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Safety and efficacy of Kaffes intraductal self-expanding metal stents in the management of post-liver transplant anastomotic strictures

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World Journal of Transplantation 2024年第2期14卷 88-98页

作者： Chee Lim jonathan Ng Babak Sarraf Rhys Vaughan Marios Efthymiou Leonardo zorron Cheng Tao Pu Sujievvan Chandran Department of Gastroenterology and Hepatology Austin HealthMelbourne HeidelbergVIC 3084Australia Melbourne Medical School The University of MelbourneMelbourne ParkvilleVIC 3052Australia

BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic *** the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is *** to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable *** was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic *** Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database *** admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical *** main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 *** efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 *** During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting *** 33 ERCPs,the stent was removed or exchanged on a 3-month *** pancreatitis,perfor-ations or deaths *** post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=*** strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 *** recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a sin

关键词： Liver transplantation Cholangiopancreatography Endoscopic retrograde Constriction Pathologic Self expandable metallic stents Bile duct diseases Cholestasis

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Virtual reality tools for training in gastrointestinal endoscopy:A systematic review

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Artificial Intelligence in Gastrointestinal Endoscopy 2024年第2期5卷 41-54页

作者： Tuấn Quang Dương jonathan Soldera Department of Acute Medicine University of South WalesCardiff CF371DLUnited Kingdom Department of Acute Medicine and Gastroenterology University of South WalesCardiff CF371DLUnited Kingdom

BACKGROUND Virtual reality(VR)has emerged as an innovative technology in endoscopy training,providing a simulated environment that closely resembles real-life scenarios and offering trainees a valuable platform to acquire and enhance their endoscopic *** systematic review will critically evaluate the effectiveness and feasibility of VR-based training compared to traditional *** To evaluate the effectiveness and feasibility of VR-based training compared to traditional *** examining the current state of the field,this review seeks to identify gaps,challenges,and opportunities for further research and implementation of VR in endoscopic *** The study is a systematic review,following the guidelines for reporting systematic reviews set out by the PRISMA statement.A comprehensive search command was designed and implemented and run in September 2023 to identify relevant studies available,from electronic databases such as PubMed,Scopus,Cochrane,and Google *** results were systematically *** Sixteen articles were included in the final *** total number of participants was *** studies focused on both upper endoscopy and colonoscopy training,two on upper endoscopy training only,eight on colonoscopy training only,and one on sigmoidoscopy training *** Mentor virtual endoscopy simulator was commonly *** reported positive results,indicating that VR-based training was feasible and acceptable for endoscopy *** technology helped the trainees enhance their skills in manipulating the endoscope,reducing the procedure time or increasing the technical accuracy,in VR scenarios and real *** studies show that the patient discomfort level decreased ***,some studies show there were no significant differences in patient discomfort and pain scores between VR group and other *** VR training is effective for endoscopy *** are several well-desi

关键词： Virtual reality Gastrointestinal endoscopy Systematic review Virtual reality training Simulation

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Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience

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World Journal of Clinical Pediatrics 2024年第1期13卷 107-117页

作者： Krishanth Manokaran jonathan Spaan Giulio Cataldo Christopher Lyons Paul D Mitchell Tatyana Sare LoriA zimmerman Paul A Rufo Center for Inflammatory Bowel Disease Boston Children's HospitalBostonMA 02115United States Institutional Centers for Clinical and Translational Research Boston Children's HospitalBostonMA 02115United States

BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous(IV)iron to treat IDA in this *** To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our *** A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019.92 patients met study criteria for IDA,of which 57 received IV iron,17 received oral iron,and 18 were discharged prior to receiving iron *** Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9(±0.2)g/dL in mean(±SE)hemoglobin(Hb)concentration by the first ambulatory follow-up,compared to patients who received oral iron 0.8(±0.3)g/dL or no iron 0.8(±0.3)g/dL(P=0.03).One out of 57(1.8%)patients that received IV iron therapy experienced an adverse *** Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.

关键词： Iron deficiency anemia Pediatric inflammatory bowel disease Intravenous iron therapy Inflammatory bowel disease

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Fjord-Type AIEgens Based on Inherent Through-Space Conjugation

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CCS Chemistry 2024年第7期6卷 1739-1747页

作者： Ye-Qiang Han Yuan Xie Jianyu zhang Shiyu Tan Haoke zhang Ben zhong Tang jonathan L.Sessler Feihe Huang Stoddart Institute of Molecular Science Department of ChemistryZhejiang UniversityHangzhou 310058 zhejiang-Israel Joint Laboratory of Self-Assembling Functional Materials ZJU-Hangzhou Global Scientific and Technological Innovation CenterZhejiang UniversityHangzhou 311215 MOE Key Laboratory of Macromolecular Synthesis and Functionalization Department of Polymer Science and EngineeringZhejiang UniversityHangzhou 310058 Center for AIE Research College of Materials Science and EngineeringShenzhen UniversityShenzhen 518061 Department of Chemistry Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and ReconstructionThe Hong Kong University of Science and TechnologyKowloonHong Kong 999077 School of Science and Engineering Shenzhen Institute of Aggregate Science and TechnologyThe Chinese University of Hong KongShenzhen(CUHK-Shenzhen)Guangzhou 518172 Department of Chemistry The University of Texas at AustinAustinTexas 78712-1224 Green Catalysis Center and College of Chemistry Zhengzhou UniversityZhengzhou 450001

Through-space conjugation(TSC)is a noncovalently electronic interaction that is emerging as a potential complement to through-bond conjugation(TBC)-based strategies for constructing luminescent ***,the design of efficient luminogens based on TSC is currently challenging due to a lack of established structure-property *** is particularly true in the case of luminogens displaying aggregation-induced emission(AIE)*** this work,three terphenyl derivatives were prepared,and their photophysical properties were systemically *** was found that relative to the corresponding m-and p-linked analogues,the electronic interaction of TBC is weakened while the strength of TSC is commensurately enhanced in the constitutional isomer containing an o-linked fjordtype *** this set of luminogens,the presence of a fjord-type arrangement promotes a transformation from aggregation-caused quenching to *** investigations involving congeneric quaterphenyl and pentphenyl isomers support the universality of the fjord-type unit as a framework for synthesizing AIE-active luminogens(AIEgens)with inherent *** work not only provides a novel set of AIEgens but also establishes the utility of TSC in controlling the photophysical properties of nonconventional and twisted luminogens.

关键词： fjord-type through-space conjugation through-bond conjugation aggregation-induced emission luminescence twisted conformation

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Mechanisms of vascular injury in neurotrauma: A critical review of the literature

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World Journal of Meta-Analysis 2024年第3期12卷 6-16页

作者： jonathan Willman Annu Lisa Kurian Brandon Lucke-Wold College of Medicine University of FloridaGainesvilleFL 32610United States College of Medicine Florida State UniversityTallahasseeFL 32304United States Department of Neurosurgery University of FloridaGainesvilleFL 32611United States

One in every two individuals will experience a traumatic brain injury in their lifetime with significant impacts on the global economy and healthcare system each *** injury is a key aspect of neurotrauma to both the brain and the spinal cord and an important avenue of current and future research seeking innovative *** this paper,we discuss primary and secondary neurotrauma,mechanisms of injury,the glymphatic system,repair and *** of these topics are directly connected to the vasculature of the central ner-vous system,affecting severity of injury and ***,neurova-scular injury in trauma represents a promising target for future therapeutics and innovation.

关键词： Neurotrauma Neurovascular injury Primary neurotrauma Secondary neurotrauma Traumatic brain injury Traumatic spinal cord injury Glymphatic system Vascular Injury

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Hepatic angiotensin-converting enzyme 2 expression in metabolic dysfunction-associated steatotic liver disease and in patients with fatal COVID-19

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World Journal of Gastroenterology 2024年第31期30卷 3705-3716页

作者： Angus K Jacobs Steven D Morley Kay Samuel Katie Morgan Lyndsey Boswell Timothy J Kendall David A Dorward jonathan A Fallowfield Peter C Hayes John N Plevris Hepatology Laboratory University of EdinburghEdinburgh EH164SBUnited Kingdom Scottish National Blood Transfusion Service Jack Copland CentreEdinburgh EH144BEUnited Kingdom Institute for Regeneration and Repair University of EdinburghEdinburgh EH164UUUnited Kingdom Edinburgh Pathology University of EdinburghEdinburgh EH164SBUnited Kingdom

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),characterised by hepatic lipid accumulation,causes inflammation and oxidative stress accompanied by cell damage and *** injury(LI)is also frequently reported in patients hospitalised with coronavirus disease 2019(COVID-19),while preexisting MASLD increases the risk of LI and the development of COVID-19-associated *** of injury at the cellular level remain unclear,but it may be significant that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)which causes COVID-19,uses angiotensin-converting expression enzyme 2(ACE2),a key regulator of the‘anti-inflammatory’arm of the renin-angiotensin system,for viral attachment and host cell *** To determine if hepatic ACE2 levels are altered during progression of MASLD and in patients who died with severe *** ACE2 protein levels and localisation,and histological fibrosis and lipid droplet accumulation as markers of MASLD were determined in formalin-fixed liver tissue sections across the MASLD pathological spectrum(isolated hepatocellular steatosis,metabolic dysfunction-associated steatohepatitis(MASH)+/-fibrosis,end-stage cirrhosis)and in post-mortem tissues from patients who had died with severe COVID-19,using ACE2 immunohistochemistry and haematoxylin and eosin and picrosirius red staining of total collagen and lipid droplet areas,followed by quantification using machine learning-based image pixel *** ACE2 staining is primarily intracellular and concentrated in the cytoplasm of centrilobular hepatocytes and apical membranes of bile duct ***,ACE2 protein levels are elevated in non-fibrotic MASH compared to healthy controls but not in the progression to MASH with fibrosis and in ***2 protein levels and histological fibrosis are not associated,but ACE2 and liver lipid droplet content are significantly correlated across the MASLD *** A

关键词： Metabolic dysfunction-associated steatotic liver disease Angiotensin-converting enzyme 2 Immunohistochemistry COVID-19 COVID-19-associated cholangiopathy

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Metabolic collaboration between cells in the tumor microenvironment has a negligible effect on tumor growth

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The Innovation 2024年第2期5卷 107-114页

作者： Johan Gustafsson Fariba Roshanzamir Anders Hagnestål Sagar M.Patel Oseeyi I.Daudu Donald F.Becker jonathan L.Robinson Jens Nielsen Department of Life Sciences Chalmers University of TechnologySE-41296 GothenburgSweden Hagnesia AB SE-43854 HindåsSweden Department of Biochemistry and Redox Biology Center University of Nebraska-LincolnLincolnNE 68588USA BioInnovation Institute DK2200 CopenhagenDenmark

The tumor microenvironment is composed of a complex mixture of different cell types interacting under conditions of nutrient deprivation,but the metabolism therein is not fully understood due to difficulties in measuring metabolic fluxes and exchange of metabolites between different cell types in ***-scale metabolic modeling enables estimation of such exchange fluxes as well as an opportunity to gain insight into the metabolic behavior of individual cell ***,we estimated the availability of nutrients and oxygen within the tumor microenvironment using concentration measurements from blood together with a metabolite diffusion *** addition,we developed an approach to efficiently apply enzyme usage constraints in a comprehensive metabolic model of human *** combined modeling reproduced severe hypoxic conditions and the Warburg effect,and we found that limitations in enzymatic capacity contribute to cancer cells’preferential use of glutamine as a substrate to the citric acid ***,we investigated the common hypothesis that some stromal cells are exploited by cancer cells to produce metabolites useful for the cancer *** identified over 200 potential metabolites that could support collaboration between cancer cells and cancer-associated fibroblasts,but when limiting to metabolites previously identified to participate in such collaboration,no growth advantage was *** work highlights the importance of enzymatic capacity limitations for cell behaviors and exemplifies the utility of enzyme-constrained models for accurate prediction of metabolism in cells and tumor microenvironments.

关键词： metabolism effect limitations

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Petrology, geochemistry, and crystal size distribution of the basaltic andesite–dacite association at Mt. Sumbing, Central Java, Indonesia: Insights to magma reservoir dynamics and petrogenesis

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Acta Geochimica 2024年第05期43卷 838-855页

作者： Indranova Suhendro Endra Yuliawan Revina Fitri zen zulfa Yogi Rahmawati Pandu Eka Priyana Sonna Diwijaya Muhammad Alsamtu Tita Sabila Pratama Suhartono Andre jonathan Gammanda Adhny El zamzamy Latief Department of Environmental Geography Faculty of Geography Universitas Gadjah Mada Sekip Utara Jl.Kaliurang Bulaksumur Centre for Disaster Studies Universitas Gadjah Mada Jl.Mahoni C-16 Bulaksumur

Ten rock samples consisting of one pyroclastic density current （PDC1） deposit,seven lava flows （LF1–7）,and two summit lava domes （LD1,2） were studied to understand the petrogenesis and magma dynamics at *** stratigraphy is arranged as LF1,PDC1,LF2,LF3,LF4,LF5,LF6,LF7,LD1,and LD2;furthermore,these rocks were divided into two *** Ⅰ,observed in the oldest （LF1） sample,has poor MgO and high Ba/Nb,Th/Yb and *** remaining samples （PDC1–LD2） represent type Ⅱ,characterized by high MgO and low Ba/Nb,Th/Yb and Sr *** suggest that type I is derived from AOC （altered oceanic crust）-rich melts that underwent significant crustal assimilation,while type Ⅱ originates from mantle-rich melts with less significant crustal *** early stage of type Ⅱ magma （PDC1–LF3） was considered a closed system,evolving basaltic andesite into andesite （55.0–60.2 wt%SiO2） with a progressively increasing phenocryst (0.30–0.48φPC) and decreasing crystal size distribution （CSD） slope（from -3.9 to -2.9）.The evidence of fluctuating silica and phenocryst contents (between 55.9–59.7 wt% and 0.25–0.41φPC,respectively),coupled with the kinked and steep （from-5.0 to-3.3） CSD curves imply the interchanging condition between open （i.e.,magma mixing） and closed magmatic systems during the middle stage （LF4–LF6）.Finally,it underwent to closed system again during the final stage（LF7–LD2） because the magma reached dacitic composition（at most 68.9 wt%SiO2） with abundant phenocryst (0.38–0.45φPC) and gentle CSD slope （from -4.1 to -1.2）.

关键词： Crystal size distribution Fractionation Magma mixing Petrogenesis Sumbing Whole-rock geochemistry

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Vaginal Birth after Cesarean after zavanelli Maneuver: A Woman’s Right to Choose

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1091-1095页

作者： Nicole Jenkins Gregory Vurture jonathan D. Baum Department of Obstetrics and Gynecology Jersey Shore University Medical Center Neptune NJ USA

Introduction: Vaginal birth after cesarean (VBAC) plays an essential role in lowering cesarean rates. Despite endorsement, trial of labor after cesarean (TOLAC) attempt rates remain low, in part due to fear of lawsuits. zavanelli maneuver is a last resort procedure in the management of shoulder dystocia. We discuss a case of a woman determined to have a vaginal birth after her prior birth was complicated by shoulder dystocia requiring a zavanelli maneuver. Her physicians were reluctant to allow her a TOLAC given her prior obstetric history. Case: A 34-year-old para 1 with prior cesarean delivery due to shoulder dystocia that required zavanelli maneuver presents determined to pursue VBAC in her current pregnancy. She considered her delivery route options and addressed her modifiable risk factors. She consulted with multiple perinatologists who agreed that a TOLAC was reasonable, however she had to travel more than 70 miles (from Pennsylvania to New Jersey) to find an obstetrical practice and hospital willing to consider VBAC. She transferred care and the remainder of her prenatal course was uncomplicated. She went into labor at 41 weeks and had a successful VBAC without complication. In a thank you letter to her obstetrician, she described her birth experience as euphoric. Conclusion: This case illustrates how a woman’s choice of delivery route may be impacted by fear of litigation. Local providers focused on her prior delivery instead of her overall improved risk profile. Delivery route decisions should be based on a thorough evaluation of all risk factors and individualized to meet the reproductive goals of each woman. .

关键词： Vaginal Birth after Cesarean zavanelli Autonomy Case Report

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A spotlight on dosage and subject selection for effective neuroprotection: exploring the central role of mitochondria

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Neural Regeneration Research 2025年第4期20卷 1081-1082页

作者： John Mitrofanis jonathan Stone Michael R.Hamblin Pierre Magistretti Alim-Louis Benabid Glen Jeffery Fonds Clinatec UniversitéGrenoble AlpesGrenobleFrance School of Medical Science University of SydneySydneyAustralia Faculty of Health Sciences University of JohannesburgJohannesburgSouth Africa King Abdullah University of Science and Technology ThuwalSaudi Arabia Institute of Ophthalmology University College LondonLondonUK

Neurons are notoriously vulnerable cell *** the slightest change in their internal and/or external environments will cause much distress and dysfunction,leading often to their death.A range of pathological conditions,including stroke,head trauma,and neurodegenerative disease,can generate stress in neurons,affecting their survival and proper *** most neural pathologies,mitochondria become dysfunctional and this plays a pivotal role in the process of cell *** challenge over the last few decades has been to develop effective interventions that improve neuronal homeostasis under pathological *** interventions,often referred to as disease-modifying or neuroprotective,have,however,proved frustratingly elusive,at both preclinical and,in particular,clinical *** this perspective,we highlight two factors that we feel are key to the development of effective neuroprotective *** are:firstly,the choice of dose of intervention and method of application,and secondly,the selection of subjects,whether they be patients or the animal model.

关键词： protective dosage distress

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