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Endoscopic ultrasound-guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

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Portal Hypertension & cirrhosis 2024年第2期3卷 67-74页

作者： Jerome c.Edelson Scott F.D.Edelson john G.Quiles cyrus V.Edelson Eric M.Montminy christian L.Horn john P.Magulick Don c.Rockey Department of Gastroenterology and Hepatology Brooke Army Medical CenterFort Sam HoustonTexasUSA Department of Medicine Uniformed Services University of the Health SciencesBethesdaMarylandUSA Department of Medicine Brooke Army Medical CenterFort Sam HoustonTexasUSA john H.Stroger Jr.Hospital of cook county ChicagoIllinoisUSA Digestive Disease Research center Medical University of South CarolinaCharlestonSouth CarolinaUSA

Aims:Portal hypertension(PH)is a complication of cirrhosis that leads to hepatic *** the portal pressure gradient(PPG)provides valuable information for disease assessment,staging,and *** this study,we aimed to report the utilization of endoscopic ultrasound(EUS)-guided PPG(EUS-PPG)measurements in a real-world ***:This retrospective analysis included patients at a tertiary care center who underwent EUS-PPG between February 2021 and May *** most common indication was to establish or exclude the diagnosis of cirrhosis,followed by an assessment of surgical risk in the setting of suspected *** demographic and clinical data were collected,and statistical analysis was performed using the Student's t ***:Eighteen patients underwent *** success was achieved in 17 of the 18 *** complications were *** mean scores of child-Pugh,Model for End-Stage Liver Disease-Sodium,and Fibrosis-4 scores were 5.1±0.5,9.0±3.0,and 3.7±4.5,*** the 18 patients,two presented with esophageal varices and six with portal hypertensive *** mean PPG was 5.8±4.5 mmHg,and five patients exhibited clinically significant PH(cSPH).Of the 18 patients,15 underwent concurrent EUS-liver biopsy,which was 100%successful and provided diagnostic histology for all *** PPG data led to changes in the clinical management of 17 ***:EUS-PPG is safe and technically *** child-Pugh score did not correlate well with the presence of cSPH;however,PPG measurements resulted in changes in the management of almost all *** studies correlating EUS-PPG with other assessments of liver diseases are required.

关键词： EUS portal hypertension portal pressure gradient

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Determinants and Outcomes of Pregnancies among Booked versus Unbooked Patients in a Tertiary Hospital South East, Nigeria

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 144-161页

作者： chijioke S. Anyigor-Ogah john O. Egede chijioke O. Ogeh chika c. Agunanne Alphosus I. Ozioko chinyere c. Duru Department of Family Medicine Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria Department of Paediatrics Alex Ekwueme Federal University Teaching Hospital Abakaliki Ebonyi State Nigeria

Background: Inadequate antenatal care, both in coverage and standard, has been linked with poor pregnancy outcomes. In a resource poor setting, home delivery is considered very cheap, but the possible outcome of such pregnancies has been a subject of interest. This study evaluated the association of booking status with pregnancy outcomes. Objectives: To examine the factors that influence booking and impact of the booking status on pregnancy outcomes. Methods: This was a hospital-based prospective cohort study of 240 (120 booked and 120 un-booked) pregnant mothers selected through systematic random sampling. The study was carried out at the Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria. chi-square test, t-test and logistic regression were used for analysis. Results: The mean age of the participants was 30.39 ± 5.05 years and 29.05 ± 6.36 years respectively for the booked and unbooked. Marital status (OR = 6.35, 95% cI = 1.24 - 32.59), educational status (OR = 36.40, 95% cI = 5.26-152.83), place of residence (OR = 0.15, 95% cI = 0.06 - 0.41), partner’s support (OR = 0.05, 95% cI = 0.01 - 0.37), family support (OR = 0.03, 95% cI = 0.01 - 0.13), mode of delivery (OR = 0.23, 95% cI = 0.12 - 0.46), APGAR score in first minute (OR = 6.02, 95% cI = 2.45 - 14.83) and NBIcU admission (OR = 3.75, 95% cI = 1.67 - 8.43) were associated with booked status. However, being unmarried, nulliparity/grandmultiparity, low level of education, blue colar jobs, low income, rural dwelling and poor partner and poor family support were associated with the unbooked. The booked parturients had a better perinatal outcome compared the unbooked. conclusion/Recommendation: There was high prevalence of operative deliveries, perinatal morbidity and mortality among the unbooked mothers. Girl child education, employment and poverty alleviation would improve antenatal care utilization.

关键词： Socio-Demographic characteristics Booking Status Antenatal Delivery

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Imaging approach for jaw and maxillofacial bone tumors with updates from the 2022 World Health Organization classification

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World Journal of Radiology 2024年第8期16卷 294-316页

作者： Woongsoon john choi Peggy Lee Penelope c Thomas Tanya J Rath Monique A Mogensen Roberta W Dalley Pattana Wangaryattawanich Division of Neuroradiology Department of RadiologyUniversity of Washington School of MedicineSeattleWA 98195United States Department of Radiology M&S Radiology AssociatesSan AntonioTX 78217United States Division of Oral Radiology University of Washington School of DentistrySeattleWA 98195United States Division of Neuroradiology Department of RadiologyMayo ClinicPhoenixAZ 85054United States

Jaw and maxillofacial bone lesions encompass a wide variety of both neoplastic and non-neoplastic *** lesions can arise from various tissues,including bone,cartilage,and soft tissue,each presenting distinct challenges in diagnosis and *** some pathologies exhibit characteristic imaging features that aid in diagnosis,many others are *** overlap often necessitates a multimodal imaging approach,combining techniques such as radiographs,computed tomography,and magnetic resonance imaging to achieve a diagnosis or narrow the diagnostic *** article provides a comprehensive review of the imaging approach to jaw and maxillofacial bone tumors,including updates on the 2022 World Health Organization classification of these *** relevant anatomy of the jaw and dental structures that is important for accurate imaging interpretation is discussed.

关键词： Mandible Maxilla Maxillofacial Jaw Tumor Neoplasm

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Superior antibody and membrane protein‑specific T‑cell responses to coronaVac by intradermal versus intramuscular routes in adolescents

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World Journal of Pediatrics 2024年第4期20卷 353-370页

作者： Jaime S.Rosa Duque Samuel M.S.cheng carolyn A.cohen Daniel Leung Xiwei Wang Xiaofeng Mu Yuet chung Tsun Ming Lau Manni Wang Wenyue Zhang Yanmei Zhang Howard H.W.Wong Leo c.H.Tsang Sara chaothai Tsz chun Kwan john K.c.Li Karl c.K.chan Leo L.H.Luk Jenson c.H.Ho Wing Yan Li Amos M.T.Lee Jennifer H.Y.Lam Sau Man chan Wilfred H.S.Wong Issan Y.S.Tam Masashi Mori Sophie A.Valkenburg Malik Peiris Wenwei Tu Yu Lung Lau Department of Paediatrics and Adolescent Medicine The University of Hong KongHong KongChina School of Public Health The University of Hong KongHong KongChina HKU‑Pasteur Research Pole School of Public HealthThe University of Hong KongHong KongChina Research Institute for Bioresources and Biotechnology Ishikawa Prefectural UniversityNonoichiJapan Department of Microbiology and Immunology Peter Doherty Institute for Infectionand ImmunityUniversity of MelbourneMelbourneVICAustralia center for Immunology and Infection c2i Hong KongChina

Background Optimising the immunogenicity of cOVID-19 vaccines to improve their protection against disease is *** dosing by intradermal(ID)administration has been shown to be equally immunogenic as intramuscular(IM)administration for several vaccines,but the immunogenicity of ID inactivated whole severe acute respiratory syndrome coronavirus 2(SARS-coV-2)at the full dose is *** study(NcT04800133)investigated the superiority of antibody and T-cell responses of full-dose coronaVac by ID over IM administration in *** Participants aged 11–17 years received two doses of IM or ID vaccine,followed by the 3rd dose 13–42 days *** and cellular immunogenicity outcomes were measured post-dose 2(IM-cc versus ID-cc)and post-dose 3(IMccc versus ID-ccc).Doses 2 and 3 were administered to 173 and 104 adolescents,*** Spike protein(S)immunoglobulin G(IgG),S-receptor-binding domain(RBD)IgG,S IgG Fcγreceptor IIIa(FcγRIIIa)-binding,SNM[sum of individual(S),nucleocapsid protein(N),and membrane protein(M)peptide pool]-specific interleukin-2(IL-2)+cD4^(+),SNM-specific IL-2^(+)cD8^(+),S-specific IL-2^(+)cD8^(+),N-specific IL-2^(+)cD4^(+),N-specific IL-2^(+)cD8^(+)and M-specific IL-2^(+)cD4^(+)responses fulfilled the superior and non-inferior criteria for ID-cc compared to IM-cc,whereas IgG avidity was *** ID-ccc,S-RBD IgG,surrogate virus neutralisation test,90%plaque reduction neutralisation titre(PRNT90),PRNT50,S IgG avidity,S IgG FcγRIIIa-binding,M-specific IL-2^(+)cD4^(+),interferon-γ+cD8^(+)and IL-2^(+)cD8^(+)responses were superior and non-inferior to *** estimated vaccine efficacies were 49%,52%,66%and 79%for IM-cc,ID-cc,IM-ccc and ID-ccc,*** ID groups reported more local,mild adverse *** This is the first study to demonstrate superior antibody and M-specific T-cell responses by ID inactivated SARScoV-2 vaccination and serves as the basis for future research to improve the

关键词： coronaVac coronavirus disease 2019 Immunity Intradermal Vaccine

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Geothermo-mechanical alterations due to heat energy extraction in enhanced geothermal systems: Overview and prospective directions

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Deep Underground Science and Engineering 2024年第3期3卷 256-268页

作者： Mary c.Ngoma Oladoyin Kolawole Olufemi Olorode john A.Reif Jr.Department of Civil and Environmental EngineeringNew Jersey Institute of TechnologyNewarkUSA Department of Petroleum Engineering Louisiana State UniversityBaton RougeUSA

Geothermal energy from deep underground (or geological) formations,with or without its combination with carbon capture and storage (ccS),can be a key technology to mitigate anthropogenic greenhouse gas emissions and meet the 2050 net‐zero carbon emission *** resources in low‐permeability and medium‐and high‐temperature reservoirs in sedimentary sequence require hydraulic stimulation for enhanced geothermal systems (EGS).However,fluid migration for geothermal energy in EGS or with potential cO_(2) storage in a cO_(2)‐EGS are both dependent on the in situ flow pathway network created by induced fluid *** thermo‐mechanical interactions can be complex and induce varying alterations in the mechanical response when the working fluid is water (in EGS) or supercritical cO_(2)(in cO_(2)‐EGS),which could impact the geothermal energy recovery from geological ***,there is a need for a deeper understanding of the heat extraction process in EGS and cO_(2)‐*** study presents a systematic review of the effects of changes in mechanical properties and behavior of deep underground rocks on the induced flow pathway and heat recovery in EGS reservoirs with or without cO_(2) storage in cO_(2) ‐***,we proposed waterless‐stimulated EGS as an alternative approach to improve heat energy extraction in ***,based on the results of our literature review and proposed ideas,we recommend promising areas of investigation that may provide more insights into understanding geothermo‐mechanics to further stimulate new research studies and accelerate the development of geothermal energy as a viable clean energy technology.

关键词： cO_(2)-EGS enhanced geothermal systems geomechanics geothermal energy underground thermal energy

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New markers of fibrosis in hepatitis c:A step towards the Holy Grail?

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World Journal of Hepatology 2024年第2期16卷 112-114页

作者： Konstantinos john Dabos Department of Hepatology St Hohn's HospitalLivingston EH546PPWest LothianUnited Kingdom

In the present issue of the World Journal of Hepatology,Ferrassi et al examine the problem of liver fibrosis staging in chronic hepatitis *** identify novel biomarkers in an effort to predict accurate fibrosis staging with the aid of the metabolome of Hepatitis c *** I think Ferrassi et al took a different approach in identifying fibrosis biomarkers,by looking at the patients’*** biomarkers clearly separate patients from *** can also separate out,patients with minimal fibrosis(F0-F1 stage)and patients with cirrhosis(F4 stage).Obviously,if these biomarkers were to be widely used,tests for all the important metabolites would need to be readily available for use in hospitals or outpatient setting and that may prove difficult and above all,***,this step could eventually lead to a metabolomic approach for novel biomarkers of ***,it would need to be validated,but could represent a step towards the Holy Grail of Hepatology.

关键词： Hepatitis c metabolomics Fibrosis Non invasive markers Metavir

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New dating indicates intermittent human occupation of the Nwya Devu Paleolithic site on the high-altitude central Tibetan Plateau during the past 45,000 years

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Science china Earth Sciences 2024年第2期67卷 531-551页

作者： Junyi GE Xiaoling ZHANG Shejiang WANG Linhui LI Wei HE Yingshuai JIN Peiqi ZhANG Bing XU chenglong DENG john WOLSEN Zhengtang GUO Xing GAO Institute of Vertebrate Paleontology and Paleoanthropology Chinese Academy of SciencesBeijing 100044China University of the chinese Academy of Sciences Beijing 100049China Tibetan cultural Relics conservation Institute Lhasa 850000China Key Laboratory of cenozoic Geology and Environment Institute of Geology and GeophysicsChinese Academy of Sciences.Beijing 100029China State Key Laboratory of Lithospheric Evolution Institute of Geology and GeophysicsChinese Academy of SciencesBeijing100029China School of Anthropology University of ArizonaTucson85721USA

The timing and mechanisms of the human occupation of the demanding high-altitude Tibetan Plateau environment are of great ***,we report on our reinvestigations and dating of the Nwya Devu site,located nearly 4600 meters above sea level on the central Tibetan Plateau.A new microblade techno-complex was identified on a lower lake shore at this site,distinct from the previously reported blade tool *** two lithic assemblages were dated to 45.6±2.6 and10.3±0.5 ka using optically stimulated luminescence and accelerator mass spectrometry^(14)c *** represent,respectively,the earliest known Paleolithic and microlithic sites on the interior Tibetan Plateau,indicating multiple occupation episodes of hunter-gatherers during the past 45 *** studies reveal that relatively stable depositional conditions and a paleoenvironment characterized by a comparatively warm climate facilitated these multiple occupations at Nwya *** contemporaneous occurrence of the Upper Paleolithic blade technology on the Tibetan Plateau and most of Eurasia between 50 and 40 ka indicates rapid,large-scale dispersals of humans that profoundly affected human demography on a large *** new archaeological evidence and previously reported genetic data,we conclude that the Tibetan Plateau provided a relatively stable habitat for Upper Paleolithic hunter-gatherers,which may have contributed to the complex and multiple-origin gene pool of present-day Tibetans.

关键词： Tibetan Plateau Paleolithic Nwya Devu High-altitude adaptation Microblade industry Early Upper Paleolithic OSLdating AMS^(14)c dating

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Eye on the Sky: A UAP Research and Field Study off New York’s Long Island coast

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Open Journal of Applied Sciences 2024年第8期14卷 2267-2295页

作者： john Joseph Tedesco Gerald Thomas Tedesco Harvard Universitys Galileo Project Independent Research Affiliate Cambridge USA consortium for The Scientific Understanding of Natures Mysteries Holbrook USA Institute of Electrical and Electronic Engineers Washington USA American Academy of Environmental Engineers and Scientist Annapolis USA Independent Researcher Holbrook USA

A ten-month field research study was meticulously conducted at Robert Moses State Park (RMSP) on the south shore of Long Island, NY. The objective was to determine if aerial phenomena of an unknown nature exist over a coastal location and to characterize their properties and behaviors. Primary and secondary field observation methods were utilized in this data-centric study. Forensic engineering principles and methodologies guided the study. The challenges set forward were object detection, observation, and characterization, where multispectral electro-optical devices and radar were employed due to limited visual acuity and intermittent presentation of the phenomena. The primary means of detection utilized a 3 cm X-band radar operating in two scan geometries, the X- and Y-axis. Multispectral electro-optical devices were utilized as a secondary means of detection and identification. Data was emphasized using HF and LF detectors and spectrum analyzers incorporating EM, ultrasonic, magnetic, and RF field transducers to record spectral data in these domains. Data collection concentrated on characterizing VIS, NIR, SWIR, LWIR, UVA, UVB, UVc, and the higher energy spectral range of ionizing radiation (alpha, beta, gamma, and X-ray) recorded by Geiger-Müller counters as well as special purpose semiconductor diode sensors.

关键词： Unidentified Anomalous Phenomenon (UAP) Forensic Techno-Signatures Office of the Director of National Intelligence (ODNI) Multispectral Electro-Optical (MEO) Ultraviolet A Radiation (UVA) Ultraviolet B Radiation (UVB) Ultraviolet c Radiation (UVc) Visible (VIS) Near-Infrared (NIR) Short-Wave Infrared (SWIR) Long-Wave Infrared (LWIR) Low-Frequency (LF) High-Frequency (HF) Radio-Frequency (RF) Alpha Beta Gamma Ultrasonic X-Band Active Radar Kinematics Aerodynamics Luminous Spheroids Robert Moses State Park (RMSP)

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse craig S Anderson Sandeep Ankolekar Lesley cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir john Potter christopher I Price Marc Randall Thompson G Robinson christine Roffe Else c Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute china at Peking University Health Science center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK centre for clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of cardiovascular Sciences and NIHR Leicester Biomedical Research centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and comprehensive Stroke center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%cI 0.85 to 1.54),death or global analysis(MWD 0.00,95%cI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIc⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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Adjuvant Rectal Diclofenac for Post Operative Analgesia after caesarean Section—A Randomized controlled Study

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 591-609页

作者： Eziaha Eric S. Ede Ayodele A. Olaleye john c. Irechukwu Uchenna Nelson Nwaedu Borniface N. Ejikeme Vincent chidiebere Ali Bartholomew I. Olinya Department of Obstetrics and Gynaecology Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria

BAcKGROUND: Pain management following caesarean section still remains a challenge in our environment. Most potent analgesics are either not readily available or expensive. Diclofenac suppository is an NSAID that can be used for postoperative analgesia. It is available and affordable. OBJEcTIVE: To compare the efficacy and safety of combined rectal diclofenac and intramuscular pentazocine with intramuscular pentazocine alone for post operative pain control following lower segment caesarean section. METHODOLOGY: A total of 120 women who met the selection criteria scheduled for caesarean section under spinal anaesthesia with bupivacaine were randomized into two equal groups to receive either 75 mg diclofenac suppository 12 hourly for 24 hours or one anusol suppository (the placebo) 12 hourly for 24 hours. Both groups received pentazocine as primary analgesia. RESULT: The primary outcome measure is the proportion of patients with severe pain at 24 hours using the visual analogue rating scale. Secondary outcome measures are the time from surgery to ambulation, Passage of flatus, maternal satisfaction and presence of complications. Statistical analysis was done using spss version 22 and graph pad statistical package. Student T-test was used for continuous variables whereas chi square was used for categorical variables P cONcLUSION: Adjuvant rectal diclofenac is superior to pentazocine alone in the management of pain after caesarean section. Less number of patients had moderate to severe pain at 24 hours post operation. Maternal satisfaction in relation to pain management is better with diclofenac suppository. The levels of complications were comparable in both groups.

关键词： Pain caesarean Section Diclofenac Placebo Suppository

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