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Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome

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Journal of Geriatric Cardiology 2016年第3期13卷 209-217页

作者： Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE sergio raposeiras-roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev Beijing Anzhen Hospital Capital Medical University Beijing China University Hospital.4lvaro Cunqueiro Vigo Spain University Academic Medical Center Amsterdam the Netherlands Dipartimento di Scienze Mediche Divisione di Cardiologia. Citt& della Salute e della Scienza Turin Italy NorthShore University Hospital Chicago. USA University Clinical Hospital of Santiago de Compostela Spain Libin Cardiovascular Institute of Alberta Calgary Canada San Carlos Hospital Madrid Spain Bellvitge Hospital Barcelona Spain University Patras Hospital Athens Greece Kerckhoff Heart and Thorax Center Frankfurt Germany Graduate School of Medicine Kyoto University Kyoto Japan University Clinical Hospital Warsaw Poland Tokai University School of Medicine Tokyo Japan Hospital Sao RafaeL Salvador Brazil Kanazawa University Graduate School of Medicine Kanazawa Japan University Clinic of Cardiology Skopje Macedonia

Background There is great debate on the possible adverse interaction between proton pump inhibitors （PPIs） and clopidogrel. In ad- dition, whether the use of PPIs affects the clinical efficacy of ticagrelor remains less known. We aimed to determine the impact of concomi- tant administration of PPIs and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome （ACS） after percuta- neous coronary intervention （PCI）. Methods We retrospectively analyzed data fi＇om a ＂real world＂, international, multi-center registry between 2003 and 2014 （n = 15,401） and assessed the impact of concomitant administration of PPIs and clopidogrel or ticagrelor on 1-year composite primary endpoint （all-cause death, re-infarction, or severe bleeding） in patients with ACS after PCI. Results Of 9429 patients in the final cohort, 54.8% （n = 5165） was prescribed a PPI at discharge. Patients receiving a PPI were older, more often female, and were more likely to have comorbidities. No association was observed between PPI use and the primary endpoint for patients receiving clopidogrel （ad- justed HR： 1.036; 95% CI： 0.903-1.189） or ticagrelor （adjusted HR： 2.320; 95% CI： 0.875-45.151）（Pinteraction = 0.2004）. Similarly, use of a PPI was not associated with increased risk of all-cause death, re-infarction, or a decreased risk of severe bleeding for patients treated with either clopidogrel or ticagrelor. Conclusions In patients with ACS following PCI, concomitant use of PPIs was not associated with in- creased risk of adverse outcomes in patients receiving either clopidogrel or ticagrelor. Our findings indicate it is reasonable to use a PPI in combination with clopidogrel or ticagrelor, especially in patients with a higher risk of gastrointestinal bleeding.

关键词： Acute coronary syndrome Clopidogrel Outcome Proton pump inhibitor Ticagrelor

Spatial sensitivity to absorption changes for various near-infrared spectroscopy methods:A compendium review

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Journal of Innovative Optical Health Sciences 2024年第4期17卷 1-115页

作者： Giles Blaney Angelo Sassaroli sergio Fantini Department of Biomedical Engineering Tufts University 4 Colby StreetMedfordMA 02155USA

This compendium review focuses on the spatial distribution of sensitivity to localized absorption changes in optically diffuse media,particularly for measurements relevant to near-infrared *** three temporal domains,continuous wave,frequency domain,and time domain,each obtain different optical data types whose changes may be related to effective homogeneous changes in the absorption *** is the relationship between a localized perturbation and the recovered effective homogeneous absorption ***,spatial sensitivity maps representing the perturbation location can be generated for the numerous optical data types in the three temporal *** review first presents a history of the past 30 years of work investigating this sensitivity in optically diffuse *** works are experimental and theoretical,presenting one-,two-,and three-dimensional sensitivity maps for different Near-Infrared Spectroscopy methods,domains,and data *** this history,we present a compendium of sensitivity maps organized by temporal domain and then data *** compendium provides a valuable tool to compare the spatial sensitivity of various measurement methods and parameters in one *** for one to generate these maps are provided in Appendix A,including the *** historical review and comprehensive sensitivity map compendium provides a single source researchers may use to visualize,investigate,compare,and generate sensitivity to localized absorption change maps.

关键词： Diffuse optics diffusion theory Monte Carlo spatial sensitivity absorption perturbations near-infrared spectroscopy continuous-wave frequency-domain time-domain

Machine learning applications in stroke medicine:advancements,challenges,and future prospectives

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Neural Regeneration Research 2024年第4期19卷 769-773页

作者： Mario Daidone sergio Ferrantelli Antonino Tuttolomondo Internal Medicine and Stroke Care Ward Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of Palermo Molecular and Clinical Medicine PhD Program University of Palermo

Stroke is a leading cause of disability and mortality worldwide,necessitating the development of advanced technologies to improve its diagnosis,treatment,and patient *** recent years,machine learning techniques have emerged as promising tools in stroke medicine,enabling efficient analysis of large-scale datasets and facilitating personalized and precision medicine *** abstract provides a comprehensive overview of machine learning’s applications,challenges,and future directions in stroke *** introduced machine learning algorithms have been extensively employed in all the fields of stroke *** learning models have demonstrated remarkable accuracy in imaging analysis,diagnosing stroke subtypes,risk stratifications,guiding medical treatment,and predicting patient *** the tremendous potential of machine learning in stroke medicine,several challenges must be *** include the need for standardized and interoperable data collection,robust model validation and generalization,and the ethical considerations surrounding privacy and *** addition,integrating machine learning models into clinical workflows and establishing regulatory frameworks are critical for ensuring their widespread adoption and impact in routine stroke *** learning promises to revolutionize stroke medicine by enabling precise diagnosis,tailored treatment selection,and improved *** research and collaboration among clinicians,researchers,and technologists are essential for overcoming challenges and realizing the full potential of machine learning in stroke care,ultimately leading to enhanced patient outcomes and quality of *** review aims to summarize all the current implications of machine learning in stroke diagnosis,treatment,and prognostic *** the same time,another purpose of this paper is to explore all the future perspectives these techniques can provide in combating this disabling dis

关键词： cerebrovascular disease deep learning machine learning reinforcement learning stroke stroke therapy supervised learning unsupervised learning

Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer

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World Journal of Gastroenterology 2024年第26期30卷 3198-3200页

作者： sergio Pérez-Holanda Office of Regional Viceministry of Health Regional Viceministry of HealthOviedo 33005AsturiasSpain

The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced *** efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other ***,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation *** barriers could include a full range of social and political aspects,especially the type of financial provision of each health *** Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including ***,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.

关键词： Colorectal neoplasms Cancer registry Diagnostic route Cancer screening Stage at diagnosis

Kinematics ofmandibular advancement devices(MADs):Why do some MADs move the lower jaw backward duringmouth opening?

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Bio-Design and Manufacturing 2024年第5期7卷 637-650页

作者： Juan A.Cabrera Alex Bataller sergio Postigo Marcos García Mechanical Engineering Department University of Malaga29071 MalagaSpain

Mandibular advancement devices(MADs)are widely used treatments for obstructive sleep *** function by advancing the lower jaw to open the upper *** increase patient comfort,most patients allow the mouth to be ***,not all systems maintain the lower jaw in a forward position during mouth opening,which results in the production of a retrusion that favors the collapse of the upper ***,the kinematic behavior of the mechanism formed by the mandible-device assembly depends on jaw *** means that,during mouth opening,some devices cause lower jaw protrusion in some patients,but cause its retraction in *** this study,we report the behavior of well-known devices currently on *** do so,we developed a kinematic model of the lower jawdevice *** validated for all devices analyzed using a high-resolution camera *** results show that some of the devices analyzed here did not produce the correct behavior during patient mouth opening.

关键词： Mandibular advancement devices Lower jaw kinematics Sleep apnea

P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析

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中华医学杂志 2016年第33期96卷 2611-2615页

作者：冯斯婷严妍范婧尧王晓郑文聂绍平 sergio raposeiras-roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev 首都医科大学附属北京安贞医院急诊危重症中心 100029 University Hospital Alvaro Cunqueiro Vigo Spain Academic Medical Center Amsterdam the Netherlands Dipartimento di Scienze Mediche Divisione di Cardiologia Citta della Salute e della Scienza Turin Italy North Shore University Hospital Chicago USA University Clinical Hospital of Santiago de Compostela Santiago de compostela Spain Libin Cardiovascular Institute of Alberta Calgary Canada San Carlos Hospital Madrid Spain Bellvitge University Hospital Barcelona Spain University Patras Hospital Athens Greece Kerckhoff Heart and Thorax Center Frankfurt Germany Graduate School of Medicine Kyoto University Kyoto Japan University Clinical Hospital Warsaw Poland Hospital Sao Rafael Salvador Brazil Kanazawa University Graduate School of Medicine Kanazawa Japan University Clinic of Cardiology Skopje Macedonia

目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂（PPI）治疗对经皮冠状动脉介入（PCI）术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究，纳入2003至2014年因急性冠脉综合征人院行PCI术的患者，分... 详细信息

目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂（PPI）治疗对经皮冠状动脉介入（PCI）术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究，纳入2003至2014年因急性冠脉综合征人院行PCI术的患者，分为PPI组及非PPI组并随访1年，主要临床终点为全因死亡／再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类，将入组患者分为氯吡格雷组及替格瑞洛组，并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者，PPI组占54．8％，具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡／再发心肌梗死复合事件的发生差异无统计学意义（HR1．00，95％CI 0．86—1．18）。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组，不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异，联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险，尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。

关键词：急性冠脉综合征氯吡格雷质子泵抑制剂患者结局评价替格瑞洛

Nonlinear dynamics of the reversed shear Alfvén eigenmode in burning plasmas

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Plasma Science and Technology 2024年第5期26卷 1-16页

作者：王涛魏士朝 sergio BRIGUGLIO Gregorio VLAD Fulvio ZONCA 仇志勇 Institute for Fusion Theory and Simulation and School of Physics Zhejiang UniversityHangzhou 310027People’s Republic of China Center for Nonlinear Plasma Science ENEA C.R.FrascatiFrascati 00044Italy Fusion and Nuclear Safety Department ENEA C.R.FrascatiFrascati 00044Italy

In a tokamak fusion reactor operated at steady state,the equilibrium magnetic field is likely to have reversed shear in the core region,as the noninductive bootstrap current profile generally peaks *** reversed shear Alfvén eigenmode(RSAE)as a unique branch of the shear Alfvén wave in this equilibrium,can exist with a broad spectrum in wavenumber and frequency,and be resonantly driven unstable by energetic particles(EP).After briefly discussing the RSAE linear properties in burning plasma condition,we review several key topics of the nonlinear dynamics for the RSAE through both wave-EP resonance and wave-wave coupling channels,and illustrate their potentially important role in reactor-scale fusion *** means of simplified hybrid MHD-kinetic simulations,the RSAEs are shown to have typically broad phase space resonance structure with both circulating and trapped EP,as results of weak/vanishing magnetic shear and relatively low *** the route of wave-EP nonlinearity,the dominant saturation mechanism is mainly due to the transported resonant EP radially decoupling with the localized RSAE mode structure,and the resultant EP transport generally has a convective *** saturated RSAEs also undergo various nonlinear couplings with other collective *** typical routes as parametric decay and modulational instability are studied using nonlinear gyrokinetic theory,and applied to the scenario of spontaneous excitation by a finite amplitude pump *** RSAEs could naturally couple and induce the spectral energy cascade into a low frequency Alfvénic mode,which may effectively transfer the EP energy to fuel ions via collisionless Landau ***,zero frequency zonal field structure could be spontaneously excited by modulation of the pump RSAE envelope,and may also lead to saturation of the pump RSAE by both scattering into stable domain and local distortion of the continuum structure.

关键词： reversed shear Alfvén eigenmode energetic particle nonlinear gyrokinetic theory saturation burning plasma

Fast prediction of rain erosion in wind turbine blades using a data-based computational tool

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Journal of Hydrodynamics 2024年第3期36卷 504-518页

作者： Juan M.Gimenez sergio R.Idelsohn Eugenio Oñate Centre Internacional de Mètodes Numèrics en Enginyeria(CIMNE) Edifici C1 Campus Nord UPC C/Gran CapitàS/NBarcelonaSpain

Wind turbines(WTs)face a high risk of failure due to environmental factors like erosion,particularly in high-precipitation areas and offshore *** this paper we introduce a novel computational tool for the fast prediction of rain erosion damage on WT blades that is useful in operation and maintenance decision making *** approach is as follows:Pseudo-Direct Numerical Simulation(P-DNS)simulations of the droplet-laden flow around the blade section profile are employed to build a high-fidelity data set of impact statistics for potential operating *** this database as training data,a machine learning-based surrogate model provides the feature of the impact pattern over the 2-D section for given wind and rain *** this information,a fatigue-based model estimates the remaining lifetime and erosion damage for both homogeneous and coating-substrate blade *** prediction is done by quantifying the accumulated droplet impact energy and evaluating operative conditions over time periods for which the weather at the installation site is *** this work,we describe the modules that compose the prediction method,namely the database creation,the training of the surrogate model and their coupling to build the prediction ***,the method is applied to predict the remaining lifetime and erosion damage to the blade sections of a reference *** evaluate the reliability of the tool,several site locations(offshore,coastal,and inland),the coating material and the coating thickness of the blade are *** few minutes we are able to estimate erosion after many years of *** results are in good agreement with field observations,showing the promise of the new rain erosion prediction approach.

关键词： Wind turbine blades leading edge erosion fatigue Pseudo-Direct Numerical Simulation(P-DNS) machine learning eblader

Semiosic Translation:a Bayesian-heuristic theory of translation and translating

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Language and Semiotic Studies 2024年第2期10卷 167-202页

作者： sergio Torres-Martínez Universidad de Antioquia Cll.67#53–108MedellínAntioquiaColombia

In the context of Semiosic Translation,two elements are essential for a translation to emerge:the body–brain–context interface(extended mind)and the sign systems making up a translation *** this paper,I explain how a renewed view of the body as a Bayesian-heuristic Semiotic Prior helps to understand in a more holistic manner the motivations and agentive character of translation,defined herein as a phenomenological grasp of the *** to the present proposal is the idea that bodily self-stabilization(homeostasis)and brain-driven correction(allostasis)provide translator-agents with maps of action upon the world that are semiotic in *** this occurs thanks to information weighing(Bayesian)and cue-driven(heuristic)types of inference whereby exteroceptive(exogenous)and interoceptive(inner-body)signals converge to create a sense of bodily awareness responsible for the construction of the symbolic persona(the translator-agent).

关键词： embodiment Bayesian semiosis heuristic semiosis semiotics Semiosic Translation translator-agents