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metformin-associated lactic acidosis:A mini review of pathophysiology,diagnosis and management in critically ill patients

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World Journal of Diabetes 2024年第6期15卷 1178-1186页

作者： kay Choong See Department of medicine National University HospitalSingapore 119228Singapore

metformin is a common diabetes drug that may reduce lactate clearance by inhibiting mitochondrial oxidative phosphorylation,leading to metforminassociated lactic acidosis(mALA).As diabetes mellitus is a common chronic metabolic condition found in critically ill patients,pre-existing metformin use can often be found in critically ill patients admitted to the intensive care unit or the high dependency *** aim of this narrative mini review is therefore to update clinicians about mALA,and to provide a practical approach to its diagnosis and *** in critically ill patients may be suspected in a patient who has received metformin and who has a high anion gap metabolic acidosis,and confirmed when lactate exceeds 5 mmol/*** factors include those that reduce renal elimination of metformin(renal impairment from any cause,histamine-2 receptor antagonists,ribociclib)and excessive alcohol consumption(as ethanol oxidation consumes nicotinamide adenine dinucleotides that are also required for lactate metabolism).Treatment of mALA involves immediate cessation of metformin,supportive management,treating other concurrent causes of lactic acidosis like sepsis,and treating any coexisting diabetic *** mALA requires extracorporeal removal of metformin with either intermittent hemodialysis or continuous kidney replacement *** optimal time to restart metformin has not been *** is nonetheless reasonable to first ensure that lactic acidosis has resolved,and then recheck the kidney function post-recovery from critical illness,ensuring that the estimated glomerular filtration rate is 30 mL/min/1.73 m^(2) or better before restarting metformin.

关键词： Acid-base equilibrium Biguanides Oxidative phosphorylation Pyruvic acid Renal replacement therapy

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Orchard Sports Injury and Illness Classification System (OSIICS) Version 15

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Journal of Sport and Health Science 2024年第4期13卷 599-604页

作者： John W.Orchard Ebonie Rio kay m.crossl.y Jessica J.Orchard margo mountjoy School of Public Health University of SydneySydneyNSW 2006Australia La Trobe Sport and Exercise medicine Research Centre La Trobe UniversityMelbourneVIC 3083Australia Department of Family medicine McMaster UniversityHamilton L8S 4L8Canada

Background:Sports medicine(injury and illnesses)requires distinct coding systems because the International Classification of Diseases is insuf-ficient for sports medicine *** Orchard Sports Injury and Illness Classification System(OSIICS)is one of two sports medicine coding systems recommended by the International Olympic *** updates of coding systems are ***:For Version 15,updates for mental health conditions in athletes,sports cardiology,concussion sub-types,infectious diseases,and skin and eye conditions were considered particularly ***:Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in *** landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology *** union protocols on head injury assessment were used to create additional concussion ***:It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international *** large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

关键词： Sports cardiology Dermatology Eye injuries Concussion Infectious diseases Sports injury classification

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A multi-Channel CmOS Analog Front-End Interface IC with 157.8 d B Current Detection Dynamic Range

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Chinese Journal of Electronics 2024年第2期33卷 393-402页

作者： Kunyu WANG Wenjing XU Chengbin ZHANG yanjun yANG man-kay LAW Li ZHOU Jie CHEN ming CHEN Institute of microelectronics of the Chinese Academy of Science University of Chinese Academy of Sciences Zunyi Normal University Institute of microelectronics and Dept.of ECE FST University of Macau

A high dynamic range and low-noise CmOS(complementary metal-oxide-semiconductor transistor)front-end interface integrated circuit(IC) with multi-channel detection is presented in this paper. Two different current detection channels, composed of a trans-impedance amplifier(TIA) and an integrator-differentiator TIA, are used to boost the current detection range. A capacitance-coupled instrument amplifier(CCIA) is also included to realize high precision voltage detection. A fourth-order sigma-delta modulator using a second-order loop filter and a second-order noise shaping integral quantizer is adopted to realize effective number of bits above 16 bits. The presented interface IC is implemented in 0.18-μm CmOS process with supply voltage of 3.3 V, and a proto-type electrochemical sensor platform with miniaturized sensor array is developed to verify the functionality of the interface IC. measurement results indicate that the designed interface IC achieves 157.8 d B current detection dynamic range, and the measured input-referred current noise and voltage noise floor are 1.04 p A and 58.4 n V within 10 k Hz integration bandwidths,respectively.

关键词： Integrated circuits Sigma-delta modulation Semiconductor device measurement Voltage measurement Current measurement Noise Bandwidth

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Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 241-248页

作者： Chao Sun George Boon-Bee Goh Wan-Cheng Chow Wah-Kheong Chan Grace Lai-Hung Wong Wai-kay Seto yi-Hsiang Huang Han-Chieh Lin I-Cheng Lee Hye Won Lee Seung Up Kim Vincent Wai-Sun Wong Jian-Gao Fan Center for Fatty Liver Disease Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghai 200092China Department of Gastroenterology&Hepatology Singapore General HospitalSingaporeSingapore Gastroenterology and Hepatology Unit Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia Department of medicine and Therapeutics and State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong KongChina Department of medicine The University of Hong KongHong KongChina Institute of Clinical medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina Division of Gastroenterology and Hepatology Taipei Veterans General HospitalTaipeiTaiwanChina Faculty of medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina Department of Internal medicine Yonsei University College of MedicineSeoulKorea

Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic ***,the prevalence and risk factors for impaired renal function in patients with NAFLD remain *** objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD ***:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective *** fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 *** renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value ofmL/min/1.73 m^(2) andmL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)***:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,*** multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(Pmore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(Pmpared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(Pying NAFLD patients with high risk of *** glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

关键词： Nonalcoholic fatty liver disease Impaired renal function Agile 3+ Agile 4 metabolic syndrome

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Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model

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Asian Pacific Journal of Tropical medicine 2020年第8期13卷 366-374页

作者： mila Nu Nu Htay Ian m Hastings Eva maria Hodel Katherine kay Liverpool School of Tropical medicine Liverpool L35QAUnited Kingdom Department of Community medicine Melaka-Manipal Medical CollegeManipal Academy of Higher Education(MAHE)MelakaMalaysia malawi-Liverpool-Wellcome Trust Clinical Research Programme BlantyreMalawi University of Liverpool Liverpool L693GFUnited Kingdom metrum Research Group TariffvilleConnecticut06081United States of America

Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive ***:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission ***:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities *** simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission ***,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,*** highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are ***:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission ***,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are *** to the recommended IPTp-SP schedules is recommended.

关键词： Intermittent preventive treatment in pregnancy Sulfadoxine-pyrimethamine malaria infection in pregnancy Three-dose regimen In silico pharmacological model

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Evaluating the Effect of Tillage on Carbon Sequestration Using the minimum Detectable Difference Concept

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Pedosphere 2008年第4期18卷 421-430页

作者： X. m. yANG C. F. DRURy m. m. WANDER B. D. kay Agriculture and Agri-Food Canada Harrow Ontario N0R 1G0 (Canada). Department of Natural Resources and Environmental Science University of Illinois at Urbana-Champaign Urbana IL61801 (USA) Department of Land Resources University of Guelph Guelph Ontario N1G 2W1 (Canada)

Three long-term field trials in humid regions of Canada and the USA were used to evaluate the influence of soil depth and sample numbers on soil organic carbon (SOC) sequestration in no-tillage (NT) and moldboard plow (mP) corn (Zea mays L.) and soybean (Glycine max L.) production systems. The first trial was conducted on a maryhill silt loam (Typic Hapludalf) at Elora, Ontario, Canada, the second on a Brookston clay loam (Typic Argiaquoll) at Woodslee, Ontario, Canada, and the third on a Thorp silt loam (Argiaquic Argialboll) at Urbana, Illinois, USA. No-tillage led to significantly higher SOC concentrations in the top 5 cm compared to mP at all 3 sites. However, NT resulted in significantly lower SOC in sub-surface soils as compared to mP at Woodslee (10-20 cm, P = 0.01) and Urbana (20-30 cm, P y more SOC storage than mP at the Elora site (3.3 mg C ha-1) and at the Woodslee site (6.2 mg C ha-1) on an equivalent mass basis (1350 mg ha-1 soil equivalent mass). Similarly, NT had greater SOC storage than mP at the Urbana site (2.7 mg C ha-1) on an equivalent mass basis of 675 mg ha-1 soil. However, these differences disappeared when the entire plow layer was evaluated for both the Woodslee and Urbana sites as a result of the higher SOC concentrations in mP than in NT at depth. Using the minimum detectable difference technique, we observed that up to 1500 soil sample per tillage treatment comparison will have to be collected and analyzed for the Elora and Woodslee sites and over 40 soil samples per tillage treatment comparison for the Urbana to statistically separate significant differences in the SOC contents of sub-plow depth soils. Therefore, it is impracticable, and at the least prohibitively expensive, to detect tillage-induced differences in soil C beyond the plow layer in various soils.

关键词： carbon sequestration minimum detectable difference moldboard plow no-tillage soil depth

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Electro-acupuncture to prevent prolonged postoperative ileus:A randomized clinical trial

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World Journal of Gastroenterology 2010年第1期16卷 104-111页

作者： m kay Garcia Joseph S Chiang Bob Thornton J Lynn Palmer Jennifer mcQuade Lorenzo Cohen Department of Anesthesiology and Pain medicine/Integrative medicine M.D.Anderson Cancer CenterThe University of Texas Department of Anesthesiology and Pain medicine M.D.Anderson Cancer CenterThe University of Texas Department of Palliative Care and Rehabilitation medicine M.D.Anderson Cancer CenterThe University of Texas Department of Behavioral Science M.D.Anderson Cancer CenterThe University of Texas Department of GI medical Oncology M.D. Anderson Cancer CenterThe University of Texas

AIm:To examine whether acupuncture can prevent prolonged postoperative ileus(PPOI)after intraperitoneal surgery for colon cancer. mETHODS:Ninety patients were recruited from the Fudan University Cancer Hospital,Shanghai,China. After surgery,patients were randomized to receive acupuncture(once daily,starting on postoperative day 1, for up to six consecutive days)or usual *** was defined as an inability to pass flatus or have a bowel movement by 96 h after *** main outcomes were time to first flatus,time to first bowel movement, and *** outcomes were quality of life(QOL)measures,including pain, nausea,insomnia,abdominal distension/fullness,and sense of well-being. RESULTS:No significant differences in PPOI on day 4 (P=0.71)or QOL measures were found between the *** were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5(P=0.69)or day 6(P= 0.88).No adverse events related to acupuncture were reported. CONCLUSION:Acupuncture did not prevent PPOI andwas not useful for treating PPOI once it had developed in this population.

关键词： Acupuncture Gastrointestinal motility Gastrointestinal disorders Gastrointestinal neoplasms

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Damage due to rolling in total knee replacement-The influence of tractive force

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Friction 2013年第2期1卷 178-185页

作者： markus AWImmER Lars BIRKEN kay SELLENSCHLOH Erich SCHNEIDER Section of Tribology Rush University Medical CenterChicagoIL 60612USA Section of Biomechanics Hamburg University of TechnologyHamburg21071Germany

The femoral condyles of a knee prosthesis articulate with a combination of rolling and sliding on the tibial polyethylene *** is known about potential polyethylene damage due to rolling *** rolling does not exclude the presence of tangential surface loads,this study sought to investigate the influence of tractive rolling on the wear of polyethylene.A“wheel-on-flat”apparatus,consisting of a metal wheel and a polyethylene flat,mimicked contact conditions present in total knee *** increasingly tractive force under conditions of pure rolling was *** was found that under rolling kinematics a tangential surface load of up to 17%of the normal load could be transferred through the *** damage was dependent on the amount of tractive force and appeared more severe with higher *** the region of highest tractive force,wear features were identified that resembled perpendicular ridges on surfaces of retrieved tibial polyethylene *** suggests that tractive rolling may be a relevant wear mode in total knee replacement.

关键词： polyethylene wear knee prosthesis tractive rolling

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Factors and expectations influencing concussion disclosure within NCAA DivisionⅠathletes:A mixed methodological approach

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Journal of Sport and Health Science 2023年第3期12卷 388-397页

作者： melissa C.kay Heidi Hennink-Kaminski Zachary y.Kerr Paula Gildner Brittany m.Ingram Kenneth L.Cameron megan N.Houston Laura A.Linnan Stephen W.marshall Karen y.Peck Johna K.Register-mihalik School of Health Professions College of Nursing and Health ProfessionsUniversity of Southern MississippiHattiesburgMS 39406USA School of media and Journalism University of North Carolina at Chapel HillChapel HillNC 27599USA Injury Prevention Research Center University of North Carolina at Chapel HillChapel HillNC 27599USA Department of Exercise and Sport Science College of Arts and SciencesUniversity of North Carolina at Chapel HillChapel HillNC 27599USA matthew Gfeller Sport-Related Traumatic Brain Injury Research Center University of North Carolina at Chapel HillChapel HillNC 27599USA Center for the Study of Retired Athletes University of North Carolina at Chapel HillChapel HillNC 27599USA Keller Army Hospital United States Military AcademyWest PointNY 10996USA Departments of Physical medicine and Rehabilitation and Surgery Uniformed Services University of the Health SciencesBethesdaMD 20814USA Department of Health Behavior School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599USA Department of Epidemiology School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599USA

Background:Participation in sports is associated with many benefits to all aspects of health;however,it also comes with the risk of injury,particularly ***-disclosure and care seeking following a concussion are especially important because of the lack of outwardly visible signs and/or *** recent research has explored factors affecting concussion disclosure,use of isolated methodologies limits the ability to contextualize how disclosure or nondisclosure ***,the purpose of this study was to describe the factors and expectations of National Collegiate Athletic Association(NCAA)athletes that may influence concussion ***:This mixed-methods convergent parallel research study included 25 NCAA Division I athletes representing 13 sports,all of whom completed a concussion-education session with pre-/post-test surveys and a semistructured *** athletes were at least 18 years old and on an NCAA *** surveys focused on previous concussion-related disclosure behaviors,knowledge,attitudes,beliefs,norms,and intentions about disclosing *** focused on the athletes’experiences related to concussion *** data were analyzed using descriptive statistics and mann-Whitney U *** were analyzed using a Consensual Qualitative Research ***:Participants had good concussion knowledge(median=46.0),positive attitudes(median=38.0),strong beliefs(median=13.0),and strong intentions to disclose concussion symptoms(median=7.0).None of the constructs differed by participants’*** quantitative findings were mostly positive,interview data highlighted factors that may explain why some participants are successful in disclosing concussions and why others may find disclosure *** efforts,sport culture,and medical professional presence were the primary facilitators discussed by ***,pressure,and a lack of team support were perceived as di

关键词： Education medical professional presence mixed methodological research Reporting Sport culture

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Identification of pathologic features associated with “ulcerative colitis-like” Crohn's disease

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World Journal of Gastroenterology 2014年第36期20卷 13139-13145页

作者： Samuel D James Paul E Wise Tania Zuluaga-Toro David A Schwartz m kay Washington Chanjuan Shi Departments of Pathology Microbiology and Immunology Vanderbilt University Medical Center Nashville TN 37232 United States Section of Colon and Rectal Surgery Washington University in St. Louis Gainesville MO 63130 United States Department of Pathology University of Florida Gainesville FL 32611 United States Departments of Gastroenterology Hepatology and Nutrition Vanderbilt University Medical Center Nashville TN 37232 United States

AIm: To identify pathologic features associated with this “ulcerative colitis (UC)-like” subgroup of Crohn’s disease (CD).

关键词： Ulcerative colitis-like Crohn’ s disease Ulcerative colitis Crohn’ s colitis Inflammatory bowel disease

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