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Flow diversion covering the M1 origin as a last resort

Stroke & Vascular Neurology 2019年第3期4卷 141-147页

作者： Li-Mei Lin Matthew T Bender Geoffrey P Colby Bowen Jiang Jessica K Campos david A Zarrin Robert W C Young Risheng Xu Justin M Caplan Judy Huang rafael J Tamargo Alexander L Coon Department of Neurosurgery University of California IrvineOrangeCaliforniaUSA Department of Neurosurgery Johns Hopkins University School of MedicineBaltimoreMarylandUSA Department of Neurosurgery University of California Los AngelesLos AngelesCaliforniaUSA

Introduction Internal carotid artery termination(ICAT)and proximal A1 aneurysms can be challenging for open surgical clipping or endovascular *** with flow diversion covering the middle cerebral artery(MCA),an end vessel supplying a terminal circulation,has not been *** A prospective,Institutional Review Board-approved database was analysed for patients with pipeline embolisation device(PED)placement from the anterior cerebral artery(ACA)to the ICA during cerebral aneurysm *** Nine cases were identified,including five proximal A1,three posterior communicating artery and one ICAT aneurysm *** aneurysm size was 8.3 mm(range 3-17),with 67%saccular and 78%*** indication for treatment was significant dome irregularity(44%),recurrence or enlargement(33%),underlying collagen vascular disorder(11%)and traumatic pseudoaneurysm(11%).Preservation of the ipsilateral ACA(with PED placed in A1)was performed when the anterior communicating artery(67%)or contralateral A1(33%)were absent on *** coiling was done in four cases(44%).There was one major stroke leading to mortality(11%)and one minor stroke(11%).Clinical follow-up was 27 months on ***-up digital subtraction angiography(average interval 15 months)showed complete aneurysm obliteration(88%)or dome occlusion with entry remnant(12%).The jailed MCA showed minimal or mild delay(primarily anterograde flow)in 75%of cases and significant delay(reliance primarily on ACA and external carotid artery collaterals)in 25%.Conclusions Covering the MCA with a flow diverting stent should be reserved for select rare *** attention to blood pressure augmentation during the periprocedural period is necessary to minimise potential ischaemic compromise.

关键词： primarily resort sided

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Influence of cirrhosis in cardiac surgery outcomes

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World Journal of Hepatology 2015年第5期7卷 753-760页

作者： Juan C Lopez-Delgado Francisco Esteve Casimiro Javierre Josep L Ventura rafael Maez Elisabet Farrero Herminia Torrado david Rodríguez-Castro Maria L Carrio Intensive Care Department Hospital Universitari de BellvitgeIDIBELL (Institut d’Investigació Biomèdica BellvitgeBiomedical Investigation Institute of Bellvitge) Physiological Sciences Ⅱ Department Universitat de BarcelonaIDIBELL (Institut d’Investigació Biomèdica BellvitgeBiomedical Investigation Institute of Bellvitge)

Liver cirrhosis has evolved an important risk factor for cardiac surgery due to the higher morbidity and mortality that these patients may suffer compared with general cardiac surgery *** presence of contributing factors for a poor outcome,such as coagulopathy,a poor nutritional status,an adaptive immune dysfunction,a degree of cirrhotic cardiomyopathy,and a degree of renal and pulmonary dysfunction,have to be taken into account for surgical evaluation when cardiac surgery is needed,together with the degree of liver disease and its primary *** associated pathophysiological characteristics that liver cirrhosis represents have a great influence in the development of complications during cardiac surgery and the postoperative *** the population of cirrhotic patients who are referred for cardiac surgery is small and recommendations come from small series,since liver cirrhotic patients have increased their chance of survival in the last 20 years due to the advances in their medical care,which includes liver transplantation,they have been increasingly considered for cardiac ***,there is an expected rise of cirrhotic patients within the cardiac surgical population due to the increasing rates of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis,especially in western *** consequence,a more specific approach is needed in the assessment of care of these patients if we want to improve their *** this article,we review the pathophysiology and outcome prediction of cirrhotic patients who underwent cardiac surgery.

关键词： Liver cirrhosis Cardiac surgery Outcomes Coagulopathy Nutritional status Adaptive immunedysfunction Cirrhotic cardiomyopathy

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Analysis of Contributions to NO<sub>2</sub>Ambient Air Quality Levels in Madrid City (Spain) through Modeling. Implications for the Development of Policies and Air Quality Monitoring

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Journal of Geoscience and Environment Protection 2014年第1期2卷 6-11页

作者： rafael Borge david de la Paz Julio Lumbreras Javier Pérez Michel Vedrenne Laboratory of Environmental Modelling Technical University of Madrid (UPM) Spain

As environmental standards become more stringent (e.g. European Directive 2008/50/EC), more reliable and sophisticated modeling tools are needed to simulate measures and plans that may effectively tackle air quality exceedances, common in large cities across Europe, particularly for NO2. Modeling air quality in urban areas is rather complex since observed concentration values are a consequence of the interaction of multiple sources and processes that involve a wide range of spatial and temporal scales. Besides a consistent and robust multi-scale modeling system, comprehensive and flexible emission inventories are needed. This paper discusses the application of the WRF-SMOKE-CMAQ system to the Madrid city (Spain) to assess the contribution of the main emitting sectors in the region. A detailed emission inventory was compiled for this purpose. This inventory relies on bottom-up methods for the most important sources. It is coupled with the regional traffic model and it makes use of an extensive database of industrial, commercial and residential combustion plants. Less relevant sources are downscaled from national or regional inventories. This paper reports the methodology and main results of the source apportionment study performed to understand the origin of pollution (main sectors and geographical areas) and define clear targets for the abatement strategy. Finally the structure of the air quality monitoring is analyzed and discussed to identify options to improve the monitoring strategy not only in the Madrid city but the whole metropolitan area.

关键词： Air Quality Modeling Source Apportionment NO2 CMAQ Urban Air Quality Madrid

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Cost-Effectiveness of Somatostatin Analogues for the Treatment of Acromegaly in Colombia

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Open Journal of Endocrine and Metabolic Diseases 2012年第4期2卷 102-106页

作者： rafael Alfonso-Cristancho Santiago Herran Diazgranados Kariluz Maestre Martinez Oscar david Diaz-Sotelo Novartis de Colombia Rafael Alfonso SA Pharmaceutical Outcomes Research and Policy Program University of Washington Seattle USA RANDOM Foundation Bogotá Colombia

Background: Somatostatin analogues have shown to be effective in controlling the levels of growth hormone and are recommended for the treatment of acromegaly. These treatments have high costs of acquisition and their use might be restricted in limited resource settings. Objective: To evaluate the cost-effectiveness of somatostatin analogues for acromegaly in Colombia. Setting/Subjects/Intervention: A decision model was developed using a hypothetical cohort of patients with Acromegaly. Patients were treated according to the clinical practice of the country. Response to treatment and transition probabilities were derived from published literature. Costs and resource utilization were extracted from public and private sources in Colombia. Main Outcome Measure(s): Cost-effectiveness ratio, measured in Colombian pesos in a 2 year time-horizon. Results: The total medical treatment costs for the octreotide group were (Colombian Pesos) COP$ 53,807,616, compared to the total costs for the lanreotide group of COP$ 83,126,567. In the octreotide arm 65.30% of the patients and in the lanreotide arm 59.50% of the patients were successfully controlled. The number of deaths was 295 (13.1%) and 302 (13.4%) for octreotide and lanreotide, respectively. Because the costs are lower and the effectiveness is higher for octreotide in comparison with lanreotide, octreotide is more cost-effective than lanreotide. Probabilistic sensitivity analyses were consistent showing octreotide as the most cost-effective option. Conclusions: Costs and effects of octreotide compare favorably to those of lanreotide in the treatment of acromegaly in Colombia. Sensitivity analysis showed that despite the uncertainty in cost-effectiveness ratio this result is robust.

关键词： Acromegaly Somatostatin Analogues Octeotride Lanreotide Cost-Effectiveness

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Thermo-mechanical dynamics of nanoimprinting anti-reflective structures onto small-core mid-IR chalcogenide fibers [Invited]

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Chinese Optics Letters 2021年第3期19卷 46-52页

作者： Christian R.Petersen Mikkel B.Lotz Christos Markos Getinet Woyessa david Furniss Angela B.Seddon rafael J.Taboryski O.Bang DTU Fotonik Technical University of DenmarkDK-2800 Kgs.LyngbyDenmark DTU Nanolab Technical University of DenmarkDK-2800 Kgs.LyngbyDenmark NORBLIS DK-2830 VirumDenmark Mid-Infrared Photonics Group University of NottinghamNottingham NG72RDUK NKT Photonics DK-3460 Bi「ke「0dDenmark

Thermal nanoimprinting is a fast and versatile method for transferring the anti-reflective properties of subwavelength nanostructures onto the surface of highly reflective substrates, such as chalcogenide glass optical fiber end faces. In this paper, the technique is explored experimentally on a range of different types of commercial and custom-drawn optical fibers to evaluate the influence of geometric design, core/cladding material, and thermo-mechanical properties. Up to32.4% increased transmission and 88.3% total transmission are demonstrated in the 2–4.3 μm band using a mid-infrared(IR) supercontinuum laser.

关键词： nanoimprint lithography anti-reflection hot imprint chalcogenide glass optical fiber mid-infrared supercontinuum

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Detection of hyper-conserved regions in hepatitis B virus X gene potentially useful for gene therapy

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World Journal of Gastroenterology 2018年第19期24卷 2095-2107页

作者： Carolina González david Tabernero Maria Francesca Cortese Josep Gregori Rosario Casillas Mar Riveiro-Barciela Cristina Godoy Sara Sopena Ariadna Rando Marcal Yll Rosa Lopez-Martinez Josep Quer rafael Esteban Maria Buti Francisco Rodríguez-Frías Liver Pathology Unit Departments of Biochemistry and MicrobiologyHospital Universitari Vall d’HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain Liver Unit Liver Disease Laboratory-Viral HepatitisVall d’Hebron Institut Recerca-Hospital Universitari Vall d’HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas(CIBERehd) Instituto de Salud Carlos IIIMadrid 28029Spain Roche Diagnostics SL Sant Cugat del Vallès 08174Spain Liver Unit Department of Internal MedicineHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain

AIM To detect hyper-conserved regions in the hepatitis B virus(HBV) X gene(HBX) 5' region that could be candidates for gene *** The study included 27 chronic hepatitis B treatmentnaive patients in various clinical stages(from chronic infection to cirrhosis and hepatocellular carcinoma, both HBeA g-negative and HBeA g-positive), and infected with HBV genotypes A-F and H. In a serum sample from each patient with viremia > 3.5 log IU/m L, the HBX 5' end region [nucleotide(nt) 1255-1611] was PCRamplified and submitted to next-generation sequencing(NGS). We assessed genotype variants by phylogenetic analysis, and evaluated conservation of this region by calculating the information content of each nucleotide position in a multiple alignment of all unique sequences(haplotypes) obtained by NGS. Conservation at the HBx protein amino acid(aa) level was also *** NGS yielded 1333069 sequences from the 27 samples, with a median of 4578 sequences/sample(2487-9279, IQR 2817). In 14/27 patients(51.8%), phylogenetic analysis of viral nucleotide haplotypes showed a complex mixture of genotypic variants. Analysis of the information content in the haplotype multiple alignments detected 2 hyper-conserved nucleotide regions, one in the HBX upstream non-coding region(nt 1255-1286) and the other in the 5' end coding region(nt 1519-1603). This last region coded for a conserved amino acid region(aa 63-76) that partially overlaps a Kunitz-like *** Two hyper-conserved regions detected in the HBX 5' end may be of value for targeted gene therapy, regardless of the patients' clinical stage or HBV genotype.

关键词： Hepatitis B virus Hepatitis B X gene Hepatitis B X protein Gene therapy Next-generation sequencing HBV conserved regions Small interference RNA

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ME0X1: a novel druggable target that orchestrates the activation of fibroblasts in cardiac fibrosis

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Signal Transduction and Targeted Therapy 2022年第1期7卷 19-21页

作者： david Schumacher Fabian Peisker rafael Kramann nstitute of Experimental Medicine and Systems Biology University Hospital AachenRWTH Aachen UniversityAachenGermany Department of Anesthesiology University Hospital AachenRWTH Aachen UniversityAachenGermany Department of Internal Medicine Erasmus Medical CenterErasmus UniversityRotterdamThe Netherlands Department of Nephrology and Clinical Immunology University Hospital AachenRWTH Aachen UniversityAachenGermany

Sin gle-cell genomic tech no logy has bee n used to ide ntify MEOX1 as a potential cell-specific,druggable target in cardiac *** this effect,a Iandmark study was recently published in Nature by Alexanian and colleagues.^(1) Fibrosis is a comm on resp onse to chronic repetitive injury to vital organs and considered an important therapeutic target to slow dow n,in hi bit,or reverse progressio n of orga n *** there is broad interest in developing novel antifibrotic therapeutics,currently,only nintedanib and pirfenidone have been approved to treat fibrosis for one disease entity;idiopathic pulmonary fibrosis.^(2)

关键词： cardiac organs drug

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Quality of monkeypox information in Wikipedia across multiple languages

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Asian Pacific Journal of Tropical Medicine 2022年第12期15卷 571-572页

作者： Eric david B.Ornos Jared Gabriel L.Dela Rosa Jea Giezl N.Solidum Jervy P.Garcia Erika P.Ong rafael Lorenzo G Valenzuela Ourlad Alzeus G.Tantengco College of Medicine University of the Philippines ManilaErmitaManilaPhilippines Department of Family and Community Medicine Eastern Visayas Medical CenterTacloban CityPhilippines

In recent years,the Internet has become the primary source of health information for the general population,which may be attributed to improvements in digital technology and Internet accessibility[1].Since the World Health Organization declared the coronavirus disease (COVID-19) as a pandemic in March 2020[2],digital information has gained more importance,as seen through the rapid growth in the number of people searching online[3].As seen from previous infectious disease outbreaks,the recent increase in monkeypox cases might compel individuals worldwide to broaden their searches for relevant virtual health information[3,4].

关键词： Wikipedia individual online

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AndroidCare: A Simple and Low Cost Assisted Living Solution

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Journal of Biomedical Science and Engineering 2016年第10期9卷 20-28页

作者： Abraham Otero Alejandro Escario david G. Márquez Gabriel Caffarena Rodrigo García-Carmona Ana Iriarte rafael Raya Department of Information Systems Engineering University San Pablo CEU Madrid Spain

Population aging places a growing stress on society’s resources. There is a need for Assisted Living (AL) technologies that allow the elderly to live independently as long as possible. The AndroidCare open source project aims to explore what functionality can be provided in a low cost AL solution where no professional health organization is involved in the deployment or maintenance of the solution, nor in supervising the pa-tient;all these tasks are carried out by a relative of the elder. Therefore, in the system’s design simplicity of use has prevailed over having a lot of features. It is based on stan-dard off-the-shell commodity hardware (a smartphone) and it provides 1) assistance to the elder in complying with the treatment of chronic diseases;2) monitors and alerts of the occurrence of risk situations such as falls;and 3) simplifies the supervision of the elder’s therapy and behavior by the caregiver.

关键词： Assisted Living Aging Chronic Diseases Behavior Monitoring

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Characterization of hepatitis B virus X gene quasispecies complexity in mono-infection and hepatitis delta virus superinfection

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World Journal of Gastroenterology 2019年第13期25卷 1566-1579页

作者： Cristina Godoy david Tabernero Sara Sopena Josep Gregori Maria Francesca Cortese Carolina González Rosario Casillas Mar?al Yll Ariadna Rando Rosa López-Martínez Josep Quer Gloria González-Aseguinolaza rafael Esteban Mar Riveiro-Barciela Maria Buti Francisco Rodríguez-Frías Liver Pathology Unit Departments of Biochemistry and Microbiology Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona Liver Unit Liver Disease Laboratory-Viral Hepatitis Vall d’Hebron Institut Recerca-Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Instituto de Salud Carlos Ⅲ Roche Diagnostics SL Centro de Investigación Médica Aplicada (CIMA) Universidad de Navarra Liver Unit Department of Internal MedicineHospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona (UAB)

Hepatitis delta virus(HDV) seems to strongly suppress hepatitis B virus(HBV)replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution of mutants, resulting in viral quasispecies. Next-generation sequencing is a viable approach for analyzing the composition of these mutant spectra. As the regulatory hepatitis B X protein(HBx) is essential for HBV replication, determination of HBV X gene(HBX)quasispecies complexity in HBV/HDV infection compared to HBV monoinfection may provide information on the interactions between these two *** To compare HBV quasispecies complexity in the HBX 5' region between chronic hepatitis delta(CHD) and chronic HBV mono-infected *** Twenty-four untreated patients were included: 7/24(29.2%) with HBeAgnegative chronic HBV infection(CI, previously termed inactive carriers), 8/24(33.3%) with HBeAg-negative chronic hepatitis B(CHB) and 9/24(37.5%) with CHD. A serum sample from each patient was first tested for HBV DNA *** HBX 5' region [nucleotides(nt) 1255-1611] was then PCR-amplified for subsequent next-generation sequencing(MiSeq, Illumina, United States). HBV quasispecies complexity in the region analyzed was evaluated using incidencebased indices(number of haplotypes and number of mutations), abundancebased indices(Hill numbers of order 1 and 2), and functional indices(mutation frequency and nucleotide diversity). We also evaluated the pattern of nucleotide changes to investigate which of them could be the cause of the quasispecies *** CHB patients showed higher median HBV-DNA levels [5.4 logIU/mL,interquartile range(IQR) 3.5-7.9] than CHD(3.4 logIU/mL, IQR 3-7.6)(P = n.s.)or CI(3.2 logIU/mL, IQR 2.3-3.5)(P < 0.01) patients. The incidence and abundance indices indicated that HBV quasispecies complexity was significantly greater in CI than CHB. A similar trend was observed in CHD patients, although only Hill numbers of order 2 showed

关键词： Hepatitis B virus Hepatitis delta virus Hepatitis B X gene Next-generation sequencing Viral quasispecies Hepatitis B virus-hepatitis delta virus interaction

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