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Impact of Social Determinants of Health on Self-Perceived resilience: An Exploratory Study of Two Cohorts of Adults with Congenital Heart Disease

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Congenital Heart Disease 2024年第1期19卷 33-48页

作者： Albert Osom Krysta S.Barton Katie Sexton Lyndia Brumback Joyce P.Yi-Frazier abby r.rosenberg ruth Engelberg Jill M.Steiner Department of Biostatistics University of WashingtonSeattleWA98195USA Biostatistics Epidemiology and Analytics for research(BEAr)Core Seattle Children’s Research InstituteSeattleWA98101USA College of Medicine University of WashingtonSeattleWA98195USA Center for Clinical and Translational research Seattle Children’s Research InstituteSeattleWA98101USA Department of Psychosocial Oncology and Palliative Care Dana-Farber Cancer InstituteDepartment of MedicineBoston Children’s HospitalBostonMA02215USA Department of Pediatrics Harvard Medical SchoolBostonMA02215USA Division of Pulmonary Critical Care and Sleep MedicineDepartment of Medicine&Cambia Palliative Care Center of ExcellenceUniversity of WashingtonHarborview Medical CenterSeattleWA98104USA Division of Cardiology Department of Medicine&Cambia Palliative Care Center of ExcellenceUniversity of WashingtonSeattleWA98195USA

Social determinants of health(SDOH)affect quality of *** investigated SDOH impacts on self-perceived resilience among people with adult congenital heart disease(ACHD).Secondary analysis of data from two com-plementary studies:a survey study conducted May 2021–June 2022 and a qualitative study conducted June 2020–August *** was assessed through CD-rISC10 score(range 0–40,higher scores reﬂect greater self-perceived resilience)and interview *** and SDOH(education,employment,living situa-tion,monetary stability,ﬁnancial dependency,area deprivation index)data were collected by healthcare record review and *** used linear regression with robust standard errors to analyze survey data and performed a thematic analysis of interview *** participants(N=127)mean age was 42±14 years;51%were female,87%*** was moderate(75%)or complex(25%);41%functional class C or ***(mean 30±7)varied by monetary stability:compared to people with difﬁculty paying bills,resilience was 15.0 points higher(95%CI:6.9–23.1,pr people reporting having enough money and 14.2 points higher(95%CI:5.9–22.4,p=0.001)for those reporting just enough *** participants’(N=25)mean age was 32 years(range 22–44);52%were female,72%*** was moderate(56%)or complex(44%);76%functional class C or *** discussed factors affecting resilience aligned with each of the major SDOH,prominently,economic stability and healthcare access and *** stability may be important for supporting self-perceived resi-lience in *** knowledge can inform the development of resilience interventions for this population.

关键词： Social determinants of health adult congenital heart disease resilience ﬁnancial stability

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An interferometric ex vivo study of corneal biomechanics under physiologically representative loading,highlighting the role of the limbus in pressure compensation

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Eye and Vision 2020年第5期7卷 412-422页

作者： abby Wilson John Jones John rTyrer John Marshall Wolfson School of Mechanical Manufacturing and Electrical EngineeringLoughborough UniversityLoughboroughUK Laser Optical Engineering Ltd. DerbyshireUK Institute of Ophthalmology UCLLondonUK

Background:The mechanical properties of the cornea are complex and regionally *** paper uses an original method to investigate the biomechanics of the cornea in response to hydrostatic loading over the typical physiological range of intra-ocular pressure(IOP)fluctuations thereby increasing understanding of clinically relevant corneal biomechanical properties and their contributions to the refractive properties of the ***:Displacement speckle pattern interferometry(DSPI)was used to measure the total surface displacement of 40 porcine and 6 human corneal-scleral specimens in response to pressure variations up to 1 mmHg from a baseline of 16.5 *** specimens were mounted in a modified artificial anterior chamber(AAC)and loaded *** of high strain in response to loading were identified by comparing the displacements across different ***:The nature of the response of the corneal surface to loading demonstrated high regional topographic *** properties were shown to be asymmetrical,and deformation of the limbal and pre-limbal regions dominated these responses respectively with over 90%(N-T)and 60%(S-I)of the total maximum displacement occurring in these regions indicating *** contrast,the curvature of the central cornea remained relatively unchanged merely translating in ***:The limbal and pre-limbal regions of the cornea appear to be fundamental to the absorption of small pressure fluctuations facilitating the curvature of the central cornea to remain relatively *** differential mechanical properties of this region could have important implications for the application of corneal surgery and corneal crosslinking,warranting further investigation.

关键词： Cornea Biomechanics Interferometry Limbus Topography

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Oesophageal and gastric varices:historical aspects,classification and grading:everything in one place

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Gastroenterology report 2016年第3期4卷 186-195,I0001页

作者： Cyriac abby Philips Amrish Sahney Department of Hepatology Institute of Liver and Biliary SciencesNew DelhiDelhiIndia

Variceal disease and its management are of the utmost importance in the treatment of portal *** guidelines are universal for management of variceal disease in portal *** and grading systems are numerous and differ according to geographical *** this exhaustive review,the historical aspects of variceal disease,its classification and the grading systems in use are discussed,with self-explanatory tables and timelines.A better and clear understanding of the evolution of portal hypertension and variceal disease is provided.

关键词： oesophageal varices gastric varices classification portal hypertension

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Still'dwelling in the possibility'-critical update on stem cell therapy for acute on chronic liver failure

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World Journal of Stem Cells 2020年第10期12卷 1124-1132页

作者： Cyriac abby Philips Philip Augustine The Liver Unit and Monarch Liver Lab Cochin Gastroenterology GroupErnakulam Medical CenterKochi 682025KeralaIndia Department of Gastroenterology and Advanced GI Endoscopy Cochin Gastroenterology GroupErnakulam Medical CenterKochi 682025KeralaIndia

Stem cells therapy could improve survival in patients with liver *** on stem cell therapy and related growth factors in decompensated cirrhosis has been on the forefront but has shown heterogenous *** high-quality studies have shown a lack of efficacy and *** with acute-on-chronic liver failure(ACLF)are a unique group with high mortality in the short-term associated with rapid onset extrahepatic organ *** these patients,there is an urgent need to identify treatments that can improve liver cell function and mass,prevent sepsis/organ failure,ameliorate systemic inflammation,and increase transplant-free *** cells are a novel treatment in ACLF but with unclear efficacy and *** this narrative review,we discuss the basics of liver regeneration in patients with ACLF and update current clinical status of stem cell use in patients with ACLF for improving our understanding of future directions.

关键词： Portal hypertension regenerative therapy Mesenchymal stem cells Liver failure Sepsis

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Potent antiviral therapy improves survival in acute on chronic liver failure due to hepatitis B virus reactivation

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World Journal of Gastroenterology 2014年第43期20卷 16037-16052页

作者： Cyriac abby Philips Shiv Kumar Sarin Department of Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India

Acute on chronic liver failure(ACLF)is a disease entity with a high mortality *** acute event arises from drugs and toxins,viral infections,bacterial sepsis,interventions(both surgical and non-surgical)and vascular events on top of a known or occult chronic liver *** secondary to reactivation of chronic hepatitis B virus is a distinct condition;the high mortality of which can be managed in the wake of new potent antiviral *** example,lamivudine and entecavir use has shown definite short-term survival benefits,even though drug resistance is a concern in the *** renoprotective effects of telbivudine have been shown in a few studies to be useful in the presence of renal *** with newer agents such as tenofovir and a combination of nucleos(t)ides is promising for improving survival in this special group of liver disease *** review describes the current status of potent antiviral therapy in patient with acute on chronic liver failure due to reactivation of chronic hepatitis B,thereby providing an algorithm in management of such patients.

关键词： Acute on chronic liver failure Chronic hepatitis B infection reactivation of hepatitis B Flare of hepatitis B Anti-viral therapy Nucleoside analogue Nucleotide analogue

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Healthy Donor Fecal Microbiota Transplantation for recurrent Bacterial Cholangitis in Primary Sclerosing Cholangitis-A Single Case report

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Journal of Clinical and Translational Hepatology 2018年第4期6卷 438-441页

作者： Cyriac abby Philips Philip Augustine Nikhil Phadke The Liver Unit Cochin Gastroenterology GroupP.A.A.Ernakulam Medical CentreNational Highway Bypass(NH-66)PalarivattomKochiKeralaIndia Gastroenterology Cochin Gastroenterology GroupP.A.A.Ernakulam Medical CentreNational Highway Bypass(NH-66)PalarivattomKochiKeralaIndia Molecular Cellular and Developmental BiologyGenepath DxPhadke HospitalShivajinagarPuneMaharashtraIndia

recurrent acute bacterial cholangitis is a unique indication for liver transplantation in primary sclerosing *** present the first report on utility of healthy donor fecal transplantation for management of recurrent acute bacterial cholangitis in a primary sclerosing cholangitis *** demonstrate the striking liver biochemistry,bile acid and bacterial community changes following intestinal microbiota transplantation associated with amelioration of recurrent cholangitis.

关键词： FMT Sclerosing cholangitis Stool transplant Gut microbiome Microbiota

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Complementary and Alternative Medicine-related Drug-induced Liver Injury in Asia

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Journal of Clinical and Translational Hepatology 2019年第3期7卷 263-274页

作者： Cyriac abby Philips Philip Augustine Sasidharan rajesh Praveen Kumar Y Deepak Madhu The Liver Unit and Monarch Liver Lab Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Gastroenterology Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Interventional radiology Cochin Gastroenterology GroupErnakulam Medical CentreKochiKeralaIndia Gastroenterology Government Medical CollegeThrissurKeralaIndia Gastroenterology Aster MIMSCalicutKeralaIndia

The use of complementary and alternative medicines(CAMs)for treatment of acute and chronic diseases is on the rise world over,especially in Asian countries,and mostly in China and ***-induced liver injury(DILI)due to CAM is increasingly reported in the literature from multiple centers all around the world and with large-number patient series published from the West,mostly based on nation-wide DILI networks and multicenter *** DILI networks are lacking among major Asian countries with high incidence of CAM *** medical societies dealing with drug toxicity,CAM practice and hepatobiliary disease have adopted an integrated approach to establishing identification,diagnosis and treatment of CAM-related DILI,representing a systematic approach that could be iterated by other countries for improving patient *** this exhaustive review,we provide published data on CAM-related DILI in Asia,with detail on incidences along with analysis of patient population and their clinical *** and clear discussion on commonly implicated CAM agents in major Asian countries and associated chemical and toxicology analyses as well as descriptions of liver biopsy findings are discussed with future directions.

关键词： CAM Herbals Ayurveda Chinese DILI Hepatitis Cirrhosis ACLF Liver biopsy

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Nigral dopaminergic neuron replenishment in adult mice through VE-cadherin-expressing neural progenitor cells

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Neural regeneration research 2017年第11期12卷 1865-1869页

作者： Abir A.rahman Nathan K.Lai Joshua E.Albright Paige E.Urquhart abby r.Webb Brad E.Morrison Department of Biological Sciences Boise State UniversityBoiseIDUSA Biomolecular Ph.D.Program Boise State UniversityBoiseIDUSA Department of Biological Sciences Boise State UniversityBoiseIDUSA

The function of dopaminergic neurons in the substantia nigra is of central importance to the coordination of movement by the brain＇s basal ganglia circuitry. This is evidenced by the loss of these neurons, resulting in the cardinal motor deficits associated with Parkinson＇s disease. In order to fully understand the physiology of these key neurons and develop potential therapies for their loss, it is essential to determine if and how dopaminergic neurons are replenished in the adult brain. recent work has presented evidence for adult neurogenesis of these neurons by Nestin＋/Sox2 neural progenitor cells. We sought to further validate this finding and explore a potential atypical origin for these progenitor cells. Since neural progenitor cells have a proximal association with the vasculature of the brain and subsets of endothelial cells are Nestin＋, we hypothesized that dopaminergic neural progenitors might share a common cell lineage. Therefore, we employed a VE-cadherin promoter-driven CrEErT2：TIlox/Tlox transgenic mouse line to ablate the tyrosine hydroxylase gene from endothelial cells in adult animals. After 26 weeks, but not 13 weeks, following the genetic blockade of tyrosine hydroxylase expression in VE-cadherin＋ cells, we observed a significant reduction in tyrosine hydroxylase＋ neurons in the substantia nigra. The results from this genetic lineage tracing study suggest that dopaminergic neurons are replenished in adult mice by a VE-cadherin＋ progenitor cell population potentially arising from an endothelial lineage.

关键词： nerve regeneration neural progenitor cells adult neurogenesis endothelial cells substantia nigra dopaminergic neurons Parkinson's disease mouse model

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Identification and Analysis of Gut Microbiota and Functional Metabolism in Decompensated Cirrhosis with Infection

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Journal of Clinical and Translational Hepatology 2023年第1期11卷 15-25页

作者： Cyriac abby Philips rizwan Ahamed Jinsha K.P.Abduljaleel Sasidharan rajesh Philip Augustine Clinical and Translational Hepatology Monarch Liver LaboratoryThe Liver InstituteCenter of Excellence in GI SciencesRajagiri HospitalAluvaKeralaIndia Gastroenterology and Advanced GI Endoscopy Center for Excellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia Diagnostic and Interventional Gastroenterology and Hepatology Center for Excellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia

Background and Aims:Intestinal dysbiosis play a role in the adverse outcomes of sepsis and septic ***,variations in bacterial diversity and microbiota-related functional metabolic alterations within the gut microbiome in decompensated cirrhosis(DC)patients with infection remain ***:We conducted 16-srrNA sequencing on stool samples(n=51:sepsis,27/no sepsis,24)collected from consecutive DC patients upon *** diversity,significant taxa,and respective metabolic profiling were performed based on subgroup ***/Cytoscape was utilized to identify significant non-random patterns of bacterial copresence and mutual exclusion for clinical ***:Genera associated with pathogenicity in conditions of immune exhaustion(Corynebacterium,Lautropia)were predominant in patients with *** pathways associated with oxidative stress and endotoxemia[lipopolysaccharide(LPS)synthesis and sulfur relay]were significantly upregulated in *** taxa were associated with sites of infection in DC *** oxidant pathways that increase glutathione were upregulated in those without *** family of sulfur-metabolizing bacteria,exaggeration of orally predominant pathogens(Prevotella),and pathways of severe LPS-related hyperinflammatory stress were notable in those with interleukin-6 levels>1,000 pg/*** genera related to an immune deficient state was significant in DC with≥2 infection *** was associated with survival during the same ***:Specific gut microbiota and their metabolites were associated with sepsis and related events in patients with *** beneficial strains that reduce immune exhaustion and supplementation of favorable metabolites could improve therapeutics for DC and sepsis,for which larger prospective,well controlled population-based studies remain an unmet need.

关键词： Microbiome Portal hypertension Sepsis Acute-on-chronic liver failure Multidrug resistance

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Outcomes and Toxicology of Herbal Drugs in Alcoholic Hepatitis-A Single Center Experience from India

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Journal of Clinical and Translational Hepatology 2019年第4期7卷 329-340页

作者： Cyriac abby Philips Sasidharan rajesh Tom George rizwan Ahamed Sandeep Kumbar Philip Augustine The Liver Unit and Monarch Liver Lab Cochin Gastroenterology GroupErnakulam Medical CenterKochiKeralaIndia Interventional radiology Department of Gastroenterology and HepatologyCochin Gastroenterology GroupErnakulam Medical CenterKochiKeralaIndia Gastroenterology and Advanced G.I.Endoscopy Cochin Gastroenterology GroupErnakulam Medical CenterKochiKeralaIndia

Background and Aims:We aimed to study clinical out-comes and liver biopsy features of alcoholic hepatitis(AH)patients on complementary and alternative medicines(CAMs)and to analyze the retrieved drugs for chemical and toxic components linked to drug-induced liver ***:We retrospectively assessed clinical,biochemical and liver bi-opsy features of AH patients on CAM with drug-induced liver injury(AH-CAM,n=27)and compared them to a control group(classical AH,n=29)on standard of *** without liver biopsy evaluation and other causes for liver dis-ease were *** of the CAMs(n=42)from pa-tients were retrieved and assessed for chemical and ***:All were males,and significantly worse clinical pre-sentation,biochemical severity,and liver disease scores were notable in patients with *** Ayurve-dic-polyherbal formulations were the most commonly used *** liver histology,varying grades of severe-necrosis,severe hepatocellular,canalicular,cholangiolar cholestasis with predominant lymphocytic-portal-inflammation and varying grades of interface-hepatitis were noted in *** of CAMs revealed presence of heavy metals up to 100,000 times above detectable range and adulter-ants,such as antibiotics,chemotherapy agents,nonsteroi-dal anti-inflammatory drugs,alcohols,antidepressants,anxiolytics,and recreational *** follow up,a signifi-cantly higher number of patients with AH on CAM died at end of 1,3-and-6-months compared to controls(37%vs.83%,29%vs.62%,18%vs.52%respectively;prelated drug-induced liver injury have extremely poor short-term survival in the absence of liver transplantation compared to those patients with AH on evidence-based *** transplant referral and educating on and curbing of CAM use in severe liver disease through strict monitoring of unregulated traditional health practices can help ease the burden of liver-related death.

关键词： Hepatitis Alcohol CAM DILI Ayurveda

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