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Clinical management of acute liver failure: Results of an international multi-center survey

World Journal of Gastroenterology 2016年第33期22卷 7595-7603页

作者： Liane Rabinowich Julia Wendon William Bernal oren Shibolet Liver Unit Department of GastroenterologyTel-Aviv Medical Center and Tel-Aviv University Liver Intensive Therapy Unit Institute of Liver StudiesKing’s College Hospital

AIM To assess the practice of caring for acute liver failure(ALF) patients in varying geographic locations and medical *** Members of the European Acute Liver Failure Consortium completed an 88-item questionnaire detailing management of ALF. Responses from 22 transplantation centers in 11 countries were analyzed,treating between 300 and 500 ALF cases and performing over 100 liver transplants(LT) for ALF annually. The questions pertained to details of the institution and their clinical activity,standards of care,referral and admission,wardbased care versus intensive care unit(ICU) as well as questions regarding liver transplantation- including criteria,limitations,and perceived performance. Clinical data was also collected from 13 centres over a 3 mo period. RESULTS The interval between referral and admission of ALF patients to specialized units was usually less than 24 h and once admitted,treatment was provided by a multidisciplinary team. Principles of care of patients with ALF were similar among centers,particularly in relation to recognition of severity and care of the more critically ill. Centers exhibited similarities in thresholds for ICU admission and management of severe hepatic encephalopathy. Over 80% of centers administered n-acetyl-cysteine to ICU patients for non-paracetamolrelated ALF. There was significant divergence in the use of prophylactic antibiotics and anti-fungals,lactulose,nutritional support and imaging investigations in admitted patients and in the monitoring and treatment of intra-cranial pressure(ICP). ICP monitoring was employed in 12 centers,with the most common indications being papilledema and renal failure. Most patients listed for transplantation underwent surgery within an average waiting time of 1-2 d. Over a period of 3 mo clinical data from 85 ALF patients was collected. Overall patient survival at 90-d was 76%. Thirty six percent of patients underwent emergency LT,with a 90% post transplant survival to hospital disc

关键词： Acute liver failure Liver transplantation Intra-cranial pressure Hepatic encephalopathy

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Uncertainty analysis of forest carbon sink forecast with varying measurement errors:a data assimilation approach

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Journal of Plant Ecology 2011年第3期4卷 178-191页

作者： Ensheng Weng Yiqi Luo Chao Gao Ram oren Department of Botany and Microbiology The University of OklahomaNormanOK 73019USA Nicholas School of the Environment Duke UniversityDurhamNC 27708USA

Aims Accurate forecast of ecosystem states is critical for improving natural resourcemanagement and climate change *** observed data into models is an effective way to reduce uncertainties in ecological ***,influences ofmeasurement errors on parameter estimation and forecasted state changes have not been carefully *** study analyzed the parameter identifiability of a process-based ecosystem carbon cycle model,the sensitivity of parameter estimates and model forecasts to the magnitudes of measurement errors and the information contributions of the assimilated data to model forecasts with a data assimilation *** We applied a Markov Chain Monte Carlo method to assimilate eight biometric data sets into the Terrestrial *** data were the observations of foliage biomass,wood biomass,fine root biomass,microbial biomass,litter fall,litter,soil carbon and soil respiration,collected at the Duke Forest free-air CO_(2)enrichment facilities from 1996 to *** levels ofmeasurement errorswere assigned to these data sets by halving and doubling their original standard *** Findings Results showed that only less than half of the 30 parameters could be constrained,though the observations were extensive and themodelwas relatively *** errors led to higher uncertainties in parameters estimates and forecasted carbon(C)pool *** longterm predictions of the slow turnover pools were affected less by the measurement errors than those of fast turnover *** data contributed less information for the pools with long residence times in long-term *** results indicate the residence times of C pools played a key role in regulating propagation of errors from measurements to model forecasts in a data assimilation *** the estimation of parameters of slowturnover C pools is the key to better forecast long-term ecosystem C dynamics.

关键词： uncertainty analysis data assimilation Markov Chain Monte Carlo(MCMC)method measurement error carbon residence time information contribution

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Crohn’s and colitis in children and adolescents

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World Journal of Gastroenterology 2012年第41期18卷 5862-5869页

作者： Andrew S Day oren Ledder Steven T Leach Daniel A Lemberg Department of Gastroenterology Sydney Children's HospitalRandwickSydneyNSW 2031Australia School of Women's and Children's Health University of New South WalesSydneyNSW 2031Australia Department of Paediatrics University of Otago ChristchurchChristchurch 8140New Zealand

Crohn＇s disease and ulcerative colitis can be grouped as the inflammatory bowel diseases （IBD）. These conditions have become increasingly common in recent years, including in children and young people. Although much is known about aspects of the pathogenesis of these diseases, the precise aetiology is not yet understood, and there remains no cure. Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life, including in infancy. Pain, diarrhoea and weight loss are typical symptoms of paediatric Crohn＇s disease whereas bloody diarrhoea is more typical of colitis in children. However, atypical symptoms may occur in both conditions： these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythma nodosum. Growth and nutrition are commonly compromised at diagnosis in both Crohn＇s disease and colitis. Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis, the- reby avoiding the consequences of diagnostic delay. Patterns of disease including location and progression of IBD in childhood differ substantially from adult- onset disease. Various treatment options are available for children and adolescents with IBD. Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn＇s disease. Medical and surgical therapies need to considered within the context of a growing and developing child. The overall management of these chronic conditions in children should include multi-disciplinary expertise, with focus upon maintaining control of gut inflammation, optimising nutrition, growth and quality of life, whilst preventing disease or treatment-related complications.

关键词： Children Adolescents Crohn's disease Ulcerative colitis Inflammatory bowel diseases

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Computationally aware systems:Recommended features through a review of 188 definitions and its relevance to advanced simulation

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International Journal of Modeling, Simulation, and Scientific Computing 2021年第1期12卷 112-141页

作者： Reza Irani Pouria Sharifian Monfared Mohammad Kazemifard Tuncer oren Department of Computer Engineering University of Razi KermanshahIran School of Electrical Engineering and Computer Science University of Ottawa OttawaONCanada

In this paper,188 definitions of aware,awareness,conscious,and consciousness,classified in different categories including cognitive science,computation,medicine,neurology,and philosophy,are *** on this systematic review,desirable features of computationally aware systems(CASs)are gleaned and reported.A discussion about the relevance of computational awareness to advanced simulation is also outlined.

关键词： Computational awareness computationally aware systems awareness consciousness computational understanding simulation

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Investigating Kernel Security in Functional Operating Systems

Investigating Kernel Security in Functional Operating System...

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作者： Eshton oren Robateau 上海交通大学

学位级别：硕士

System security has always been concerned with software vulnerabilities especially in privileged applications like web browsers and *** and architecture security are relatively new developments due to recently publicized vulnerabilities（Spectre,Meltdown,Foreshadow）.A cursory glance at list of current of CVEs exhibits a myriad of C related issues（buffer overflows,memory corruption etc.）yet operating systems and bare-metal development continue to be dominated by C and *** programming is often touted as the paradigm shift to reduce and possibly eliminate many of the issues in traditional,imperative style ***,the functional paradigm is almost never found below the application level.A few operating systems have been designed and implemented in the functional *** systems are usually attempts to prove the viability of usable systems built with functional and high-level *** security aspect is often ignored or relegated to off-hand *** work explores the darker side of kernel implementations: security of kernel components and the techniques available to kernel developers when functional concepts are available at bare metal.

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Treatment of hepatocellular carcinoma: Steps forward but still a long way to go

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World Journal of Hepatology 2015年第3期7卷 566-574页

作者： Liat Mlynarsky Yoram Menachem oren Shibolet Department of Gastroenterology Tel-Aviv Medical Center and the Sackler Faculty of Medicine Tel-Aviv University

Hepatocellular carcinoma(HCC) is the fifth most common malignancy and the third cause of tumor associated deaths worldwide. HCC incidence rates are increasing in many parts of the world including developing and developed countries. Potentially curative treatments for HCC are resection and liver transplantation, but these are only suitable for patients with small tumors, meeting strict pre-defined criteria, or well-compensated liver disease. Early diagnosis of HCCcan be achieved by surveillance of at-risk populations. For patients with non-resectable disease treatments modalities include loco-ablative and systemic therapies. In this review we focus on treatment options in HCC and their allocation. Although significant research is in progress, to this date, the results are unsatisfactory with limited long-term survival. In the fight against this deadly disease, there is still a long way to go.

关键词： Hepatocellular carcinoma Liver resection Liver transplantation Loco-ablative therapies Sorafenib

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Microbial community structure and nitrogenase gene diversity of sediment from a deep-sea hydrothermal vent field on the Southwest Indian Ridge

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Acta Oceanologica Sinica 2014年第10期33卷 94-104页

作者： WU Yuehong CAO Yi WANG Chunsheng WU Min AHARON oren XU Xuewei Laboratory of Marine Ecosystem and Biogeochemistry Second Institute of Oceanography State Oceanic Administration State Key Laboratory of Microbial Resources Institute of Microbiology Chinese Academy of Sciences College of Life Sciences Zhejiang University Department of Plant and Environmental Sciences the Alexander Silberman Institute of Life Sciences The Hebrew University of JerusalemJerusalem 91904 Israel The Hebrew University of Jerusalem The Edmond J. Safra CampusGivat Ram Jerusalem 91904 Israel

A sediment sample was collected from a deep-sea hydrothermal vent field located at a depth of 2 951 m on the Southwest Indian Ridge. Phylogenetic analyses were performed on the prokaryotic community using polymerase chain reaction（PCR） amplification of the 16 S rRNA and nifH genes. Within the Archaea, the dominant clones were from marine benthic group E（MBGE） and marine group I（MGI） belonging to the phyla Euryarchaeota and Thaumarchaeota, respectively. More than half of the bacterial clones belonged to the Proteobacteria, and most fell within the Gammaproteobacteria. No epsilonproteobacterial sequence was observed. Additional phyla were detected including the Actinobacteria, Bacteroidetes, Planctomycetes, Acidobacteria, Nitrospirae, Chloroflexi, Chlorobi, Chlamydiae, Verrucomicrobia, and candidate divisions OD1, OP11, WS3 and TM6, confirming their existence in hydrothermal vent environments. The detection of nifH gene suggests that biological nitrogen fixation may occur in the hydrothermal vent field of the Southwest Indian Ridge. Phylogenetic analysis indicated that only Clusters I and III NifH were present. This is consistent with the phylogenetic analysis of the microbial 16 S rRNA genes, indicating that Bacteria play the main role in nitrogen fixation in this hydrothermal vent environment.

关键词： deep-sea hydrothermal vent microbial diversity 16S rRNA gene nifH gene

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Framework of behavioral indicators evaluating TB health promotion outcomes: a modified Delphi study of TB policymakers and health workers

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Infectious Diseases of Poverty 2015年第1期4卷 447-459页

作者： Ying Li John Ehiri Daiyu Hu Eyal oren Jia Cao Department of Social Medicine and Health Service Management Third Military Medical UniversityNo.30 Gaotanyan RoadShapingba districtChongqingChina Department of Health Promotion Sciences Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA Chongqing Institute of TB Prevention and Treatment Jiulongpo districtChongqingChina Department of Epidemiology&Biostatistics Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA Institute of Toxicology Third Military Medical UniversityNo.30 Gaotanyan RoadShapingba districtChongqingChina

Background:Although TB health promotion directed at policy makers and healthcare workers(HCWs)is considered important to tuberculosis(TB)control,no indicators currently assess the impact of such promotional *** article is the second in a series of papers that seek to establish a framework of behavioral indicators for outcome evaluation of TB health promotion,using the Delphi *** the first article,we sought to establish a framework of behavioral indicators for outcome evaluation of TB health promotion among TB suspects and *** objective of this second article is to present an indicator framework that can be used to assess behavioral outcomes of TB health promotion directed at policy makers and ***:A two-round,modified Delphi method was used to establish the *** experts who were knowledgeable and experienced in the field of TB control were consulted in Delphi surveys.A questionnaire was developed following 4 steps,and involved ranking indicators on a five-point Likert *** consensus level was 70%.Median,mode,and Coefficient of variation(CV)were used to describe expert *** authority coefficient(Cr)was used to assess the degree of each expert’s ***:Consensus was achieved following the two survey rounds and several iterations among the *** TB health-promotion activities directed at policymakers,the experts reached consensus on 2 domains(“Resource inputs”and“Policymaking and monitoring behaviors”),4 subdomains(“Human resources”among others),and 13 indicators(“Human resources per 100,000 person”among others).For TB health-promotion activities directed at HCWs,the experts reached consensus on 5 domains(“Self-protective behaviors”among others),6 sub-domains(“Preventing infection”among others),and 15 indicators(“Average hours of daily workplace disinfection by ultraviolet radiation”among others).Conclusions:This study identified a conceptual framework of core behavioral indicators to evalua

关键词： Health promotion Evaluation Policymakers TB healthcare workers TB HCWs Indicator Delphi method

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Analysis of aggressiveness factors in hepatocellular carcinoma patients undergoing transarterial chemoembolization

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World Journal of Gastroenterology 2018年第15期24卷 1641-1649页

作者： Yossi Ventura Brian I Carr Issac Kori Vito Guerra oren Shibolet Liver Unit Department of Gastroenterology and Hepatology Tel-Aviv Medical Center Sackler faculty of Medicine Tel-Aviv University Izmir Biomedicine and Genome Center Dokuz Eylul University Interventional Radiology Division of Imaging TelAviv Medical Center Department of Clinical Trials and Epidemiology IRCCS de Bellis

AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC) patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospectively analyzed to identify factors that might contribute to their HCC biology and aggressiveness. We correlated routine laboratory results(total bilirubin, AST, ALKP, GGTP, albumin etc.) to maximum tumor diameter, number of tumor nodules, portal vein thrombosis and blood alpha-fetoprotein levels. These 4 parameters were previously combined to form an aggressiveness index(AgI). We used The Wilcoxon ranksum(Mann-Whitney), to test the correlation between the AgI categories and liver function parameters. The Cox proportional hazards model was applied to evaluate the categories of AgI associated with overall survival. RESULTS The AgI was strongly correlated with survival in this novel patient population. Three year survival probability for AgI > or ranspeptidase(GGTP) had ORs of 1.01(95%CI: 1.003-1.026, P 4 had HR for mortality of 2.18(95%CI: 1.108-4.310, P 4 had a HR for mortality of 2.26(95%CI: 1.184-4.327, P < 0.016). GGTP had a HR of 1.003(95%CI: 1.001-1.004, P < 0.001).CONCLUSION Our study validates the AgI in a new population with un-

关键词： Hepatocellular carcinoma Aggressiveness index Liver function Transarterial chemoembolization survival

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The Wingate anaerobic test cannot be used for the evaluation of growth hormone secretion in children with short stature

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Journal of Sport and Health Science 2017年第4期6卷 443-446页

作者： Nitzan Dror Liat oren Michal Pantanowitz Alon Eliakim Dan Nemet Child Health and Sports Center Pediatric Department Meir Medical Center Sackler School of Medicine Tel Aviv University Kfar-Saba 44281 Israel

Purpose: To assess the growth hormone(GH) response to the Wingate anaerobic test(WAn T) among children with short stature and suspected GH deficiency. We hypothesized that the GH response to the WAn T would be similar to the GH response to a commonly used pharmacologic provocation ***: Ten children(6 males and 4 females, age range 9.0–14.9 years) participated in the study. Each participant performed 2 tests: a standard all-out WAn T, cycling for 30 s against constant resistance, and a standardized pharmacologic test(clonidine or glucagon). Blood samples for GH were collected before and 10, 30, 45, and 60 min after the beginning of exercise. In addition, we collected pre-and post-exercise blood lactate ***: There was a significant increase in GH levels after the WAn T, yet in 9 of 10 participants, this increase was below the threshold for GH sufficiency. Peak GH after the WAn T was significantly lower compared to the pharmacologic GH provocation tests(with 9 of 10 demonstrating GH-sufficient response).Conclusion: The traditional WAn T cannot be used as a GH provocation test. Further research is needed to develop anaerobic exercise protocols sufficient to promote GH secretion.

关键词： Anaerobic Exercise Growth hormone Lactate Provocation test Short stature

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