： To compare the cleansing quality of polyethylene glycol electrolyte solution and sodium phosphate with different schedules of administration, and to evaluate whether the timing of the administration of bowel preparation affects the detection of polyps. METHODs： One hundred and seventy-seven consecutive outpatients scheduled for colonoscopy were randomized in one of four groups to receive polyethylene glycol electrolyte solution or oral sodium phosphate with two different timing schedules. Quality of cleansing, polyp detection, and tolerance were evaluated. REsULTs： patients receiving polyethylene glycol or sodium phosphate on the same day as the colonoscopy, obtained good to excellent global cleansing scores more frequently than patients who received polyethylene glycol or sodium phosphate on the day prior to the procedure （p 〈 0.001）. Flat lesions, but not fiat adenomas, were more frequent in patients prepared on the same day （p = 0.02）. CONCLUsION： The quality of colonic cleansing and the detection of fiat lesions are significantly improved when the preparation is taken on the day of the colonoscopy.

关键词： Colonoscopy preparation polyp Flat lesion sodium phosphate polyethylene glycol

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rate of adverse events of gastroduodenal snare polypectomy for non-flat polyp is low: A prospective and multicenter study

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World Journal of Gastroenterology 2017年第47期23卷 8405-8414页

作者： Henry Córdova Lidia Argüello Carme Loras Antonio Naranjo Rodríguez Faust Riu pons Joan B Gornals david nicolás-pérez Xavier Andújar Murcia Luis Hernández santos santolaria Carles Leal Carles pons Enrique pérez-Cuadrado-Robles Orlando García-Bosch Michel papo Berger José Luis Ulla Rocha Cristina sánchez-Montes Gloria Fernández-Esparrach Endoscopy Unit.Institut de Malalties Digestives Hospital ClínicIDIBAPSCIBERehdUniversitat de Barcelona Digestive Endoscopy Unit Digestive Diseases DepartmentGastrointestinal Endoscopy Research GroupIISLa Fe Polytechnic University Hospital Hospital Universitari Mútua de Terrassa CIBERehd Hospital Reina sofía Hospital Del Mar Hospital Universitari de Bellvitge IDIBELLUniversitat de BarcelonaHospitalet de Llobregat Hospital Universitario de Canarias Hospital santos Reyes Aranda de Duero Hospital san Jorge Consorci Hospitalari de Vic Universitat de Vic Hospital de Viladecans Hospital Morales Meseguer Hospital Moisès Broggi Sant Joan Despí Hospital Joan XXIII Complejo Hospitalario de pontevedra

AIM To evaluate the rate of adverse events(AEs) during consecutive gastric and duodenal polypectomies in several spanish centers. METHODs polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American society for Gastrointestinal Endoscopy. patients were followed for 48 h, one week and 1 mo after theprocedure. REsULTs308 patients were included and a single polypectomy was performed in 205. Only 36(11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm(5-60) and in 294 cases(95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219(71.1%) patients. Nine patients presented AEs(2.9%), and 6 of them were bleeding(n = 6, 1.9%)(in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of *** Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.

关键词： polypectomy Bleeding Adverse events protruded polyps Gastroduodenal Foregut

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Navigating the controversy regarding antibiotic prophylaxis in acute variceal bleeding

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World Journal of Gastroenterology 2024年第18期30卷 2485-2487页

作者： david Aguirre-Villarreal Ignacio García-Juárez Department of Gastroenterology and Liver Transplant Unit Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico

Antibiotic prophylaxis in patients with cirrhosis and acute variceal bleeding is part of the standard of care according to most clinical ***,with recent evidence arguing against antibiotic prophylaxis,the role of this... 详细信息

关键词： Cirrhosis Acute variceal bleeding Antibiotic prophylaxis Endoscopic band ligation spontaneous bacterial peritonitis

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An Investigation into Forced Convection of a Nanofluid Flowing in a Rectangular Microchannel under the Influence of a Magnetic Field

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Fluid Dynamics & Materials processing 2024年第2期20卷 311-323页

作者： Muataz s.Alhassan Ameer A.Alameri Andrés Alexis Ramírez-Coronel I.B.sapaev Azher M.Abed david-Juan Ramos-Huallpartupa Rahman s.Zabibah Division of Advanced Nanomaterial Technologies Scientific Research CenterAl-Ayen UniversityThi-QarIraq Department of Chemistry College of ScienceUniversity of BabylonBabylonIraq Research Group in Educational statistics National University of EducatiosnAzoguesEcuador Department physics and Chemistry Tashkent Institute of Irrigation and Agricultural Mechanization EngineersNational Research UniversityTashkentUzbekistan Akfa University TashkentUzbekistan New Uzbekistan University TashkentUzbekistan Department of Airconditioning and Refrigeration Engineering Al-Mustaqbal University CollegeHilla51001Iraq Academic Department of Agro-Industrial Engineering and Technology Universidad Nacional JoséMaría ArguedasApurimacPerú The Islamic University NajafIraq

In line with recent studies,where it has been shown that nanoﬂuids containing graphene have a stronger capacity to boost the heat transfer coefﬁcient with respect to ordinary nanoﬂuids,experiments have been conducted using water with cobalt ferrite/graphene *** particular,a circular channel made of copper subjected to a constant heatﬂux has been *** nanoparticles are sensitive to the presence of a magneticﬁeld,different conditions have been examined,allowing both the strength and the frequency of such aﬁeld to span relatively wide ranges and assuming different concentrations of *** to theﬁndings,the addition of nanoparticles to theﬂuid causes its rotation speed to increase by a factor of two,whereas ultraviolet radiation plays a negligible *** amount of time required to attain the maximum rotation speed of the nanoﬂuid and the Nusselt number have been measured under both constant and alternating magneticﬁelds for a ferroﬂuid with a concentration of 0.5%and atﬂow Reynolds number of 550 and 1750.

关键词： Nano fluid rectengular tube magnetic field

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Direct-to-indirect mapping for optimal low-thrust trajectories

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Astrodynamics 2024年第1期8卷 27-46页

作者： david Ottesen Ryan p.Russell Department of Aerospace Engineering and Engineering Mechanics The University of Texas at AustinAustinTexas78712USA

Optimal,many-revolution spacecraft trajectories are challenging to solve.A connection is made for a class of models between optimal direct and indirect *** transfers that minimize thrust-acceleration-squared,primer vector theory maps direct,many-impulsive-maneuver trajectories to the indirect,continuous-thrust-acceleration *** mapping algorithm is independent of how the direct solution is obtained and requires only a solver for a boundary value problem and its partial derivatives.A Lambert solver is used for the two-body problem in this *** mapping is simple because the impulsive maneuvers and co-states share the same linear space around an optimal *** numerical results,the direct coast-impulse solutions are demonstrated to converge to the indirect continuous solutions as the number of impulses and segments *** two-body design space is explored with a set of three many-revolution,many-segment examples changing semimajor axis,eccentricity,and *** first two examples involve a small change to either semimajor axis or eccentricity,and the third example is a transfer to geosynchronous *** a single processor,the optimization runtime is seconds to minutes for revolution counts of 10 to 100,and on the order of one hour for examples with up to 500 *** of these thrust-acceleration-squared solutions are good candidates to start a homotopy to a higher-fidelity minimization problem with practical constraints.

关键词： direct optimization indirect optimization impulsive maneuvers Lambert's problem two-body dynamics primer vectortheory

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The great catastrophe: causes of the permo-Triassic marine mass extinction

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National science Review 2024年第1期11卷 37-50页

作者： paul B.Wignall david p.G.Bond school of Earth & Environment University of Leeds school of Environmental sciences University of Hull

The marine losses during the permo-Triassic mass extinction were the worst ever experienced. All groups were badly affected, especially amongst the benthos(e.g. brachiopods, corals, bryozoans, foraminifers,ostracods). planktonic populations underwent a fundamental change with eukaryotic algae being replaced by nitrogen-fixing bacteria, green-sulphur bacteria, sulphate-reducing bacteria and prasinophytes. Detailed studies of boundary sections, especially those in south China, have resolved the crisis to a ～55 kyr interval straddling the permo-Triassic boundary. Many of the losses occur at the beginning and end of this interval painting a picture of a two-phase extinction. Improved knowledge of the extinction has been supported by numerous geochemical studies that allow diverse proposed extinction mechanisms to be studied. A transition from oxygenated to anoxic-euxinic conditions is seen in most sections globally, although the intensity and timing shows regional variability. Decreased ocean ventilation coincides with rapidly rising temperatures and many extinction scenarios attribute the losses to both anoxia and high *** kill mechanisms include ocean acidification for which there is conflicting support from geochemical proxies and, even less likely, siltation(burial under a massive influx of terrigenous sediment) which lacks substantive sedimentological evidence. The ultimate driver of the catastrophic changes at the end of the permian was likely siberian Trap eruptions and their associated carbon dioxide emissions with consequences such as warming, ocean stagnation and acidification. Volcanic winter episodes stemming from siberian volcanism have also been linked to the crisis, but the short-term nature of these episodes(s) and the overwhelming evidence for rapid warming during the crisis makes this an unlikely cause. Finally, whilst the extinction is well studied in equatorial latitudes, a different history is found in northern Boreal latitudes

关键词： ocean anoxia ocean acidification siltation productivity collapse volcanic winter

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Role of climatic variability in shaping intraspecific variation of thermal tolerance in Mediterranean water beetles

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Insect science 2024年第1期31卷 285-298页

作者： susana pallarés david Garoffolo Belén Rodríguez david sánchez-Fernández Department of Zoology University of SevilleSevilleSpain Faculty of Biology Department of Ecology and HydrologyUniversity of MurciaCampus EspinardoMurciaSpain

The climatic variability hypothesis(CVH)predicts that organisms in more thermally variable environments have wider thermal breadths and higher thermal plasticity than those from more stable ***,due to evolutionary trade-offs,taxa with greater absolute thermal limits may have little plasticity of such limits(trade-off hypothesis).The CVH assumes that climatic variability is the ultimate driver of thermal tolerance variation across latitudinal and altitudinal gradients,but average temperature also varies along such *** explored intraspecific variation of thermal tolerance in three typical Mediterranean saline water beetles(families Hydrophilidae and Dytiscidae).For each species,we compared two populations where the species coexist,with similar annual mean temperature but contrasting thermal variability(continental *** population).We estimated thermal limits of adults from each population,previously acclimated at 17,20,or 25℃.We found species-specific patterns but overall,our results agree with the CVH regarding thermal ranges,which were wider in the continental(more variable)*** the two hydrophilid species,this came at the cost of losing plasticity of the upper thermal limit in this population,supporting the trade-off hypothesis,but not in the dytiscid *** results support the role of local adaptation to thermal variability and trade-offs between basal tolerance and physiological plasticity in shaping thermal tolerance in aquatic ectotherms,but also suggest that intraspecific variation of thermal tolerance does not fit a general pattern among aquatic *** such intraspecific variation could lead to inaccurate predictions of the vulnerability of aquatic insects to global warming.

关键词： acclimation capacity aquatic insects climate change heat coma temperature supercooling point thermal plasticity

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A combined experimental and DEM investigation of grain interlocking in sheared granular assemblies

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particuology 2024年第7期90卷 436-451页

作者： Rui Lu Qiang Luo Tengfei Wang david p.Connolly Tao Xie school of Civil Engineering Southwest Jiaotong UniversityChengdu 610031China Key Laboratory of High-speed Railway Engineering(southwest Jiaotong University) Ministry of EducationChengdu 610031China school of Civil Engineering University of LeedsLeeds LS29JTUK Department of Civil Engineering McMaster UniversityHamiltonONCanada

Compacted granular material,integral to geotechnical engineering,undergoes translation,rotation,and interlocking when subject to shear displacements or external *** present study focuses on the interlocking of heterogeneous granular materials,a complex behavior influenced by gradation,compaction,and varying particle geometry,and has consequently received limited attention in existing *** address this research gap,we conducted an analysis on the effect of grain interlocking on the shear resistance of granular assemblies,using a combination of laboratory testing and the discrete element method(DEM).Initially,large-scale direct shear tests were conducted on gravel−sand mixes with varying degrees of compaction and normal *** of the mixes also underwent subsequent shear reversal to explore the differences in grain interlocking between the two shearing processes on the shear *** analyzing the laboratory results,a mesoscopic scale investigation was performed by replicating the test using discrete element *** facilitate this,granular particle geometries were measured using 3D laser scanning based on the physical lab ***,based on these scans,discrete element R-block and ball models were utilized to construct both the coarse and fine particles within the *** vibro-compaction was employed to regulate the degree of *** results indicate that an increase in vertical pressure,coupled with a zero dilatancy angle,results in a rising stress ratio,indicative of grain *** interlocking exhibits a positive correlation with both the coarse content and the degree of compaction,and varies depending on the shear *** interlocking progresses,the shear band,induced by particle movement,expands and is associated with reduced particle rotation near the shear *** study further reveals a consistent positive correlation between interlocking and the principal orientation angle of strong normal c

关键词： Granular material Interlocking shear resistance Direct shear Discrete element method Vibro-compaction

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