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Health Care Science 2023年第3期2卷 153-163页

作者： John Abisheganaden Kheng Hock Lee Lian Leng Low Eugene Shum Han Leong Goh Christine Gia Lee Ang Andy Wee An Ta Steven M.Miller Department of Respiratory and Critical Care Medicine Tan Tock Seng HospitalNational Healthcare GroupSingaporeSingapore National Working Group for the Hospital to Home Program SingaporeSingapore Department of Family Medicine and Continuing Care Singapore General HospitalSingHealth GroupSingaporeSingapore singhealth community hospitals SingHealth GroupSingaporeSingapore Population Health and Integrated Care Office SingHealth GroupSingaporeSingapore Office of community Development Changi General HospitalSingHealth GroupSingaporeSingapore Data Analytics and AI Department Integrated Health Information SystemsSingaporeSingapore School of Computing and Information Systems Singapore Management UniversitySingaporeSingapore

In a prior practice and policy article published in Healthcare Science,we introduced the deployed application of an artificial intelligence(AI)model to predict longer‐term inpatient readmissions to guide community care interventions for patients with complex conditions in the context of Singapore's Hospital to Home(H2H)program that has been operating since *** this follow on practice and policy article,we further elaborate on Singapore's H2H program and care model,and its supporting AI model for multiple readmission prediction,in the following ways:(1)by providing updates on the AI and supporting information systems,(2)by reporting on customer engagement and related service delivery outcomes including staff‐related time savings and patient benefits in terms of bed days saved,(3)by sharing lessons learned with respect to(i)analytics challenges encountered due to the high degree of heterogeneity and resulting variability of the data set associated with the population of program participants,(ii)balancing competing needs for simpler and stable predictive models versus continuing to further enhance models and add yet more predictive variables,and(iii)the complications of continuing to make model changes when the AI part of the system is highly interlinked with supporting clinical information systems,(4)by highlighting how this H2H effort supported broader Covid‐19 response efforts across Singapore's public healthcare system,and finally(5)by commenting on how the experiences and related capabilities acquired from running this H2H program and related community care model and supporting AI prediction model are expected to contribute to the next wave of Singapore's public healthcare efforts from 2023 *** the convenience of the reader,some content that introduces the H2H program and the multiple readmissions AI prediction model that previously appeared in the prior Healthcare Science publication is repeated at the beginning of this article.

关键词： hospital to home community care hospital to home lessons learned transitional care integrated care multiple readmissions AI prediction model machine learning in healthcare healthcare technology

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Role of nitric oxide in cerebral ischemia/reperfusion injury:A biomolecular overview

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World Journal of Clinical Cases 2025年第10期13卷 9-13页

作者： Roberto Anaya-Prado Abraham I Canseco-Villegas Roberto Anaya-Fernández Michelle Marie Anaya-Fernandez Miguel A Guerrero-Palomera Citlalli Guerrero-Palomera Ivan F Garcia-Ramirez Daniel Gonzalez-Martinez Consuelo Cecilia Azcona-Ramírez Claudia Garcia-Perez Airim L Lizarraga-Valencia Aranza Hernandez-Zepeda Jacqueline F Palomares-Covarrubias Jorge HA Blackaller-Medina Jacqueline Soto-Hintze Mayra C Velarde-Castillo Dayri A Cruz-Melendrez Department of Research&Department of Surgery School of Medicine and Health SciencesTecnologico de MonterreyCorporate Hospitals Puerta de HierroZapopan 45116JaliscoMexico Direction of Research and Education Corporate Hospitals Puerta de HierroZapopan 45116JaliscoMexico Department of Research School of Medicine and Health SciencesTecnologico de MonterreyZapopan 45116JaliscoMexico Division of Research and Education Corporate Hospitals Puerta de HierroZapopan 45116JaliscoMexico Division of Research School of MedicineUniversity of GuadalajaraGuadalajara 44340JaliscoMexico Division of Research School of MedicineAutonomous University of GuadalajaraZapopan 45116JaliscoMexico Research&Education Corporate Hospitals Puerta de HierroZapopan 45116JaliscoMexico Division of Research Corporate Hospitals Puerta de HierroZapopan 45116JaliscoMexico Research School of MedicineUNIVA UniversityZapopan 45116JaliscoMexico

Nitric oxide(NO)is a gaseous molecule produced by 3 different NO synthase(NOS)isoforms:Neural/brain NOS(nNOS/bNOS,type 1),endothelial NOS(eNOS,type 3)and inducible NOS(type 2).Type 1 and 3 NOS are constitutively *** can serve different purposes:As a vasoactive molecule,as a neurotransmitter or as an *** plays a key role in cerebral ischemia/reperfusion injury(CIRI).Hypoxic episodes simulate the production of oxygen free radicals,leading to mitochondrial and phospholipid *** reperfusion,increased levels of oxygen trigger oxide synthases;whose products are associated with neuronal damage by promoting lipid peroxidation,nitrosylation and *** pathways in CIRI can be altered by *** effects are observed with eNOS *** nNOS interplay is prone to endothelial inflammation,oxidative stress and ***,nNOS appears to be *** interaction between NO and other free radicals develops peroxynitrite;which is a cytotoxic *** plays a main role in the likelihood of hemorrhagic events by tissue plasminogen activator(t-PA).Peroxynitrite scavengers are currently being studied as potential targets to prevent hemorrhagic transformation in CIRI.

关键词： Nitric oxide Cerebral ischemia/reperfusion injury Nitric oxide synthase Reactive nitrogen species Nitrosylation

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Elderly patients over 80 years undergoing colorectal cancer resection: Development and validation of a predictive nomogram for survival

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 892-905页

作者： Aik Yong Chok Yun Zhao Hui Lionel Raphael Chen Ivan En-Howe Tan Desmond Han Wen Chew Yue Zhao Marianne Kit Har Au Emile John Kwong Wei Tan Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Group Finance Analytics Singapore Health ServicesSingapore 168582Singapore Group Finance Singapore Health ServicesSingapore 168582Singapore singhealth community hospitals Singapore 168582Singapore

BACKGROUND Surgery remains the primary treatment for localized colorectal cancer(CRC).Improving surgical decision-making for elderly CRC patients necessitates an accurate predictive *** To build a nomogram to predict the overall survival of elderly patients over 80 years undergoing CRC *** Two hundred and ninety-five elderly CRC patients over 80 years undergoing surgery at Singapore General Hospital between 2018 and 2021 were identified from the American College of Surgeons–National Surgical Quality Improvement Program(ACS-NSQIP)*** variables were selected using univariate Cox regression,and clinical feature selection was performed by the least absolute shrinkage and selection operator regression.A nomogram for 1-and 3-year overall survival was constructed based on 60%of the study cohort and tested on the remaining 40%.The performance of the nomogram was evaluated using the concordance index(C-index),area under the receiver operating characteristic curve(AUC),and calibration *** groups were stratified using the total risk points derived from the nomogram and the optimal cut-off *** curves were compared between the high-and low-risk *** Eight predictors:Age,Charlson comorbidity index,body mass index,serum albumin level,distant metastasis,emergency surgery,postoperative pneumonia,and postoperative myocardial infarction,were included in the *** AUC values for the 1-year survival were 0.843 and 0.826 for the training and validation cohorts,*** AUC values for the 3-year survival were 0.788 and 0.750 for the training and validation cohorts,respectively.C-index values of the training cohort(0.845)and validation cohort(0.793)suggested the excellent discriminative ability of the *** curves demonstrated a good consistency between the predictions and actual observations of overall survival in both training and validation cohorts.A significant difference in overall survival wa

关键词： Colorectal cancer Elderly Nomogram Overall survival Prognostic Risk stratification

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The risk factors of SARS-CoV-2 antibody level differences in healthcare workers post vaccination in Siloam hospitals:A nationwide multicenter study

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Infectious Medicine 2022年第4期1卷 229-235页

作者： Allen Widysanto Ignatius Bima Prasetya Tandry Meriyanti Veli Sungono Diane Lukito Setiawan Edy Gunawan Bayu Adiputra Jane Olivia Lorens Theresia Santi Cindy Meidy Leony Pradhana Irawan Yusuf Catherine Gunawan Siloam hospitals Lippo Village BantenIndonesia Faculty of Medicine Pelita Harapan UniversityBantenIndonesia Siloam hospitals Surabaya East JavaIndonesia Clinical Research Department Siloam hospitals Group BantenIndonesia Siloam hospitals Lippo Cikarang West JavaIndonesia Mochtar Riady Institute for Nanotechnology BantenIndonesia

Background:Several vaccines have been approved against COVID-19,and 5 have been used in *** to the decrease in antibody levels 3 to 6 months after the second dose of CoronaVac,healthcare workers received the third booster of mRNA vaccine(mRNA-1273)to increase the antibody *** study aimed to evaluate the risk factors of anti-S-RBD IgG levels differences in healthcare ***:This study is a retrospective cohort study of 576 healthcare workers without previous SARS-CoV-2 infection who received 2 doses of CoronaVac and the third dose of mRNA-12736 months after the second *** samples were obtained 2nd,6th,12th,and 24th weeks after the second dose of CoronaVac vaccine administration,with mRNA-1273 booster on week *** measurements of IgG antibodies were performed with Elecsys Anti-SARS-CoV-2 S *** identify the baseline factors predicting post-vaccination antibody titers using univariate and multivariate linear regression ***:This study comprised 576 participants aged 32 years old,72.05%female,and 45.84%from high-risk occupation *** median antibodies titer level on the 2nd,6th,12th,and 24th weeks after the second vaccine dose administration were 40.99 u/mL,42.01 u/mL,54.78 u/mL,and 23,225 u/*** levels trended highest in female and younger age group(20-29 years old).Conclusions:The third dose of vaccine increased the quantitative SARS-CoV-2 spike IgG antibody titers and eliminated differences in antibodies titer by gender.

关键词： Antibodies titer COVID-19 Immune response S-RBD IgG Vaccine

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Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma

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World Journal of Gastrointestinal Oncology 2014年第5期6卷 139-144页

作者： Omar S Al-Taan Amar Eltweri David Sharpe Peter M Rodgers Sukhbir S Ubhi David J Bowrey Departments of Surgery University Hospitals of Leicester Departments of Radiology University Hospitals of Leicester

AIM: To evaluate the influence of baseline maximum standardized uptake value(SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography(PET-CT) scan for esophageal carcinoma. METHODS: The pre-treatment SUVmax numeric reading was determined in patients with confirmed esophageal or junctional cancer having PET-CT scan during the time period 1st January 2007 until 31 st July 2012. A minimum follow up of 12 mo was required. Patients were subdivided into quartiles according to SUVmax value and the influence of SUVmax on survival was assessed using univariate and multivariate analysis. The following pre-treatment factors were investigated: patient characteristics, tumor characteristics and planned treatment. RESULTS: The study population was 271 patients(191male) with esophageal or junctional carcinoma. The median age was 65 years(range 40-85) and histologic subtype was adenocarcinoma in 197 patients and squamous carcinoma in 74 patients. The treatment intent was radical in 182 and palliative in 89 patients. SUVmax was linked to histologic subtype(P = 0.008), tumor site(P = 0.01) and Union for International Cancer Control(UICC) stage(P < 0.001). On univariate analysis, prognosis was significantly associated with SUVmax(P = 0.001), T-stage(P < 0.001) and UICC stage(P < 0.001). On multivariate analysis, only T-stage and UICC stage remained significant. CONCLUSION: Pretreatment SUVmax was not a useful marker in isolation for determining prognosis of patients with esophageal carcinoma.

关键词： Esophageal neoplasms Fluorodeoxyglucose F18 Positron emission tomography Positron emission tomography-computed tomography Prognosis

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Chondroitinase ABC combined with Schwann cell transplantation enhances restoration of neural connection and functional recovery following acute and chronic spinal cord injury

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Neural Regeneration Research 2025年第5期20卷 1467-1482页

作者： Wenrui Qu Xiangbing Wu Wei Wu Ying Wang Yan Sun Lingxiao Deng Melissa Walker Chen Chen Heqiao Dai Qi Han Ying Ding Yongzhi Xia George Smith Rui Li Nai-Kui Liu Xiao-Ming Xu Spinal Cord and Brain Injury Research Group Stark Neurosciences Research InstituteDepartment of Neurological SurgeryIndiana University School of MedicineIndianapolisINUSA Department of Hand Surgery the Second Hospital of Jilin UniversityChangchunJilin ProvinceChina Shriners hospitals Pediatric Research Center Temple University School of MedicinePhiladelphiaPAUSA Department of Anatomy&Cell Biology Indiana University School of MedicineIndianapolisINUSA

Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal *** we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord *** report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal *** Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder ***,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord *** findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.

关键词： axonal regrowth bladder function chondroitinase ABC functional recovery glial scar lentivirus migration Schwann cell spinal cord injury transplantation

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Double-blind randomized sham controlled trial of intraperitoneal bupivacaine during emergency laparoscopic cholecystectomy

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Hepatobiliary & Pancreatic Diseases International 2013年第3期12卷 310-316页

作者： Keith J Roberts Jeff Gilmour Ruplay Pande James Hodson For Tai Lam Saboor Khan Department of Hepatopancreatobiliary Surgery University Hospitals Coventry and Warwickshire Wolfson Laboratory University Hospitals Birmingham

BACKGROUND: Intraperitoneal local anesthesia (IPLA) during elective laparoscopic cholecystectomy (el-LC) decreases post-operative pain. None of the studies have explored the efficacy of IPLA at emergency laparoscopic cholecystectomy (em-LC). A longer operative duration, the greater frequency of washing, and the inflammation associated with cholecystitis or pancreatitis are a few reasons why it cannot be assumed that a benefit in pain scores will be seen in em-LC with IPLA. This study was undertaken to assess the efficacy of IPLA in patients undergoing em-LC. METHODS: Double-blind randomized sham controlled trial was conducted of 41 consecutive subjects undergoing em-LC. IPLA was delivered by a combination of injection to the diaphragmatic and topical wash over the liver and gallbladder with bupivacaine or saline. The primary outcome was visual analogue scale pain scores until discharge. Secondary outcomes included pain scores in theatre recovery and analgesic consumption. RESULTS: One patient had a procedure converted to open and was excluded. There was no significant difference in pain scores in the ward or theatre recovery. Analgesic use, respiratory rate, oxygen saturation, duration to ambulation, eating, satisfaction scores, and time to discharge were comparable between the two groups. CONCLUSIONS: IPLA during em-LC does not influence postoperative pain. Other modalities of analgesia should be explored for decreasing the interval between diagnosis of acute admission and em-LC.

关键词： gallbladder stone disease gallbladder cholecystectomy

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Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period:A questionnaire-based study

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World Journal of Clinical Cases 2025年第1期13卷 29-37页

作者： Bijnya Birajita Panda Chitaranjan Mishra Bhagabat Nayak Avik Kumar Roy Logesh Balakrishnan Priyadarshini Mishra Department of Ophthalmology All India Institute of Medical SciencesBhubaneswar 751019OdishaIndia Department of Vitreo-Retina Trilochan NetralayaSambalpur 768004India Department of Glaucoma Services LV Prasad Eye InstituteBhubaneswar 751013India Department of Statistics Apollo HospitalsChennai 823104India

BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic *** oculoplastic conditions,like nasolacrimal duct obstruction,have been extensively studied,whereas others,like eyelid malposition and thyroid eye disease,have received minimal or no *** To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic *** A cross-sectional survey was disseminated among ophthalmologists all over *** survey included questions related to pre-operative evaluation,anaesthetic and surgical techniques preferred,post-operative care,the use of adjunctive therapies,and patient follow-up *** A total of 180 ophthalmologists responded to the *** practitioners(89%)felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was *** most common surgical techniques employed were lacrimal drainage procedures(Dacryocystorhinostomy)(63.3%),eyelid malposition repair(36.9%),and ptosis repair(58.7%).Post-operatively,47.7%of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid ***-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease *** Approximately 50%of ophthalmologists handle prevalent oculoplastic issues themselves,seeking the expertise of an oculoplastic surgeon under particular *** ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract *** conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

关键词： Oculoplasty Ophthalmic plastic surgery Nasolacrimal duct obstruction Practice patterns Survey

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Posttransplant lymphoproliferative disorders following liver transplantation: where are we now?

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World Journal of Gastroenterology 2015年第39期21卷 11034-11043页

作者： Daan Dierickx Nina Cardinaels Department of Hematology University Hospitals Leuven

Liver transplantation has emerged as a life-saving treatment for several patients with acute liver failure, end stage liver disease and primary hepatic malignancies. However, long term immunosuppressive therapy aiming to reduce the risk of transplant rejection increases the incidence of several com-plications including malignancies. This is illustrated by the observation of a high ratio between observed and expected cases of lymphoproliferative disorders following liver transplantation. Despite a huge heterogeneity in morphological appearance of these disorders ranging from reactive-like lesions to real lymphomas, they are collectively termed posttransplant lymphoproliferative disorders. In this review we will provide an overview of this rare but challenging disorder as a complication of liver transplantation.

关键词： Epstein Barr virus Liver transplantation Posttrans

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Green synthesis and characterization of palladium nanoparticles and its conjugates from solanum trilobatum leaf extract

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Nano-Micro Letters 2010年第3期2卷 169-176页

作者： Amarnath Kanchana Saveetha Devarajan Senniyanallur Rathakrishnan Ayyappan Department of Biochemistry Sathyabama University Dental College and Hospitals Department of Biotechnology Sathyabama University Department of Microbiology Sathyabama University Dental College and Hospitals

An important area of research in nanotechnology deals with the synthesis of nanoparticles of different chemical compositions,sizes and controlled ***,there is a growing need to develop environmentally benign nanoparticle synthesis in which no toxic chemicals are used in the synthesis *** nanoparticles(Pd Np) are of interest because of their catalytic properties and affinity for *** protocol for the phyto-synthesis of Pd Np under moderate p H and room temperature offers a new means to develop environmentally benign *** trilobatum is enlightened in our present study as it is enriched with phytochemicals to reduce palladium chloride *** MVA a dietary supplement based on the nontoxic chemotherapeutic lipoic acid-palladium complex(LA-Pd) is been hypothesized as the new paradigm of cancer *** forth we successfully conjugated lipoic acid(S-Pd Np-LA) and vitamins(S-Pd Np-Vitamin-LA) to palladium nanoparticles synthesised from Solanum trilobatum leaf *** nanoparticles(S-Pd Np,S-Pd Np-LA,S-Pd Np-Vitamin-LA) were characterized with UV-Vis Spectroscopy,SEM and FTIR analysis,which revealed that S-Pd Np are polydisperse and of different morphologies ranging from 60?70 nm(S-Pd Np),65?80 nm(S-Pd Np-LA) and 75?100 nm(S-Pd Np-Vitamin-LA) in size.

关键词： Nanoparticles Palladium Lipoic acid Palladium lipoic acid complex Poly-MVA Green synthesis Solanum trilobatum

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