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Prognostic significance of red blood cell distribution width in gastrointestinal disorders

World Journal of Gastroenterology 2017年第27期23卷 4879-4891页

作者： Hemant Goyal Giuseppe Lippi Altin Gjymishka Bijo John Rajiv Chhabra elizabeth may Department of Internal Medicine Mercer University School of Medicine Section of Clinical Biochemistry University of Verona Texas Digestive Disease Consultants Department of Gastroenterology Saint Luke’s HospitalSchool of MedicineUniversity of Missouri Kansas City Gastroenterology Attending Mc Laren Northern Hospital

The red blood cell distribution width(RDW) is a routinely measured and automatically reported blood parameter,which reflects the degree of anisocytosis. Recently,the baseline RDW was found to have clinical significance for assessing clinical outcome and severity of various pathological conditions including cardiovascular diseases,sepsis,cancers,leukemia,renal dysfunction and respiratory diseases. A myriad of factors,most of which ill-defined,have an impact on the red cell population dynamics(i.e.,production,maturation and turnover). A delay in the red blood cell clearance in pathological conditions represents one of the leading determinants of increased anisocytosis. Further study of RDW may reveal new insight into inflammation mechanisms. In this review,we specifically discuss the current literature about the association of RDW in various disease conditions involving the gastrointestinal and hepatobiliary systems. We also present some of the related measurements for their value in predicting clinical outcomes in such conditions. According to our data,RDW was found to be a valuable prognostic index in gastrointestinal disorders along with additional inflammatory biomarkers(i.e.,C reactive protein,erythrocyte sedimentation rate,and platelet count) and current disease severity indices used in clinical practice.

关键词： Red blood cell distribution width Hepatitis Pancreatitis Inflammatory bowel diseases Crohn’s disease Ulcerative colitis Colon cancer Hepatocellular carcinoma Acute mesenteric ischemia Gastrointestinal diseases

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Effect of Treatment for CHC on Liver Disease Progression and Hepatocellular Carcinoma Development in African Americans

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Journal of Clinical and Translational Hepatology 2015年第3期3卷 163-168页

作者： Naveen Reddy Paul Naylor Zaher Hakim Redwan Asbahi Karthik Ravindran elizabeth may Murray Ehrinpreis Milton Mutchnick Department of Internal Medicine/Division of Gastroenterology Wayne State University School of MedicineHarper University Hospital Detroit MI USA

Background and Aims:African Americans (AA) historically have a low response rate to hepatitis C therapies,and there is limited information available for this patient population regarding the development and treatment of chronic hepatitis C (CHC).The aim of this study was to evaluate liver disease progression and hepatocellular carcinoma (HCC) development in AA with ***:Between 1995 and 2008,246 AA patients with CHC were identified from a database of patients and followed until 2012-2013 (average 8 years)or the development of HCC after ***:Viral clearance (intent to treat;sustained virus response (SVR)) was achieved in 15% of patients with interferon based therapies with or without *** patients who achieved an SVR (n=22) did not develop HCC or new onset cirrhosis,whereas the HCC incidence in untreated AA patients was 23% (51/203).Patients who achieved an SVR also had improved fibrosis,as defined by the AST Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) score,relative to nonresponders and untreated ***:The severity of liver disease at the first visit (except for cirrhosis) correlated with the development of HCC,but because of the overlap in values between patients,these measurements were not useful for predicting individual *** cirrhosis at the first visit was not a predictive factor,treatment with newer antiviral therapies is the best option for reducing the incidence of advanced liver disease and its harmful outcomes in the AA population.

关键词： Hepatitis C Cirrhosis Hepatocellular carcinoma APRI Fib-4

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Latent hepatitis B is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C

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World Journal of Gastroenterology 2013年第48期19卷 9328-9333页

作者： Arvind Reddy elizabeth may Murray Ehrinpreis Milton Mutchnick Division of Gastroenterology Wayne State University Detroit MI 48201 United States

AIM:To study the potential association between hepatocellular carcinoma(HCC)in patients with chronic hepatitis C(CHC),cirrhosis and latent hepatitis B(LHB)infection,defined as the absence of detectable serum hepatitis B surface antigen(HBsAg)and the presence of hepatitis B core antibody(HBcAb).METHODS:This retrospective analysis is comprised of 185 cirrhotic patients with HCC who were hepatitis C virus antibody(HCV Ab)(+)and HBsAg(-)at Wayne State University between 1999 and *** these,108 patients had HCV polymerase chain reaction confirmation of viremia while the remaining(77)were considered to have CHC on the basis of a positive HCV Ab and the absence of any other cause of liver *** were drawn from our institutional database from the same time period and consisted of 356 HBsAg(-)age,race and gender matched patients with HCV RNA-confirmed CHC and without evidence of HCC.A subgroup of controls included 118matched patients with liver cirrhosis.χ2test and t test were used for data ***:Seventy-seven percent of patients in all3 groups were African *** with HCC had a significantly higher body mass index(P=0.03),a higher rate of co-infection with human immunodeficiency virus(HIV)(P=0.05)and a higher prevalence of alcohol abuse(P=0.03)than the *** patients with HCC had LHB than controls(78%vs39%,P=0.01).Sixty three percent of patients with HCC were both hepatitis B surface antigen(HBsAb)(-)and HBcAb(+)compared to 23%of controls(P<0.01).When compared to cirrhotic controls,the frequency of HBcAb(+)remained higher in patients with HCC(78%vs 45%,P=0.02).Patients with HCC were more likely to be both HBsAb(-)and HBcAb(+)than the cirrhotic controls(63%vs 28%,P=0.01).Although not statistically significant,100%of CHC and HIV coinfected patients with HCC(n=11)were HBcAb(+)when compared to controls(44%;n=9).CONCLUSION:These data suggest that LHB occurs at a significantly increased frequency in patients with CHC and HCC than in

关键词： Hepatocellular carcinoma Chronic hepatitis C Latent hepatitis B Hepatitis C virus

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Childhood sleep:physical,cognitive,and behavioral consequences and implications

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World Journal of Pediatrics 2024年第2期20卷 122-132页

作者： Jianghong Liu Xiaopeng Ji Susannah Pitt Guanghai Wang elizabeth Rovit Terri Lipman Fan Jiang School of Nursing University of Pennsylvania418 Curie Blvd.Room 424Claire M.Fagin HallPhiladelphiaPA 19104USA College of Health Sciences University of DelawareNewarkDE 19716USA Geisinger Commonwealth School of Medicine ScrantonPA 18510USA Pediatric Translational Medicine Institute Department of Developmental and Behavioral PediatricsSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background Sleep problems in children have been increasingly recognized as a major public health *** research has extensively studied and presented many risk factors and potential mechanisms for children’s sleep *** this paper,we aimed to identify and summarize the consequences and implications of child sleep *** sources A comprehensive search for relevant English language full-text,peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed,SCOPUS,and Psych Info published in the past two *** relevant data-based articles and systematic reviews are *** Many adverse consequences are associated with child sleep deficiency and other sleep problems,including physical outcomes(e.g.,obesity),neurocognitive outcomes(e.g.,memory and attention,intelligence,academic performance),and emotional and behavioral outcomes(e.g.,internalizing/externalizing behaviors,behavioral disorders).Current prevention and intervention approaches to address childhood sleep problems include nutrition,exercise,cognitive–behavioral therapy for insomnia,aromatherapy,acupressure,and *** interventions may be particularly important in the context of coronavirus disease *** research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of *** Given the increasing prevalence of child sleep problems,which have been shown to affect children’s physical and neurobehavioral wellbeing,understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention,thus improving sleep-related child development and health.

关键词： Behavior Child sleep Consequences Implications Neurocognitive Physical Prevention/intervention

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Role of buccal mucosa graft ureteroplasty in the surgical management of pyeloplasty failure

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Asian Journal of Urology 2024年第3期11卷 373-376页

作者： Matthew Lee elizabeth Nagoda David Strauss Matthew Loecher Michael Stifelman Lee Zhao Department of Urology Lewis Katz School of MedicineTemple UniversityPhiladelphiaPAUSA Department of Urology Hackensack Meridian School of MedicineHackensack University Medical CenterHackensackNJUSA Department of Urology New York University Grossman School of MedicineNew York University Langone Health SystemNew YorkNYUSA

Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for *** study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed ***:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed *** primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on ***:Overall,ten patients were included in our *** median stricture length was 2.5(interquartile range[IQR]1.8-4.0)*** median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)*** a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)***:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.

关键词： Ureteral obstruction Buccal mucosagraft Pyeloplasty Robotic Stricture

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Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

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Open Journal of Preventive Medicine 2024年第5期14卷 90-109页

作者： Kenneth Mugambi Jackline Nyaberi elizabeth Echoka Kemri Graduate School NRB Nairobi Kenya Jomo Kenyatta University of Science & Technology Nairobi Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from may 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to

关键词： Non-Communicable Diseases Barriers Challenges Healthcare Infrastructure Awareness Cultural Beliefs Financial Constraints

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The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

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Open Journal of Preventive Medicine 2024年第4期14卷 61-78页

作者： Kenneth Mugambi Jackline Nyaberi elizabeth Echoka Kemri Graduate School Nairobi Kenya Jomo Kenyatta University of Science & Technology Nairobi Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from may 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

关键词： Intervention Community Health Volunteers Non-Communicable Disease Screening Linkages

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Degradation and resynthesis of chlorophyll during increased oxidative stress and prolonged darkness differ between annual and perennial flax(Linum L.)

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Oil Crop Science 2024年第2期9卷 121-130页

作者： Kenyon J. Nisbett Abida Alokozai Su Hyun elizabeth Ko G. Adam Mott Jason C.L. Browna Department of Biological Sciences University of Toronto ScarboroughTorontoONCanada Department of Cell&Systems Biology University of TorontoTorontoONCanada Centre for the Analysis of Genome Evolution&Function University of TorontoTorontoONCanada

Among plants,there is considerable variation in lifespan:annuals live less than one year,whereas perennials live for several years,with the longest-living perennial having survived 43,600 *** proposed by the Disposable Soma Theory,this lifespan variation among plants likely reflects differential investment of limited energy and nutrient resources,with perennials investing more energy and nutrients into biomolecular maintenance compared to annuals in order to ensure persistence over multiple *** differential investment may be particularly important during periods of exogenous stress,which are known to accelerate biomolecular *** present study evaluated this hypothesis using annual and perennial flax(Linum L.)subjected to two exogenous stressors—increased oxidative stress(i.e.,foliar H2O2spraying)and complete prolonged *** chlorophyll has been shown to exhibit degradation in response to changes in environmental conditions,we utilized changes in chlorophyll levels during and after periods of exogenous stress to evaluate our *** predicted that i)perennials would exhibit a slower rate of chlorophyll degradation during exposure to exogenous stressors compared to annuals,and ii)perennials would exhibit a faster rate of chlorophyll resynthesis following such exposure compared to *** levels before,during,and after exposure to both exogenous stressors were measured in two separate trails,once using image colour analysis and once using *** chlorophyll degradation rates in response to oxidative stress did not differ between annuals and perennials,contrary to our predictions,chlorophyll resynthesis rates following such exposure were significantly higher in perennials,as *** plants were subjected to complete prolonged darkness,chlorophyll degradation rates were significantly lower in perennials than annuals,as predicted;however,when plants were subsequently reintroduced to natural photoperiod,ch

关键词： Ageing Life history Maximum lifespan Oxidative stress Somatic maintenance

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How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

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Journal of Sport and Health Science 2024年第4期13卷 537-547页

作者： Jacqueline Josee van Ierssel Olivia Galea Kirsten Holte Caroline Luszawski elizabeth Jenkins Jennifer O’Neil Carolyn A Emery Rebekah Mannix Kathryn Schneider Keith Owen Yeates Roger Zemek Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada The Centre for Health Activity and Rehabilitation ResearchUniversity of OtagoDunedin 9016New Zealand Sport Injury Prevention Research Centre Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada Alberta Children’s Hospital Research Institute University of Calgary CalgaryAB T2N 1N4Canada Hotchkiss Brain Institute University of CalgaryCalgaryAB T2N 4N1Canada Department of Psychology University of CalgaryCalgaryAB T2N 1N4Canada g Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada School of Rehabilitation Sciences University of OttawaOttawaON K1H 8M5Canada Bruyere Research Institute OttawaON K1N 5C8Canada Departments of Pediatrics and Emergency Medicine Harvard Medical SchoolBostonMA 02115USA Departments of Pediatrics and Emergency Medicine University of OttawaOttawaON K1H 8M5Canada

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following ***:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to may *** reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)*** information was sought my study authors where reporting was *** of bias(ROB)was assessed with the Cochrane ROB-2 *** examining non-pharmacological interventions following ***:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck *** scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified *** completeness improved after TIDieR and CERT publication,but p

关键词： Concussion Intervention Randomized controlled trial Systematic review

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Temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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Family Medicine and Community Health 2024年第4期12卷 1-8页

作者： elizabeth T Thomas Diana R Withrow Cynthia Wright Drakesmith Peter J Gill Rafael Perera-Salazar Carl Heneghan Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK Nuffield Department of Primary Care Health Sciences University of OxfordOxfordUK Department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective The primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis This was a descriptive study of population-based data from Clinical Practice Research Datalink Aurum primary care consultation records from 1 January 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).Tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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