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Individualized treatment options for patients with non-cirrhotic and cirrhotic liver disease

World Journal of Gastroenterology 2021年第19期27卷 2281-2298页

作者： lukas hartl Joshua Elias Gerhard Prager Thomas Reiberger lukas W Unger Division of Gastroenterology and Hepatology Department of Internal Medicine IIIMedical University of ViennaVienna A-1090Austria Vienna Hepatic Hemodynamic Lab Medical University of ViennaVienna A-1090Austria Cambridge Institute of Therapeutic Immunology and Infectious Disease Jeffrey Cheah Biomedical CentreUniversity of CambridgeCambridge CB20AWUnited Kingdom Division of Gastroenterology and Hepatology Department of MedicineUniversity of CambridgeAddenbrooke’s HospitalCambridge CB20QQUnited Kingdom Division of Visceral Surgery Department of General SurgeryMedical University of ViennaVienna A-1090Austria

The obesity pandemic has led to a significant increase in patients with metabolic dysfunction-associated fatty liver disease(MAFLD).While dyslipidemia,type 2 diabetes mellitus and cardiovascular diseases guide treatment in patients without signs of liver fibrosis,liver related morbidity and mortality becomes relevant for MAFLD’s progressive form,non-alcoholic steatohepatitis(NASH),and upon development of liver *** should be prescribed in patients without significant fibrosis despite concomitant liver diseases but are underutilized in the real-world *** surgery,especially Y-Roux bypass,has been proven to be superior to conservative and/or medical treatment for weight loss and resolution of obesity-associated diseases,but comes at a low but existent risk of surgical complications,reoperations and very rarely,paradoxical progression of *** end-stage liver disease develops,obese patients benefit from liver transplantation(LT),but may be at increased risk of perioperative infectious *** LT,metabolic comorbidities are commonly observed,irrespective of the underlying liver disease,but MAFLD/NASH patients are at even higher risk of disease *** studies with low patient numbers evaluated if,and when,bariatric surgery may be an option to avoid disease recurrence but more high-quality studies are needed to establish clear *** this review,we summarize the most recent literature on treatment options for MAFLD and NASH and highlight important considerations to tailor therapy to individual patient’s needs in light of their risk profile.

关键词： Metabolic dysfunction-associated fatty liver disease Non-alcoholic fatty liver disease Portal hypertension Cirrhosis Bariatric surgery Metabolism

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Spectrally tunable high-power Yb:fiber chirped-pulse amplifier

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Photonics Research 2022年第10期10卷 2309-2316页

作者： VALENTINA SHUMAKOVA VITO F.PECILE JAKOB FELLINGER MICHAEL LESKOWSCHEK P.E.COLLIN ALDIA ALINE S.MAYER lukas W.PERNER SARPER SALMAN MINGQI FAN PRANNAY BALLA STÉPHANE SCHILT CHRISTOPH M.HEYL INGMAR hartl GIL PORAT OLIVER H.HECKL Christian Doppler Laboratory for Mid-IR Spectroscopy and Semiconductor Optics Faculty Center for Nano Structure ResearchFaculty of PhysicsUniversity of ViennaA-1090 ViennaAustria Photonics Institute TU WienA-1040 ViennaAustria Vienna Doctoral School in Physics University of ViennaA-1090 ViennaAustria Deutsches Elektronen-Synchrotron DESY 22607 HamburgGermany Laboratoire Temps-Fréquence Universitéde NeuchâtelCH-2000 NeuchâtelSwitzerland GSI Helmholtzzentrum für Schwerionenforschung GmbH 64291 DarmstadtGermany Helmholtz-Institute Jena 07743 JenaGermany Department of Electrical and Computer Engineering University of AlbertaEdmontonAlberta T6G 1H9Canada Department of Physics University of AlbertaEdmontonAlberta T6G 2E1Canada

Tailoring the properties of the driving laser to the need of applications often requires compromises among laser stability,high peak and average power levels,pulse duration,and spectral *** instance,spectroscopy with optical frequency combs in the extreme/visible ultraviolet spectral region requires a high peak power of the near-IR driving laser,and therefore high average power,pulse duration of a few tens of fs,and maximal available spectral ***,the parametric conversion efficiency is higher for pulses with a duration in the 100-fs range due to temporal walk-off and coating *** we suggest an approach to adjust the spectral characteristics of high-power chirped-pulse amplification(CPA)to the requirements of different nonlinear frequency converters while preserving the low-phase-noise(PN)properties of the *** achieve spectral tunability,we installed a mechanical spectral shaper in a free-space section of the stretcher of an in-house-developed ytterbium-fiber-based CPA *** CPA system delivers 100 W of average power at a repetition rate of 132.4 *** gaining control over the spectral properties,we preserve the relative-intensity-noise and PN properties of the *** high-power CPA can easily be adjusted to deliver either a spectrum ideal for mid-IR light generation(full width at half maximum of∼11 nm,compressed pulse duration of 230 fs)or a spectrum ideal for highly nonlinear processes such as high-harmonic generation(−10 dB level of>50 nm,transform-limited pulse duration of∼65 fs).

关键词： pulse power fiber

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