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The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly Gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA Department of Gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly Gastroenterology and Digestive Endoscopy Unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA Department of Gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of Gastroenterology HyderabadIndia Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 bleeding.Conclusions: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

Experimental study on lightweight expanded clay at particle level:Breakage of isolated grains

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Journal of Rock Mechanics and Geotechnical Engineering 2023年第7期15卷 1846-1858页

作者： Elías Roces-Alonso jose Estaire Miriam Martín-ruiz Jesús González-Galindo ETS de Ingenieros de Caminos Universidad Politécnica de MadridSpain Laboratorio de Geotecnia CEDEXMadridSpain

In this study,more than 1500 particles of lightweight expanded clay aggregate(LECA)are individually loaded up to breakage,following different patterns of contact(from 2 to 7)using a purpose-built apparatus.Consequently,a statistical model for predicting the number of fragments into which a grain breaks as a function of the number of contacts and their diameter is proposed.The number of fragments is found to follow a statistical binomial-type distribution function that depends on the number of contacts.In addition,a model based on Bayesian networks,capable of assessing the number of fragments and their size(measured as normalized weight)as a function of the number of contacts,is implemented.The proposed method is applicable when performing discrete element method(DEM)simulations on granular media in which grain breakage plays a relevant role.

关键词： Lightweight expanded clay aggregate(LECA) Grain fragmentation Grain breakage Biaxial grain load

Exploring Alternatives to Create Digital Twins from and for Process Simulation

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Journal of Computer Science Research 2024年第1期6卷 16-30页

作者： Jaime Barbero-Sánchez Alicia Megía-Ortega Víctor R.Ferro jose-Luis Valverde Department of Chemical Engineering University of Castilla La ManchaAvda.Camilo JoséCela 12Ciudad Real13071Spain Department of Chemical Engineering Autonomous University of MadridCantoblancoMadrid28049Spain

In this work,Digital Twins based on Neural Networks for the steady state production of styrene were generated.Thus,both the Aspen Technology AI Model Builder(alternative 1)and a homemade MS Excel VBA code connected to Aspen HYSYS and Aspen Plus(alternative 2)were used with this same aim.The raw data used for generating the Digital Twins were obtained from process simulations using Aspen HYSYS and/or Aspen Plus,which were connected through a recycle-like stream via automation for solving the entire simulation flowsheet.Aspen HYSYS was used for solving the pre-heating,reaction,and stabilization sections of the process whereas Aspen Plus ensured the computing of the separation and purification columns.Both alternatives led to an excellent prediction showing the capability of creating Digital Twins from and for process simulation.

关键词： Digital Twin Aspen Hybrid Model Builder Aspen HYSYS Aspen Plus Automation MS Excel-VBA

Invasive versus non-invasive hemodynamic monitoring of heart failure patients and their outcomes

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Journal of Geriatric Cardiology 2022年第4期19卷 315-318页

作者： Fadi Kandah Pooja Dhruva Raj Shukla Maedeh Ganji Carlos Palacio Emil Missov jose ruiz-Morales Internal Medicine University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA Division of Cardiology University of Florida College of Medicine-JacksonvilleJacksonvilleFloridaUSA

Acute decompensated heart failure(HF)is the most common cause of hospital ad-mission in patients older than 65 years.Mean length of hospital stay is about 5-6 days and with a frequent number of hospital readmission rates of 25%to 50%at 30 days and 6-12 months,respect-ively.[1]Treatment options are vast and depend on certain patient characteristics,including hemody-namics,which drive the acute management.A pop-ular modality to assess hemodynamics in acute HF is the right heart catheterization(RHC).While in-vasive,the use of RHC gives providers the oppor-tunity to evaluate values that directly contribute to the management of the patient.These numbers can calculate the cardiac output as well as help establish the underlying etiology of the patient’s symptoms and guide therapy.

关键词： patients acute Acute

One-year survival in recipients older than 50 bridged to heart transplant with Impella 5.5 via axillary approach

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Journal of Geriatric Cardiology 2023年第5期20卷 319-329页

作者： Smit Paghdar Smruti Desai Ji-Min Jang jose ruiz Sharan Malkani Parag Patel Daniel S Yip Juan C Leoni jose Nativi Basar Sareyyupoglu Kevin Landolfo Si Pham Rohan M Goswami Division of Heart Failure and Transplant Mayo Clinic in FloridaUSA Department of Cardiothoracic Surgery Mayo Clinic in FloridaUSA

BACKGROUND Optimizing patients with advanced heart failure before orthotopic heart transplantation(OHT), especially in patients greater than 50 years old, is imperative to achieving successful post-transplant outcomes. Complications are well-described for patients bridged to transplant(BTT) with durable left ventricular assist device(LVAD) support. Given the lack of data available in older recipients after the recent increase in mechanical support use, we felt it crucial to report our center’s one-year outcomes in older recipients after heart transplantation with percutaneously placed Impella 5.5 as a BTT.METHODS Forty-nine OHT patients were supported with the Impella 5.5 intended as a bridge between December 2019 and October 2022 at Mayo Clinic in Florida. Data were extracted from the electronic health record at baseline and during their transplant episode of care after Institutional Review Boards approval as exempt for retrospective data collection.RESULTS Thirty-eight patients aged 50 or older were supported with Impella 5.5 as BTT. Ten patients underwent heart and kidney transplantation within this cohort. The median age at OHT was 63(58–68) years, with 32 male(84%) and six female patients(16%). Etiology was divided into ischemic(63%) and non-ischemic cardiomyopathy(37%). The baseline median ejection fraction was 19%(15–24). Most patients were in blood group O(60%), and 50% were diabetic. The average duration of support was 27 days(range 6–94). The median duration of follow-up is 488 days(185–693). For patients that have reached the 1-year follow-up timeframe(22 of 38, 58%), the 1-year post-transplant survival is 95%.CONCLUSION Our single-center data provides awareness for using the Impella 5.5 percutaneously placed axillary support device in older heart failure patients in cardiogenic shock as a bridge to transplantation. One-year survival outcomes after heart transplantation are excellent despite the older recipient’s age and prolonged pre-transplant support.

关键词： One approval transplant

COVID-19 pandemic and nurse teaching:Our experience

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World Journal of Clinical Cases 2022年第8期10卷 2657-2659页

作者： Juan Carlos Molina ruiz jose Luis Guerrero Orriach Maria Luisa Bravo Arcas Angela Montilla Sans RocioEscano Gonzalez Department of Anesthesia Hu Virgen De La VictoriaMalaga 29006Spain

In this letter to the editor,we would like to show in our hospital how our nurse team manage formation during coronavirus disease 2019 pandemic.

关键词： COVID-19 Anesthesia Critical care Nurses First wave Training

Gene editing in plants:progress and challenges

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National Science Review 2019年第3期6卷 421-437页

作者： Yanfei Mao jose ramon Botella Yaoguang Liu Jian-Kang Zhu Shanghai Center for Plant Stress Biology CAS Center of Excellence in Molecular Plant Sciences Chinese Academy of Sciences School of Agriculture and Food Sciences University of Queensland State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources College of Life Sciences South China Agricultural University Department of Horticulture and Landscape Architecture Purdue University

The clustered regularly interspaced short palindromic repeat(CRISPR)-associated protein 9(Cas9)genome editing system is a powerful tool for targeted gene modifications in a wide range of species,including plants. Over the last few years, this system has revolutionized the way scientists perform genetic studies and crop breeding, due to its simplicity, flexibility, consistency and high efficiency. Considerable progress has been made in optimizing CRISPR/Cas9 systems in plants, particularly for targeted gene mutagenesis. However, there are still a number of important challenges ahead, including methods for the efficient delivery of CRISPR and other editing tools to most plants, and more effective strategies for sequence knock-ins and replacements. We provide our viewpoint on the goals, potential concerns and future challenges for the development and application of plant genome editing tools.

关键词： CRISPR Cas9 genome editing base editing gene targeting crop breeding

Cancer and diet: significance of diet in a patient whose life expectancy was 4 to 5 months

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Cancer Advances 2023年第2期6卷 1-8页

作者： jose ramon Toro Lopez Independent Researcher Sevilla 41500Spain

Clinical summary:The patient,62 years old,a professional laboratory technician specialist,married with two children who in the month of January 2017,came to the emergency department for presenting problems of metrorrhagia and severe pain in left hip that prevented her from ambulation.Once the appropriate tests were performed,the clinical judgment was moderately differentiated endometroid adenocarcinoma with squamous metaplasia infiltrating the cervix,M1(bone and lung metastases);image compatible with left femoral DVT and PET in the right lower lobar branch,and her life expectancy at that time was four to five months.Objective:Given the situation in which the patient was,the few posibilties of a restorative treatment,and the short life expectancy expected for the patient,the only objective was to seek help through a special diet focusing the interest mainly on the nutritional aspect so that it could help to control especially the metastases,the tumor cell and the activation and reinforcement of the immune system.Method:In 2017,when the study was started,a systematic literature review was conducted in search of information related to diets,cancer and metastasis.In this study,the references used for the establishment of the diet have been taken into account and updated to the last five years,where we have been able to confront and confirm the same results obtained in 2017.For the reviews,databases related to health sciences on published articles that related alkaline diets with cancer and metastasis have been used.Results:The patient was recommended a special alkaline dissociated diet based mainly on a nutritional point of view that she started from the first day of treatment with the intention that she could be controlled and favor her recovery;after six months,both tumors and metastases and the problems of DVT and PTE had practically disappeared.Conclusions:The results(although it is only one case)make us think about nutrition's importance,especally in this type of disease.We know this disease is not specific to a

关键词： diet cancer,alkaline dissociated diet alkaline diet dissociated diet minerals metastasis collagen

Performance Parameters:Demobilization Antibiotic Resistant Bacteria(ARB)and Carrying Genes(ARG)in Wastewater Disinfection

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Journal of Environmental Science and Engineering(B) 2024年第1期13卷 1-8页

作者： Solange Kazue Utimura Denise Crocce Romano Espinosa Marcio Luís Busi da Silva Elisabete de Santis Braga Pedro jose Alvarez Department of Chemical Engineering USPR.do LagoSão Paulo 25005508-080Brazil Department of Physical Chemical and Geological OceanographyUSPPraça do Oceanográfico 191SPBrazil Department of Civil and Environmental Engineering Rice University6100 Main St.HoustonTexas 77005USA

The UV irradiation is used for removing Antibiotic Resistant Bacteria(ARB)and Antibiotic Resistance Genes(ARG)from wastewater treatment.Bacteriophages are viruses that infect within bacteria,are recognized for bacterial control.The influence of some parameters in quantification and performance influencing of pathogen demobilization could be considered in disinfection of wastewater.The comparison of Polyvalent phage(NE1)versus Coliphage(NE4)in suppressing a bacterium Escherichia coli(NDM-1:b-lactam-resistant)with UV irradiation was observed the efficacy in reduction of cells in the disinfection and parameter process.The results with the effect of UV-C irradiation on NDM-1 infected with 1%of NE4 showed a decrease of cells from 8×10^(6)to 2×10^(5)in 60 min with UV-C dose.The NDM1(E.coli)was infected with 1%of NE4(Polyvalent Phage)under magnetic stirring for 1 h,the cells count was 8×10^(6).After 1 h in UV-C e×posure,the cells number reached 3×10^(5).The NDM1 that was e×posed in 1 h of UV-C irradiation and then was infected with 1%of NE4.Cells counting were done 24 h after this procedure.These cells were e×posed in UV-C and showed a reduction in the number of cells from 1×10^(8)to 4×10^(5)after 60 min.The results indicate that bacteriophages can mitigate bacteria species,and combined the conventional water disinfection technologies that can support the microbial safety control strategies.

关键词： Antibiotic Resistant Bacteria(ARB) Antibiotic Resistance Genes(ARG) wastewater treatment disinfection Escherichia coli(E.coli).