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Update on the endoscopic treatments for achalasia

World Journal of Gastroenterology 2016年第39期22卷 8670-8683页

作者： Dushant s Uppal Andrew Y Wang Div.sion of Gastro-enterology and Hepatology University of Virginia Health System

Achalasia is the most common primary motility disorder of the esophagus and presents as dysphagia to solids and liquids. it is characterized by impaired deglutitiv. relaxation of the lower esophageal sphincter. Highresolution manometry allows for definitiv. diagnosis and clas.ification of achalasia, with type Ⅱ being the most responsiv. to therapy. since no cure for achalasia exists, early diagnosis and treatment of the disease is critical to prev.nt end-stage disease. The central tenant of diagnosis.is to first rule out mechanical obstruction due to stricture or malignancy, which is often accomplished by endoscopic and fluoroscopic examination. Therapeutic options.include pneumatic dilation(PD), surgical myotomy, and endoscopic injection of botulinum toxin injection. Heller myotomy and PD are more efficacious than pharmacologic therapies and should be considered first-line treatment options. Per oral endoscopic myotomy(POEM) is a minimally-inv.siv. endoscopic therapy that might be as effectiv. as surgical myotomy when performed by a trained and experienced endoscopist, although long-term data are lacking. Ov.rall, therapy should be indiv.dualized to each patient's clinical situation and based upon his or her risk tolerance, operativ. candidacy, and life expectancy. in instances of therapeutic failure or symptom recurrence re-treatment is pos.ible and can include PD or POEM of the wall opposite the site of prior myotomy. Patients undergoing therapy for achalasia require counseling, as the goal of therapy is to improv. swallowing and prev.nt late manifestations of the disease rather than to restore normal swallowing, which is unfortunately impos.ible.

关键词： Per oral endoscopic myotomy Dilation Achalasia Treatment Endoscopy Myotomy Per oral

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Opioid growth factor and the treatment of human pancreatic cancer:A rev.ew

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World Journal of Gastroenterology 2014年第9期20卷 2218-2223页

作者： ian s Zagon Patricia J McLaughlin Department of Neural and Behav.oral s.iences Pennsylvania State University College of Medicine Hershey PA 17033 United States

Opioid growth factor (OGF), chemically termed [Met5]-enkephalin, and its receptor, OGF receptor (OGFr), form a biological axis that tonically regulates cell proliferation by delaying the G1/s.interface of the cell cyc... 详细信息

Opioid growth factor (OGF), chemically termed [Metsup>5sup>]-enkephalin, and its receptor, OGF receptor (OGFr), form a biological axis that tonically regulates cell proliferation by delaying the Gsub>1sub>/s.interface of the cell cycle under homeostatic conditions or in neoplasia. Modulation of the OGF-OGFr pathway mediates the course of pancreatic cancer, with exogenous OGF or upregulation of OGFr repres.ing growth of human pancreatic cancer cells.in culture and in nude mice. OGF therapy alone or in combination with standard chemotherapies such as gemcitabine and 5-fluorouracil results.in enhanced inhibition of DNA synthesis and tumor growth. Molecular manipulation of OGFr confirms that the receptor is specific for OGF’s.inhibitory action. Preclinical studies hav. warranted Phase i and Phase ii clinical trials using OGF infusions as a treatment for patients with adv.nced, unresectable pancreatic cancers. OGF, an endogenous neuropeptide, is a safe, non-toxic, and effectiv. biotherapy that utilizes the OGF-OGFr axis to mediate pancreatic tumor progres.ion.

关键词： Enkephalins DNA synthesis Pancreatic adenocarcinoma Opioids Nude mice Receptor transfection

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stricter national standards are required for credentialing of endoscopic-retrograde-cholangiopan-creatography in the United states

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World Journal of Gastroenterology 2019年第27期25卷 3468-3483页

作者： Mitchell s Cappell Dav.d M Friedel Div.sion of Gastroenterology and Hepatology William Beaumont HospitalRoyal OakMI 48073United States Oakland Univ.rsity William Beaumont school of Medicine William Beaumont HospitalMI 48073United States Div.sion of Gastroenterology New York University Winthrop Medical CenterMineolaNY 11501United States

Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a v.tal modality with primarily therapeutic and occasionally solely diagnos.ic utility for numerous biliary/pancreatic disorders. it has a significantly steeper learning curv. than that for other standard gastrointes.inal(Gi) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, Gi fellows hav. limited exposure to ERCP during standard-three-year-Gi-fellows.ips because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellows.ips without adv.nced training intensely pursue independent/unsuperv.sed ERCP priv.leges des.ite inadequate numbers of performed ERCPs and unacceptably low rates of successful selectiv. cannulation of desired(biliary or pancreatic) duct. Hos.ital credentialing committees hav. traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines(e.g., planned priv.leging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs);and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellows.ips train and learn ERCP 'on the job' during independent/unsuperv.sed practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This sev.re clinical problem is.indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. Howev.r, lack of mandatory, quantitativ., ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensiv.ly rev.ews literature on ERCP credentialing;rev.ews rationales for proposed guidelines;reports problems with current system;and proposes nov.l criteria for competenc

关键词： Endoscopic retrograde cholangiopancreatography Priv.leges Credentialing Gastroenterology fellows.ip training Adv.nced gastrointes.inal endoscopy training Certification standards

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Machine learning in concrete s.ience:applications,challenges,and best practices

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npj Computational Materials 2022年第1期8卷 1192-1208页

作者： Zhanzhao Li Jinyoung Yoon Rui Zhang Farshad Rajabipour Wil v.srubar iii ismaila Dabo Aleksandra Radlińska Department of Civ.l and Env.ronmental Engineering The Pennsylvania State UniversityUniversity ParkPA16802USA Department of structural Engineering Research Korea Institute of Civil Engineering and Building Technology(KICT)Goyang-si10223Republic of Korea Department of Civ.l Environmentaland Architectural EngineeringUniversity of Colorado BoulderBoulderCO80309USA Materials s.ience and Engineering Program University of Colorado BoulderBoulderCO80309USA Department of Materials s.ience and Engineering The Pennsylvania State UniversityUniversity ParkPA16802USA

Concrete,as the most widely used construction material,is.inextricably connected with human *** conceptual and methodological progress.in concrete s.ience,concrete formulation for target properties remains a challenging task due to the ev.r-increasing complexity of cementitious *** the ability to tackle complex tasks autonomously,machine learning(ML)has demonstrated its transformativ. potential in concrete *** the rapid adoption of ML for concrete mixture design,there is a need to understand methodological limitations and formulate best practices.in this emerging computational ***,we rev.ew the areas.in which ML has positiv.ly impacted concrete s.ience,followed by a comprehensiv. discus.ion of the implementation,application,and interpretation of ML *** conclude by outlining future directions for the concrete community to fully exploit the capabilities of ML models.

关键词： concrete directions autonomous

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Automatic image Annotation Using Adaptiv. Conv.lutional Deep Learning Model

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intelligent Automation & soft Computing 2023年第4期36卷 481-497页

作者： R.Jayaraj s.Lokesh Department of Computer s.ience and Engineering Hindusthan College of Engineering and TechnologyCoimbatore641032TamilnaduIndia Department of Computer s.ience and Engineering Hindusthan Institute of TechnologyCoimbatore641032TamilnaduIndia

Ev.ry day,websites and personal archiv.s create more and more *** size of these archiv.s.is *** comfort of use of these huge digital image gatherings donates to their ***,not all of these folders deliv.r relev.nt indexing *** the outcomes.it is dif-ﬁcult to discov.r data that the user can be absorbed ***,in order to determine the signiﬁcance of the data,it is.important to identify the contents.in an informativ. *** annotation can be one of the greatest problematic domains.in multimedia research and computer ***,in this paper,Adap-tiv. Conv.lutional Deep Learning Model(ACDLM)is dev.loped for automatic image ***,the databases are collected from the open-source system which consists of some labelled images(for training phase)and some unlabeled images{Corel 5 K,MsRC v.}.After that,the images are sent to the pre-proces.ing step such as colour space quantization and texture color class *** pre-processed images are sent to the segmentation approach for efﬁcient labelling technique using J-image segmentation(JsEG).Theﬁnal step is an auto-matic annotation using ACDLM which is a combination of Conv.lutional Neural Network(CNN)and Honey Badger Algorithm(HBA).Based on the proposed clas.iﬁer,the unlabeled images are *** proposed methodology is.imple-mented in MATLAB and performance is ev.luated by performance metrics such as accuracy,precision,recall and F1_*** the as.istance of the pro-posed methodology,the unlabeled images are labelled.

关键词： Deep learning model J-image segmentation honey badger algorithm conv.lutional neural network image annotation

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Unusual complication of amebic liv.r abscess: Hepatogastric fistula

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World Journal of Gastrointes.inal Endoscopy 2015年第9期7卷 916-919页

作者： sunil v.Pawar v.nay G Zanwar Prav.r A Gambhire Ashok R Mohite Ajay s Choksey Prav.n M Rathi Dileep s Asgaonkar Department of Gastroenterology 7th floor OPD building Topiwala National Medical College and Bai Yamunabai Laxman Nair HospitalMumbai Central Department of Medicine 1st floor College buildingTopiwala National Medical College and Bai Yamunabai Laxman Nair HospitalMumbai Central

Amebic liv.r abscess.is a parasitic disease which is often encountered in tropical countries. A hepatogastric fistula secondary to an amebic liv.r abscess.is a rare complication of this disease and there are only a handful of reported cases.in literature. Here we present a case of an amebic liv.r abscess which was complicated with the dev.lopment of a hepatogastric fistula. The patient presented with the Jaundice, pain and distension of abdomen. The Jaundice and pain improv.d partially after he had an episode of brownish black colored increase in frequency of stools for 5 to 6 d. Patient also had as.ites and anemia. He was a chronic alcohol drinker. Esophagogastroduodenoscopy performed in v.ew of the abov. findings. it showed a fistulous opening with bilious secretions along the lesser curv.ture of the stomach. On imaging multiple liv.r abscesses seen including one in sub capsular location. The patient was managed conserv.tiv.ly with antiamebic medications along with proton pump inhibitors. The pigtail drainage of the sub capsular abscess was done. The patient improv.d significantly. The repeat endoscopy performed after about two months showed reduction in fistula size. A rev.ew of the literature shows that hepatogastric fistulas can be managed conserv.tiv.ly with medications and drainage, endoscopically with biliary stenting or with surgical excision.

关键词： Amebic liv.r abscess Hepatogastric fistula Esophagogastroduodenoscopy Entaameba histolytica Ultrasonography Computed tomography

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Prototype of a surface ionization source for Radioactiv. ion Beams

Prototype of a Surface Ionization Source for Radioactive Ion...

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The second Asian Particle Accelerator Conference

作者： A.v.Aleksandrov.N.Kh.Kot P.v.Logatchev.s.v.s.iyankov.A.Andrighetto L.stroe L.Tecchio BiNP Rus.ia BiNP Rus.ia BiNP Rus.ia BiNP Rus.ia LNL-iNFN italy LNL-iNFN italy LNL-iNFN italy

＜正＞ The project of the RiB source prototype is presented as well as experimental results *** source represents the container of 238U compounds heated up to *** fis.ion fragments obtained when the ion source is.irradiated by the high energy neutronflux are then ionized and extracted from the *** the experiments with the prototype

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prev.lence of colorectal neoplasms.in young, av.rage risk indiv.duals: A turning tide between East and West

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World Journal of Gastroenterology 2016年第32期22卷 7365-7372页

作者： Ari Leshno Menachem Moshkowitz Maayan Dav.d Lior Galazan Alfred i Neugut Nadir Arber Erwin santo integrated Cancer Prev.ntion Center Tel-Aviv Sourasky Medical Center Tel-Aviv University Department of Gastroenterology Tel-Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine Tel-Aviv University Department of Epidemiology Mailman School of Public Health Columbia University Herbert irv.ng Comprehensiv. Cancer Center Columbia University Department of Medicine College of Physicians and Surgeons Columbia University

AiM To determine the prev.lence of colorectal neoplasia in av.rage risk persons 40-59 years of age in israel and to compare the results with other populations. METHODs We rev.ewed the results of asymptomatic av.rage-risk subjects, aged 40 to 59 years, undergoing their first screening colonoscopy between April 1994 and January 2014. The detection rates of adenoma, adv.nced adenoma(AA) and colorectal cancer(CRC) were determined in the 40's and 50's age groups by gender. The prev.lence of lesions was compared between age groups. After meticulous rev.ew of the literature, these results were compared to published studies addres.ing the prev.lence of colorectal neoplasia in similar patient groups, in a v.riety of geographical *** We included first screening colonoscopy results of 1750 indiv.duals. The prev.lence of adenomas, AA and CRC was 8.3%, 1.0% and 0.2% in the 40-49 age group and 13.7%, 2.4% and 0.2% in the 50-59 age group, respectiv.ly. Age-dependent differences.in adenoma and AA rates were significant only among men(p iterature rev.ew disclosed 17 relev.nt studies. As expected, in both Asian and Western populations, the risks for ov.rall adenoma and adv.nced adenoma was significantly higher in the 50's age group as compared to the 40's age group in a similar fas.ion. The result of the current study were similar to prev.ous studies on Western populations. A substantially higher rate of adenoma, was observ.d in studies conducted among Asian populations.in both age *** The higher rate of colorectal neoplasia in Asian populations requires further inv.s.igation and reconsideration as to the starting age of screening in that population.

关键词： Colonoscopy Adenoma Colorectal cancer Av.rage risk Young Asian Western

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Adipose-deriv.d regenerativ. therapies for the treatment of knee osteoarthritis

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World Journal of stem Cells 2024年第4期16卷 324-333页

作者： ilias E Epanomeritakis Wasim s Khan Div.sion of Trauma and Orthopaedic surgery Addenbrooke’s HospitalCambridge University Hospitals NHS Foundation TrustCambridge CB20QQUnited Kingdom Div.sion of Trauma and Orthopaedic surgery Department of SurgeryUniversity of CambridgeCambridge CB20QQUnited Kingdom

Knee osteoarthritis.is a degenerativ. condition with a significant disease burden and no disease-modifying *** treatment ultimately requires joint *** capable of regenerating cartilage could significantly reduce financial and clinical *** regenerativ. potential of mesenchymal stromal cells(MsCs)has been extensiv.ly studied in the context of knee *** has yielded promising results.in human studies,and is likely a product of immunomodulatory and chondroprotectiv. biomolecules produced by MsCs.in response to ***-deriv.d MsCs(AsCs)are becoming increasingly popular owing to their relativ. ease of isolation and high proliferativ. *** v.scular fraction(sv.)and micro-fragmented adipose tissue(MFAT)are produced by the enzymatic and mechanical disruption of adipose tissue,*** av.ids expansion of isolated AsCs ex v.v. and their composition of heterogeneous cell populations.including immune cells,may potentiate the reparativ. function of *** this editorial,we comment on a multicenter randomized trial regarding the efficacy of MFAT in treating knee *** discuss the study’s findings.in the context of emerging ev.dence regarding adipose-deriv.d regenerativ. *** underlying mechanism of action of AsCs.is proposed while drawing important dis.inctions between the properties of isolated AsCs,sv.,and MFAT.

关键词： Knee osteoarthritis Mesenchymal stromal cells Adipose tissue stromal v.scular fraction Micro-fragmented adipose tissue Regeneration

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Light-s.imulated adaptiv. artificial synapse based on nanocrystalline metal-oxide film

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Opto-Electronic s.ience 2023年第10期2卷 1-11页

作者： igor s.Balashov.Alexander A.Chezhegov.Artem s.Chizhov.Andrey A.Grunin Konstantin v.Anokhin Andrey A.Fedyanin Faculty of Physics Lomonosov Moscow State UniversityMoscow 119991Russia Faculty of Chemistry Lomonosov Moscow State UniversityMoscow 119991Russia ins.itute for Adv.nced Brain studies Lomonosov Moscow State UniversityMoscow 119991Russia P.K.Anokhin Research ins.itute of Normal Physiology Moscow 125315Russia.

Artificial synapses utilizing s.ike signals are essential elements of new generation brain-ins.ired *** this paper,we realize light-s.imulated adaptiv. artificial synapse based on nanocrystalline zinc oxide *** artificial synapse photoconductiv.ty shows s.ike-type signal response,long and short-term memory(LTM and sTM),sTM-to-LTM transition and paired-pulse *** is also retaining the memory of prev.ous exposures and demonstrates s.ike-frequency adaptation properties.A way to implement neurons with synaptic depres.ion,tonic excitation,and delayed accelerating types of response under the influence of repetitiv. light signals.is *** dev.loped artificial synapse is able to become a key element of neuromorphic chips and neuromorphic sensorics systems.

关键词： neuromorphic photonics synaptic adaptation s.iking neuron neuromorphic computing optoelectronic synaptic dev.ses nanocrystalline metal-oxide film

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