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Drug-induced liver injury and COVID-19:Use of artificial intelligence and the updated Roussel Uclaf Causality Assessment Method in clinical practice

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Artificial Intelligence in Gastroenterology 2023年第2期4卷 36-47页

作者： Gabriela Xavier Ortiz Ana Helena Dias Pereira dos Santos Ulbrich Gabriele Lenhart Henrique Dias Pereirados Santos Karin Hepp Schwambach Matheus William Becker Carine Raquel Blatt Graduate Program in Medicine–Hepatology Federal University of Health Sciences of Porto AlegrePorto Alegre 90050-170Brazil Institute of Artificial Intelligence in healthcare Porto Alegre 90.620-200Brazil Multiprofessional Residency Integrated in Health Federal University of Health Sciences of Porto AlegrePorto Alegre 90050-170Brazil Department of Pharmacoscience Graduate Program in Medicine–HepatologyFederal University of Health Sciences of Porto AlegrePorto Alegre 90050-170Brazil

BACKGROUND Liver injury is a relevant condition in coronavirus disease 2019(COVID-19)*** varies from direct infection by virus,systemic inflammation or drug-induced adverse reaction(DILI).DILI detection and monitoring is clinically relevant,as it may contribute to poor prognosis,prolonged hospitalization and increase indirect healthcare *** Intelligence(AI)applied in data mining of electronic medical records combining abnormal liver tests,keyword searching tools,and risk factors analysis is a relevant opportunity for early DILI detection by automated *** To describe DILI cases in COVID-19 inpatients detected from data mining in electronic medical records(EMR)using AI and the updated Roussel Uclaf Causality Assessment Method(RUCAM).METHODS The study was conducted in March 2021 in a hospital in southern *** NoHarm©system uses AI to support decision making in clinical *** admissions were 100523 during this period,of which 478 met the inclusion *** these,290 inpatients were excluded due to alternative causes of liver injury and/or due to not having *** manually reviewed the EMR of 188 patients for DILI *** of clinical information excluded most eligible *** DILI assessment causality was possible via the updated RUCAM in 17 *** Mean patient age was 53 years(SD±18.37;range 22-83),most were male(70%),and admitted to the non-intensive care unit sector(65%).Liver injury pattern was mainly mixed,mean time to normalization of liver markers was 10 d,and mean length of hospitalization was 20.5 d(SD±16;range 7-70).Almost all patients recovered from DILI and one patient died of multiple organ *** were 31 suspected drugs with the following RUCAM score:Possible(n=24),probable(n=5),and unlikely(n=2).DILI agents in our study were ivermectin,bicalutamide,linezolid,azithromycin,ceftriaxone,amoxicillin-clavulanate,tocilizumab,piperacillin-tazobactam,and a

关键词： Chemical and drug induced liver injury RUCAM Artificial intelligence COVID-19 Liver injury

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A looming twindemic of COVID-19 and dengue on post-flood scenario in the developing countries

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Asian Pacific Journal of Tropical Medicine 2022年第9期15卷 383-384页

作者： Abdullah Sher Ali Muhammad Salman Muddasir Khan Department of Health and Biological Sciences Abasyn University Peshawar Khyber Pakhtunkhwa(KPK)Pakistan Department of Food Engineering School of Animal Science and Food EngineeringUniversity of Sao PauloCEP13635-900PirassunungaSPBrazil Department of Veterinary Microbiology Faculty of Veterinary SciencesChulalongkorn UniversityBangkokThailand Centre of Biotechnology and Microbiology University of PeshawarKPKPakistan

Pakistan has recently faced a disastrous and lethal flooding across the country,affecting 33 million people and 1400 healthcare facilities,putting further strain on the nation's fragile healthcare *** country faces widespread infectious diseases including dengue and COVID-19[1].To date,SARS-CoV-2 has caused about 6.53 million deaths and spread globally,infecting about 612 million *** the developing world,infection rate is particularly high in Pakistan,causing 30606 deaths so far[2].As of September 2022,healthcare authorities claimed a continued rise in dengue cases due to heavy flood in the *** date,a total of 14173 dengue cases have been reported,and the highest number of cases was documented in Sindh province(5203),followed by Khyber Pakhtunkhwa(4538),Punjab(3101),and Islamabad with 1331[3].

关键词： flood continued globally

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Coronary artery plaque imaging:Comparison of black-blood MRI and 64-multidetector computed tomography

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Chronic Diseases and Translational Medicine 2016年第3期2卷 -页

作者： Yi He Qin-Yi Da Jing An Xian-Tao Song De-Biao Li Department of Radiology Beijing Institute of Heart Lung and Blood Vessel Disease Beijing Anzhen Hospital Capital Medical University Beijing 100029 China siemens healthcare MR Collaboration NE Asia Beijing 100102 China Department of Cardiology Beijing Institute of Heart Lung and Blood Vessel Disease Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Cedars-Sinai Medical Center University of California Los Angeles USA

Objective: To comparatively evaluate black-blood coronary arterial wall MRI and 64-multidetector computed tomography (64-MDCT) for detection and classification of coronary artery plaques. Methods: We included 15 patients with confirmed coronary artery plaques in the proximal or middle segments of coronary arteries by 64-MDCT, who underwent black-blood coronary wall MRI at 1.5 T within 10 days. Cross-sectional coronary wall images were acquired using a 2D double-inversion-recovery, electrocardiograph-triggered, navigator-gated, fat-suppressed, turbo-spin-echo sequence on the coronary arteries with lesions from the ostium to the middle segment continuously without gap. The vessel cross-sectional area (CSA), luminal CSA, maximal wall thickness, plaque burden, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were measured in each slice and subsequently compared with computed tomography angiography (CTA) images. CTA images were divided into 5-mm segments for side-by-side comparison with MRI. Results: Of the 15 patients, 12 were enrolled in the study. Coronary plaques were found in 46 slices on both CTA and MRI. Plaques were classified to 3 groups based on CTA:calcified plaques (n ? 11), soft plaques (n ? 23), and mixed plaques (n ? 12). In MRI, the plaque burden, maximal wall thickness, SNR, and CNR in the coronary walls containing plaques were greater than in the normal coronary walls (0.83 ± 0.08 vs. 0.73 ± 0.08, 1.88 ± 0.51 vs. 1.51 ± 0.26 mm, 12.95 ± 2.78 vs. 9.93 ± 2.31, and 6.76 ± 2.52 vs. 3.89 ± 1.54, respectively;P<0.05). The luminal CSA at the plaque was smaller than in normal coronary walls (2.50 ± 1.50 vs. 4.72 ± 2.28 mm2;P<0.05). The SNR in the soft plaque was significantly greater than in calcified and mixed plaques (P<0.05). Conclusions: Coronary wall MRI can identify coronary plaques in the proximal and middle segments and has the potential to differentiate plaque types based on signal intensity.

关键词： Magnetic resonance imaging Coronary artery Wall imaging Atherosclerosis Plaques

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eHealth,telehealth,and telemedicine in the management of the COVID-19 pandemic and beyond:Lessons learned and future perspectives

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World Journal of Clinical Cases 2022年第8期10卷 2363-2368页

作者： Andrea Giacalone Luca Marin Massimiliano Febbi Thomas Franchi Marcos Roberto Tovani-Palone Department of Industrial Engineering Technologies for Sports Medicine and RehabilitationUniversity of Rome Tor VergataRome 00133Italy Department of Research Asomi College of SciencesMarsa MRS 19112Malta The Medical School The University of SheffieldSheffield S102RXUnited Kingdom Department of Pathology and Legal Medicine Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão Preto 14049-900Brazil

In this article,we discuss evidence supporting the effective implementation of e Health,telehealth,and telemedicine during the coronavirus disease 2019 pandemic,with a view towards its permanent future integration in *** performed a literature search for articles describing the use of telehealth/telemedicine in the pandemic context using five *** articles selected describe the use of telemedicine as its advantages in terms of practicality and *** synthesis of articles is applicable to high-,middle-and lowincome *** of the notable benefits include breaking down geographical and time barriers,reducing waiting lists and crowding in healthcare facilities,and saving on national healthcare ***,there are a number of difficulties with the widespread implementation of telemedicine services that mainly relate to bureaucratic and regulatory ***,it is also important to make healthcare professionals and providers aware of the limits of this tool to avoid potential cases of *** in turn will have to be made aware of and be educated on the use of this new healthcare modality before it is accepted by *** the current socio-economic climate,it is therefore essential to implement a telehealth model aimed at efficiency and continuity of healthcare,as well as leading to an improvement in the quality of life of patients,whilst optimising existing resources and reducing *** that regard,the adoption of e Health,telehealth,and telemedicine services should be considered highly timely,despite current existing limitations.

关键词： eHealth Telehealth Telemedicine Coronavirus disease 2019 Pandemics Delivery of healthcare

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Clinical Trial Demonstrates Efficacy of Transcranial Direct Current Stimulation (tDCS) in Improving Pain Management from Post-Laminectomy Syndrome

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Pain Studies and Treatment 2023年第4期11卷 27-42页

作者： Marilia Capuço Oliveira Fernanda Menezes de Faria Gerardo Maria de Araújo Filho Ana Carolina Gonçalves Olmos Demosthenes Santana Silva Junior Camila Souza Alves Cosmo Department of Neurological Sciences Psyquiatry and Medical Psychology Faculdade de Medicina de S&#227o José do Rio Preto S&#227o Paulo Brazil

Chronic pain, a multidimensional experience affecting individuals’ sensory, cognitive, and emotional aspects, significantly impacts their quality of life. Post-laminectomy syndrome, a condition characterized by persistent back pain following spinal surgery, often leads to disability and increased healthcare utilization. Methods: This randomized, controlled, blind clinical trial aimed to investigate the efficacy of Transcranial Direct Current Stimulation (tDCS) in managing pain from post-laminectomy syndrome in patients. Twenty-four participants were assigned to three groups: sham stimulation, active stimulation over primary motor cortex (M1), or stimulation over dorsolateral prefrontal cortex (DLPFC). Stimulation was administered for five consecutive days, 20 minutes per session, using a current of 1.5 mA through 25 cm2 electrodes. Pain intensity was assessed using Visual Analog Scale (VAS) before, during, and after intervention. Results: An ANOVA model demonstrates significant reduction in pain intensity compared to baseline in VAS, (F(7, 285) = 12.292;p 0.001;Power = 1.000;η2p = 0.534), in tDCS applied to M1, after five days of intervention. After stimulation, a significant improvement was observed in WHOQoL-Bref Quality of life item 1 (p = 0.04), considering statistical significant difference p 0.05. Correlation between the variables: quality of life, depression, anxiety and pain also demonstrates reduction in depression and anxiety according to Beck’s Depression and Anxiety Inventories (BDI and BAI), p 0.05. This effect was not observed in DLPFC stimulation group. Patients who believed they received active stimulation, in sham group, demonstrated potential for effective blinding. Conclusion: The tDCS applied to primary motor cortex effectively improved pain management and psychiatry symptoms in post-laminectomy syndrome patients. The technique’s low cost, ease of use, and high tolerability make it a promising adjuvant therapy for chronic pain conditio

关键词： Non-Invasive Neuromodulation Transcranial Direct Current Stimulation Post-Laminectomy Syndrome Chronic Pain

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Gallbladder perforation due to endoscopic sleeve gastroplasty: A case report and review of literature

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World Journal of Gastrointestinal Endoscopy 2020年第3期12卷 111-118页

作者： João de Siqueira Neto Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Sérgio Alexandre Barrichello Kelly E Harthorn Christopher C Thompson Department of Surgery Federal University of Espirito SantoVitoria 29075-910Espirito SantoBrazil Gastrointestinal Endoscopy Unit Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 05403-000São PauloBrazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States

BACKGROUND The healthcare impact of obesity is enormous,and there have been calls for new approaches to containing the epidemic *** invasive procedures have become more popular,with one of the most widely used being endoscopic sleeve gastroplasty(ESG).Although major adverse events after ESG are rare,some can cause considerable *** our knowledge,there has been no previous report of biliary ascites after *** SUMMARY A 48-year-old female with obesity refractory to lifestyle changes and prior gastric balloon placement underwent uncomplicated ESG and was discharged on the following *** postoperative day 3,she developed abdominal pain,which led to an emergency department visit the following *** was readmitted to the hospital,with poor general health status and signs of peritoneal *** tomography imaging showed fluid in the abdominal *** revealed biliary ascites and showed that the gallbladder was sutured to the gastric *** patient underwent cholecystectomy and lavage of the abdominal cavity and was admitted to the intensive care unit *** 7 d of antibiotic therapy and 20 d of hospitalization,she was ***,6 mo later,she presented in excellent general condition and with a 20.2%weight *** ESG is a safe ***,adverse events can still occur,and precautions should be taken by the *** general,patient position,depth of tissue acquisition,location of stitch placement,and endoscopist experience are all important factors to consider to mitigate procedural risk.

关键词： Bariatric surgery Obesity Weight loss Peritonitis Case report

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COVID-19:It's still time for health professionals,physical activity enthusiasts and sportive leagues not to let guard down

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Sports Medicine and Health Science 2021年第1期3卷 49-53页

作者： Rodrigo L.Vancini Marília S.Andrade Pantelis T.Nikolaidis Beat Knechtle Thomas Rosemann Ricardo B.Viana Claudio A.B.de Lira Centro de Educaçao Física e Desportos(CEFD) Universidade Federal do Espírito Santo(UFES)Espírito Santo(ES)Brazil Departamento de Fisiologia Universidade Federal de Sao Paulo(UNIFESP)Sao Paulo(SP)Brazil Exercise Physiology Laboratory NikaiaGreece Medbase St.Gallen Am Vadianplatz St.Gallen and Institute of Primary CareUniversity of ZurichZurichSwitzerland Institute of Primary Care University of ZurichSwitzerland Setor de Fisiologia Humana e do Exercício Faculdade de Educaçao Física e DançaUniversidade Federal de Goias(UFG)GoianiaGois(GO)Brazil Setor de Fisiologia Humana e do Exercício Faculdade de Educaçao Física e DançaUniversidade Federal de Goias(UFG)Goi^aniaGoias(GO)Brazil

Emerging viral diseases represent a serious issue to public and global healthcare systems and have a high potential for disease dissemination in sport/physical activity and exercise *** Coronavirus disease 2019(COVID-19)pandemic has frightened the sports and physical activity community and enthusiasts for potential trans-mission,dissemination,and lethality in vulnerable populations;those with chronic diseases,co-morbidities,the elderly people,and in young and healthy *** pandemic has caused a chain reaction with cancellations of sports competitions and gymnasiums closing around the ***,some sporting events are gradually resuming in certain regions of the world and also the return of competitions and *** general,without fans and public,the sports media can only report the infection of athletes and coaching staff ***,this situation is dynamic-the world is currently experiencing the second wave of the disease;with the safety and containment measures for the disease is changing *** purpose of this article is to present information concerning the COVID-19 pandemic,to clarify health issues for professionals and people connected to sport and physical activity venues,presenting information to assist in educations and the health promotion and *** time is now for making changes,reviewing the actions and conducts necessary for prevention,and most importantly not letting our guard down,even as vaccines become available for all people in the *** that even after getting vaccinated,it is necessary to continue with safety measures,for example,the use of facial masks and social distance and hygiene,that is,washing your hands frequently and/or sanitizing with 70%*** can't let our guard down for COVID-19.

关键词： Viral disease Covid-19 Coronavirus Sport Physical activity

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healthcare Application:An Analysis of Reception Studies in Interactive Digital Television

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Journalism and Mass Communication 2019年第5期9卷 235-242页

作者： Alexandre Kieling Amanda Caroline Rodrigues élida Borges Jhéssika Almeida Watson Odilon áulus Diniz Diogo Caetano Kênia Freitas Catholic University BrasíliaBrazil Brasilia University BrasíliaBrazil Communication Paulista State University Julio Mesquita BauruBrazil

This paper presents a healthcare application for brazilian digital television,its main purposes and its reception tests with end *** is an applied research for testing the scope of the Global ITV project funded by the brazilian National Council for Scientific and Technological Development(CNPq)and the European community which has developed a hybrid broadband and broadcasting platform.

关键词： interactive digital television TV application healthcare Ginga ecosystem Global ITV project

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Smoking influences outcome in patients who had thrombolysed ischaemic stroke:the ENCHANTED study

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Stroke & Vascular Neurology 2021年第3期6卷 395-401,I0033,I0034页

作者： Lingli Sun Lili Song Jie Yang Richard I Lindley Thompson Robinson Pablo M Lavados Candice Delcourt Hisatomi Arima Bruce Ovbiagele John Chalmers Craig S Anderson Xia Wang The George Institute for Global Health Peking University Health Science CentreBeijingChina The George Institute for Global Health University of New South WalesSydneyNSWAustralia Department of Neurology The First Affiliated Hospital of Chengdu Medical CollegeChengduChina Faculty of Medicine University of SydneySydneyNSWAustralia Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Sciences University of LeicesterLeicesterUK Clínica Alemana de Santiago Universidad del DesarrolloSantiago de ChileRegion Metropolitana de SChile Department of Preventive Medicine and Public Health Faculty of MedicineFukuoka UniversityFukuokaJapan San Francisco VA healthcare System University of CaliforniaSan FranciscoCaliforniaUSA

Background and purpose As studies vary in defining the prognostic significance of smoking in acute ischaemic stroke(AIS),we aimed to determine the relation of smoking and key outcomes in patient participants who had thrombolysed AIS of the international quasi-factorial randomised Enhanced Control of Hypertension and Thrombolysis Stroke Study(ENCHANTED).Methods Post-hoc analyses of ENCHANTED,an international quasi-factorial randomised evaluation of intravenous alteplase-dose comparison and levels of blood pressure control in patients who had thrombolysed *** logistic regression models with inverse probability of treatment weighting(IPTW)propensity scores were used to determine associations of self-reported smoking status and clinical outcomes,according to 90-day modified Rankin Scale(mRS)scores and symptomatic intracerebral haemorrhage(sICH).Results Of 4540 patients who had an AIS,there were 1008(22.2%)current smokers who were younger and predominantly male,with more comorbidities of hypertension,coronary artery disease,atrial fibrillation and diabetes mellitus,and greater baseline neurological impairment,compared with *** univariate analysis,current smokers had a higher likelihood of a favourable shift in mRS scores(OR 0.88,95%CI 0.77 to 0.99;p=0.038)but this association reversed in a fully adjusted model with IPTW(adjusted OR 1.15,95%CI 1.04 to 1.28;p=0.009).A similar trend was also apparent for dichotomised poor outcome(mRS scores 2–6:OR 1.18,95%CI 1.05 to 1.33;p=0.007),but not with the risk of sICH across standard *** Smoking predicts poor functional recovery in patients who had thrombolysed *** registration number NCT01422616.

关键词： patients smoke acute

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Association between ACTN3 R577X genotype and risk of non-contact injury in trained athletes:A systematic review

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Journal of Sport and Health Science 2023年第3期12卷 359-368页

作者： Hassane Zouhal Juan Del Coso Ayyappan Jayavel Claire Toumy Guillaume Ravé Nidhal Jebabli Cain C.T.Clark Benjamin Barthélémy Anthony C.Hackney Abderraouf Ben Abderrahman M2S(Laboratoire Mouvement SportSanté)-EA 1274Department of Sport SciencesUniversity of RennesRennes F-35000France Rey Juan Carlos University Centre for Sport StudiesMadrid 28032Spain SRM College of Physiotherapy SRM Institute of Science and TechnologySRM NagarKattankulathur 603203India Department of Sport Sciences University of RouenMont Saint AignanCETAPS EA 3832F-76821France Toulouse Football Club Toulouse 31000France Higher Institute of Sport and Physical Education Ksar-SaidUniversity of ManoubaTunis 2010Tunisia Centre for Intelligent healthcare Coventry UniversityCoventry CV15FBUK Department of Exercise&Sport Science Department of NutritionUniversity of North CarolinaChapel HillNC 27514USA

Purpose:The aim of this study was to review,systematically,evidence concerning the link between the ACTN3 R577X polymorphism and the rates and severity of non-contact injuries and exercise-induced muscle damage in athletes and individuals enrolled in exercise training ***:A computerized literature search was performed in the electronic databases PubMed,Web of Science,and SPORTDiscus,from inception until November *** included studies compared the epidemiological characteristics of non-contact injury between the different genotypes of the ACTN3 R577X ***:Our search identified 492 *** the screening of titles,abstracts,and full texts,13 studies examining the association between the ACTN3 genotypes and the rate and severity of non-contact injury were included in the *** studies were performed in 6 different countries(Spain,Japan,brazil,China,the Republic of Korea,and Italy)and involved a total participant pool of 1093 *** the studies,2 studies involved only women,5 studies involved only men,and 6 studies involved both men and *** the studies included were classified as highquality studies(≥6 points in the Physiotherapy Evidence Database(PEDro)scale score).Overall,evidence suggests there is an association between the ACTN3 R577X genotype and non-contact injury in 12 *** studies observed a significant association between A CTN3 R577X polymorphism and exercise induced muscle damage:2 with non-contact ankle injury,3 with non-contact muscle injury,and 1 with overall non-contact ***:The present findings support the premise that possessing the ACTN3 XX genotype may predispose athletes to a higher probability of some non-contact injuries,such as muscle injury,ankle sprains,and higher levels of exercise-induced muscle damage.

关键词： α-actinin-3 deficiency Athletic performance Exercise-related injury Muscle injury Single nucleotide polymorphism

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