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Artificial intelligence analysis of videos to augment clinical assessment:an overview

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Neural Regeneration Research 2024年第4期19卷 717-718页

作者： David C.Wong Stefan Williams University of Leeds Leeds Teaching Hospitals Trust LeedsUK

Observation is a fundamental part of the practice of clinical *** of movement is particularly important for the *** such as Parkinson’s disease,multiple sclerosis,stroke,epilepsy,and many others affect a person’s movement in characteristic *** some conditions,changes in the patient’s voice can be included in this-changes in sound caused by changes in the movements of *** clinician’s detection of a characteristic abnormality,and their judgment of its severity,plays a central role in both diagnosis and the assessment of prognosis or response to ***,that practice depends upon a limited resource of experienced *** addition,these experts are limited by human visual judgment,which cannot reliably or precisely detect and measure small or subtle changes in movement(Williams et al.,2023).

关键词： clinical epilepsy diagnosis

Lipopolysaccharide inhibits or accelerates biomedical titanium corrosion depending on environmental acidity

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International Journal of Oral Science 2015年第3期7卷 179-186页

作者： Fei Yu Owen Addison Stephen J Baker Alison J Davenport School of Metallurgy and Materials University of Birmingham Biomaterials Unit College of Medical and Dental Sciences University of Birmingham School of Geography Earth and Environmental Sciences University of Birmingham

Titanium and its alloys are routinely used as biomedical implants and are usually considered to be corrosion resistant under physiological conditions. However, during inflammation, chemical modifications of the peri-implant environment including acidification occur. In addition certain biomolecules including lipopolysaccharide（LPS）, a component of Gram-negative bacterial cell walls and driver of inflammation have been shown to interact strongly with Ti and modify its corrosion resistance. Gram-negative microbes are abundant in biofilms which form on dental implants. The objective was to investigate the influence of LPS on the corrosion properties of relevant biomedical Ti substrates as a function of environmental acidity. Inductively coupled plasma mass spectrometry was used to quantify Ti dissolution following immersion testing in physiological saline for three common biomedical grades of Ti（ASTM Grade 2, Grade 4 and Grade 5）. Complementary electrochemical tests including anodic and cathodic polarisation experiments and potentiostatic measurements were also conducted. All three Ti alloys were observed to behave similarly and ion release was sensitive to p H of the immersion solution. However, LPS significantly inhibited Ti release under the most acidic conditions（p H 2）, which may develop in localized corrosion sites, but promoted dissolution at p H 4–7, which would be more commonly encountered *** observed pattern of sensitivity to environmental acidity of the effect of LPS on Ti corrosion has not previously been reported. LPS is found extensively on the surfaces of skin and mucosal penetrating Ti implants and the findings are therefore relevant when considering the chemical stability of Ti implant surfaces in vivo.

关键词： corrosion electrochemistry inductively coupled plasma mass spectrometry lipopolysaccharide titanium

Role of early transjugular intrahepatic portosystemic stent-shunt in acute variceal bleeding:An update of the evidence and future directions

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World Journal of Gastroenterology 2021年第44期27卷 7612-7624页

作者： Faisal Khan Dhiraj Tripathi Gastroenterology Unit University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUnited Kingdom Liver Unit University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUnited Kingdom nihr Birmingham Biomedical Research Centre University Hospitals BirminghamNHS Foundation Trust and University of BirminghamBirmingham B152THUnited Kingdom Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152THUnited Kingdom

Variceal bleeding is a serious complication of cirrhosis and portal *** the improvement in management of acute variceal bleed(AVB),it still carries significant *** pressure is the main driver of variceal bleeding and also a main predictor of *** in portal pressure has been the mainstay of management of variceal *** intrahepatic porto-systemic stent shunt(TIPSS)is a very effective modality in reducing the portal hypertension and thereby,controlling portal hypertensive ***,its use in refractory bleeding(rescue/salvage TIPSS)is still associated with high mortality.“Early”use of TIPSS as a“pre-emptive strategy”in patients with AVB at high risk of failure of treatment has shown to be superior to standard treatment in several *** patients with Child C cirrhosis(up to 13 points)clearly benefit from early-TIPSS strategy,it’s role in less severe liver disease(Child B)and more severe disease(Child C>13 points)remains less ***,standard of care has improved in the last decade leading to improved 1-year survival in high-risk patients with AVB as compared to earlier“early”TIPSS *** in the real world,only a minority of patients with AVB fulfil the stringent criteria for early ***,there is unmet need to explore role of early TIPSS in management of AVB in well-designed prospective studies. In this review, we have appraised the role of early TIPSS, patient selection anddiscussed future directions in the management of patients with AVB.

关键词： Transjugular intrahepatic portosystemic stent-shunt Early transjugular intrahepatic portosystemic stent-shunt Salvage transjugular intrahepatic portosystemic stent-shunt Portal hypertension Acute variceal bleed Hepatic encephalopathy

Performance of the Enhanced Liver Fibrosis Score,Comparison with Vibration-controlled Transient Elastography Data,and Development of a Simple Algorithm to Predict Significant Liver Fibrosis in a Community-based Liver Service:A Retrospective Evaluation

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 800-808页

作者： Tina Reinson Janisha Patel Mead Mathews Derek Fountain Ryan M.Buchanan Christopher DByrne Nutrition and Metabolism Faculty of MedicineUniversity of SouthamptonSouthamptonUK National Institute for Health and Care Research Southampton Biomedical Research CenterUniversity Hospital SouthamptonSouthamptonUK Hepatology Department University Hospital SouthamptonSouthamptonUK St Mary’s Surgery SouthamptonUK Core Minutes Ltd RingwoodUK Clinical and Experimental Sciences Faculty of MedicineUniversity of SouthamptonSouthamptonUK

Background and Aims:Liver fibrosis is a key risk factor for cirrhosis,hepatocellular carcinoma and end stage liver *** National Institute for Health and Care Excellence guidelines for assessment for advanced(≥F3)liver fibrosis in people with nonalcoholic fatty liver disease recommend the use of enhanced liver fibrosis(ELF)test,followed by vibration-controlled transient elastography(VCTE).Performance of ELF at predicting significant(≥F2)fibrosis in real-world practice is *** assess the accuracy of ELF using VCTE;investigate the optimum ELF cutoff value to identify≥F2and≥F3;and develop a simple algorithm,with and without ELF score,for detecting≥***:Retrospective evaluation of patients referred to a Community Liver Service for VCTE,Jan-Dec *** included:body mass index(BMI),diabetes status,alanine aminotransferase(ALT)levels,ELF score and biopsy-validated fibrosis stages according to ***:Data from 273 patients were available.n=110 patients had *** showed fair performance for≥F2 and≥F3,area under the curve(AUC)=0.70,95%confidence interval(CI)0.64-0.76 and AUC=0.72,95%CI:0.65-0.79 ***≥F2 Youden's index for ELF=9.85 and for≥F3,ELF=*** ALT,BMI,and HbA1c(ALBA algorithm)to predict≥F2 showed good performance(AUC=0.80,95%CI:0.69-0.92),adding ALBA to ELF improved performance(AUC=0.82,95%CI:0.77-0.88).Results were independently ***:Optimal ELF cutoff for≥F2 is 9.85 and 9.95 for≥***,BMI,and HbA1c(ALBA algorithm)can stratify patients at risk of≥*** is improved by adding ALBA.

关键词： Primary health care Retrospective evaluation Liver disease Diabetes Nonalcoholic fatty liver disease

Age at diagnosis of type 2 diabetes and cardiovascular risk factor profile:A pooled analysis

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World Journal of Diabetes 2022年第3期13卷 260-271页

作者： Mary M Barker Francesco Zaccardi Emer M Brady Gaurav S Gulsin Andrew P Hall Joseph Henson Zin ZinHtike Kamlesh Khunti Gerald P McCann Emma L Redman David R Webb Emma G Wilmot Tom Yates Jian Yeo Melanie J Davies Jack A Sargeant Diabetes Research Centre University of LeicesterLeicester General HospitalLeicester LE54PWUnited Kingdom Department of Cardiovascular Sciences Glenfield HospitalUniversity of LeicesterLeicester LE39QPUnited Kingdom The Hanning Sleep Laboratory University Hospitals of Leicester NHS TrustUniversity of LeicesterLeicester LE54PWUnited Kingdom National Institute for Health Research Leicester Biomedical Research CentreLeicester LE54PWUnited Kingdom Leicester Diabetes Centre University Hospitals of Leicester NHS TrustLeicester LE54PWUnited Kingdom National Institute for Health Research Applied Research Collaboration East MidlandsLeicester LE54PWUnited Kingdom Department of Diabetes University Hospitals of Derby and Burton NHS Foundation TrustDerby DE223NEUnited Kingdom

BACKGROUND The diagnosis of type 2 diabetes(T2D)in younger adults,an increasingly common public health issue,is associated with a higher risk of cardiovascular complications and mortality,which may be due to a more adverse cardiovascular risk profile in individuals diagnosed at a younger *** To investigate the association between age at diagnosis and the cardiovascular risk profile in adults with *** A pooled dataset was used,comprised of data from five previous studies of adults with T2D,including 1409 participants of whom 196 were diagnosed with T2D under the age of 40 *** and blood biomarker measurements included body weight,body mass index(BMI),waist circumference,body fat percentage,glycaemic control(HbA1c),lipid profile and blood *** and multivariable linear regression models,adjusted for diabetes duration,sex,ethnicity and smoking status,were used to investigate the association between age at diagnosis and each cardiovascular risk *** A higher proportion of participants diagnosed with T2D under the age of 40 were female,current smokers and treated with glucose-lowering medications,compared to participants diagnosed later in *** diagnosed with T2D under the age of 40 also had higher body weight,BMI,waist circumference and body fat percentage,in addition to a more adverse lipid profile,compared to participants diagnosed at an older *** results showed that each one year reduction in age at diagnosis was significantly associated with 0.67 kg higher body weight[95%confidence interval(CI):0.52-0.82 kg],0.18 kg/m^(2) higher BMI(95%CI:0.10-0.25)and 0.32 cm higher waist circumference(95%CI:0.14-0.49),after adjustment for duration of diabetes and other *** age at diagnosis was also significantly associated with higher HbA1c,total cholesterol,low-density lipoprotein cholesterol and *** The diagnosis of T2D earlier in life is associated with a worse cardi

关键词： Type 2 diabetes mellitus Early-onset adult type 2 diabetes Age of onset Cardiovascular risk Young adults Glycaemic control Obesity

Functional gastrointestinal disorders in inflammatory bowel disease: Time for a paradigm shift?

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World Journal of Gastroenterology 2020年第26期26卷 3712-3719页

作者： Dipesh H Vasant Alexander C Ford Gastroenterology Manchester University NHS Foundation TrustWythenshawe HospitalManchester M239LTUnited Kingdom Division of Diabetes Endocrinology and GastroenterologyUniversity of ManchesterManchester M239LTUnited Kingdom Leeds Institute of Medical Research at St.James’s University of LeedsLeeds LS97TFUnited Kingdom Leeds Gastroenterology Institute Leeds Teaching Hospitals NHS TrustLeeds LS97TFUnited Kingdom

Recent advances in biological therapies have revolutionalised and redefined treatment targets in inflammatory bowel disease(IBD).There is now a stronger emphasis on achieving the more stringent therapeutic goals of mucosal and histological healing,rather than clinical remission ***,the treatment of refractory“functional”gastrointestinal symptoms,often attributed as the aftermath of previous inflammation,has recently become more prominent in quiescent *** further expected advances in anti-inflammatory treatments on the horizon,the burden of such symptoms in quiescent disease,which have been relatively neglected,is set to become an even bigger *** this article,we highlight the current state of research and understanding in this field,including recent developments and clinical practice guidelines on the diagnosis and management of functional gastrointestinal symptoms,such as irritable bowel syndrome and functional anorectal and pelvic floor disorders,in patients with quiescent *** disorders are not only highly prevalent in these patients,they are often misdiagnosed,and are difficult to treat,with very few evidence-based ***,they are associated with substantial impairment in quality-of-life,considerable morbidity,and psychological *** is therefore an urgent need for a change in emphasis towards earlier recognition,positive diagnosis,and targeted treatment for patients with ongoing functional gastrointestinal symptoms in the absence of active *** article also highlights the need for further research to develop much needed evidence-based therapies.

关键词： Irritable bowel syndrome Inflammatory bowel disease Functional gastrointestinal disorders Faecal incontinence Pelvic floor dyssynergia

Remote ischaemic conditioning for stroke: unanswered questions and future directions

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Stroke & Vascular Neurology 2021年第2期6卷 298-309页

作者： Sheharyar Baig Bethany Moyle Krishnan Padmakumari Sivaraman Nair Jessica Redgrave Arshad Majid Ali Ali Cerebrovascular Medicine The University of Sheffield Institute for Translational NeuroscienceSheffieldUK Neurosciences Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK Faculty of Medicine and Dentistry University of SheffieldSheffieldUK Geriatrics and Stroke Medicine Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK Sheffield nihr Biomedical Research Centre The University of SheffieldSheffieldUK

Remote ischaemic conditioning(RIC)refers to a process whereby periods of intermittent ischaemia,typically via the cyclical application of a blood pressure cuff to a limb at above systolic pressure,confers systemic protection against ischaemia in spatially distinct vascular *** mechanisms underlying this have not been characterised fully but have been shown to involve neural,hormonal and systemic inflammatory signalling *** and early clinical studies have been promising and suggest beneficial effects of RIC in acute ischaemic stroke,symptomatic intracranial stenosis and vascular cognitive *** systematic searches of several clinical trials databases we identified 48 active clinical trials of RIC in ischaemic stroke,intracerebral haemorrhage and subarachnoid *** summarise the different RIC protocols and outcome measures studied in ongoing clinical trials and highlight which studies are most likely to elucidate the underlying biological mechanisms of RIC and characterise its efficacy in the near *** discuss the uncertainties of RIC including the optimal frequency and duration of therapy,target patient groups,cost-effectiveness,the confounding impact of medications and the absence of a clinically meaningful biomarker of the conditioning *** several large clinical trials of RIC expected to report their outcomes within the next 2 years,this review aims to highlight the most important studies and unanswered questions that will need to be addressed before this potentially widely accessible and low-cost intervention can be used in clinical practice.

关键词： Remote directions founding

Surgical treatment for liver cancer

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World Journal of Gastroenterology 2010年第8期16卷 927-933页

作者： Nicole C Tsim Adam E Frampton Nagy A Habib Long R Jiao Department of Hepatopancreatobiliary Surgery Division of SurgeryHammersmith Hospital campusImperial College London

Primary liver cancer is amongst the commonest tumors worldwide,particularly in parts of the developing world,and is increasing in incidence. Over the past three decades,surgical hepatic resection has evolved from a high risk,resource intensive procedure with limited application,to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer,metastatic liver de-posits and neuroendocrine tumors. Survival data after resection is also reviewed,as well as indications for curative resection.

关键词： Liver cancer Surgical resection Indications Hepatocellular carcinoma Colorectal liver metastases Neuroendocrine tumors Non-colorectal non-neuroendo-crine

Enhancing Public Health Competencies via Action on Salt China—China,2017–2022

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China CDC weekly 2023年第32期5卷 720-723页

作者： Puhong Zhang ASC working group The George Institute for Global HealthChinaBeijingChina.

The Action on Salt China(ASC)project is a noteworthy collaborative venture between China and UK,with the China CDC serving as a key *** objective of this report is to present a case study that demonstrates the significant role of ASC in bolstering the capacity of public health services in ***,this study aims to offer valuable references and provoke thoughtful insight for potential international collaborations in the future.

关键词： venture Action partner