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Global geoepidemiology of gastrointestinal surgery rates in Crohn’s disease

World Journal of Gastrointestinal Surgery 2024年第6期16卷 1835-1844页

作者： Simcha Weissman Muhammad Aziz Ayrton Bangolo Vignesh K Nagesh Htat Aung Midhun Mathew Lino Garcia Shiva A Chandar Praveena Karamthoti Harinder Bawa Aseel Alshimari Yabets Kejela Nazish Mehdi Chrishanti A joseph Athri Kodali Rohan Kumar Priya Goyal Sanya Satheesha Fnu Nivedita Nicole Tesoro Tanni Sethi Gurpreet Singh Areej Belal Alina Intisar Hirra Khalid Samuel Cornwell Suchith B Suresh Kareem Ahmed Karabo K Marole Om P Anand Rahat B Reshi Tej I Mehta Sameh Elias joseph d feuerstein department of Medicine Hackensack Meridian Health Palisades Medical CenterNorth BergenNJ 07047United States division of Gastroenterology and Hepatology University of Toledo Medical CenterToledoOH 43614United States department of Medicine University of WashingtonSeattleWA 98195United States department of Radiology Johns Hopkins University HospitalBaltimoreMD 21218United States division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

BACKGROUNd data regarding the worldwide gastrointestinal surgery rates in patients with Crohn’s disease(Cd)remains *** To systematically review the global variation in the rates of surgery in *** A comprehensive search analysis was performed using multiple electronic databases from inception through July 1,2020,to identify all full text,randomized controlled trials and cohort studies pertaining to gastrointestinal surgery rates in adult patients with *** included continent based demographic data,Cd surgery rates over time,as well as the geoepidemiologic variation in Cd surgery *** analyses were conducted using *** Twenty-three studies spanning four continents were *** median proportion of persons with Cd who underwent gastrointestinal surgery in studies from North America,Europe,Asia,and Oceania were 30%(range:1.7%-62.0%),40%(range:0.6%-74.0%),17%(range:16.0%-43.0%),and 38%*** clear association was found regarding the proportion of patients undergoing gastrointestinal surgery over time in North America(R^(2)=0.035)and Europe(R^(2)=0.100).A moderate,negative association was seen regarding the proportion of patients undergoing gastrointestinal surgery over time(R^(2)=0.520)in *** There appears to be significant inter-continental variation regarding surgery rates in *** evidencebased guidelines accounting for the geographic differences in managing patients with Cd is ***,as a paucity of data on surgery rates in Cd exists outside the North American and European continents,future studies,particularly in less studied locales,are warranted.

关键词： Gastrointestinal surgery Crohn’s disease Geoepidemiology Inflammatory bowel disease Prevalence

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Colorectal cancer surveillance in inflammatory bowel disease:Practice guidelines and recent developments

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World Journal of Gastroenterology 2019年第30期25卷 4148-4157页

作者： William T Clarke joseph d feuerstein department of Medicine and division of Gastroenterology Beth Israel Deaconess Medical Center Harvard Medical School

Patients with long-standing inflammatory bowel disease(IBd)involving at least 1/3 of the colon are at increased risk for colorectal cancer(CRC).Advancements in CRC screening and surveillance and improved treatment of IBd has reduced CRC incidence in patients with ulcerative colitis and Crohn’s *** cases of CRC are thought to arise from dysplasia,and recent evidence suggests that the majority of dysplastic lesions in patients with IBd are visible,in part thanks to advancements in high definition colonoscopy and *** practice guidelines have supported the use of chromoendoscopy with targeted biopsies of visible lesions rather than traditional random *** are encouraged to endoscopically resect visible dysplasia and only recommend surgery when a complete resection is not *** technologies such as virtual chromoendoscopy are emerging as potential tools in CRC *** with IBd at increased risk for developing CRC should undergo surveillance colonoscopy using new approaches and techniques.

关键词： Inflammatory bowel disease Colorectal cancer screening Ulcerative colitis Crohn’s disease Colonoscopy Chromoendoscopy

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目前的溃疡性结肠炎和克罗恩病治疗指南是否有一个规范的制定流程?

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Gastroenterology Report 2021年第5期9卷 408-417,I0001,I0002页

作者： Alexander Goldowsky Rohan Sen Gila Hoffman joseph d feuerstein department of Medicine Beth Israel Deaconess Medical CenterBostonMAUSA department of Gastroenterology and Hepatology Beth Israel Deaconess Medical CenterBostonMAUSA

背景:国际上各个胃肠病协会都会发布各自的溃疡性结肠炎(UC)和克罗恩病(Cd)治疗指南,以帮助临床医生为患者提供高水平诊治。我们对这些指南进行了分析,评估其用于形成推荐意见的证据质量及强度、证据分级的方法学、疾病特异性推荐意见... 详细信息

背景:国际上各个胃肠病协会都会发布各自的溃疡性结肠炎(UC)和克罗恩病(Cd)治疗指南,以帮助临床医生为患者提供高水平诊治。我们对这些指南进行了分析,评估其用于形成推荐意见的证据质量及强度、证据分级的方法学、疾病特异性推荐意见的差异、制定指南期间存在的利益冲突以及指南更新计划。方法:我们于2019年4月,使用“溃疡性结肠炎”、“克罗恩病”和“指南”作为关键词在PubMed中进行系统检索,并在国际各个胃肠病协会的官网搜索UC和Cd指南。由两名作者对12个协会的指南进行研读,采用卡方检验比较各个指南间的证据等级、推荐强度和报道的利益冲突之间的差异,采用线性回归模型评估作者数量与推荐意见数量之间的关系。结果:28部指南纳入分析,其中25部(89%)采用了三种不同的评价系统对证据水平进行分级,另有2部(7%)采用了一种未知的证据水平评价方法。3部(11%)指南没有做利益冲突的声明;3部(11%)指南提供了指南更新的时间表。在1265条推荐意见中,246条(19%)没有报道证据等级或明确指出该意见是基于专家意见。UC推荐意见中有135条(22%)被标注为“弱推荐”或“有条件推荐”,95条(16%)并没有给出推荐强度。Cd推荐意见中有242条(37%)被标注为“弱推荐”或“有条件推荐”,151条(23%)没有给出推荐强度。结论:大多数UC和Cd指南的制定是基于比较低甚至非常低的证据等级,而且某些治疗方面的推荐意见各个指南间缺乏同质性,加之一些利益冲突未进行声明,进一步削弱了指南的价值。

关键词： Crohn’s disease ulcerative colitis inflammatory bowel disease guidelines conflicts of interest

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生物治疗时代的外科手术

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Gastroenterology Report 2019年第2期7卷 77-90,I0001页

作者： daniel J.Wong Eve M.Roth joseph d.feuerstein Vitaliy Y.Poylin department of Surgery Division of Colon&Rectum SurgeryBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA department of Medicine Division of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA

自20世纪90年代后期首个抗肿瘤坏死因子抗体问世后,生物治疗为炎症性肠病(IBd)患者的药物治疗带来了革命性的改变。然而,外科手术在IBd的治疗中仍然占据重要作用。无论是对于克罗恩病的小肠切除术还是对溃疡性结肠炎的结肠切除术,手术... 详细信息

自20世纪90年代后期首个抗肿瘤坏死因子抗体问世后,生物治疗为炎症性肠病(IBd)患者的药物治疗带来了革命性的改变。然而,外科手术在IBd的治疗中仍然占据重要作用。无论是对于克罗恩病的小肠切除术还是对溃疡性结肠炎的结肠切除术,手术切除率长期以来一直在下降但降幅并不显著。不断增多的生物制剂可越来越多地满足不同情况下IBd患者的治疗需求。于是,出现了一系列关于生物制剂如何影响手术需求及IBd病程的问题。考虑到生物制剂越来越早且越来越多地应用于IBd患者,了解这些药物对手术决策和外科预后的影响,对于结直肠外科医生和胃肠科医生的临床实践是必需的。本文总结了生物治疗与IBd手术方面的相关文献,重点是探讨在“手术治疗时代”,生物制剂对手术频率、类型及并发症的影响。

关键词： Biologics inflammatory bowel disease surgery review

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开放获取内镜筛查能准确安全地筛选出可清醒镇静的病例

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Gastroenterology Report 2016年第4期4卷 281-286,I0001页

作者： darshan Kothari joseph d.feuerstein Laureen Moss Julie d’Souza Kerri Montanaro daniel A.Leffler Sunil G.Sheth department of Medicine and division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA department of Nursing Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA

背景与目的:开放获取内镜筛查能很好地应用于普通低风险的内镜操作。内镜操作前的筛查重点是镇静需求,但筛查结果欠准确将有损内镜的安全性。本研究旨在论证我们的开放获取内镜筛查系统能否准确筛选出可清醒镇静的病例。方法:前瞻性连... 详细信息

背景与目的:开放获取内镜筛查能很好地应用于普通低风险的内镜操作。内镜操作前的筛查重点是镇静需求,但筛查结果欠准确将有损内镜的安全性。本研究旨在论证我们的开放获取内镜筛查系统能否准确筛选出可清醒镇静的病例。方法:前瞻性连续入组经开放获取筛查系统或在胃肠科办公室咨询后进行预约的门诊内镜操作病例。收集错误预约为清醒镇静的病例,对其病例特征进行分析。结果:共计有8063例门诊病例预约行清醒镇静状态下的内镜操作,其中5959例通过开放获取系统进行预约。仅78例(0.97%,78/8063)后续被认为需要麻醉医生支持下的镇静处理,其中44例(56.4%,44/78)是通过开放获取筛查系统预约的,长期服用鸦片(47.7%,21/44)和苯二氮(34.1%,15/44)是需要麻醉医生支持镇静的主要原因。长期服用苯二氮者较未服用者在清醒镇静时需要更高剂量的咪达唑仑(P=0.03),长期服用鸦片者镇静时则需要更高剂量的芬太尼(P=0.04)。进展期肝病和长期饮酒是胃肠科办公室咨询后预约病例需要麻醉医生支持镇静的常见原因,其所占比例明显高于开放获取筛查系统预约病例(均P<0.01)。结论:我们观察到经过多层筛查,绝大多数病例都适合于清醒镇静,更重要的是,只有很少一部分(<1.0%)病例清醒镇静预约不当。需要麻醉医生辅助镇静的主要原因包括鸦片和苯二氮的长期服用和/或长期饮酒和进展期肝病,提示这些病例应纳入开放获取筛查系统中。

关键词：开放获取内镜镇静筛查

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Sustainable Biocomposites Materials for Automotive Brake Pad Application:An Overview

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Journal of Renewable Materials 2024年第3期12卷 485-511页

作者： joseph O.dirisu Imhade P.Okokpujie Olufunmilayo O.joseph Sunday O.Oyedepo Oluwasegun Falodun Lagouge K.Tartibu Firdaussi d.Shehu department of Mechanical Engineering Covenant UniversityOtaOgunNigeria department of Mechanical and Mechatronics Engineering AFE Babalola UniversityAdoEkitiNigeria department of Mechanical and Industrial Engineering Technology University of JohannesburgJohannesburg2028South Africa School of Chemical and Metallurgical Engineering University of the WitwatersrandJohannesburgSouth Africa

Research into converting waste into viable eco-friendly products has gained global *** natural fibres and pulverized metallic waste becomes necessary to reduce noxious environmental emissions due to indiscriminately occupying the *** study reviews the literature in the broad area of green composites in search of materials that can be used in automotive brake *** made by biocomposite,rather than fossil fuels,will be favoured.A database containing the tribo-mechanical performance of numerous potential components for the future green composite was established using the technical details of bio-polymers and natural *** development of materials with diverse compositions and varying proportions is now conceivable,and these materials can be permanently connected in fully regulated *** explanation demonstrates that all of these variables affect friction coefficient,resistance to wear from friction and high temperatures,and the operating life of brake pads to varying *** this study,renewable materials for the matrix and reinforcement are screened to determine which have sufficient strength,coefficient of friction,wear resistance properties,and reasonable costs,making them a feasible option for a green *** most significant,intriguing,and unusual materials used in manufacturing brake pads are gathered in this review,which also analyzes how they affect the tribological characteristics of the pads.

关键词： Asbestos brake pad biocomposites green composite mechanical properties natural reinforcement waste

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2024 Wheelchair Compendium of Physical Activities:An update of activity codes and energy expenditure values

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Journal of Sport and Health Science 2024年第1期13卷 18-23页

作者： Scott A.Conger Stephen d.Herrmann Erik A.Willis Tom E.Nightingale joseph R.Sherman Barbara E.Ainsworth department of Kinesiology Boise State UniversityBoiseID 83725USA Kansas Center for Metabolism and Obesity Research The University of Kansas Medical CenterKansas CityKS 66160USA Center for Health Promotion and disease Prevention University of North Carolina at Chapel HillChapel HillNC 27599USA School of Sport Exercise and Rehabilitation SciencesUniversity of BirminghamBirmingham AL B152TTUK Centre for Trauma Sciences Research University of BirminghamEdgbastonBirmingham AL B152TTUK College of Health Solutions Arizona State UniversityPhoenixAZ 85003USA School of Exercise and Health Shanghai University of SportShanghai 200438China

Purpose:This paper presents an update of the 2011 Wheelchair Compendium of Physical Activities designed for wheelchair users and is referred to as the 2024 Wheelchair *** Wheelchair Compendium aims to curate existing knowledge of the energy expenditure for wheelchair physical activities(PAs).Methods:A systematic review of the published energy expenditure of PA for wheelchair users was completed between 2011 and May *** added these data to the 2011 Wheelchair Compendium data that was compiled previously in a systematic review through ***:A total of 47 studies were included,and 124 different wheelchair PA reported energy expenditure values ranging from 0.8 metabolic equivalents for wheelchair users(filing papers,light effort)to 11.8 metabolic equivalents for wheelchair users(Nordic sit skiing).Conclusion:In introducing the updated 2024 Wheelchair Compendium,we hope to bridge the resource gap and challenge the prevailing narratives that inadvertently exclude wheelchair users from physical fitness and health PAs.

关键词： disability Exercise MET Mobility

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Stability and Time-Step Constraints of Implicit-Explicit Runge-Kutta Methods for the Linearized Korteweg-de Vries Equation

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Communications on Applied Mathematics and Computation 2024年第1期6卷 658-687页

作者： joseph Hunter Zheng Sun Yulong Xing department of Mathematics The Ohio State UniversityColumbusOH43210USA department of Mathematics The University of AlabamaTuscaloosaAL35487USA

This paper provides a study on the stability and time-step constraints of solving the linearized Korteweg-de Vries(KdV)equation,using implicit-explicit(IMEX)Runge-Kutta(RK)time integration methods combined with either finite difference(Fd)or local discontinuous Galerkin(dG)spatial *** analyze the stability of the fully discrete scheme,on a uniform mesh with periodic boundary conditions,using the Fourier *** the linearized KdV equation,the IMEX schemes are stable under the standard Courant-Friedrichs-Lewy(CFL)conditionτ≤λ***,λis the CFL number,τis the time-step size,and h is the spatial mesh *** study several IMEX schemes and characterize their CFL number as a function ofθ=d/h^(2)with d being the dispersion coefficient,which leads to several interesting *** also investigate the asymptotic behaviors of the CFL number for sufficiently refined meshes and derive the necessary conditions for the asymptotic stability of the IMEX-RK *** numerical experiments are provided in the paper to illustrate the performance of IMEX methods under different time-step constraints.

关键词： Linearized Korteweg-de Vries(KdV)equation Implicit-explicit(IMEX)Runge-Kutta(RK)method Stability Courant-Friedrichs-Lewy(CFL)condition Finite difference(Fd)method Local discontinuous Galerkin(dG)method

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Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding:A nationwide analysis

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 285-296页

作者： Simcha Weissman Muhammad Aziz Ayrton I Bangolo dean Ehrlich Arnold Forlemu Anthony Willie Manesh K Gangwani danish Waqar Hannah Terefe Amritpal Singh diego MC Gonzalez Jayadev Sajja Fatma L Emiroglu Nicholas dinko Ahmed Mohamed Mark A Fallorina david Kosoy Ankita Shenoy Anvit Nanavati joseph d feuerstein James H Tabibian department of Internal Medicine Palisades Medical CenterNorth BergenNJ 07047United States department of Gastroenterology University of Toledo Medical CenterToledoOH 43614United States division of digestive diseases David Geffen School of Medicine at University of California at Los AngelesLos AngelesCA 90095United States department of Internal Medicine Creighton University School of MedicinePhoenixAZ 85012United States division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States division of Gastroenterology Department of MedicineOlive View-University of California at Los Angeles Medical CenterSylmarCA 91342United States

BACKGROUNd The optimal timing of esophagogastroduodenoscopy(EGd)and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding(NVUGIB)remains an area of active *** To identify independent predictors of outcomes in patients with NVUGIB,with a particular focus on EGd timing,anticoagulation(AC)status,and demographic *** A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICd-9 codes from the National Inpatient Sample *** were stratified by EGd timing relative to hospital admission(≤24 h,24-48 h,48-72 h,and>72 h)and then by AC status(yes/no).The primary outcome was all-cause inpatient *** outcomes included healthcare *** Of the 1082516 patients admitted for NVUGIB,553186(51.1%)underwent *** mean time to EGd was 52.8 ***(dmission)EGd was associated with significantly decreased mortality,less frequent intensive care unit admission,shorter length of hospital stays,lower hospital costs,and an increased likelihood of discharge to home(all with Pd with mortality among patients who underwent early EGd(aOR 0.88,P=0.193).Male sex(OR 1.30)and Hispanic(OR 1.10)or Asian(aOR 1.38)race were also independent predictors of adverse hospitalization outcomes in *** Based on this large,nationwide study,early EGd in NVUGIB is associated with lower mortality and decreased healthcare usage,irrespective of AC *** findings may help guide clinical management and would benefit from prospective validation.

关键词： Upper gastrointestinal bleeding Esophagogastroduodenoscopy Outcomes Mortality Anticoagulation

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对腹膜透析患者进行下消化道内镜检查的预防性抗生素和感染性并发症

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Gastroenterology Report 2020年第5期8卷 407-409,I0003页

作者： William T.Clarke Venkata R.Satyam david I.Fudman Samantha Zullow Kashika G.Goyal Katerina LByanova Christopher Huang joseph d.feuerstein division of Gastroenterology Department of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA department of Medicine Boston Medical CenterBoston University School of MedicineBostonMAUSA Present affiliation:division of digestive and Liver diseases Department of Internal MedicineUniversity of Texas Southwestern Medical CenterDallasTXUSA Present affiliation:division of Gastroenterology and Hepatology New York University Langone Medical CenterNew York University School of MedicineNew YorkNYUSA department of Medicine Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Section of Gastroenterology Department of MedicineBoston Medical CenterBoston University School of MedicineBostonMAUSA

Introduction Peritoneal dialysis(Pd)is widely used for the treatment of endstage renal *** treated with Pd have similar outcomes to those treated with hemodialysis[1].However,Pdrelated infections including peritonitis have been reported at 1.66 episodes per patient per year[2].One possible source of peritonitis is gastrointestinal(GI)endoscopic *** 2005,the International Society for Peritoneal dialysis(ISPd)published guidelines suggesting antibiotics be given to Pd patients prior to colonoscopy[3].This suggestion was mostly based on expert opinion and a theoretical concern that patients undergoing colonoscopy are at increased risk for enteric peritonitis from bacterial translocation across the bowel *** there is no direct evidence to support this theory,case reports have suggested a risk of transient bacteremia associated with colonoscopy.

关键词：预防性抗生素消化道内镜检查感染性并发症

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