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Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage

World Journal of Gastrointestinal Surgery 2018年第4期10卷 40-48页

作者： Brendan T Everett steven d lidofsky Gastroenterology and Hepatology Unit University of Vermont Medical Center

AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences *** We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.

关键词： Liver cirrhosis Endoscopy Esophageal varices Secondary prevention Patient adherence

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Hospitalization for variceal hemorrhage in an era with more prevalent cirrhosis

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World Journal of Gastroenterology 2014年第32期20卷 11326-11332页

作者： Nicholas Lim Michael J desarno steven d lidofsky Eric Ganguly division of Gastroenterology and Hepatology University of Vermont College of Medicine Burlington VT 05401 United States department of Biostatistics University of Vermont College of Medicine Burlington VT 05401 United States

AIM: To examine hospitalization rates for variceal hemorrhage and relation to cause of cirrhosis during an era of increased cirrhosis prevalence.

关键词： Varices Gastrointestinal bleeding Cirrhosis Hospitalization Portal hypertension

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Oligodendroglial heterogeneity in health,disease,and recovery:deeper insights into myelin dynamics

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Neural Regeneration Research 2025年第11期20卷 3179-3192页

作者： Pieter-Jan Serneels Julie d.de Schutter Lies de Groef Lieve Moons steven Bergmans KU Leuven Leuven Brain InstituteDepartment of BiologyAnimal Physiology and Neurobiology DivisionNeural Circuit Development&Regeneration Research GroupLeuvenBelgium KU Leuven Leuven Brain InstituteDepartment of BiologyAnimal Physiology and Neurobiology DivisionCellular Communication&Neurodegeneration Research GroupLeuvenBelgium

decades of research asserted that the oligodendroglial lineage comprises two cell types:oligodendrocyte precursor cells and ***,recent studies employing single-cell RNA sequencing techniques have uncovered novel cell states,prompting a revision of the existing *** forward,the oligodendroglial lineage should be delineated into five distinct cell states:oligodendrocyte precursor cells,committed oligodendrocyte precursor cells,newly formed oligodendrocytes,myelin-forming oligodendrocytes,and mature *** new classification system enables a deeper understanding of the oligodendroglia in both physiological and pathological *** this uniform terminology will facilitate comparison and integration of data across ***,including the consolidation of findings from various demyelinating models,is essential to better understand the pathogenesis of demyelinating ***,comparing injury models across species with varying regenerative capacities can provide insights that may lead to new therapeutic strategies to overcome remyelination ***,by standardizing terminology and synthesizing data from diverse studies across different animal models,we can enhance our understanding of myelin pathology in central nervous system disorders such as multiple sclerosis,Alzheimer's disease,and amyotrophic lateral sclerosis,all of which involve oligodendroglial and myelin dysfunction.

关键词： animal models demyelination fish mammals multiple sclerosis myelin neurodegeneration oligodendrocytes oligodendroglial lineage remyelination

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Treatment strategies in obstructed defecation and fecal incontinence

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World Journal of Gastroenterology 2006年第20期12卷 3168-3173页

作者： Marat Khaikin steven d Wexner department of Colorectal Surgery Cleveland Clinic Florida WestonFL 33331United States

Obstructed defecation （Od） and fecal incontinence （FI） are challenging clinical problems, which are commonly encountered in the practice of colorectal surgeons and gastroenterologists. These disorders sodally and psychologically distress patients and greatly impair their quality of life. The underlying anatomical and pathophysiological changes are complex, often incompletely understood and cannot always be determined. As a consequence, many medical, surgical, and behavioral approaches have been described, with no panacea. Over the past decade, advances in an understanding of these disorders together with rational and similar methods of evaluation in anorectal physiology laboratories （ARP）, radiology studies, and new surgical techniques have led to promising results. In this brief review, we discuss treatment strategies and recent updates on clinical and therapeutic aspects of obstructed defecation and fecal incontinence.

关键词： Obstructed defecation Fecal incontinence Treatment

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Idiopathic fistula-in-ano

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World Journal of Gastroenterology 2011年第28期17卷 3277-3285页

作者： Sherief Shawki steven d Wexner department of Colorectal Surgery Cleveland Clinic Florida department of Surgery Suez Canal University

Fistula-in-ano is the most common form of perineal ***,a fistula includes an internal opening,a track,and an external *** external opening might acutely appear following infection and/or an abscess,or more insiduously in a chronic *** includes control of infection,assessment of the fistulous track in relation to the anal sphincter muscle,and finally,definitive treatment of the *** was the most commonly used mode of management,but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps,fibrin glue,collagen fistula plug,ligation of the intersphincteric fistula track,and stem *** descriptive and comparative studies have evaluated these different techniques with variable *** lack of consistent results,level I evidence,or long-term follow-up,as well as the heterogeneity of fistula pathology has prevented a definitive treatment *** article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano.

关键词： Anal fistula Seton Fistulotomy Advancement flap Fibrin glue Fistula plug

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Hierarchical methodology to evaluate the quality of disparate axle load data sources for pavement design

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Journal of Traffic and Transportation Engineering(English Edition) 2022年第2期9卷 261-279页

作者： steven Wood Jonathan d.Regehr Transportation division City of WinnipegWinnipegMB R3B 1B9Canada department of Civil Engineering University of ManitobaMB R3T 5V6Canada

Axle load data are an essential input for pavement design,yet for most North American agencies,there is uncertainty about the quality of axle load data obtained from weigh-inmotion(WIM)systems,the applicability of these data for pavement design,and potential opportunities to integrate axle load data from disparate *** article presents a novel and practical methodology to evaluate the quality of axle load data from WIM systems and roadside weigh scales through a series of hierarchical analyses designed to test data *** applied using data from Manitoba,Canada,the methodology quantified the uncertainty of axle loads measured at the weigh scales and piezo-quartz WIM,concluding that both could be used for pavement design *** collected at piezo-polymer WIM sites exhibited poorer data validity;however,application of site-specific temperature correction factors significantly improved data validity at these *** article describes how other data quality dimensions,including spatial coverage,temporal coverage,and long-term data availability,could be considered when determining the suitability of disparate axle load data sources for pavement *** of the methodology enables a pragmatic evaluation of the quality and limitations of commonlyavailable axle load data,revealing uncertainties and data needs relevant for pavement design practice.

关键词： Road engineering Pavement design Axle load Weigh-in-motion data quality Truck traffic

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Current status of laparoscopy for the treatment of rectal cancer

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World Journal of Gastroenterology 2014年第41期20卷 15125-15134页

作者： Noam Shussman steven d Wexner department of Colorectal Surgery Cleveland Clinic Florida

Surgery for rectal cancer in complex and entails many *** the laparoscopic approach in general and specific to colon cancer has been long proven to have short term benefits and to be oncologically safe,it is still a debatable topic for rectal *** attempt to benefit rectal cancer patients with the known advantages of the laparoscopic approach while not compromising their oncologic outcome has led to the conduction of many studies during the past *** we describe our technique for laparoscopic proctectomy and assess the current literature dealing with short term outcomes,immediate oncologic measures(such as lymph node yield and specimen quality) and long term oncologic outcomes of laparoscopic rectal cancer *** also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations and trends in the minimally invasive approach to rectal cancer surgery.

关键词： Laparoscopy Rectal cancer Minimally invasive surgery Oncological outcomes Short term benefits

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An investigation of roof runoff during rain events at the Royal Military College of Canada and potential discharge to Lake Ontario

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Journal of Environmental Sciences 2011年第7期23卷 1072-1078页

作者： david G. Kelly Ron d. Weir steven d. White Analytical Sciences Group & SLOWPOKE-2 Facility at RMC Department of Chemistry and Chemical Engineering Royal Military College of Canada 11 General Crerar Crescent

The Royal Military College of Canada, located on the north eastern shore of Lake Ontario, possesses an abundance of copper roofs and lacks surface water treatment prior to discharge into Lake Ontario. Rainwater, roof runoff and soil samples were collected and analyzed for copper and other parameters. Copper was consistently detected in runoff samples with average concentrations of 3200 ± 2100 μg/L. Multivariable linear regression analysis for a dependant copper runoff concentration yielded an adjusted R 2 value of 0.611, based on an independent variable model using minimum temperature, maximum temperature, total precipitation, and wind speed. Lake water samples taken in the vicinity of storm water outfalls draining areas with copper roofs ranged from 2.0 to 40 μg/L copper. Such data exceed the 2.0 μg/L Canadian Water Quality Guidelines for the Protection of Aquatic Life as outlined by the Canadian Council of Ministers of the Environment （CCME）. Analysis of raw, filtered and digested forms suggested that the majority of copper present in runoff and lake water samples was in a dissolved form. The majority of soils taken in this study displayed copper concentrations below the 63 μg/g CCME residential/parkland land use limits. These findings suggested that ion exchange processes between runoff water and soil do not occur to a sufficient extent to elevate copper levels in soil. It may therefore be concluded that the eventual fate of copper, which is not discharged via storm water outfalls, is lost to the water table and Lake Ontario through the sub-soil.

关键词： copper roof runoff Lake Ontario Canadian water quality guidelines for the protection of aquatic life

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New instability and mixing simulations using SPH and a novel mixing measure

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Journal of Hydrodynamics 2020年第4期32卷 684-698页

作者： Georgina Reece Benedict d.Rogers steven Lind Georgios Fourtakas department of Mechanical Aerospace and Civil EngineeringUniversityof ManchesterManchesterUK

This paper assesses the ability of smoothed particle hydrodynamics (SPH) to simulate mixing of two-phase flows and theirtransition to instabilities under different flow regimes. A new measure for quantification of the degree of mixing between phases in aLagrangian framework is also developed. The method is validated using the lid-driven cavity and two-phase Poiseuille flow cases. Thevelocity along the centre of the cavity is compared with results from the literature, whilst commercial volume-of-fluid codeSTAR-CCM+ provides a benchmark for the mixing and different mixing measures are considered. The velocity of two-phase Poiseuilleflow along the channel is compared to the analytical solution, and the appearance of interfacial instabilities with perturbation *** is the first time SPH has been used to investigate the onset and development of these instabilities. In particular, it is able to modelthe deforming shape of the interface, which is not given by analytical studies, while also offering improved predictions overconventional mesh-based computational fluid dynamics simulations.

关键词： Smoothed particle hydrodynamics(SPH) multi-phase mixing instability

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Plant photosystem Ⅱ assembly:TROL2 to the rescue

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Molecular Plant 2023年第11期16卷 1719-1721页

作者： Sujith Puthiyaveetil steven d.McKenzie department of Biochemistry and Center for Plant Biology Purdue UniversityWest LatayetteIN 47907USA

In one of the most consequential biochemical reactions on earth,a pigment-protein complex known as photosystem Ⅱ(PSⅡ)in photosynthesis extracts electrons,protons,and oxygen from water using energy from ***Ⅱ thereby sustains life on earth by harnessing the potential of two nearly inexhaustible raw materials:sunlight and *** plant PSllis a membrane-embedded *** monomer consists of around 28 unique protein subunits,157 chlorophylls,44 carotenoids,2 pheophytins,a heme,a non-heme iron,two quinones,and a Mn_(4)CaO_(5) cluster(Su et al.,2017;Cao et al.,2018).Within each monomeric complex,20 protein subunits constitute a core(Figure 1A).

关键词： Figure earth thereby

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