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Hepatic decompensation/serious adverse events in post-liver transplantation recipients on sofosbuvir for recurrent hepatitis C virus

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World Journal of Gastroenterology 2016年第9期22卷 2844-2854页

作者： Neal Patel Kian Bichoupan Lawrence Ku Rachana Yalamanchili Alyson Harty Donald Gardenier Michel Ng David Motamed Viktoriya Khaitova Nancy Bach Charissa Chang Priya Grewal Meena Bansal Ritu Agarwal Lawrence Liu Gene Im Jennifer Leong leona kim-schluger Joseph Odin Jawad Ahmad Scott Friedman Douglas Dieterich Thomas Schiano Ponni Perumalswami Andrea Branch Division of Liver Diseases Icahn School of Medicine at Mount Sinai Recanati Miller Transplant Institute Icahn School of Medicine at Mount Sinai

AIM: To determine the safety profile of new hepatitis C virus (HCV) treatments in liver transplant (LT) recipients with recurrent HCV ***: Forty-two patients were identified with recurrent HCV infection that underwent LT at least 12 mo prior to initiating treatment with a Sofosbuvir-based regimen during December 2013-June 2014. Cases were patients who experienced hepatic decompensation and/or serious adverse events (SAE) during or within one month of completing treatment. Controls had no evidence of hepatic decompensation and/or SAE. HIV-infected patients were excluded. Cumulative incidence of decompensation/SAE was calculated using the Kaplan Meier method. Exact logistic regression analysis was used to identify factors associated with the composite ***: Median age of the 42 patients was 60 years [Interquartile Range (IQR): 56-65 years], 33% (14/42) were female, 21% (9/42) were Hispanic, and 9% (4/42) were Black. The median time from transplant to treatment initiation was 5.4 years (IQR: 2.1-8.8 years). Thirteen patients experienced one or more episodes of hepatic decompensation and/or SAE. Anemia requiring transfusion, the most common event, occurred in 62% (8/13) patients, while 54% (7/13) decompensated. The cumulative incidence of hepatic decompensation/SAE was 31% (95%CI: 16%-41%). Risk factors for decompensation/SAE included lower pre-treatment hemoglobin (OR = 0.61 per g/dL, 95%CI: 0.40-0.88, P 2, 95%CI: 0.90-0.99, P = 0.01), and higher baseline serum total bilirubin (OR = 2.43 per mg/dL, 95%CI: 1.17-8.65, P < 0.01). The sustained virological response rate for the cohort of 42 patients was 45%, while it was 31% for ***: Sofosbuvir/ribavirin will continue to be used in the post-transplant population, including those with HCV genotypes 2 and 3. Management of anemia remains an important clinical challenge.

关键词： Hepatitis C virus Sofosbuvir Ribavirin Anemia Hepatic decompensation Serious adverse event Liver transplant

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Utility of the low-accelerating-dose regimen in 182 liver recipients with recurrent hepatitis C virus

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World Journal of Gastroenterology 2015年第20期21卷 6236-6245页

作者： Kieron BL Lim Hamid R Sima M Isabel Fiel Viktoriya Khaitova John T Doucette Maria Chernyiak Jawad Ahmad Nancy Bach Charissa Chang Priya Grewal leona kim-schluger Lawrence Liu Joseph Odin Ponni Perumalswami Sander S Florman Thomas D Schiano Division of Liver Diseases Icahn School of Medicine at Mount Sinai Division of Gastroenterology and Hepatology National University Center for Organ TransplantationNational University Hospital Lillian and Henry M Stratton-Hans Popper Department of Pathology Icahn School of Medicine at Mount Sinai Recanati-Miller Transplantation Institute Icahn School of Medicine at Mount Sinai Department of Preventive Medicine Icahn School of Medicine at Mount Sinai

AIM: To describe our experience using a low-acceleratingdose regimen(LADR) with pegylated interferon alpha-2a and ribavirin in treatment of hepatitis C virus(HCV) recurrence. METHODS: From 2003, a protocolized LADR strategy was employed to treat liver transplant(LT) recipients with recurrent HCV at our institution. Medical records of 182 adult patients with recurrent HCV treated with LADR between 1/2003 and 1/2011 were reviewed. Histopathology from all post-LT liver biopsies were reviewed in a blinded fashion. Paired recipient and donor IL28 B status were assessed. A novel technique was employed to ascertain recipient and donor IL28B(rs12979860) Gt data using DNA extracted from archival FFPE tissue from explanted native livers and donor gallbladders respectively. The primary endpoint was SVR; secondary endpoints examined include(1) patient and graft survival;(2) effect of anti-viral therapy on liver histology(fibrosis and inflammation);(3) incidence of on-treatment development of ACR, CDR, or PCH;(4) association of recipient and donor IL28 B genotype with SVR; and(5) incidence of antiviral therapy-associated adverse events(anemia, leukopenia, thrombocytopenia, depression) and hepatic ***: The overall SVR rate was 38%(29% Gt1, 67% Gt2, 86% Gt3 and 58% Gt4). HCV Gt(P < 0.0001), donor age(P = 0.003), cytomegalovirus mismatch(P = 0.001), baseline serum bilirubin(P = 0.002), and baseline viral load(P = 0.04) were independent predictors for SVR. SVR rates were significantly higher in the recipient-CC/donor-non CC pairs(P = 0.007). Neither baseline fibrosis nor change in fibrosis stage after anti-viral therapy were associated with SVR. Fibrosis progressed in 72% of patients despite SVR. Median graft survival was 91 mo. Five-year patient survival was superior in patients who achieved SVR(97% vs 82%, P = 0.001). Pre-treatment ALP ≥ 150 U/L(P = 0.01), total bilirubin ≥ 1.5 mg/d L(P = 0.001) and creatinine ≥ 2 mg/d L(P = 0.001) were independently associated

关键词： Hepatitis C recurrence Liver transplant Low accelerating dose regimen Peginterferon α-2a IL28B

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Beyond the Rex: an innovative meso-intrahepatic portal vein bypass for late-onset extrahepatic portal vein occlusion after living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 662-668页

作者： Chee-Chien Yong Hsu-Ting Yen Yu-Fan Cheng leona Bettina Dungca Raymond Joseph De Vera Itsuko Chih-Yi Chen Chao-Long Chen Department of Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Cardiovascular Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung Department of Diagnostic Radiology Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

The Meso-Rex bypass(MRB)is recognized as an effective treatment for portal hypertension secondary to extrahepatic portal vein occlusion(EHPVO)both in the pediatric and adult population,within or outside the context of liver *** is the preferred surgical treatment in most centers because not only does it addresses the portal hypertension,but also restores physiologic portal hepatopetal ***,the Rex recess,the landmark for this technique,may not be safely accessible in some *** present a 22-year-old male who underwent living donor liver transplant(LDLT)for neonatal *** presented with variceal bleeding due to EHPVO at 13 years after *** endoscopic,radiologic,and surgical interventions were employed to address the recurrent gastrointestinal bleeding,but results have been *** performed a meso-intrahepatic portal vein bypass(MIPVB),an innovative alternative to the MRB,for this patient with extensive post-operative adhesions,perihilar collaterals,and cavernous *** creation in patients where the Rex recess is inaccessible is technically *** with a multidisciplinary team approach,meticulous preoperative planning,and close follow-up,the authors have demonstrated that it is a safe and feasible option for patients with late-onset EHPVO after liver transplantation.

关键词： Meso-Rex bypass(MRB) portal vein occlusion liver transplantation(LT)

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The neuroimaging of neurodegenerative and vascular disease in the secondary prevention of cognitive decline

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Neural Regeneration Research 2021年第8期16卷 1490-1499页

作者： Morgan J.Schaeffer leona Chan Philip A.Barber Department of Clinical Neurosciences University of CalgaryCalgaryABCanada

Structural brain changes indicative of dementia occur up to 20 years before the onset of clinical symptoms. Efforts to modify the disease process after the onset of cognitive symptoms have been unsuccessful in recent years. Thus, future trials must begin during the preclinical phases of the disease before symptom onset. Age related cognitive decline is often the result of two coexisting brain pathologies: Alzheimer's disease(amyloid, tau, and neurodegeneration) and vascular disease. This review article highlights some of the common neuroimaging techniques used to visualize the accumulation of neurodegenerative and vascular pathologies during the preclinical stages of dementia such as structural magnetic resonance imaging, positron emission tomography, and white matter hyperintensities. We also describe some emerging neuroimaging techniques such as arterial spin labeling, diffusion tensor imaging, and quantitative susceptibility mapping. Recent literature suggests that structural imaging may be the most sensitive and cost-effective marker to detect cognitive decline, while molecular positron emission tomography is primarily useful for detecting disease specific pathology later in the disease process. Currently, the presence of vascular disease on magnetic resonance imaging provides a potential target for optimizing vascular risk reduction strategies, and the presence of vascular disease may be useful when combined with molecular and metabolic markers of neurodegeneration for identifying the risk of cognitive impairment.

关键词： amyloid arterial spin labeling cognitive decline dementia imaging magnetic resonance imaging positron emission tomography quantitative susceptibility mapping tau vascular disease white matter hyperintensities

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Rapid determination of iron oxide content in magnetically modified particulate materials

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Particuology 2016年第3期14卷 114-117页

作者： Ivo Safarik leona Nydlova Kristyna Pospiskova Eva Baldikova Zdenka Maderova Mirka Safarikova Department of Nanobiotechnology Institute of Nanobiology and Structural Biology ofGCRC Na Sadkach 7 370 05 Ceske Budejovice Czech Republic Regional Centre of Advanced Technologies and Materials Palacky University Slechtitelu 27 783 71 Olomouc Czech Republic Department of Nanobiotechnology Biology Centre CAS Na Sadkach 7 370 05 Ceske Budejovice Czech Republic Department of Applied Chemistry Faculty of Agriculture University of South Bohemia Branisovska 1457 370 05 Ceske Budejovice Czech Republic

Magnetically responsive composite materials have been used in interesting applications in various areas of bioscience, biotechnology, and environmental technology. In this work, a simple method to determine the amount of magnetic iron oxide nano- and microparticles attached to magnetically-modified partic- ulate diamagnetic materials has been developed using a commercially available magnetic permeability meter, The procedure is fast and enables dry particulate magnetically modified materials to be analysed without any modification or pretreatment. We show that the magnetic permeability can be measured for materials containing up to 20% magnetic iron oxide, The magnetic permeability measurements are highly reproducible.

关键词： Magnetic permeability meter Magnetic iron oxides Magnetically modified materials

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Portal vein thrombosis in patients with cirrhosis

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Gastroenterology Report 2017年第2期5卷 148-156,I0002页

作者： leona von Kockritz Andrea De Gottardi Jonel Trebicka Michael Praktiknjo Hepatology Clinic of Visceral Surgery and MedicineInselspitalBernSwitzerland Department of Clinical Research University of BernBernSwitzerland Department of Internal Medicine I University of BonnBonnGermany Faculty of Health Sciences University of Southern DenmarkOdenseDenmark European Foundation for the Study of Chronic Liver Failure(EF CLIF) BarcelonaSpain

Portal vein thrombosis(PVT)is frequent in patients with liver cirrhosis and possible severe complications such as mesenteric ischemia are rare,but can be ***,different aspects of clinical relevance,diagnosis and management of PVT are still areas of uncertainty and investigation in international *** this article,we elaborate on PVT classification,geographical differences in clinical presentation and standards of diagnosis,and briefly on the current pathophysiological understanding and risk *** review considers and highlights the pitfalls of the various treatment approaches and prophylactic ***,we review the controversial issue of clinical impact of PVT on prognosis,especially considering liver transplantation and future perspectives.

关键词： portal vein thrombosis liver cirrhosis thrombophilia tests low-molecular-weight heparin transjugular intrahepatic portosystemic shunt liver transplantation

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Flipped classroom approach to global outreach:cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents

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International Journal of Ophthalmology(English edition) 2023年第2期16卷 280-285页

作者： Randy Lu Ryan E Dodge Ⅲ Jocelyn Lam Laura Enyedi Tammy Yanovitch Nandini Gandhi leona Ding Michelle T Cabrera University of Washington School of Medicine SeattleWA 98195USA Department of Anesthesia Massachusetts General HospitalBostonMA 02114USA Eyehealth Northwest PortlandOR 97209USA Department of Ophthalmology Duke UniversityDurhamNC 27708USA Department of Ophthalmology University of OklahomaOklahoma CityOK 73019USA Department of Ophthalmology University of California DavisSacramentoCA 95817USA Department of Ophthalmology University of WashingtonSeattleWA 98195USA Division of Ophthalmology Seattle Children’s HospitalSeattleWA 98105USA

AIM:To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United ***:Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in *** were instructed to watch a pre-class video lecture prior to the in-class-casebased *** tests(5 Ophthalmic Knowledge Assessment Program style questions)and surveys were administered before and after the classroom sessions(100%response rate).These results were compared to that of an American cohort who were taught the same ***:The Chinese cohort of 12 residents preferred the flipped classroom to the traditional classroom at higher rates than the American cohort of 40 residents(92%vs 55%,P=0.04)and felt that all ophthalmology topics would be appropriate for the flipped classroom teaching style(P-values between 0.008 and<0.001).In both Chinese and American cohorts,we found that the exotropia curriculum saw a small but significant improvement in performance following the flipped classroom session(P=0.025 for Chinese residents;P=0.001 for US residents),whereas scores in both groups for the esotropia course did not significantly ***:This is the first study to evaluate the flipped classroom model implemented by a visiting ophthalmology professor in a global outreach *** flipped classroom sessions are viewed favorably by the Chinese residents relative to the US cohort with a modest impact on *** in-person interpreter requirement and increased student engagement make this model valuable in cross-cultural visiting professorship ***,the flipped classroom may lend itself well to a virtual format to prevent the transmission of COVID-19,although such a format requires further study.

关键词： flipped classroom international ophthalmology residency graduate medical education China active learning medical education ophthalmology

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Poor agreement between endoscopists and gastrointestinal pathologists for the interpretation of probe-based confocal laser endomicroscopy findings

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World Journal of Gastroenterology 2014年第47期20卷 17993-18000页

作者： Shajan Peter leona Council Ji Young Bang Helmut Neumann Klaus Mnkemüller Shyam Varadarajulu Charles Melbern Wilcox Division of Gastroenterology and Hepatology University of AlabamaBirminghamAL 35294-0012United States Department of Pathology University of Alabama at BirminghamBirminghamAL 35294-0012United States Department of Medicine 1 University of Erlangen-Nuremberg91054 ErlangenGermany

AIM: To compare the interpretation of probe-based confocal laser endomicroscopy (pCLE) findings between endoscopists and gastrointestinal (GI)-pathologists.

关键词： Confocal endomicroscopy Gastointestinal Interobserver variation

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Survey of current retinopathy of prematurity practices in China

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International Journal of Ophthalmology(English edition) 2021年第8期14卷 1241-1247页

作者： Thao Phuong Le Jing Feng leona Ding Rong Hu Xiao-Bo Lou J Niklas Ulrich Michelle T Cabrera Eye Associates Northwest P.C. SeattleWashington 98104-1306USA Department of Ophthalmology Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Ophthalmology University of WashingtonSeattleWA 98195-0005USA Department of Ophthalmology Hunan People’s HospitalChangsha 410005Hunan ProvinceChina Department of Ophthalmology University of North CarolinaChapel HillNC 27515USA Department of Ophthalmology Seattle Children’s HospitalSeattleWA 98105USA

AIM:To understand retinopathy of prematurity(ROP)screening and treatment preferences among Chinese ***:A Chinese language survey was administered anonymously using Web Q(Catalyst,Seattle,WA,USA)among Chinese ROP screeners from December 2016 to January ***:Among 70 ophthalmologists contacted,65 responded(93%;78%female,mean age 40 y,57%pediatric ophthalmologists and 25%retina specialists).Most used screening criteria of birth weight≤2 kg(62%)with variation in cut-off gestational age(≤37 wk,34%;≤34 wk,22%;≤32 wk,31%).Ret Cam(Natus Medical Incorporated,Pleasanton,CA,USA)wide-field fundus photography assisted most screeners(72%)and was exclusively used by many(29%).Among 55 ophthalmologists treating ROP,anti-vascular endothelial growth factor(VEGF)was preferred over laser for both zoneⅠ(76%vs 24%)and zoneⅡROP(58%vs 42%).Retina specialists(P=0.004)and ophthalmologists with>3 mo of training(P=0.03)were more likely to use antiVEGF over laser for zoneⅠ*** of laser training(8/20,40%),access(6/20,30%)and anesthesia(4/20,20%)were common barriers to laser ***:Chinese ROP screeners favor antiVEGF injection and Ret Cam imaging for ROP management.A better understanding of ROP screening and treatment informs future research and education efforts in China.

关键词： pediatrics retina retinopathy of prematurity survey telemedicine

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Lasing-enhanced surface plasmon resonance spectroscopy and sensing

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Photonics Research 2021年第9期9卷 1699-1714页

作者： ZHE ZHANG leona NEST SUO WANG SI-YI WANG REN-MIN MA State Key Laboratory for Mesoscopic Physics School of PhysicsPeking UniversityBeijing 100871China Department of Physics Free University BerlinBerlin 14195Germany Frontiers Science Center for Nano-optoelectronics&Collaborative Innovation Center of Quantum Matter Beijing 100871China Yangtze Delta Institute of Optoelectronics Peking UniversityNantong 226010China

Surface plasmon resonance(SPR)sensors are a prominent means to detect biological and chemical analytes and to investigate biomolecular interactions in various ***,the performance of SPR sensors is ultimately limited by ohmic loss,which substantially weakens the resonance signal and broadens the response *** studies have shown that ohmic loss can be fully compensated in plasmonic nanolasers,which leads to a novel class of lasing-enhanced surface plasmon resonance(LESPR)sensors with improved sensing *** this paper,we detail the underlying physical mechanisms of LESPR sensors and present their implementation in various sensing *** review recent progress on their applications,particularly for refractive index sensing,gas detection and biological imaging,labeling,tracking,and *** then summarize the review and highlight remaining challenges of LESPR sensing technology.

关键词： technology. resonance surface

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