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Medications in type-2 diabetics and their association with liver fibrosis

World Journal of Gastroenterology 2020年第23期26卷 3249-3259页

作者： Mohamed Tausif Siddiqui Hina Amin Rajat garg Pravallika Chadalavada Wael Al-Yaman Rocio Lopez Amandeep Singh Department of Gastroenterology Hepatology and NutritionDigestive Diseases and Surgery InstituteCleveland ClinicClevelandOH 44195United States Department of Hospital Medicine Cleveland ClinicOH 44195United States Department of Quantitative Health Sciences Cleveland ClinicOH 44195United States

BACKGROUND The prevalence of nonalcoholic fatty liver disease(NAFLD) is significantly rising worldwide. Type-2 diabetes(T2D) is a major risk factor for NAFLD *** To assess the association of commonly used medications to advanced fibrosis(AF) in patients with biopsy-proven NAFLD and *** We used the International Classification of Disease 9 th Revision Clinical Modification coding system to identify patients with T2D and included patients who underwent liver biopsy for suspected NAFLD between January 1, 2000 to December 31, 2015. We compared demographics, clinical characteristics, and differences in pattern of medication use in patients who had biopsy-proven AF to those without it. A univariate and multivariate analysis was performed to assess the association of different classes of medication with the presence of *** A total of 1183 patients were included in the final analysis, out of which 32%(n =381) had AF on liver biopsy. Mean age of entire cohort was 52 years and majority were females(65%) and Caucasians(85%). Among patients with AF, 51% were on oral hypoglycemics, 30% were on insulin, 66% were on antihypertensives and 27% were on lipid lowering agents for the median duration of 19 mo, 10 mo, 26 mo, and 24 mo respectively. Medications associated with decreased risk of AF included metformin, liraglutide, lisinopril, hydrochlorothiazide, atorvastatin and simvastatin while the use of furosemide and spironolactone were associated with higher prevalence of *** In our cohort of T2D with biopsy proven NAFLD, the patients who were receiving metformin, liraglutide, lisinopril, hydrochlorothiazide, atorvastatin and simvastatin were less likely to have AF on biopsy, while patients who were receiving furosemide and spironolactone had a higher likelihood of having AF when they underwent liver biopsy. Future studies are needed to confirm these findings and to establish measures for prevention of NAFLD progression in patients with T2D.

关键词： Diabetes medications Anti-lipid medications Antihypertensive medication Fatty liver Advanced fibrosis

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Morning Meeting

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小学生时代（大嘴英语） 2020年第4期 20-22页

作者： Elizabeth Ehrenfest Steinglass sheena Dempsey(图) 不详

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Fuzzy Logic-Based Health Monitoring System for COVID’19 Patients

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Computers, Materials & Continua 2021年第5期67卷 2431-2447页

作者： M.Jayalakshmi Lalit garg K.Maharajan K.Jayakumar Kathiravan Srinivasan Ali Kashif Bashir K.Ramesh National Engineering College Kovilpatti628503India Faculty of Information and Communication Technology University of MaltaMsidaMSD2080Malta Vel Tech Rangarajan Dr.Sagunthala R&D Institute of Science and Technology Chennai600062India School of Computer Science and Engineering Vellore Institute of Technology(VIT)Vellore632014India School of Information Technology and Engineering Vellore Institute of Technology(VIT)Vellore632014India Department of Computing and Mathematics Manchester Metropolitan UniversityManchesterUK Department of Computer Science Karnataka State Akkamahadevi Women’s UniversityVijayapuraIndia

In several countries,the ageing population contour focuses on high healthcare costs and overloaded health care *** health care monitoring system can be a potential alternative,especially in the COVID-19 pandemic situation to help mitigate such problems by encouraging healthcare to transition from hospital-centred services to self-care,mobile care and home *** this aspect,we propose a pervasive system to monitor the COVID’19 patient’s conditions within the hospital and outside by monitoring their medical and psychological *** facilitates better healthcare assistance,especially for COVID’19 patients and quarantined *** identies the patient’s medical and psychological condition based on the current context and activities using a fuzzy context-aware reasoning engine based *** reasoning engine makes decisions using linguistic rules based on inference mechanisms that support the patient condition *** rules are framed based on the fuzzy set attributes belong to different context *** fuzzy semantic rules are used to identify the relationship among the attributes,and the reasoning engine is used to ensure precise real-time context interpretation and current evaluation of the *** are measured using a fuzzy logic-based context reasoning system under *** results indicate the usefulness of monitoring the COVID’19 patients based on the current context.

关键词： Pervasive healthcare COVID’19 context-aware fuzzy reasoning engine fuzzy logic role-based expert system

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Bariatric surgery in old age:a comparative study of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in an Asia centre of excellence

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The Journal of Biomedical Research 2015年第2期29卷 118-124页

作者： Chih-Kun Huang Amit garg Hsin-Chih Kuao Po-Chih Chang Ming-Che Hsin Bariatric & Metabolic International(B.M.I) Surgery Centre E-Da Hospital Department of Health Management I-Shou University

Bariatric surgery has been proved to be the safest and efficient procedure in treating morbid obese patients,but data is still lacking in the elderly *** aim of our study was to compare the safety and efficacy of laparoscopic Roux-en-Y gastric bypass（LRYGB） and sleeve gastrectomy（LSG） in patients aged more than 55 *** performed2 a retrospective review of a prospectively collected *** patients with body mass index（BMI） §32 kg/mand aged more than 55 years undergoing LRYGB or LSG in BMI Surgery Centre,E-Da Hospital between January 2008 and December 2011 with at least one year of follow up were included for the ***,peri-operative data,weight loss and surgical complications were all recorded and *** age and BMI of these 68 patients22（22 males and 46 female） were 58.8 years（55-79 years） and 39.5 kg/m（32.00-60.40 kg/m）.LRYGB was performed in 44 patients and LSG in 24 *** two groups were comparable in their preoperative BMI,American Society of Anaesthesia（ASA） score and gender *** patients were significantly older than patients receiving *** proportion of type 2 diabetes preoperatively was significantly higher in LRYGB patients as compared to LSG patients（88.63% vs.50%; P,0.01）.The prevalence of other co-morbidities was similar and comparable2 between the *** BMI in the LRYGB and LSG groups at the end of 1 year were 28.8 kg/mand228.2 kg/m,respectively,and there was no statistically significant difference in mean percentage of excess weight loss（%EWL） at 1 *** percentage of resolution of diabetes was significantly higher in LRYGB（69.2%） as compared to LSG（33.3%）.On the other hand,there was no statistical difference in the percentage of resolution of hypertension,hyperlipidemia and fatty liver *** overall morbidity and re-operation rate was higher in LRYGB *** morbidly elderly patients,both surgeries achieved good weight loss and resolution of *** is s

关键词： obesity metabolic surgery Roux-en-Y gastric bypass laparoscopic sleeve gastrectomy effiacy safety

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Acellular extracellular matrix anal fistula plug:Results in high fistula-in-ano awaited

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World Journal of Gastroenterology 2008年第46期14卷 7143-7143页

作者： Pankaj garg MM Institute of Medical Sciences & Research

Song et al have reported a 100% success rate of acellular extracellular matrix (AEM) anal fistula plug in low fistula-in-ano. The results with this product in high fistula-in-ano are keenly awaited.

关键词：非细胞性肛门直肠瘘直肠瘘恢复方法

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Lessons learned from an audit of 1250 anal fistula patients operated at a single center:A retrospective review

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 340-354页

作者： Pankaj garg Baljit Kaur Ankita Goyal Vipul D Yagnik Sushil Dawka Geetha R Menon Department of Colorectal Surgery Garg Fistula Research InstitutePanchkula 134113HaryanaIndia Department of Colorectal Surgery Indus International HospitalMohali 140201PunjabIndia Department of Radiology SSRD Magnetic Resonance Imaging InstituteChandigarh 160011ChandigarhIndia Department of Pathology Gian Sagar Medical College and HospitalPatiala 140601PunjabIndia Department of Surgical Gastroenterology Nishtha Surgical Hospital and Research CenterPatan 384265GujaratIndia Department of Surgery SSR Medical CollegeBelle Rive 744101Mauritius Department of Statistics Indian Council of Medical ResearchNew Delhi 110029New DelhiIndia

BACKGROUND A complex anal fistula is a challenging disease to *** To review the experience and insights gained in treating a large cohort of patients at an exclusive fistula *** Anal fistulas operated on by a single surgeon over 14 years were *** magnetic resonance imaging was done in all *** procedures were performed:fistulotomy;two novel sphincter-saving procedures,proximal superficial cauterization of the internal opening and regular emptying and curettage of fistula tracts(PERFACT)and transanal opening of intersphincteric space(TROPIS),and anal fistula *** was initiated before *** per the institutional GFRI algorithm,fistulotomy was done in simple fistulas,and TROPIS was done in complex *** with associated abscesses were treated by definitive *** was evaluated objectively by Vaizey incontinence *** A total of 1351 anal fistula operations were performed in 1250 *** overall fistula healing rate was 19.4%in anal fistula plug(n=56),50.3%in PERFACT(n=175),86%in TROPIS(n=408),and 98.6%in fistulotomy(n=611)*** did not change significantly after surgery in any *** per the new algorithm,1019 patients were operated with either the fistulotomy or TROPIS *** overall success rate was 93.5%in those *** a subgroup analysis,the overall healing rate in supralevator,horseshoe,and fistulas with an associated abscess was 82%,85.8%,and 90.6%,*** 90.6%healing rate in fistulas with an associated abscess was comparable to that of fistulas with no abscess(94.5%,P=0.057,not significant).CONCLUSION Fistulotomy had a high 98.6%healing rate in simple fistulas without deterioration of continence if the patient selection was done *** sphincter-sparing procedure,TROPIS,was safe,with a satisfactory 86%healing rate for complex *** is the largest anal fistula series to date.

关键词： Anal fistula Fistulotomy Incontinence Surgery Recurrence

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Influence of soil density on gas permeability and water retention in soils amended with in-house produced biochar

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Journal of Rock Mechanics and Geotechnical Engineering 2021年第3期13卷 593-602页

作者： Ankit garg He Huang Weiling Cai Narala Gangadhara Reddy Peinan Chen Yifan Han Viroon Kamchoom Shubham Gaurav Hong-Hu Zhu Department of Civil and Environmental Engineering Guangdong Engineering Center for Structure Safety and Health MonitoringShantou UniversityShantouChina Department of Civil Engineering Kakatiya Institute of Technology and ScienceWarangalIndia Department of Civil Engineering King Mongkut’s Institute of Technology LadkrabangBangkokThailand Department of Biology Science and Biology Technology Indian Institute of Technology GuwahatiGuwahatiIndia School of Earth Sciences and Engineering Nanjing UniversityNanjing210023China

Biochar has been used as an environment-friendly enhancer to improve the hydraulic properties(*** and water retention)of ***,variations in densities alter the properties of the soil ebiochar *** density variations are observed in agriculture(loosely compacted)and engineering(densely compacted)*** influence of biochar amendment on gas permeability of soil has been barely investigated,especially for soil with different *** major objective of this study is to investigate the water retention capacity,and gas permeability of biochar-amended soil(BAS)with different biochar contents under varying degree of compaction(DOC)***-house produced novel biochar was mixed with the soil at different amendment rates(*** contents of 0%,5%and 10%).All BAS samples were compacted at three DOCs(65%,80%and 95%)in polyvinyl chloride(PVC)*** soil column was subjected to dryingewetting cycles,during which soil suction,water content,and gas permeability were measured.A simplified theoretical framework for estimating the void ratio of BAS was *** experimental results reveal that the addition of biochar significantly decreased gas permeability kg as compared with that of bare soil(BS).However,the addition of 5%biochar is found to be optimum in decreasing kg with an increase of DOC(i.e.k_(g,65%)>k_(g,80%)>k_(g,95%))at a relatively low suction range(<200 kPa)because both biochar and compaction treatment reduce the connected pores.

关键词： Biochar Degree of compaction(DOC) Gas permeability Soil water retention Wettingedrying cycle

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Staphylococcus cohnii: Not so innocuous

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Journal of Acute Disease 2017年第5期6卷 239-240页

作者： Sunil garg NMC Hospital Dubai Investment park-1 Dubai-United Arab Emirates

Staphylococcus cohnii is not known to causes meningitis. We present a case of mennigitis due to this organism. We are highlighting this case not only for its rarity but rapidity of worsening also. This report indicates that Staphylococcus cohnii are not as innocuous as once thought to be and these organisms should not be disregarded as possible skin contaminants. Before labelling them as contaminants their possible association with disease should be ruled out.

关键词： Meningitis Staphylococcus cohnii Coagulase negative staphylococci

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Cosmetic arm lengthening with monorail fixator

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Chinese Journal of Traumatology 2015年第3期18卷 170-174页

作者： Hemendra Kumar Agrawal Balvinder Singh Mohit garg Vipin Khatkar Sumit Batra Vinod Kumar Sharma Central Institute of Orthopaedics. Safdarjung Hospital New Delhi 110029 India

Upper limb length discrepancy is a rare occurrence. Humerus shortening may need specialized treatment to restore the functional and cosmetic status of upper limb. We report a case of humerus lengthening of 9 cm with a monorail external fixator and the result was observed during a 2-year follow-up. Humerus lengthening needs specialized focus as it is not only a cosmetic issue but also a functional demand. The monorail unilateral fixator is more functional and cosmetically acceptable, and thus becomes an effective treatment option.

关键词：单轨化妆品手臂随访观察外固定架美容固定器上肢

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Linking Real-Life Situations with Classroom Assessment: Development of Real-Life Performance-Based Tasks in Business Mathematics

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Journal of Applied Mathematics and Physics 2021年第3期9卷 485-502页

作者： sheena Mai A. Galman Jennalyn C. Del Rosario Faculty of Mathematics Nueva Ecija University of Science and Technology Cabanatuan City Philippines Eduardo L. Joson Memorial High School Nueva Ecija Philippines

This study aimed to develop real-life performance-based tasks in Business Mathematics (RLPBTs) following the ADDIE’s model of instructional development. Using the descriptive-developmental research design, the study developed RLPBTS with mathematics experts, mathematics department head, bank manager, mathematics teachers, and students as respondents. The RLPBTs consist of instructional plans. Each instructional plan has these components: Introduction, Learning Competency, Learning Outcome, Task Execution, Scoring Guide, and Generalization. The design and content of the instructional plans were assessed as very good. On the other hand, the design and execution of the Tasks were assessed as favorable. Grade 11 students also agreed that real-life performance-based tasks helped them understand better concepts in business mathematics. They claimed that they enjoyed the tasks because of the inclusion of real-life situations that they simulated. The use of the RLPBTs provides another innovation in the teaching and learning concepts in Business Mathematics.

关键词： ADDIE Model Real-Life Performance-Based Tasks Instructional Plans Business Mathematics

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