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Timing of surgery in Crohn’s disease: A key issue in the management

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World Journal of Gastroenterology 2008年第36期14卷 5532-5539页

作者： rafael Alós Joaquín Hinojosa Servicio de Cirugía General Unidad de Coloproctología Hospital de Sagunto Valencia Spain Unidad de Digestivo Servicio de Medicina Interna Hospital de Sagunto Valencia Spain

The timing of the decision for operation in Crohn’s disease is based on an evaluation of the several factors such as the failure of medical treatment, complications due to the Crohn’s disease or to the farmacological therapy, development of dysplasia or cancer and growth retardation. A complete evaluation of these factors should result in operation timed to the patient’s best advantage, achieving maximal relief of symptoms with improvement of quality of life. Given the complexity and heterogeneity of the disease and the different options for treatment, is difficult to systematize when the optimal moment for the surgery is arrived. A very important factor in the management of Crohn’s disease is the multidisciplinary approach and the patient preference should be a significant factor in determining the choice of therapy. The surgery should be considered such another option in the sequential treatment of Crohn’s disease. We have analyzed the factors that are involved in the decision taking of the surgical treatment regarding to the experience and the published literature. When did the medical therapy fail? when is the appropriate moment to operate on the patient? Or which complications of Crohn’s disease need a surgery? These are some of the questions we will try to answer.

关键词： Crohn's disease Surgical treatment Medical therapy

Coarse-graining auto-encoders for molecular dynamics

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npj Computational Materials 2019年第1期5卷 48-56页

作者： Wujie Wang rafael Gómez-Bombarelli Department of Materials Science and Engineering Massachusets Institute of Technology77 Massachusetts AvenueCambridgeMA 02319USA

Molecular dynamics simulations provide theoretical insight into the microscopic behavior of condensed-phase materials and,as a predictive tool,enable computational design of new ***,because of the large spatial and temporal scales of thermodynamic and kinetic phenomena in materials,atomistic simulations are often computationally ***-graining methods allow larger systems to be simulated by reducing their dimensionality,propagating longer timesteps,and averaging out fast ***-graining involves two coupled learning problems:defining the mapping from an all-atom representation to a reduced representation,and parameterizing a Hamiltonian over coarse-grained *** propose a generative modeling framework based on variational auto-encoders to unify the tasks of learning discrete coarse-grained variables,decoding back to atomistic detail,and parameterizing coarse-grained force *** framework is tested on a number of model systems including single molecules and bulk-phase periodic simulations.

关键词： dynamics representation steps

Three-dimensional seismic face stability of shield tunnels inundrained clay

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Underground Space 2024年第2期15卷 26-43页

作者： Milad Davoodi Salvador Senent Amin Keshavarz rafael Jimenez Civil Engineering Department School of EngineeringPersian Gulf UniversityBushehr ***Iran Universidad Politecnica de Madrid C/Prof.Aranguren s/nMadrid 28040Spain

Tunnel face stability has received increasing research interest over the past few decades. However, computing time-efficient and safethree-dimensional solutions under seismic loading is still an unsolved problem, while case studies indicate that seismic loading can be onecritical destabilizing factor affecting tunnel stability. The primary objective of this work is to fill this gap in knowledge by providing compromisingand computationally efficient solutions, along with their respective lower and upper bounds, to compute face stability underseismic conditions. The analyses employ the finite element limit analysis method to evaluate the limit support pressure in undrained clay,considering horizontal pseudo-static seismic forces pointing outwards from the face. Moreover, the analyses employ both constant andlinearly increasing shear strengths with depth. The results are summarized as dimensionless stability charts and tables to facilitate theirinterpretation and future use for tunnel design. A new design equation has been developed to evaluate the stability of the tunnel faceconsidering the effect of seismic forces. Additionally, the effects of different parameters on the shape of the failure mechanism have beeninvestigated by analysing the distribution of shear dissipation.

关键词： Tunnel face stability Finite element limit analysis Undrained clay Seismic stability

Analysing the quality of Swiss National Forest Inventory measurements of woody species richness

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Forest Ecosystems 2020年第3期7卷 478-488页

作者： Berthold Traub rafael O.Wüest Scientific Service NFI Swiss Federal Research Institute WSLZürcherstrasse 1118903BirmensdorfSwitzerland Spatial Evolutionary Ecology Swiss Federal Research Institute WSLZürcherstrasse 1118903BirmensdorfSwitzerland

Background: Under ongoing climate and land-use change, biodiversity is continuously decreasing and monitoring biodiversity is becoming increasingly important. National Forest Inventory(NFI) programmes provide valuable timeseries data on biodiversity and thus contribute to assessments of the state and trends in biodiversity, as well as ecosystem functioning. Data quality in this context is of paramount relevance, particularly for ensuring a meaningful interpretation of changes. The Swiss NFI revisits about 8%–10% of its sample plots regularly in repeat surveys to supervise the quality of ***: We analysed the relevance of observer bias with equivalence tests, examined data quality objectives defined by the Swiss NFI instructors, and calculated the pseudo-turnover(PT) of species composition, that is, the percentage of species not observed by both teams. Three attributes of woody species richness from the latest Swiss NFI cycles(3 and 4) were analysed: occurrence of small tree and shrub species(1) on the sample plot and(2) at the forest edge, and(3) main shrub and trees species in the upper ***: We found equivalent results between regular and repeat surveys for all attributes. Data quality, however,was significantly below expectations in all cases, that is, as much as 20%–30% below the expected data quality limit of 70%–80%(proportion of observations that should not deviate from a predefined threshold). PT values were about 10%–20%, and the PT of two out of three attributes decreased significantly in NFI4. This type of uncertainty –typically caused by a mixture of overlooking and misidentifying species – should be considered carefully when interpreting change figures on species richness estimates from NFI ***: Our results provide important information on the data quality achieved in Swiss NFIs in terms of the reproducibility of the collected data. The three applied approaches proved to be effective for evaluating the quality of plot

关键词： Biodiversity Data quality Equivalence test Forest inventory Monitoring Observer agreement Richness Pseudo-turnover

Involvement of substance P and the NK-1 receptor in pancreatic cancer

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World Journal of Gastroenterology 2014年第9期20卷 2321-2334页

作者： Miguel Muoz rafael Coveas Virgen del Rocío University Hospital Research Laboratory on Neuropeptides (IBIS) 41013 Seville Spain Institute of Neurosciences of Castilla y León (INCYL) Laboratory of Neuroanatomy of the Peptidergic Systems (Lab 14) University of Salamanca 37007 Salamanca Spain

Pancreatic cancer is the fourth leading cause of cancer related-death for both men and women and the 1-and5-year relative survival rates are 25%and 6%,***,it is urgent to investigate new antitumor drugs to improve the survival of pancreatic cancer *** peptide substance P(SP)has a widespread distribution throughout the *** binding to the neurokinin-1(NK-1)receptor,SP regulates biological functions related to cancer,such as tumor cell proliferation,neoangiogenesis,the migration of tumor cells for invasion,infiltration and metastasis,and it exerts an antiapoptotic effects on tumor *** is known that the SP/NK-1 receptor system is involved in pancreatic cancer progression:(1)pancreatic cancer cells and samples express NK-1 receptors;(2)the NK-1 receptor is overexpressed in pancreatic cancer cells in comparison with non-tumor cells;(3)nanomolar concentrations of SP induce pancreatic cancer cell proliferation;(4)NK-1 receptor antagonists inhibit pancreatic cell proliferation in a concentration-dependent manner,at a certain concentration,these antagonists inhibit100%of tumor cells;(5)this antitumor action is medi-ated through the NK-1 receptor,and tumor cells die by apoptosis;and(6)NK-1 receptor antagonists inhibit angiogenesis in pancreatic cancer *** these data suggest that the SP/NK-1 receptor system could play an important role in the development of pancreatic cancer;that the NK-1 receptor could be a new promising therapeutic target in pancreatic cancer,and that NK-1 receptor antagonists could improve the treatment of pancreatic cancer.

关键词： Pancreas Substance P Neurokinin-1 receptor antagonists Apoptosis Antitumor Angiogenesis Metastasis Pancreatic cancer

Quercetin prevents spinal motor neuron degeneration induced by chronic excitotoxic stimulus by a sirtuin 1-dependent mechanism

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Translational Neurodegeneration 2017年第1期6卷 310-323页

作者： rafael Lazo-Gomez Ricardo Tapia División de Neurociencias Instituto de Fisiología CelularUniversidad Nacional Autónoma de MéxicoCircuito exterior s/nCiudad UniversitariaCoyoacán04510 Ciudad de MéxicoMexico

Background:Excitotoxicity is a mechanism of foremost importance in the selective motor neuron degeneration characteristic of motor neuron *** therapeutic strategies are an unmet need for these ***,such as quercetin and resveratrol,are plant-derived compounds that activate sirtuins(SIRTs)and have shown promising results in some models of neuronal death,although their effects have been scarcely tested in models of motor neuron ***:In this work we investigated the effects of quercetin and resveratrol in an in vivo model of excitotoxic motor neuron death induced by the chronic infusion ofα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid(AMPA)into the rat spinal cord *** and resveratrol were co-infused with AMPA and motor behavior and muscle strength were assessed daily for up to ten ***,animals were fixed and lumbar spinal cord tissue was analyzed by histological and immunocytological ***:We found that the chronic infusion of AMPA[1 mM]caused a progressive motor neuron degeneration,accompanied by astrogliosis and microgliosis,and motor deficits and paralysis of the rear *** infusion ameliorated AMPA-induced paralysis,rescued motor neurons,and prevented both astrogliosis and microgliosis,and these protective effects were prevented by EX527,a very selective SIRT1 *** contrast,neither resveratrol nor EX527 alone improved motor behavior deficits or reduced motor neuron degeneration,albeit both reduced ***:These results suggest that quercetin exerts its beneficial effects through a SIRT1-mediated mechanism,and thus SIRT1 plays an important role in excitotoxic neurodegeneration and therefore its pharmacological modulation might provide opportunities for therapy in motor neuron disorders.

关键词： Motor neuron disorder Quercetin Resveratrol Sirtuin Excitotoxicity

Immersed Boundary Approach to Biofilm Spread on Surfaces

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Communications in Computational Physics 2022年第1期31卷 257-292页

作者： Ana Carpio rafael Gonzalez-Albaladejo Departamento de Matematica Aplicada Universidad Complutense28040 MadridSpain

We propose a computational model to study the growth and spread of bacterial biofilms on interfaces,as well as the action of antibiotics on *** membranes are represented by boundaries immersed in a fluid matrix and subject to interaction ***,division and death of bacterial cells follow dynamic energy budget rules,in response to variations in environmental concentrations of nutrients,toxicants and substances released by the *** this way,we create,destroy and enlarge boundaries,either spherical or *** forces represent details of the interaction between cells,and the interaction with the *** can investigate geometrical arrangements and the formation of porous *** simulations illustrate the evolution of top views and diametral slices of small biofilm seeds,as well as the action of *** show that cocktails of antibiotics targeting active and dormant cells can entirely eradicate a biofilm.

关键词： Hybrid multiscale models immersed boundary methods dynamic energy budget models bacterial biofilm antibiotic resistance

Lipedema:A common though often unrecognized condition

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Chinese Journal of Plastic and Reconstructive Surgery 2024年第3期6卷 149-153页

作者： rafael Carvalho Private Practice R.Iolanda del Nero Barco101PirassunungaSao Paulo13631-064Brazil

Lipedema is a chronic disorder primarily affecting women,characterized by abnormal fat deposition in the extremities,leading to pain,mobility issues,and psychological *** fat deposits are clear-cut and spare hands and *** misdiagnosed as lymphedema,its prevalence remains uncertain due to a lack of universally accepted diagnostic criteria and difficulty in differentiating it from obesity or *** factors and hormonal influences are likely related to the pathophysiology of the disease,though the specific causes remain *** techniques may aid evaluation,but no definitive test exists,and diagnosis is made *** treatments such as lifestyle modifications and compression garments are considered first-line treatments,while surgical options such as liposuction and lipectomy are reserved for severe or refractory *** support may be recommended,given lipedema’s impact on quality of life and *** review aims to present the current understanding of this condition,including challenges in diagnosis,current guideline recommendations for clinical care,and associated comorbid conditions.

关键词： Lipedema Obesity Lymphedema Liposuction Lipectomy

Nylon 6-cellulose composite hosted in a hypodermic needle: Biofluid extraction and analysis by ambient mass spectrometry in a single device

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Journal of Pharmaceutical Analysis 2023年第11期13卷 1346-1352页

作者： Jaime Millan-Santiago rafael Lucena Soledad Cardenas Affordable and Sustainable Sample Preparation(AS2P)Research Group Analytical Chemistry DepartmentChemical Institute for Energy and Environment(IQUEMA)University of CordobaE-14071CordobaSpain

This study proposes a hypodermic needle(HN)as a sorbent holder and an electrospray(ESI)emitter,thus combining extraction and analysis in a single device.A novel nylon 6-cellulose(N6-Cel)composite sorbent is proposed to extract methadone from oral fluid *** cellulosic substrate provides the composite with high porosity,permitting the flow-through of the sample,while the polyamide contributes to the extraction of the *** low price of the devices(considering the holder and the sorbent)contributes to the affordability of the method,and their small size allows easy transportation,opening the door to on-site *** the optimum conditions,the analyte can be determined by high-resolution ambient ionization mass spectrometry at a limit of detection(LOD)as low as 0.3 mg/L and precision(expressed as relative standard deviation,RSD)better than 9.3%.The trueness,expressed as relative recovery(RR),ranged from 90%to 109%.As high-resolution mass spectrometers are not available in many laboratories,the method was also adapted to low-resolution *** this sense,the direct infusion of the eluates in a triple quadrupole-mass spectrometry provided an LOD of 2.2 mg/*** RSD was better than 5.3%,and the RR ranged from 96%to 121%.

关键词： ESI emitter Mass spectrometry Hypodermic needle Composite Methadone