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Thrombotic microangiopathy after kidney transplantation: Expanding etiologic and pathogenetic spectra

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World Journal of Transplantation 2024年第1期14卷 84-95页

作者： Muhammed Mubarak Amber Raza Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Nephrology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Thrombotic microangiopathy(TMA)is an uncommon but serious complication that not only affects native kidneys but also transplanted *** review is specifically focused on post-transplant TMA(PT-TMA)involving kidney transplant *** reported prevalence in the latter population varies from 0.8%to 14%with adverse impacts on both graft and patient *** has many causes and associations,and the list of etiologic agents and associations is growing *** pathogenesis is equally varied and a variety of pathogenetic pathways lead to the development of microvascular injury as the final common ***-TMA is categorized in many ways in order to facilitate its ***,more than one causes are contributory in PT-TMA and it is often difficult to pinpoint one particular cause in an individual ***,the hallmark lesions are endothelial cell injury and intravascular thrombi affecting the *** diagnosis and classification of PT-TMA are imperative for optimal outcomes but are challenging for both clinicians and *** Banff classification has addressed this issue and has developed minimum diagnostic criteria for pathologic diagnosis of PT-TMA in the first *** of the condition is also challenging and still largely *** varies from simple maneuvers,such as plasmapheresis,drug withdrawal or modification,or dose reduction,to lifelong complement blockade,which is very expensive.A thorough understanding of the condition is imperative for an early diagnosis and quick treatment when the treatment is potentially *** review aims to increase the awareness of relevant stakeholders regarding this important,potentially treatable but under-recognized cause of kidney allograft dysfunction.

关键词： Thrombotic microangiopathy Microvascular injury Anemia Thrombocytopenia Kidney allograft failure

Physical activity with or without dietary intervention for the prevention of cardiovascular diseases

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Journal of Sport and Health Science 2024年第6期13卷 753-755页

作者： Carl J.Lavie Salvatore Carbone Leandro Slipczuk The John Ochsner Heart and Vascular institute Ochsner Clinical Schoolthe University of Queensland School of MedicineNew OrleansLA 70121USA Department of Kinesiology and Health Sciences College of Humanities and SciencesVirginia Commonwealth UniversityRichmondVA 23284USA montefiore Health System/Albert Einstein College of Medicine BronxNY 10461USA

We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.

关键词： mortality prevention diseases

Expanding role and scope of artificial intelligence in the field of gastrointestinal pathology

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Artificial Intelligence in Gastroenterology 2024年第2期5卷 10-19页

作者： Muhammed Mubarak Rahma Rashid Fnu Sapna Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan Department of Pathology Montefiore Medical CenterThe University Hospital for Albert Einstein School of MedicineBronxNY 10461United States

Digital pathology(DP)and its subsidiaries including artificial intelligence(AI)are rapidly making inroads into the area of diagnostic anatomic pathology(AP)including gastrointestinal(GI)*** is poised to revolutionize the field of diagnostic ***,AP has been slow to adopt digital technology,but this is changing rapidly,with many centers worldwide transitioning to *** with advanced techniques of AI such as deep learning and machine learning,DP is likely to transform histopathology from a subjective field to an objective,efficient,and transparent *** is increasingly integrated into GI pathology,offering numerous advancements and improvements in overall diagnostic accuracy,efficiency,and patient ***,AI in GI pathology enhances diagnostic accuracy,streamlines workflows,provides predictive insights,integrates multimodal data,supports research,and aids in education and training,ultimately improving patient care and *** review summarized the latest developments in the role and scope of AI in AP with a focus on GI *** main aim was to provide updates and create awareness among the pathology community.

关键词： Gastrointestinal pathology Digital pathology Artificial intelligence Machine learning Deep learning Precision diagnostics

Gym-ANM: Reinforcement learning environments for active network management tasks in electricity distribution systems

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能源与人工智能(英文) 2021年第3期5卷 171-193页

作者： Robin Henry Damien Ernst School of Engineering Sanderson BuildingThe University of EdinburghEdinburgh EH93FBUK Department of Electrical Engineering and Computer Science Montefiore InstituteUniversity of LiegeLiege B-4000Belgium

Active network management(ANM)of electricity distribution networks include many complex stochastic sequential optimization *** problems need to be solved for integrating renewable energies and distributed storage into future electrical *** this work,we introduce Gym-ANM,a framework for designing reinforcement learning(RL)environments that model ANM tasks in electricity distribution *** environments provide new playgrounds for RL research in the management of electricity networks that do not require an extensive knowledge of the underlying dynamics of such *** with this work,we are releasing an implementation of an introductory toy-environment,ANM6-Easy,designed to emphasize common challenges in *** also show that state-of-the-art RL algorithms can already achieve good performance on ANM6-Easy when compared against a model predictive control(MPC)***,we provide guidelines to create new Gym-ANM environments differing in terms of(a)the distribution network topology and param-eters,(b)the observation space,(c)the modeling of the stochastic processes present in the system,and(d)a set of hyperparameters influencing the reward ***-ANM can be downloaded at https://***/robinhenr y/gym-anm.

关键词： Gym-ANM Reinforcement learning Active network management Distribution networks Renewable energy

A narrative review of ocular surface disease considerations in the management of glaucoma

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Annals of Eye Science 2023年第3期8卷 33-40页

作者： Nathan J.Arboleda Wen-Jeng(Melissa)Yao Alex Theventhiran Gene Kim Department of Ophthalmology&Visual Sciences Albert Einstein College of MedicineMontefiore Medical CenterGreene Medical Arts Pavilion-Henkind InstituteBronxNYUSA

s from those searches were screened for relevance to our review *** were included if the subjects included glaucoma patients,and if ocular surface outcomes were ***-English papers were *** Content and Findings:Topical glaucoma medications frequently cause adverse effects on the ocular surface,both through direct action of the medications themselves as well as through toxicity from their associated *** of the ocular surface may improve medication compliance *** surgical treatments for glaucoma,such as trabeculectomy,can exacerbate OSD by disrupting the ocular surface but can also reduce the need for chronic *** of ocular surface health is imperative in reducing trabeculectomy complication rates,while also potentially reducing the need for trabeculectomy in patients that are able to achieve intraocular pressure control through improved drop *** introduction of MIGS represents a promising alternative to existing therapies and has been shown to alleviate the overall medication *** would be reasonable to assume that decreasing the medication burden could reduce OSD prevalence and ***,more research is needed to directly assess the extent of improvement seen after ***:A comprehensive understanding of the importance of OSD in medical and surgical management of glaucoma is essential in optimizing patient care and improving outcomes.

关键词： Glaucoma ocular surface disease(OSD) dry eye minimally invasive glaucoma surgery(MIGS) trabeculectomy

Interobserver and intraobserver agreement for Letournel acetabular fracture classification system using 3-dimensional printed solid models

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World Journal of Orthopedics 2021年第2期12卷 82-93页

作者： Eran Keltz Doron Keshet Eli Peled Yoav Zvi Doron Norman Yaniv Keren Division of Orthopedic Surgery Rambam Health Care CampusHaifa 3525408Israel Ruth Rappaport Faculty of Medicine Technion Israel Institute of TechnologyHaifa 3200003Israel Department of Orthopaedic Surgery Montefiore Medical CenterNew YorkNY 10461United States

BACKGROUND Acetabular fractures pose diagnostic and surgical *** are classified using the Judet-Letournel system,which is based solely on ***,computed tomography(CT)imaging is now more widely utilized in diagnosing these *** emergence of 3-dimensional(3-D)printing technology in varying orthopedic fields has provided surgeons a solid model that improves their spatial understanding of complex fractures and ability to plan *** To evaluate the reliability of the Judet-Letournel classification system of acetabular fractures,when using either CT imaging or 3-D printed *** Seven patients with acetabular fractures underwent pelvic CT imaging,which was then used to create solid,3-D printed *** orthopaedic trauma surgeons responded to questionnaires regarding fracture classification and preferred surgical *** same questionnaire was completed using only CT imaging,and two weeks later,using only 3-D printed *** inter-and intra-observer agreement rates were then *** Inter-observer agreement rates based on CT imaging or 3-D printed models were moderate for fracture classification:κ=0.44,κ=0.55,respectively(P<0.001)and fair for preferred surgical approach:κ=0.34,κ=0.29,respectively(P<0.005).Intra-observer agreement rates for fracture classification and preferred surgical approach comparing CT imaging or 3-D printed models were moderate:κ=0.48,κ=0.41,*** significant difference in intra-observer agreement was detected when comparing orthopedic pelvic specialists to general orthopedic *** The Judet-Letournel classification demonstrated only moderate rates of *** use of 3-D printed models increased the inter-observer agreement rates with respect to fracture classification,but decreased it with respect to the preferred surgical *** study highlights the role of 3-D printed models in acetabular fractures by improving spatial understandin

关键词： Acetabulum Pelvic trauma Acetabular fracture Three-dimensional printing Three-dimensional reconstruction Judet-Letournel

Emerging roles of Aurora-A kinase in cancer therapy resistance

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药学学报:英文版 2023年第7期13卷 2826-2843页

作者： Dayong Zheng Jun Li Han Yan Gang Zhang Wei Li Edward Chu Ning Wei School of Pharmacy North China University of Science and TechnologyTangshan 063210China Basic Medical Science College Liaoning University of Traditional Chinese MedicineShenyang 110032China Division of Biology and Biological Engineering California Institute of TechnologyPasadenaCA 91125USA Department of Oncology and Cancer Therapeutics Program Montefiore Einstein Cancer CenterAlbert Einstein College of MedicineBronxNY 10461USA

Aurora kinase A(Aurora-A),a serine/threonine kinase,plays a pivotal role in various cellular processes,including mitotic entry,centrosome maturation and spindle *** or gene-amplification/mutation of Aurora-A kinase occurs in different types of cancer,including lung cancer,colorectal cancer,and breast *** of Aurora-A impacts multiple cancer hallmarks,especially,immortalization,energy metabolism,immune escape and cell death resistance which are involved in cancer progression and *** review highlights the most recent advances in the oncogenic roles and related multiple cancer hallmarks of Aurora-A kinase-driving cancer therapy resistance,including chemoresistance(taxanes,cisplatin,cyclophosphamide),targeted therapy resistance(osimertinib,imatinib,sorafenib,etc.),endocrine therapy resistance(tamoxifen,fulvestrant) and ***,the mechanisms of Aurora-A kinase promote acquired resistance through modulating DNA damage repair,feedback activation bypass pathways,resistance to apoptosis,necroptosis and autophagy,metastasis,and ***,our review also summarizes the promising synthetic lethality strategy for Aurora-A inhibitors in RB1,ARID1A and MYC gene mutation tumors,and potential synergistic strategy for m TOR,PAK1,MDM2,MEK inhibitors or PD-L1 antibodies combined with targeting Aurora-A *** addition,we discuss the design and development of the novel class of Aurora-A inhibitors in precision medicine for cancer treatment.

关键词： Aurora-A Therapy resistance Chemoresistance Targeted therapy Radioresistance Synthetic lethality Alisertib PROTAC

Foundations of medical decision-making for older adults with cardiovascular disease

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Journal of Geriatric Cardiology 2015年第4期12卷 335-339页

作者： Hannah I Lipman Ankur Kalra James N Kirkpatrick Department of Medicine Divisions of Geriatrics and Cardiology Montefiore Medical Center of the Albert Einstein College of Medicine Bronx N~ USA Minneapolis Heart institute at Abbott Northwestern Hospital Department of Medicine Division of Cardiology Hennepin County Medical Center Minneapo- lis MN USA Cardiovascular Division Department of Medicine University of Pennsylvania' Department of Medical Ethics and Health Policy University of Pennsylvania Philadelphia PA USA

In order to help older adults with cardiovascular disease navigate complex decisions, clinicians must know tenets of medical ethics and have good communication skills. The elements of decision making capacity and informed consent are reviewed, using relevant clinical ex- amples to illustrate the basic concepts. The shared decision making model, by which clinician and patient work together to determine the plan of care, is described. Useful communication techniques to implement shared decision making are suggested.

关键词： Cardiovascular disease Medical decision-making Older adults

Weaning of nasal CPAP in preterm infants:who,when and how?a systematic review of the literature

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World Journal of Pediatrics 2015年第1期11卷 7-13页

作者： Shaili Amatya Deepa Rastogi Alok Bhutada Shantanu Rastogi Division of Neonatology Maimonides Infants&Children's Hospital4802 Tenth AveK-113Brooklyn NY 11219USA Children's Hospital at montefiore Albert Einstein College of MedicineBronxNY 10467USA

Background:There is increased use of early nasal continuous positive airway pressure(NCPAP)to manage respiratory distress in preterm infants but optimal methods and factors associated with successful wean are not well defined.A systematic review was performed to define the corected gestational age(CGA),weight to wean NCPAP and the methods associated with successful weaning of the NCPAP among preterm infants,along with factors affecting ***:Searches were made of PubMed using the keywords-NCPAP,CPAP,weaning,withdrawal,preterm,and infants from its inception to January 1st,2014,for studies in all languages but limited to *** reviews(including cross references)were also *** included all randomized and quasi-randomized controlled trials where preterm neonates were randomized to different NCPAP weaning *** of CGA,weight and methods used for weaning NCPAP were extracted along with factors which affect its ***:Seven studies met the search *** successful wean was at 32 to 33 weeks CGA and at 1600 *** different methods were used for weaning were sudden,gradual pressure wean and gradual graded time off *** for readiness,success and failure to wean were *** affecting successful weaning were intubation,anemia,infection and gastro-esophageal ***:The successful wean was at 32 to 33 weeks CGA and 1600 *** for readiness,success and failure to wean are well *** weaning may be associated with a shorter weaning *** trials are needed comparing weaning methods using defined criteria for readiness and success of NCPAP wean and stratify the results by gestational age and birth weight.

关键词： continuous positive airway pressure infants preterm systematic review weaning