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Acute upper gastrointestinal bleeding in octοgenarians:Clinical outcome and factors related to mortality

World journal of Gastroenterology 2008年第25期14卷 4047-4053页

作者： george j theocharis Vassiliki Arvaniti Stelios F Assimakopoulos Konstantinos C Thomopoulos Vassilis Xourgias Irini Mylonakou Vassiliki N Nikolopoulou Division of Gastroenterology Department of Internal Medicine University Hospital of Patras Department of Gastroenterology "Tzaneio" General Hospital Department of Internal MedicineUniversity Hospital of Patras

AIM: To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS: We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from january 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Four hundred and sixteen patients over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presenceof severe co-morbidity (P < 0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

关键词： Acute upper gastrointestinal bleeding Octogenarians Elderly Co-morbidity Mortality

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Acute upper gastrointestinal bleeding in patients on long-term oral anticoagulation therapy: Endoscopic findings, clinical management and outcome

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World journal of Gastroenterology 2005年第9期11卷 1365-1368页

作者： Konstantinos C Thomopoulos Konstantinos P Mimidis george j theocharis Anthie G Gatopoulou Georgios N Kartalis Vassiliki N Nikolopoulou Department of Internal Medicine the First Department of Internal Medicine

AIM: Acute gastrointestinal bleeding is a severe complication in patients receiving long-term oral anticoagulant therapy. The purpose of this study was to describe the causes and clinical outcome of these patients. METHODS: From january 1999 to October 2003, 111 patients with acute upper gastrointestinal bleeding (AUGIB) were hospitalized while on oral anticoagulants. The causes and clinical outcome of these patients were compared with those of 604 patients hospitalized during 2000-2001 with AUGIB who were not taking warfarin. RESULTS: The most common cause of bleeding was peptic ulcer in 51 patients (45%) receiving anticoagulants compared to 359/604 (59.4%) patients not receiving warfarin (Pjority of patients with concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs) (26/35, 74.3%) had a peptic ulcer as a cause of bleeding while 32/76 (40.8%) patients not taking a great dose of NSAIDs had a negative upper and lower gastrointestinal endoscopy. Endoscopic hemostasis was applied and no complication was reported. Six patients (5.4%) were operated due to continuing or recurrent hemorrhage, compared to 23/604 (3.8%) patients not receiving anticoagulants. Four patients died, the overall mortality was 3.6% in patients with AUGIB due to anticoagulants, which was not different from that in patients not receiving anticoagulant therapy. CONCLUSION: Patients with AUGIB while on long-term anticoagulant therapy had a clinical outcome, which is not different from that of patients not taking anticoagulants. Early endoscopy is important for the management of these patients and endoscopic hemostasis can be safely applied.

关键词： AUGIB Anticoagulant therapy Endoscopy

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Examining the“revisability”benefit of hip resurfacing arthroplasty

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World journal of Orthopedics 2024年第6期15卷 554-559页

作者： jose george Adam j Taylor Thomas P Schmalzried Department of Orthopedics Harbor UCLA Medical CenterTorranceCA 90509United States

BACKGROUND Hip resurfacing arthroplasty(HRA)is an alternative to total hip arthroplasty(THA)that is typically reserved for young active patients because it preserves ***,the benefits of HRA only hold true if conversion THA after failed HRA provides acceptable *** To compare patient reported outcomes for conversion THA after HRA failure to primary *** A retrospective review of 36 patients(37 hips)that underwent conversion THA for failed HRA between October 2006 and May 2019 by a single surgeon was *** reported outcomes[modified Harris Hip Score(mHHS),University of California Los Angeles(UCLA)activity score]were obtained via an email-based responder-anonymous *** were compared to normative data of a primary THA cohort with similar *** analysis was performed comparing outcomes of conversion THA for adverse local tissue reaction(ALTR)vs all other causes for *** The study group had a lower mHHS than the control group(81.7±13.8 vs 90.2±11.6,P<0.01);however,both groups had similar UCLA activity levels(7.5±2.3 vs 7.2±1.6,P=0.51).Patients that underwent conversion for non-ATLR causes had similar mHHS(85.2±11.5 vs 90.2±11.6,P=0.11)and higher UCLA activity levels(8.5±1.8 vs 7.2±1.6,P<0.01)compared to the control *** that underwent conversion for ATLR had worse mHHS(77.1±14.5 vs 90.2±11.6,P<0.01)and UCLA activity levels(6.1±2.3 vs 7.2±1.6,P=0.05)when compared to the control *** Patient outcomes equivalent to primary THA can be achieved following HRA conversion to ***,inferior outcomes were demonstrated for ALTR-related HRA *** selection and perhaps further studies examining alternative HRA bearing surfaces should be considered.

关键词： Total hip arthroplasty Hip resurfacing arthroplasty Conversion total hip arthroplasty Adverse local tissue reaction Patient reported outcome measures

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Genetics of Gallstone Disease and Their Clinical Significance: A Narrative Review

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journal of Clinical and Translational Hepatology 2024年第3期12卷 316-326页

作者： Christopher j.Costa Minh Thu T.Nguyen Haleh Vaziri george Y.Wu Department of Medicine University of Connecticut Health CenterFarmingtonCTUSA Division of Gastroenterology and Hepatology University of Connecticut Health CenterFarmingtonCTUSA

Gallstone(GS)disease is common and arises from a combination of genetic and environmental *** genetic abnormalities specifically leading to cholesterol GSs are rare,there are clinically significant gene variants associated with cholesterol *** contrast,most bilirubin GSs can be attributed to genetic *** pathogenesis of cholesterol and bilirubin GSs differs *** GSs are notably influenced by genetic variants within the ABC protein superfamily,including ABCG8,ABCG5,ABCB4,and ABCB11,as well as genes from the apolipoprotein family such as ApoB100 and ApoE(especially the E3/E3 and E3/E4 variants),and members of the MUC ***,bilirubin GSs are associated with genetic variants in highly expressed hepatic genes,notably UGT1A1,ABCC2(MRP2),ABCC3(MRP3),CFTR,and MUC,alongside genetic defects linked to hemolytic anemias and conditions impacting *** genetic cases constitute a small portion of GS disease,recognizing genetic predisposition is essential for proper diagnosis,treatment,and genetic counseling.

关键词： Gallstones Cholelithiasis ATP-binding cassette transporters ABCG8 protein Human UDP-glucuronosyltransferase A1

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Adaptive Random Effects/Coefficients Modeling

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Open journal of Statistics 2024年第2期14卷 179-206页

作者： george j. Knafl School of Nursing University of North Carolina at Chapel Hill Chapel Hill USA

Adaptive fractional polynomial modeling of general correlated outcomes is formulated to address nonlinearity in means, variances/dispersions, and correlations. Means and variances/dispersions are modeled using generalized linear models in fixed effects/coefficients. Correlations are modeled using random effects/coefficients. Nonlinearity is addressed using power transforms of primary (untransformed) predictors. Parameter estimation is based on extended linear mixed modeling generalizing both generalized estimating equations and linear mixed modeling. Models are evaluated using likelihood cross-validation (LCV) scores and are generated adaptively using a heuristic search controlled by LCV scores. Cases covered include linear, Poisson, logistic, exponential, and discrete regression of correlated continuous, count/rate, dichotomous, positive continuous, and discrete numeric outcomes treated as normally, Poisson, Bernoulli, exponentially, and discrete numerically distributed, respectively. Example analyses are also generated for these five cases to compare adaptive random effects/coefficients modeling of correlated outcomes to previously developed adaptive modeling based on directly specified covariance structures. Adaptive random effects/coefficients modeling substantially outperforms direct covariance modeling in the linear, exponential, and discrete regression example analyses. It generates equivalent results in the logistic regression example analyses and it is substantially outperformed in the Poisson regression case. Random effects/coefficients modeling of correlated outcomes can provide substantial improvements in model selection compared to directly specified covariance modeling. However, directly specified covariance modeling can generate competitive or substantially better results in some cases while usually requiring less computation time.

关键词： Adaptive Regression Correlated Outcomes Extended Linear Mixed Modeling Fractional Polynomials Likelihood Cross-Validation Random Effects/Coefficients

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An Analysis of Specific Categories of Birth Defects and Developmental Disabilities for Children of Participants of the Air Force Health Study

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Open journal of Epidemiology 2024年第2期14卷 312-330页

作者： george j. Knafl School of Nursing University of North Carolina at Chapel Hill Chapel Hill NC USA

Background: The Air Force Health Study collected reproductive outcomes for live-born children of male Air Force veterans of the Vietnam War. Methods: Dioxin values for participants were obtained from blood samples. Analyses were conducted of occurrence of 16 specific categories of birth defects and developmental disabilities. Children were categorized as conceived before and after the start of participants’ Vietnam War service. Children conceived before the start of Vietnam War service were treated as being conceived when their fathers had unquantifiable dioxin values. Children conceived after the start of Vietnam War service for participants with missing dioxin values were excluded from primary analyses, but were used to assess the impact of their exclusion on conclusions. Correlation between values for specific categories for multiple children fathered by the same participant was accounted for. The dose-response relationship was treated as a step function increasing for dioxin values larger than adaptively identified individual thresholds changing with the specific category. Results: For 15 of 16 specific categories, the probability of occurrence increased substantially for a sufficiently high dioxin level above identified thresholds. Exclusion of children due to missing dioxin likely did not affect these results. Conclusions: Results supported the conclusion of substantial adverse effects on a wide variety of specific categories of birth defects and developmental disabilities due to sufficiently high exposures to dioxin, a toxic contaminant of Agent Orange used for herbicide spraying in the Vietnam War. Results may hold more generally, but might also have been affected by a variety of limitations.

关键词： Agent Orange Air Force Health Study Birth Defects Developmental Disabilities Dioxin Dose-Response Relationship Vietnam War

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Thermochemical co-conversion of biomass-plastic waste to biochar:a review

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Green Chemical Engineering 2024年第1期5卷 31-49页

作者： Adewale george Adeniyi Kingsley O.Iwuozor Ebuka Chizitere Emenike Oluwaseun j.Ajala Samuel Ogunniyi Kabir B.Muritala Department of Chemical Engineering Faculty of Engineering and TechnologyUniversity of IlorinIlorinP.M.B.1515Nigeria Department of Chemical Engineering Landmark UniversityOmu-AranKwara StateP.M.B.1001Nigeria Department of Pure and Industrial Chemistry Nnamdi Azikiwe UniversityAwkaP.M.B.5025Nigeria Department of Chemistry Federal University of TechnologyBosso CampusMinnaNiger StateP.M.B.65Nigeria

Biomass and plastics are two of the most common municipal solid wastes globally that have continuously placed a burden on the *** is therefore important that they are properly *** coconversion offers a valuable opportunity to recycle biomass and plastics simultaneously into biochar,which reduces the time and cost of recycling them individually while producing a material with a wide range of *** study is a review of published literature that discusses the thermochemical co-processing of biomass and plastic wastes into *** was observed that co-pyrolysis and co-hydrothermal carbonization are the most commonly utilized technologies for this *** characteristics of different biomass and plastics that have been thermochemically converted into biochar were *** properties of the resulting biochar are affected by the feedstock composition,pre-treatment and blending ratio,the reactor’s configuration,reaction temperature,and the presence of a *** studies found that treating the feedstocks separately resulted in a lower yield of biochar than processing them *** biochar created by this procedure has been used as a soil additive and as an adsorbent for water *** perspectives and suggestions,such as the necessity for some technical advancement,biochar’s economic benefits,improved government participation,and raised social awareness,were also *** factors have the potential to propel this field of study to great horizons.

关键词： Biomass Co-pyrolysis Plastic Thermochemical process Valorization

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Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna george Anil jha Nitish Sharma jennifer Sargent Mark j Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from june 2017 to june 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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A real-world data collection framework for a fused dataset creation for joint human and remotely operated vehicle monitoring and anomalous command detection

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CAAI Transactions on Intelligence Technology 2022年第3期7卷 432-445页

作者： Rafaella Elia george Plastiras Eva Pettemeridou Antonis Savva theocharis Theocharides Department of Electrical and Computer Engineering University of CyprusNicosiaCyprus KIOS Research and Innovation Center of Excellence University of CyprusNicosiaCyprus Center for Applied Neuroscience(CAN) University of CyprusNicosiaCyprus

Unmanned Remotely Operated Vehicles(ROVs)are widely used in safety-critical missions,spanning across monitoring,surveillance,and search and rescue *** most cases,the human operator controls the ROV under stressful conditions and in harsh *** physical and mental states of the operator are vital as they may cause involuntary movements,issuing unintentional commands due to fatigue or ***,a joint monitoring mechanism that will assess the operator's commands can be beneficial in preventing potentially catastrophic events,such as *** this end,in this study,we propose a data collection framework for creating a fused dataset,consisting of data obtained from both the human operator and the ROV,and we integrate stress induction to stimulate stress and fatigue that may affect operators during *** optimise the dataset,which includes the operator's physiological signals and inertial measurement unit(IMU)sensor data from the ROV,using data fusion approaches and feature *** evaluate the dataset through the statistical analysis,illustrating a statistical difference between data characterising normal and involuntary ***,we evaluate the optimised and original datasets over a variety of classifiers,demonstrating an accuracy of 94%and 95%,respectively.

关键词： operator fused operators

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Chronic effects of stretching on range of motion with consideration of potential moderating variables:A systematic review with meta-analysis

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journal of Sport and Health Science 2024年第2期13卷 186-194页

作者： Andreas Konrad Shahab Alizadeh Abdolhamid Daneshjoo Saman Hadjizadeh Anvar Andrew Graham Ali Zahiri Reza Goudini Chris Edwards Carina Scharf David george Behm Institute of Human Movement Science Sport and HealthGraz UniversityGraz A-8010Austria School of Human Kinetics and Recreation Memorial University of NewfoundlandSt.John’sNL A1C 5S7Canada Department of Sport Injuries and Corrective Exercises Faculty of Sport SciencesShahid Bahonar University of KermanKerman 76169-13439Iran

Background:It is well known that stretch training can induce prolonged increases in joint range of motion(ROM).However,to date more information is needed regarding which training variables might have greater influence on improvements in ***,the purpose of this metaanalysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables,such as stretching technique,intensity,duration,frequency,and muscles stretched,as well as sex-specific,age-specific,and/or trained state-specific adaptations to stretch ***:We searched through PubMed,Scopus,Web of Science,and SportDiscus to find eligible studies and,finally,assessed the results from 77 studies and 186 effect sizes by applying a random-effect ***,by applying a mixed-effect model,we performed the respective subgroup *** find potential relationships between stretch duration or age and effect sizes,we performed a ***:We found a significant overall effect,indicating that stretch training can increase ROM with a moderate effect compared to the controls(effect size=-1.002;Z=-12.074;95%confidence interval:-1.165 to-0.840;p<0.001;I^(2)=74.97).Subgroup analysis showed a significant difference between the stretching techniques(p=0.01)indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic ***,there was a significant effect between the sexes(p=0.04),indicating that females showed higher gains in ROM compared to ***,further moderating analysis showed no significant relation or ***:When the goal is to maximize ROM in the long term,proprioceptive neuromuscular facilitation or static stretching,rather than ballistic/dynamic stretching,should be *** to consider in future research as well as sports practice is that neither volume,intensity,nor frequency of stretching were

关键词： Flexibility Long-term stretching Stretch training

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