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Successful combination of direct antiviral agents in livertransplanted patients with recurrent hepatitis C virus

World Journal of Gastroenterology 2018年第12期24卷 1353-1360页

作者： christian rupp Theresa Hippchen Manuel Neuberger Peter Sauer Jan Pfeiffenberger Wolfgang Stremmel Daniel Nils Gotthardt Arianeb Mehrabi Karl-Heinz Weiss Department of Internal Medicine IV University Hospital of Heidelberg Interdisciplinary Endoscopy Unit University Hospital of Heidelberg Department of General Visceral and Trans- plantation Surgery University Hospital of Heidelberg

AIM To analyze the safety and efficiency of direct-actingantiviral(DAA) regimens in liver-transplanted patients with hepatitis C virus(HCV) *** Between January 2014 and December 2016, 39 patients with HCV reinfection after liver transplantation were treated at our tertiary referral center with sofosbuvir(SOF)-based regimens, including various combinations with interferon(IFN), daclatasvir(DAC), simeprivir(SIM) and/or ledipasvir(LDV). Thirteen patients were treated with SOF + IFN ± RBV. Ten patients were treated with SOF + DAC ± RBV. Fiveteen patients were treated with fixed-dose combination of SOF + LDV ± RBV. One patient was treated with SOF + SIM + RBV. Three patients with relapse were retreated with SOF + LDV + RBV. The treatment duration was 12-24 wk in all cases. The decision about the HCV treatment was made by specialists at our transplant center, according to current available or recommended *** The majority of patients were IFN-experienced(29/39, 74.4%) and had a history of hepatocellular carcinoma(26/39, 66.7%) before liver transplantation. Sustained virological response at 12 wk(SVR12) was achieved in 10/13(76.9%) of patients treated with SOF + IFN ± RBV. All patients with relapse were treated with fixed-dose combination of SOF + LDV + RBV. Patients treated with SOF + DAC + RBV or SOF + LDV + RBV achieved 100% SVR12. SVR rates after combination treatment with inhibitors of the HCV nonstructural protein(NS)5 A and NS5 B for 24 wk were significantly higher, as compared to all other therapy regimens(P = 0.007). Liver function was stable or even improved in the majority of patients during treatment. All antiviral therapies were safe and well-tolerated, without need of discontinuation of treatment or dose adjustment of immunosuppression. No serious adverse events or any harm to the liver graft became overt. No patient experienced acute cellular rejection during the study period. CONCLUSION Our cohort of liver-transplanted patient

关键词： Hepatitis C virus Recurrence Direct acting antivirals Liver transplantation Sustained virological response

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Comparative effectiveness of medical treatment *** surgery for histologically proven non-alcoholic steatohepatitis and fibrosis:a matched network meta-analysis

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Hepatobiliary Surgery and Nutrition 2022年第5期11卷 696-708,I0008-I0011页

作者： Adrian T.Billeter Beatrice Reiners Svenja E.Seide Pascal Probst Eva Kalkum christian rupp Beat P.Müller-Stich Department of General Visceral and Transplant SurgeryUniversity of HeidelbergHeidelbergGermany Institute of Medical Biometry and Informatics University of HeidelbergHeidelbergGermany The Study Center of the German Surgical Society(SDGC) HeidelbergGermany Department of Gastroenterology and Hepatology University of HeidelbergHeidelbergGermany

Background:Non-alcoholic steatohepatitis(NASH)comprises a major healthcare problem affecting up to 30%of patients with obesity and the associated risk for cardiovascular and liver-related *** new drugs for NASH-treatment are currently *** study thus far directly compared surgical and non-surgical therapies for *** network meta-analysis compares for the first time the effectiveness of different therapies for NASH using a novel statistical ***:The study was conducted according to the PRISMA guidelines for network ***,CENTRAL and Web of Science were searched without restriction of time or language using a validated search *** investigating therapies for NASH in adults with liver biopsies at baseline and after at least 12 months were *** with liver cirrhosis were *** of bias was assessed with ROB-2 and ROBINS-I-tools.A novel method for population-adjusted indirect comparison to include and compare single-arm trials was *** outcomes were NASH-resolution and improvement of ***:Out of 7,913 studies,twelve randomized non-surgical studies and twelve non-randomized surgical trials were ***-resolution after non-surgical intervention was 29%[95%confidence interval(CI):23-40%]and 79%(95%CI:72-88%)after *** network meta-analysis showed that surgery had a higher chance of NASH-resolution than medication[odds ratio(OR)=2.68;95%CI:1.44-4.97]while drug treatment was superior to placebo(OR=2.24;95%CI:1.55-3.24).Surgery(OR=2.18;95%CI:1.34-3.56)and medication(OR=1.79;95%CI:1.39-2.31)were equally effective to treat fibrosis compared to placebo without difference between *** results did not change when only new drugs specifically developed for the treatment of NASH were ***:Metabolic surgery has a higher effectiveness for NASH-therapy than medical therapy while both were equally effective regarding improvement of *** d

关键词： Non-alcoholic fatty liver disease(NAFLD) non-alcoholic steatohepatitis(NASH) metabolic surgery fatty liver

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German critical incident reporting system database of prehospital emergency medicine: Analysis of reported communication and medication errors between 2005–2015

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World Journal of Emergency Medicine 2016年第2期7卷 90-96页

作者： christian Hohenstein Thomas Fleischmann Peter rupp Dorothea Hempel Sophia Wilk Johannes Winning Department of Emergency Medicine University Hospital Jena Department of Emergency Medicine Westküstenklinikum Heide Department of Emergency Medicine Ubbo-Emmius-Klinik Department of Gastroenterology University Hospital Jena Department of Anaesthesiology and Intensive Care Medicine University Hospital Jena

BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication ***: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at ***: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication ***: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.

关键词： Critical incident reporting system Prehospital emergency medicine Communication error Medication error

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Key technologies for wireless network digital twin towards smart railways

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High-Speed Railway 2024年第1期2卷 1-10页

作者： Ke Guan Xinghai Guo Danping He Philipp Svoboda Marion Berbineau Stephen Wang Bo Ai Zhangdui Zhong Markus rupp State Key Laboratory of Advanced Rail Autonomous Operation Beijing Jiaotong UniversityBeijing 100044China School of Electronic and Information Engineering Beijing Jiaotong UniversityBeijing 100044China christian Doppler Laboratory for Digital Twin Assisted AI for Sustainable Radio Access Networks Institute of TelecommunicationsTU WienVienna 1040Austria UniversitéGustave Eiffel COSYSLEOSTVilleneuve d′Ascq 59650France VIAVI Marconi Labs VIAVI SolutionsStevenage SG12ANUK Institute of Telecommunications TU WienVienna 1040Austria

An emerging railway technology called smart railway promises to deliver higher transportation efficiency,enhanced comfort in services,and greater *** smart railway is expected to integrate fifth-generation mobile communication(5G),Artificial Intelligence(AI),and other technologies,which poses new problems in the construction,operation and maintenance of railway wireless *** Digital Twins(DTs),which have recently emerged as a new paradigm for the design of wireless networks,can address these problems and enable the whole lifecycle management of railway wireless ***,there are still many scientific issues and challenges for railway-oriented wireless *** key technologies to solve these problems are introduced and described,including characterization of materials'physical-EM properties,autonomous reconstruction of Three-dimensional(3D)environment model,AI-empowered environmental cognition,Ray-Tracing(RT),model-based and AIbased RT acceleration,and generation of multi-spectra sensing ***,this paper presents our research results for each key technology and describes the wireless network planning and optimization system based on highperformance RT developed by our *** paper outlines the framework for realizing the wireless DT of smart railways,providing the direction for future research.

关键词： Digital twin Smart railways Ray tracing Channel characterization

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