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1H nuclear magnetic resonance spectroscopy-basedmetabonomic study in patients with cirrhosis and hepaticencephalopathy

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World Journal of Hepatology 2015年第12期7卷 1701-1707页

作者： Konstantinos john Dabos john andrew parkinson Ian Howard Sadler john Nicholas Plevris Peter Clive Hayes Centre of Liver and Digestive Disorders Royal Infirmary of Edinburgh Department of Chemistry University of Strathclyde Department of Chemistry University of Edinburgh

AIM: To identify plasma metabolites used as biomarkers in order to distinguish cirrhotics from controls and ***: A clinical study involving stable cirrhotic patients with and without overt hepatic encephalopathy was designed. A control group of healthy volunteers was used. Plasma from those patients was analysed using 1H- nuclear magnetic resonance spectroscopy. We used the Carr Purcell Meiboom Gill sequence to process the sample spectra at ambient probe temperature. We used a gated secondary irradiation field for water signal suppression. Samples were calibrated and referenced using the sodium trimethyl silyl propionate peak at 0.00 ppm. For each sample 128 transients(FID's) were acquired into 32 K complex data points over a spectral width of 6 KHz. 30 degree pulses were applied with an acquisition time of 4.0 s in order to achieve better resolution, followed by a recovery delay of 12 s, to allow for complete relaxation and recovery of the magnetisation. A metabolic profile was created for stable cirrhotic patients without signs of overt hepatic encephalopathy and encephalopathic patients as well as healthy controls. Stepwise discriminant analysis was then used and discriminant factors were created to differentiate between the three ***: Eighteen stabled cirrhotic patients, eighteen patients with overt hepatic encephalopathy and seventeen healthy volunteers were recruited. Patients with cirrhosis had significantly impaired ketone body metabolism, urea synthesis and gluconeogenesis. This was demonstrated by higher concentrations of acetoacetate(0.23 ± 0.02 vs 0.05 ± 0.00, P < 0.01), and b-hydroxybutarate(0.58 ± 0.14 vs 0.08 ± 0.00, P < 0.01), lower concentrations of glutamine(0.44 ± 0.08 vs 0.63 ± 0.03, P < 0.05), histidine(0.16 ± 0.01 vs 0.36 ± 0.04, P < 0.01) and arginine(0.08 ± 0.01 vs 0.14 ± 0.02, P < 0.03) and higher concentrations of glutamate(1.36 ± 0.25 vs 0.58 ± 0.04, P < 0.01), lactate(1.53 ± 0.11 vs 0.42 ± 0.05, P < 0.01),

关键词： Ketone bodies Branch chain amino acids Glutamine Glycolysis

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Resection and reconstruction in high-grade pancreatic head injuries

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1467-1469页

作者： Jake Krige Eduard Jonas andrew john Nicol Pradeep Harkson Navsaria HPB Surgery University of Cape Town Health Sciences FacultyCape Town 7925Western CapeSouth Africa Trauma Center Department of SurgeryGroote Schuur HospitalCape Town 7925Western CapeSouth Africa Department of Surgery Trauma CenterGroote Schuur HospCape Town 7925Western CapeSouth Africa

This study by Chui et al adds further important evidence in the treatment of highgrade pancreatic injuries and endorses the concept of the model of pancreatic trauma care designed to optimize treatment,minimize morbidity and enhance survival in patients with complex pancreatic *** the authors have demonstrated favorable outcomes based on their limited experience of 5 patients who underwent a pancreaticoduodenectomy(PD),including 2 patients who were“unstable”and did not have damage control surgery(DCS),we would caution against the general recommendations promoting index PD without DCS in“unstable”grade 5 pancreatic head injuries.

关键词： Pancreas Injury Surgery Pancreaticoduodenectomy

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Latest updates on structure and recommendations of cardiac rehabilitation programs in chronic heart failure

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World Journal of Clinical Cases 2024年第8期12卷 1382-1387页

作者： Christos Kourek Alexandros Briasoulis Dimitrios E Magouliotis john Skoularigis andrew Xanthopoulos Medical School of Athens National and Kapodistrian University of AthensAthens 15772Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Surgery University Hospital of LarissaLarissa 41110Greece of Cardiology University Hospital of LarissaLarissa 41110Greece

Chronic heart failure(HF)is a clinical syndrome with high morbidity and mor-tality *** rehabilitation(CR)is a medically supervised program designed to maintain or improve cardiovascular health of people living with HF,recommended by both American and European guidelines.A CR program con-sists of a multispecialty group including physicians,nurses,physiotherapists,trainers,nutritionists,and psychologists with the common purpose of improving functional capacity and quality of life of chronic HF *** activity,lifestyle,and psychological support are core components of a successful CR *** has been shown to be beneficial in all ejection fraction categories in HF and most patients,who are stable under medication,are capable of *** individualized exercise prescription should be developed on the basis of a baseline evaluation in all *** main modalities of exercise training are aerobic exercise and muscle strength training of different intensity and *** is important to set the appropriate clinical outcomes from the beginning,in order to assess the effectiveness of a CR *** are still significant limitations that prevent patients from participating in these programs and need to be solved.A significant limitation is the generally low quality of research in CR and the presence of negative trials,such as the rehabilitation after myocardial infarction trial,where comprehensive rehabilitation following myocardial infraction had no important effect on mortality,morbidity,risk factors,or health-related quality of life or *** the present editorial,we present all the updated knowledge and recommendations in CR programs.

关键词： Cardiac rehabilitation Heart failure Outcomes Exercise protocols Prescription Future perspectives Limitations

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Smart contract applications in the built environment: How prepared are Nigerian construction stakeholders?

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Frontiers of Engineering Management 2024年第1期11卷 50-61页

作者： andrew EBEKOZIEN Clinton AIGBAVBOA Samuel Adeniyi ADEKUNLE Mohamad Shaharudin SAMSURIJAN john ALIU Bernard Martins ARTHUR-AIDOO Godpower Chinyeru AMADI Department of Construction Management and Quantity Surveying University of JohannesburgJohannesburg 2006South Africa School of Social Sciences Universiti Sains MalaysiaGelugor11800 USM PenangMalaysia Department of Quantity Surveying Auchi PolytechnicAuchiNigeria Institute for Resilient Infrastructure Systems College of EngineeringUniversity of GeorgiaAthensGA 30602USA Department of Building Technology Faculty of Built EnvironmentAccra Technical UniversityAccraGhana Nigerian Institute of Management Port HarcourtNigeria

Studies have demonstrated that advanced technology,such as smart contract applications,can enhance both pre-and post-contract administration within the built environment *** contract technology,exemplifying blockchain technologies,has the potential to improve transparency,trust,and the security of data transactions within this ***,there is a dearth of academic literature concerning smart contract applications within the construction industries of developing countries,with a specific focus on ***,this study seeks to explore the relevance of smart contract technology and address the challenges impeding its adoption,offering strategies to mitigate the obstacles faced by smart contract *** investigate the stakeholders,this research conducted 14 virtual interview sessions to achieve data *** interviewees encompassed project management practitioners,senior management personnel from construction companies,experts in construction dispute resolution,professionals in construction software,and representatives from government construction *** data obtained from these interviews underwent thorough analysis employing a thematic *** study duly recognizes the significance of smart contract applications within the *** the 12 identified barriers,issues such as identity theft and data leakage,communication and synchronization challenges,high computational expenses,lack of driving impetus,excessive electricity consumption,intricate implementation processes,absence of a universally applicable legal framework,and the lack of a localized legal framework were recurrent impediments affecting the adoption of smart contract applications within the *** study also delves into comprehensive measures to mitigate these *** conclusion,this study critically evaluates the relevance of smart contract applications within the built environment,with a specific focus on promoting their *** may serve

关键词： built environment industry digitalization Nigeria smart contract technological revolution

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Hard Paternalism and Confucian Familism

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Fudan Journal of the Humanities and Social Sciences 2024年第3期17卷 455-478页

作者： andrew Tsz Wan Hung Division of Social Sciences Humanities and DesignCollege of Professional and Continuing EducationThe Hong Kong Polytechnic University9 Hoi Ting RoadYau Ma TeiKowloonHong KongChina

In this paper,I criticize Joel Feinberg's argument of soft paternalism,which stands against hard paternalism,as being *** assessing one's voluntariness is very difficult and controversial,paternalistic measures would be preferable to be implemented by hard paternalism rather than soft paternalism.I then examine four usual criticisms of hard paternalism from the perspective of utilitarianism and the principle of autonomy.I argue that these criticisms are unsound and unfounded,and I defend hard paternalism from the perspective of Confucian familism.I argue that as one's life and identity are inseparable from one's family,“self-regarding”actions,traditionally understood,do not only affect the self,but also one's family ***,paternalistic measures to protect individuals from self-harming are also aimed to protect their family members which are indeed compatible with Mill's harm principle.

关键词： Paternalism Feinberg john S.Mill-Confucian familism Autonomy:Voluntariness

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Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus:A systematic review

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World Journal of Orthopedics 2024年第6期15卷 585-592页

作者： Katherine Esser James J Butler Mackenzie Roof Nathaniel P Mercer Michael C Harrington Alan P Samsonov andrew J Rosenbaum john G Kennedy Department of Orthopaedic Surgery University of Toledo Medical Center University of Toledo College of Medicine and Life SciencesToledoOH 43614United States Department of Orthopedic Surgery NYU Langone HealthNew YorkNY 10002United States Department of Orthopedic Surgery Albany Medical CenterAlbanyNY 12208United States

BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPJ)is one of the most common procedures for the management of hallux ***,there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy(MIDC)for the management of hallux *** To evaluate outcomes following MIDC for the management of hallux *** During November 2023,the PubMed,EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux *** Six studies were *** total,348 patients(370 feet)underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9±16.5 *** distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows:Ⅰ(58 patients,27.1%),Ⅱ(112 patients,52.3%),Ⅲ(44 patients,20.6%).Three studies performed an additional 1^(st)MTPJ arthroscopy and debridement following *** intra-articular bone debris was observed in 100%of patients in 1 *** weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9±3.2 to a postoperative score of *** complication rate was 8.4%,the most common of which was persistent joint pain and ***-two failures(8.7%)were ***-three secondary procedures(8.9%)were performed at a weighted mean time of 8.6±3.2 months following the index *** This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up.A moderate reoperation rate at short-term follow-up was *** marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.

关键词： Minimally invasive dorsal cheilectomy Hallux rigidus The first metatarsophalangeal joint Cheilectomy Minimally invasive surgery

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Recent advances in the diagnostic methods and therapeutic strategies of transthyretin cardiac amyloidosis

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World Journal of Cardiology 2024年第7期16卷 370-379页

作者： Christos Kourek Alexandros Briasoulis Dimitrios E Magouliotis Panagiotis Georgoulias Grigorios Giamouzis Filippos Triposkiadis john Skoularigis andrew Xanthopoulos Clinical Ergospirometry Exercise and Rehabilitation Laboratory1^(st)Critical Care Medicine DepartmentEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Department of Clinical Therapeutics Alexandra HospitalFaculty of MedicineNational and Kapodistrian University of AthensAthens 11528Greece Department of Cardiothoracic Surgery University of ThessalyLarissa BiopolisLarissa 41110Greece Department of Nuclear Medicine University Hospital of LarissaLarissa 41110Greece Department of Cardiology School of MedicineUniversity Hospital of LarissaLarissa 41110Greece

Cardiac amyloidosis is a progressive disease characterized by the buildup of amyloid fibrils in the extracellular space of the *** is divided in 2 main types,immunoglobulin light chain amyloidosis and transthyretin amyloidosis(ATTR),and ATTR amyloidosis is further divided in 2 subtypes,non-hereditary wild type ATTR and hereditary mutant variant *** and prevalence of ATTR cardiac amyloidosis is increasing over the last years due to the improvements in diagnostic *** rates are improving due to the development of novel therapeutic *** is the only disease-modifying approved therapy in ATTR amyloidosis so ***,the most recent advances in medical therapies have added more options with the potential to become part of the therapeutic armamentarium of the *** including acoramidis,eplontersen,vutrisiran,patisiran and anti-monoclonal antibody NI006 are being investigated on cardiac function in large,multicenter controlled trials which are expected to be completed within the next 2-3 years,providing promising results in patients with ATTR cardiac ***,further and ongoing research is required in order to improve diagnostic methods that could provide an early diagnosis,as well as survival and quality of life of these patients.

关键词： Transthyretin cardiac amyloidosis Tafamidis Acoramidis Eplontersen Vutrisiran Patisiran

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Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer andrew Wong Michael Roizman Amanda Gilligan andrew Lee Kee Meng Tan Susan Day Christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain Centre at Royal Melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(5mL,regardless of anticoagulation *** Commencing anticoagulation<4days after stroke or TIA is associated with fewer ischaemic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： patients lesions ischaemic

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Carbon dioxide enrichment affected flower numbers transiently and increased successful post-pollination development stably but without altering final acorn production in mature pedunculate oak (Quercus robur L.)

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Journal of Forestry Research 2024年第4期35卷 1-12页

作者： Ryan McClory Richard H.Ellis Martin Lukac Jo Clark Carolina Mayoral Kris M.Hart andrew R.G.Plackett A.Rob MacKenzie School of Agriculture Policy and DevelopmentUniversity of ReadingAgricultureEarley GateWhiteknights RoadPO Box 237Reading RG66EUUK Faculty of Forestry and Wood Sciences Czech University of Life Sciences PraguePrague 165000Czechia Future Trees Trust Harwell Innovation CentreBuilding 173Curie AvenueHarwellOxford OX110QGUK Birmingham Institute of Forest Research University of BirminghamEdgbastonBirmingham B152TTUK School of Biosciences University of BirminghamEdgbastonBirmingham B152TTUK School of Geography Earth and Environmental SciencesUniversity of BirminghamEdgbastonBirmingham B152TTUK

Acorn production in oak(Quercus spp.)shows considerable inter-annual variation,known as masting,which provides a natural defence against seed predators but a highly-variable supply of acorns for uses such as in commercial tree planting each *** emissions of greenhouse gases have been very widely reported to influence plant growth and seed or fruit size and quantity via the‘fertilisation effect’that leads to enhanced *** examine if acorn production in mature woodland communities will be affected by further increase in CO_(2),the contents of litter traps from a Free Air Carbon Enrichment(FACE)experiment in deciduous woodland in central England were analysed for numbers of flowers and acorns of pedunculate oak(Quercus robur L.)at different stages of development and their predation levels under ambient and elevated CO_(2) ***-annual variation in acorn numbers was considerable and cyclical between 2015 and 2021,with the greatest numbers of mature acorns in 2015,2017 and 2020 but almost none in *** numbers of flowers,enlarged cups,immature acorns,empty acorn cups,and galls in the litter traps also varied amongst years;comparatively high numbers of enlarged cups were recorded in 2018,suggesting *** at this site is a fruit maturation masting species(i.e.,the extent of abortion of pollinated flowers during acorn development affects mature acorn numbers greatly).Raising the atmospheric CO_(2) concentration by 150μL L^(−1),from early 2017,increased the numbers of immature acorns,and all acorn evidence(empty cups+immature acorns+mature acorns)detected in the litter traps compared to ambient controls by 2021,but did not consistently affect the numbers of flowers,enlarged cups,empty cups,or mature *** number of flowers in the elevated CO_(2) plots’litter traps was greater in 2018 than 2017,one year after CO_(2) enrichment began,whereas numbers declined in ambient *** with CO_(2) also increased the number o

关键词： Quercus robur L. Acorns Masting Pedunculate oak Carbon dioxide

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Chronic effects of stretching on range of motion with consideration of potential moderating variables:A systematic review with meta-analysis

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Journal of Sport and Health Science 2024年第2期13卷 186-194页

作者： Andreas Konrad Shahab Alizadeh Abdolhamid Daneshjoo Saman Hadjizadeh Anvar andrew Graham Ali Zahiri Reza Goudini Chris Edwards Carina Scharf David George Behm Institute of Human Movement Science Sport and HealthGraz UniversityGraz A-8010Austria School of Human Kinetics and Recreation Memorial University of NewfoundlandSt.John’sNL A1C 5S7Canada Department of Sport Injuries and Corrective Exercises Faculty of Sport SciencesShahid Bahonar University of KermanKerman 76169-13439Iran

Background:It is well known that stretch training can induce prolonged increases in joint range of motion(ROM).However,to date more information is needed regarding which training variables might have greater influence on improvements in ***,the purpose of this metaanalysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables,such as stretching technique,intensity,duration,frequency,and muscles stretched,as well as sex-specific,age-specific,and/or trained state-specific adaptations to stretch ***:We searched through PubMed,Scopus,Web of Science,and SportDiscus to find eligible studies and,finally,assessed the results from 77 studies and 186 effect sizes by applying a random-effect ***,by applying a mixed-effect model,we performed the respective subgroup *** find potential relationships between stretch duration or age and effect sizes,we performed a ***:We found a significant overall effect,indicating that stretch training can increase ROM with a moderate effect compared to the controls(effect size=-1.002;Z=-12.074;95%confidence interval:-1.165 to-0.840;p<0.001;I^(2)=74.97).Subgroup analysis showed a significant difference between the stretching techniques(p=0.01)indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic ***,there was a significant effect between the sexes(p=0.04),indicating that females showed higher gains in ROM compared to ***,further moderating analysis showed no significant relation or ***:When the goal is to maximize ROM in the long term,proprioceptive neuromuscular facilitation or static stretching,rather than ballistic/dynamic stretching,should be *** to consider in future research as well as sports practice is that neither volume,intensity,nor frequency of stretching were

关键词： Flexibility Long-term stretching Stretch training

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