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Intensive care drug therapy and its potential adverse effects on blood pressure and heart rate in critically ill children

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World Journal of Pediatrics 2023年第9期19卷 902-911页

作者： Lisa Marie Kiesel Astrid Bertsche Wieland Kiess manuela Siekmeyer Thilo Bertsche Martina Patrizia Neininger Drug Safety Center and Clinical Pharmacy Institute of PharmacyMedical FacultyLeipzig UniversityBruederstr.3204103 LeipzigGermany Division of Neuropediatrics University Hospital for Children and AdolescentsFleischmannstr.817475 GreifswaldGermany Department of Women and Child Health Hospital for Children and Adolescents and Center for Pediatric ResearchUniversity Hospital of LeipzigLiebigstr.20a04103 LeipzigGermany

Background Owing to complex treatment,critically ill children may experience alterations in their vital *** investigated whether such hemodynamic alterations were temporally and causally related to drug *** In a university pediatric intensive care unit,we retrospectively analyzed hemodynamic alterations defined as values exceeding the limits set for heart rate(HR)and blood pressure(BP).For causality assessment,we used the World Health Organization–Uppsala Monitoring Center(WHO–UMC)system,which categorizes the probability of causality as“certain,”“probable,”“possible,”and“unlikely.”Results Of 315 analyzed patients with 43,200 drug prescriptions,59.7%experienced at least one hemodynamic alteration;39.0%were affected by increased HR,19.0%by decreased HR,18.1%by increased BP,and 16.2%by decreased *** to drug information databases,83.9%of administered drugs potentially lead to hemodynamic ***,88.3%of the observed hemodynamic alterations had a temporal relation to the administration of drugs;in 80.2%,more than one drug was *** on the WHO–UMC system,a drug was rated as a“probable”causing factor for only 1.4%of hemodynamic *** the remaining alterations,the probability ratings were lower because of multiple potential causes,e.g.,several *** Critically ill children were frequently affected by hemodynamic *** administration of drugs with potentially adverse effects on hemodynamic parameters is often temporally related to hemodynamic *** alterations are often multifactorial,e.g.,due to administering multiple drugs in rapid succession;thus,the influence of individual drugs cannot easily be captured with the WHO–UMC system.

关键词： Adverse drug reaction Drug therapy Hemodynamic monitoring Multifactorial causality Pediatric intensive care unit

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Food quality and safety progress in the Brazilian food and beverage industry:chemical hazards

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Food Quality and Safety 2017年第2期1卷 117-129页

作者： Adriana Pavesi Arisseto-Bragotto Maria manuela Camino Feltes Jane Mara Block Department of Food Science State University of Campinas-UNICAMPRua Monteiro LobatoCampinas-SPBrazil Department of Food Science and Technology Federal University of Santa Catarina-UFSCRod.Admar GonzagaFlorianópolis-SCBrazil

INTRODUCTION:Ensuring food safety is a challenge for developed and developing countries and depends on the combined efforts of government,regulators,academia,consumers,food producers,and ***:In this work,an overview of the main regulatory aspects related to chemical hazards in the Brazilian food and beverage industry is *** presence of contaminants,food additives,and residues of pesticides and veterinary drugs,including current regulations and their impacts on the safety and quality of locally produced foods,are ***:In Brazil,the assessment,management,and communication of human health risks in food and beverage are the joint responsibility of the Ministry of Health and the Ministry of Agriculture,Livestock and Food Supply,which enforce the international regulations established mainly by the Codex Alimentarius Commission,the European Commission,and the US Food and Drug ***:Constant updates of the national legislation following internationally recognized standards,the intensification of the existing monitoring plans and efficient actions of sanitary surveillance,major investments in scientific research,and a greater awareness among the food producers may contribute to the safety and quality of the food produced in Brazil.

关键词： Food safety Regulation Food and beverage Industry Health risks Chemical contamination.

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Impact of simulated in vitro gastrointestinal digestion on bioactive compounds,bioactivity and cytotoxicity of melon (Cucumis melo L. inodorus) peel juice powder

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Food Bioscience 2022年第3期47卷 1358-1367页

作者： Ricardo Gómez-García Ana A.Vilas-Boas manuela Machado Débora A.Campos Cristóbal N.Aguilar Ana R.Madureira manuela Pintado Universidade Católica Portuguesa CBQF-Centro de Biotecnologia e Química Fina – Laboratório AssociadoEscola Superior de BiotecnologiaRua Diogo Botelho 13274169-005PortoPortugal BBG-DIA.Bioprocesses and Bioproducts Group.Food Research Department School of ChemistryAutonomous University of CoahuilaSaltilloCoahuilaMexico

The objectives of this research work were to evaluate the effect of in vitro gastrointestinal digestion (GIT) on melon peel juice (MPJ) powder from fruit processing industry by-products,considering (i) the recovery and accessibility indexes,(ii) the changes on antioxidant activity,and (iii) the prebiotic *** exposition to GIT conditions a decrease on the total phenolic content (TPC = 65.31%) and antioxidant activity by ABTS = 39.77% and DPPH = 45.91% were ***,these both parameters exhibited stable accessibility,accounting with 81.89%,76.55%,and 54.07% for TPC,ABTS and DPPH,*** gastrointestinal digestion,the non-absorbed fraction exhibited a positive impact on the growth of Bifidobacterium and Lactobacillus strains,possibly associated with the high content of simple sugar (glucose and fructose).This fraction also showed to be safe on Caco-2 intestinal *** findings suggest that MPJ might be used as a potential food functional ingredient.

关键词： Melon by-products Functional ingredients Phenolic antioxidants Simulated digestion Prebiotic effect

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Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice

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World Journal of Gastroenterology 2008年第17期14卷 2757-2762页

作者： Stefania Angeloni Cinzia Leboffe Antonella Parente Mario Venditti Alessandra Giordano manuela Merli Oliviero Riggio Department of Clinical Medicine "Sapienza" University of Rome Department of Public Health "Sapienza" University of Rome

AIM： To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis （SBP） in clinical practice. METHODS： All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study. SBP was diagnosed when the ascitic fluid polymorphonuclear （PIN） cell count was 〉 250 cells/mm^3, and empirically treated with cefotaxime. RESULTS： Thirty-eight SBP episodes occurred in 32 cirrhotics （22 men/20 women; mean age： 58.6 ＋ 22.2 years）. Prevalence of SBP, in our population, was 27%. Ascitic fluid culture was positive in nine （24%） cases only. Eleven episodes were nosocomial and 71% community-acquired. Treatment with cefotaxime was successful in 59% of cases, while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h. Change of antibiotic therapy led to the resolution of infection in 87% of episodes. Among the cases with positive culture, the initial antibiotic therapy with cefotaxime failed at a percentage （44%） similar to that of the whole series. In these cases, the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime. CONCLUSION： In clinical practice, ascitic PMN count is a valid tool for starting a prompt antibiotic treatment andevaluating its efficacy. The initial treatment with cefotaxime failed more frequently than expected. An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding. A different first-line antibiotic treatment should be investigated.

关键词： Spontaneous bacterial peritonitis Cefotaxi-me Antibiotic-resistant pathogens Ascitic polymorpho-nuclear count Cirrhosis

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Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis

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World Journal of Gastroenterology 2008年第37期14卷 5689-5694页

作者： Oliviero Riggio Stefania Angeloni Antonella Parente Cinzia Leboffe Giorgio Pinto Teresa Aronne manuela Merli Department of Clinical Medicine "Sapienza" University of RomeRome 00185 Italy

AIM： To evaluate the accuracy of automated blood cell counters for ascitic polymorphonuclear （PMN） determination for：（1） diagnosis, （2） efficacy of the ongoing antibiotic therapy, and （3） resolution of spontaneous bacterial peritonitis （SBP）. METHODS： One hundred and twelve ascitic fluid samples were collected from 52 consecutive cirrhotic patients, 16 of them with SBP. The agreement between the manual and the automated method for PMN count was assessed. The sensitivity/specificity and the positive/negative predictive value of the automated blood cell counter were also calculated by considering the manual method as the ＂gold standard＂ RESULTS： The mean ＋ SD of the difference between manual and automated measurements was 7.8 4- 58 cells/ram3, while the limits of agreement were ＋124 cells/mm3 [95% confidence interval （CI）：＋145 to ＋103] and -108 cells/mm3 （95% CI： -87 to -129）. The automated cell counter had a sensitivity of 100% and a specificity of 97.7% in diagnosing SBP, and a sensitivity of 91% and a specificity of 100% for the efficacy of the ongoing antibiotic therapy. The two methods showed a complete agreement for the resolution of infection. CONCLUSION： Automated cell counters not only have a good diagnostic accuracy, but are also very effectivein monitoring the antibiotic treatment in patients with SBP. Because of their quicker performance, they should replace the manual counting for PMN determination in the ascitic fluid of patients with SBP.

关键词： Spontaneous bacterial peritonitis Ascites Polymorphonuclear cell count Automated cell counter Paracentesis Cirrhosis

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Gastrointestinal motility disorders in inflammatory bowel diseases

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World Journal of Gastroenterology 2014年第1期20卷 37-44页

作者： Gabrio Bassotti Elisabetta Antonelli Vincenzo Villanacci Marianna Salemme manuela Coppola Vito Annese Gastroenterology and Hepatology Section Department of Clinical and Experimental MedicineUniversity of Perugia06156 PerugiaItaly Second Pathology Section Spedali Civili of Brescia25100 BresciaItaly Gastroenterology Unit Careggi University Hospital50134 FlorenceItaly

The relationship between motility and inflammatory gastrointestinal disorders is at the same time complex and intriguing since these conditions might share some genetic, environmental, immunological and microbial predisposing factors. In addition, significant symptom overlapping may occur, muddling the waters within the clinical context. Although on one hand this represents a challenge for the clinician for a potential under- or over-treatment and diagnostic delay, on the other hand it possibly represents an opportunity for the researcher to better disclose the intimate relationship between chronic (often low-grade) inflammation, motor disorders and deranged sensory function. The best example is probably represented by Crohn’s disease and ulcerative colitis. In fact, a number of gastrointestinal motor disorders have been described in association with these diseases, disorders which span from the esophagus to the anorectum, and which will be extensively covered in this review. It is conceivable that at least part of this derangement is strictly related to inflammatory cytokine trafficking and neuromuscular changes; however, given the high prevalence of functional gastrointestinal disorders in the general population, this overlap might also be serendipitous. However, it is worth noting that literature data on this topic are relatively scarce, sometimes quite outdated, and mostly focused on the interplay between irritable bowel syndrome and inflammatory bowel disease. Nevertheless, both researchers and clinicians must be aware that symptoms related to gastrointestinal motility disorders may be highly prevalent in both active and inactive inflammatory bowel disease, correlate with greater psychological comorbidity and poorer quality of life, and may negatively influence the therapeutic approaches.

关键词： Crohn’ s disease, Gastrointestinal motility disorders, Gut, Inflammatory bowel diseases, Perception, Ulcerative colitis

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Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis:A comparative study

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World Journal of Gastroenterology 2010年第38期16卷 4832-4837页

作者： Ioan Sporea Roxana Sirli Alexandra Deleanu Adriana Tudora Alina Popescu manuela Curescu Simona Bota Department of Gastroenterology and Hepatology University of Medicine and Pharmacy(Timisoara) Department of Infectious Diseases University of Medicine and Pharmacy(Timisoara)

AIM:To assess the values of liver stiffness (LS) in pa-tients with hepatitis B virus (HBV) chronic hepatitis and to compare them with those in patients with hepatitis C virus (HCV) chronic hepatitis. METHODS: The study included 140 patients with HBV chronic hepatitis, and 317 patients with HCV chronic hepatitis, in which LS was measured (FibroScan-Echo-sens) and liver biopsy was performed in the same session (assessed according to the Metavir score). RESULTS:According to the Metavir score of the 140 HBV patients: one had F0,32 had F1, 67 had F2,33 had F3 and 7 had F4. Of the 317 HCV patients:5 had F0, 34 had F1, 146 had F2, 93 had F3 and 39 had F4. For the same severity of fibrosis, the mean values of LS in HBV patients were similar to those in HCV patients:F1,6.5±1.9 kPa vs 5.8±2.1 kPa (P=0.0889); F2,7.1±2 kPa vs 6.9±2.5 kPa (P = 0.3369); F3,9.1±3.6 kPa vs 9.9±5 kPa (P=0.7038); F4,19.8± 8.6 kPa vs 17.3±6.1 kPa (P=0.6574). A signif icant direct correlation between LS measurements and fibrosis was found in HCV patients (Spearman’s r=0.578, P<0.0001), as well as in HBV patients (r=0.408, P<0.0001). The correlation was more signif icant in HCV than in HBV patients (Fisher’s Z-test,Z= 2.210,P=0.0271). CONCLUSION:In our group, the mean values of LS in patients with chronic B hepatitis were similar to those in patients with chronic HCV hepatitis, for the same stage of f ibrosis. Also, LS was correlated with the severity of fibrosis both in HBV and HCV chronic hepatitis patients.

关键词： Chronic B hepatitis Chronic C hepatitis Fibrosis Transient elastography Liver biopsy

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Comparison of outcomes between early and delayed weight bearing following lower limb free flaps:an 18-month single-center study

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Plastic and Aesthetic Research 2023年第1期10卷 656-662页

作者： Majid Al-Khalil manuela Roman Ahmed Emam Nicholas Marsden Welsh Centre for Burns&Plastic Surgery Morriston HospitalSwansea SA66NLUnited Kingdom Major Trauma Centre University Hospital of WalesCardiff CF144XWUnited Kingdom

Aim:Post-operative protocols following lower limb free flap surgery are not well defined,with a lack of consensus in the literature around limb dependency and weight *** aim was to compare the complication rate for lower limb free flaps before and after the introduction of an enhanced lower limb free flap protocol with earlier dangling(day 3 *** 4)and weight bearing(day 5 *** 14)post lower limb free flap ***:All lower limb free flaps between June 2020-January 2022 were identified from a departmental flap *** data were collected from the comprehensive lower limb free flap database,medical notes,and electronic *** prescribed an extended non-weight-bearing period due to the method of bone fixation were ***:A total of 37 patients,15 pre-and 22 post-enhanced protocol,were identified for *** mean age was 43(17-72)with a M:F of 3:*** was no difference in the type of flap reconstruction between groups,with the anterolateral thigh flap being the most common in both *** differences were identified in the number of complications related to dependency/weight bearing before and after the introduction of the enhanced protocol,with the mean length of stay reduced from 12.1 to 10.6 days(P=0.34).Conclusion:The new enhanced protocol remains the standard of care in our unit,as we demonstrated a reduction in length of stay with no difference in complication rates following early weight bearing after lower limb free flap surgery.

关键词： Lower limb reconstruction free flap free tissue transfer weight bearing post-operative complications

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From landslide characterization to nature reserve management:The“Scialimata Grande di Torre Alfina”landslide Geosite(Central Apennines,Italy)

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山地科学学报（英文） 2023年第3期20卷 585-606页

作者： Gianluca TRONTI Francesca VERGARI Irene Maria BOLLATI Filippo BELISARIO Maurizio DELMONTE manuela PELFINI Paola FREDI Earth Sciences Department"Ardito Desio" University La StataleMilan 20133(MI)Italy Monte Rufeno Nature Reserve Acquapendente 01021(VT)Italy Earth Sciences Department University La SapienzaRome 00185(RM)Italy

Italy is characterized by widespread geomorphological instability,among which landslides leave impressive marks on the ***,landslide bodies may represent key sites for thematic and educational itineraries,especially in protected areas,where their management becomes an important *** study focuses on the"Monte Rufeno Nature Reserve"(Central Apennines,Italy),where iconic landslides are ***,the"Scialimata Grande di Torre Alfina"landslide(SGTA)is listed in the regional Geosite *** work aims to propose a multiscale procedure for landslide analysis,in terms of both hazard sources but also educational and geoheritage enhancement opportunities in natural *** performing a Landslide Susceptibility conditional Analysis(LSA)for the reserve territory,attention was focused on the SGTA,to define properly its features and morphodynamics.A multi-disciplinary approach was adopted,by applying both remote sensing(UAV structure from motion,Photointerpretation)and field survey(geomorphological and GPS monitoring).From the LSA,based on drainage density,curvature,and slope triggering factors,the road and trail susceptibility maps were derived,as base tools for future risk assessments and trail paths management within the *** the SGTA scale,the monitoring showed a displacement of up to 23 m during the time interval between 2015 and *** landslide dynamics seem to be driven by alternating dry and extremely wet periods;moreover,leaks from the aqueduct in the detachment area and piping effects through clays may have also decreased the substrate *** SGTA complex influence on the Paglia River valley geometry was also hypothesized,underlining the action of landslide through different spatial scales(on-site and off-site)and on different environment features(sediment connectivity,hydrology).Finally,the SGTA appears highly representative of the geomorphic dynamics within the Nature Reserve(i.e.,scientific value)and it could be

关键词： Landslides Geoheritage Geosites Nature reserves management UAV structure from motion Landslides conditional analyses

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Optical properties of titanium oxide films obtained by cathodic arc plasma deposition

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Plasma Science and Technology 2017年第12期19卷 111-118页

作者： Vukoman JOKANOVIC Bozana COLOVIC Anka TRAJKOVSKA PETKOSKA Ana MRAKOVIC Bojan JOKANOVIC Milo NENADOVIC manuela FERRARA llija NASOV Vinca Institute of Nuclear Sciences University of BelgradeMike Petrovica Alasa 12-1411001 BelgradeSerbia ALBOS Doo Orahovacka 1911000 BelgradeSerbia University St Kliment Ohridski Faculty of Technology and Technical SciencesVelesR.Macedonia4 GL groupWemer-von-Siemens-Straβe86405 MetingenGermany GL group Wemer-von-Siemens-Straβe86405 MetingenGermany TE-STT-SCIS Laboratorio Sviluppo Componenti ed Impianti SolariPiazzale Enrico Fermi 180055Porfici(NA)Italia Plasma Doo 29 November 66/91000 SkopjeR.Macedonia

Structural and optical properties of nanometric titanium oxide（TixOy） films obtained by cathodic arc plasma deposition were investigated. Phase analysis by x-ray diffraction and Fouriertransform infrared spectroscopy showed the presence of anatase, rutile, Ti_2O_3, Ti_4O_7 and amorphous phases. Scanning electron microscopy images showed well-developed surface morphology with nano-patterns. Spectroscopic ellipsometry revealed film thicknesses of 53 and50 nm, variable refractive indices dependent on the light wavelength and close to zero extinction coefficients for wavelengths higher than 500 nm. On the basis of ultraviolet–visible spectroscopy data and using the Tauc equation, band gap values for direct and indirect electron transitions were determined.

关键词： optical materials plasma deposition thin films ellipsometry

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