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Percutaneous coronary intervention in octogenarians:10-year experience from a primary percutaneous coronary intervention centre with off-site cardiothoracic support

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Journal of Geriatric Cardiology 2022年第3期19卷 189-197页

作者： Joanna Abramik Amardeep Dastidar nestoras kontogiannis Victoria North Gopendu Patri Nicholas Weight Tushar Raina George Kassimis Cheltenham General Hospital Gloucestershire Hospitals NHS Foundation TrustCheltenhamUnited Kingdom Bristol Heart Institute University Hospitals NHS Foundation TrustBristolUnited Kingdom Second Department of Cardiology Hippokration HospitalMedical SchoolAristotle University of ThessalonikiThessalonikiGreece

OBJECTIVE To examine the trends in patient characteristics and clinical outcomes over a ten-year period and to analyse the predictors of mortality in octogenarians undergoing percutaneous coronary intervention(PCI)in our *** A total of 782 consecutive octogenarians(aged 80 and above)were identified from a prospectively collected PCI database within our non-surgical,medium volume centre between 1st January 2007 and 31st December *** represented 10.9%of all PCI procedures performed in our centre during this *** evaluated the demographic and procedural character-istics of the cohort with respect to clinical outcomes(all-cause in-hospital and 1-year mortality,in-hospital complication rates,duration of hospital admission,coronary disease angiographic complexity and major co-morbidities).The cohort was further stratified into three chronological tertiles(January 2007 to July 2012,261 cases;August 2012 to May 2015,261 cases;June 2015 to December 2016,260 cases)to assess for differences over *** of mortality were identified through a multivariate re-gression *** The number of octogenarians undergoing PCI increased nearly ten-fold over the studied *** this,there were no significant differences in clinical outcomes or patient characteristics,except for the increased use of trans-radial vascular access[11.9%in first tertile vs.73.2%in third tertile(P<0.0001)].The all-cause in-hospital(5.8%vs.4.6%vs.3.8%,P=0.578)and 1-year mortality(12.4%vs.12.5%vs.14.4%,P=0.746)remained constant in all three tertiles *** independent predict-ors of mortality were identified-increasing age[HR=1.12(1.03−1.22),P=0.008],cardiogenic shock[HR=16.40(4.04-66.65),P<0.0001],severe left ventricular impairment[HR=3.52(1.69−7.33),P=0.001],peripheral vascular disease[HR=2.73(1.22−6.13),P=0.015],diabetes[HR=2.59(1.30−5.17),P=0.007]and low creatinine clearance[HR=0.98(0.96−1.00),P=0.031].CONCLUSION This contemporary observational study pro

关键词： coronary mortality cardio

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Prognostic value of ΔSYNTAX% score in octogenarians undergoing percutaneous coronary intervention

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Journal of Geriatric Cardiology 2023年第7期20卷 509-515页

作者： Joanna Abramik nestoras kontogiannis Roberto Scarsini Giovanni Luigi De Maria Tushar Raina Nikolaos Fragakis George Kassimis Department of Cardiology Cheltenham General HospitalGloucestershire Hospitals NHS Foundation TrustCheltenhamUnited Kingdom Department of Cardiology Oxford University Hospitals NHS Foundation TrustOxfordUnited Kingdom Division of Cardiology Department of MedicineUniversity of VeronaVeronaItaly Second Department of Cardiology Hippokration HospitalMedical SchoolAristotleUniversity of ThessalonikiThessalonikiGreece

OBJECTIVES To verify whether incomplete revascularisation(IR),quantified using the rSYNTAX(Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery)score andΔSYNTAX%score,could predict short-(in-hospital mortality)and long-term outcomes(12-month mortality)in octogenarians undergoing percutaneous coronary intervention(PCI).METHODS&RESULTS A retrospective analysis of 665 consecutive octogenarian patients presenting for PCI to a UK centre was *** baseline SYNTAX and rSYNTAX scores were assessed from angiographic images.ΔSYNTAX%score was calculated(ΔSYNTAX%=((SYNTAX-rSYNTAX)/SYNTAX)×100%))to measure the relative completeness of ***-Meier analysis assessed survival at 12 months by tertiles of rSYNTAX andΔSYNTAX%***ΔSYNTAX%score was associated with reduced in-hospital mortality(P=0.017),and improved survival benefit(log rank 14.8,P=0.001)at 12 *** Enhancing the completeness of revascularisation in octogenarians selected to undergo PCI is associated with a lower in-hospital mortality and a survival benefit at 12 months.

关键词： SYNTAX mortality coronary

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Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja

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Journal of Geriatric Cardiology 2019年第1期16卷 54-59页

作者： George Kassimis nestoras kontogiannis Tushar Raina Department of Cardiology Cheltenham General HospitalGloucestershire Hospitals NHS Foundation TrustCheltenhamUnited Kingdom Second Department of Cardiology Hippokration HospitalMedical SchoolAristotle University of ThessalonikiThessalonikiGreece

0ctogenarians represent the fastest growing group of patients undergoing percutaneous coronary intervention(PCI),now constituting more than one in five patients treated with PCI in real-world practice.[1,2]Comparing coronary lesion characteristics of patients aged<≥80 years to those≥80 years undergoing PCI,the octogenarians have a higher prevalence of calcified and ostial lesions,tortuous coronary anatomy,multi-vessel disease and left main stem(LMS)stenosis.⑶Furthermore,they often have greater ischemic burden than their younger counterparts,suggesting an even greater benefit following revascularization.

关键词： Acute angle branch Octogenarians Steerable microcatheters Supercross Swift Ninja Venture wire control catheter

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基于大语言模型的糖尿病管理:潜力与展望

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Science Bulletin 2024年第5期69卷 583-588页

作者：盛斌管洲榆 Lee-Ling Lim 江泽铧 nestoras Mathioudakis 李佳佳刘茹涵包玉倩 Yong Mong Bee 王亚星郑颖丰 Gavin Siew Wei Tan 纪宏伟 Josip Car 王海波 David C.Klonoff 李华婷覃宇宗黄天荫贾伟平 Shanghai International Joint Laboratory of Intelligent Prevention and Treatment for Metabolic Diseases Department of Computer Science and EngineeringSchool of ElectronicInformationand Electrical EngineeringShanghai Jiao Tong UniversityDepartment of Endocrinology and MetabolismShanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Diabetes InstituteShanghai Clinical Center for DiabetesShanghai 200240China MOE Key Laboratory of Artificial Intelligence Artificial Intelligence InstituteShanghai Jiao Tong UniversityShanghai 200240China Department of Medicine Faculty of MedicineUniversity of MalayaKuala Lumpur 50603Malaysia Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Asia Diabetes Foundation Hong KongChina Tsinghua Medicine of Tsinghua University Beijing 100084China School of Clinical Medicine Beijing Tsinghua Changgung HospitalBeijing 102218China Division of Endocrinology Diabetes&MetabolismJohns Hopkins University School of MedicineBaltimoreMD 21211USA Department of Endocrinology Singapore General HospitalSingapore 169608Singapore Beijing Institute of Ophthalmology Beijing Tongren HospitalCapital University of Medical ScienceBeijing Ophthalmology and Visual Sciences Key LaboratoryBeijing 100730China State Key Laboratory of Ophthalmology Zhongshan Ophthalmic CenterSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Ophthalmology and Visual ScienceGuangzhou 510060China Singapore Eye Research Institute Singapore National Eye CentreSingapore 168751Singapore Department of Cardiology the Affiliated Hospital of Qingdao UniversityQingdao 266011China Centre for Population Health Sciences Lee Kong Chian School of MedicineNanyang Technological University SingaporeSingapore 639798Singapore Department of Primary Care and Public Health School of Public HealthImperial College LondonLondon SW72BUUK Clinical Trial Unit Research Centre of Big Data and Artificial Intelligence in Medicine

The increasing prevalence of diabetes has become a global public health concern in the 21st *** 2021,it was estimated that 537 million people had diabetes,and this number is projected to reach 643 million by 2030,and 783 million by 2045[1].Such a huge burden of diabetes brings great challenges in its prevention and management,including early diagnosis,timely interventions,and regular monitoring of risk factor control and complications *** self-care support and patient empowerment can enhance clinical and psychobehavioural outcomes[2],although these require additional resources including manpower,infrastructure(hard and technology),and *** emergence of digital health technologies(DHTs),especially artificial intelligence(AI),may help address these obstacles and alleviate the burden of diabetes[3].Large language models(LLMs),a generative AI that can accept image and text inputs and produce text outputs,have shown promise in various aspects of medical care.

关键词： prevention diagnosis finance

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Inner jet kinematics and the viewing angle towards the γ-ray narrow-line Seyfert 1 galaxy 1H 0323＋342

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Research in Astronomy and Astrophysics 2016年第11期16卷 87-98页

作者： Lars Fuhrmann Vassilis Karamanavis Stefanie Komossa Emmanouil Angelakis Thomas E Krichbaum Robert Schulz Annika Kreikenbohm Matthias Kadler Ioannis Myserlis Eduardo Ros Ioannis nestoras J. Anton Zensus Max-Planck-Institut fur Radioastronomie Auf dem Htigel 69 D-53121 Bonn Germany Le-hrstuhl ftir Astronomie Universitat Wtirzburg Campus Hubland Nord Emil-Fischer-StralBe 31 D-97074 Wtirzburg Germany Dr. Karl Remeis-Sternwarte & Erlangen Centre for Astroparticle Physics Sternwartstr. 7 D-96049 Bamberg Germany Observatori Astronbmic Universitat de Valencia C/Catedraitico Jose Beltran 2 46980 Paterna Valencia Spain Departament d'Astronomia i Astroffsica Universitat de Valencia C/Dr. Moliner 50 46100 Burjassot Valencia Spain

Near-Eddington accretion rates onto low-mass black holes are thought to be a prime driver of the multi-wavelength properties of the narrow-line Seyfert 1 （NLS1） population of active galactic nuclei （AGNs）. Orientation effects have repeatedly been considered as another important factor involved, but detailed studies have been hampered by the lack of measured viewing angles towards this type of AGN. Here we present multi-epoch, 15 GHz VLBA images （MOJAVE program） of the radio-loud and Fermi/LAT- detected NLS 1 galaxy 1H 0323＋342. These are combined with single-dish, multi-frequency radio monitoring of the source＇s variability, obtained with the Effelsberg 100-m and IRAM 30-m telescopes, in the course of the F-GAMMA program. The VLBA images reveal six components with apparent speeds of 1 - 7 c, and one quasi-stationary feature. Combining the obtained apparent jet speed （βapp） and variability Doppler factor （Dvar） estimates together with other methods, we constrain the viewing angle 0 towards 1H 0323＋342 to 0 ≤ 4°-13°. Using literature values of βapp and Dvar, we also deduce a viewing angle of 〈8°-9° towards another radio- and γ-ray-loud NLS1, namely SBS 0846＋513.

关键词： galaxies: active -- galaxies: jets -- galaxies: individual: 1H 0323+342 -- -) -rays: galaxies

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Challenging rescue of a 4 years old boy with H1N1 infection by extracorporeal membrane oxygenator: A case report

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World Journal of Clinical Cases 2014年第10期2卷 578-580页

作者： nestoras Papadopoulos Sven Martens Harald Keller Ali El-Sayed Ahmad Anton Moritz Andreas Zierer Division of Thoracic and Cardiovascular Surgery Johann-Wolfgang-Goethe University Division of Thoracic and Cardiovascular Surgery University Hospital Muenster

Introduction: World Health Organization announced on April 2009 a public health emergency of international concern caused by swine-origin influenza A(H1N1) virus. Acute respiratory distress syndrome(ARDS) has been reported to be the most devastating complications of this pathogen. Extracorporeal membrane oxygenator(ECMO) therapy for patients with H1N1 related ARDS has been described once all other therapeutic options have been exhausted. Here, we report the case of a child(German, male) with H1N1-associated fulminate respiratory and secondary hemodynamic deterioration who was rescued by initial emergent ECMO established through a dialysis catheter and subsequent switch to central cannulation following median sternotomy. This report highlights several important issues. First, it describes a successful use of a dialysis catheter for the establishment of a veno-venous ECMO in an emergency case by child. Second, it highlights the importance of a closely monitoring of clotting parameters during ECMOtherapy and third, if severe respiratory failure is complicated by cardiogenic shock, veno-atrial ECMO support via median sternotomy should be considered as a viable treatment option without further delay.

关键词： Airway Circulatory temporary support Coagulants Extracorporeal membrane oxygenation Infection

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CRL4Wdr70 facilitates chromatin recruitment of Exo1 to promote long-range resection of double strand breaks

CRL4Wdr70 facilitates chromatin recruitment of Exo1 to promo...

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2014年第七届中国模式真菌研讨会

作者：曾鸣 Laifeng Ren Ken'Ichi Mizuno Konstantinos nestoras Haibin Wang Zizhi Tang Xiaobo Wang Liandi Guo Daochun Kong Qun He Lilin Du Antony M.Carr Cong Liu Sussex Centre for Genome Damage and Stability Centre School of Life SciencesUniversity of Sussex West China Second University Hospital Sichuan University

Homologous recombination(HR)is important for repairing potentially lethal DNA double strand breaks(DSBs)in the context of *** are resected by the combination action of the Mrell-Rad50-Nbsl(MRN),Ctpl,Exol and Rqhl-Top3-Dna2 factors to form the ssDNA substrates which initiate *** these DNA processing enzymes navigate nucleosome-packaged DNA remains poorly *** find that the fission yeast DCAF protein,Wdr70,is recruited to DSBs in complex with Ddbl and the Cullin4 ubiquitin ligase(CRL4).CRL4recruitment stimulates H2B lysine 119 mono-ubiquitination(uH2B)of chromatin both proximal

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