AIM: To examine the predictive factors of capsule en- doscopy (CE) completion rate (CECR) including the ef- fect of inpatient and outpatient status.METHODS: We identified 355 consecutive patients who completed C...AIM: To examine the predictive factors of capsule en- doscopy (CE) completion rate (CECR) including the ef- fect of inpatient and outpatient status.METHODS: We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient (OP), 70 in-patient (IP)], CE indications, findings, location of the patients [IP vs OP and intensive care unit (ICU) vs general medical floor (GMF)] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 (Chicago, IL). Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS: The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs (P = 0.07). The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding (OGB) was significantly more com- mon for the IP CE (P = 0.0001), while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams (P = 0.002 and P = 0.01, respec- tively). Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel (SB) in 6/70 IPs and 8/264 OPs (P = 0.04). The capsule never reached the cecum in 31.4% (22/70) of IP vs 9.5% (25/ 264) of OP ex- aminations (P 〈 0.001). The mean gastric transit time (GTT) was delayed in IPs compared to OPs, 98.5 ± 139.5 min vs 60.4 ± 92.6 min (P = 0.008). Minimal SB transit time was significantly prolonged in the IP com- pared to the OP setting [IP = 275.1±111.6 min vs OP = 244.0 ± 104.3 min (P = 0.037)]. CECR was also sig- nificantly higher in the subgroup of patients with OGB who had OP vs IP exams (95% vs 80% respectively, P = 0.001). The proportion of patients with incomplete exams was higher in the ICU (n = 7/13, 54%) as com- pared to the GMF (n = 15/57, 26%) (P = 0.05). There was only a single permanent SB retention case which was secondary to a previously unknown SB stricture, and the remaining incomplete SB exams were due to slow transit. Medications which affect gastrointesti- nal system motility were tested both individually and also in aggregate in univariate analysis in hospitalized patients (ICU and GMF) and were not predictive of incomplete capsule passage (P 〉 0.05). Patient loca- tion (IP vs OP) and GTT were independent predictors of incomplete CE exams (P 〈 0.001 and P = 0.008, respectively). CONCLUSION: Incomplete CE is a multifactorial prob- lem. Patient location and related factors such as sever- ity of illness and sedentary status may contribute to incomplete exams.展开更多
Background Transcatheter aortic valve replacement (TAVR) has been performed for many elderly patients with severe aortic stenosis (AS). The SAPIEN 3 is one of the latest balloon-expandable prosthesis. This study a...Background Transcatheter aortic valve replacement (TAVR) has been performed for many elderly patients with severe aortic stenosis (AS). The SAPIEN 3 is one of the latest balloon-expandable prosthesis. This study aimed to investigate the early clinical outcomes after TAVR using the SAPIEN 3 in nonagenarians. Methods A total of 97 consecutive patients underwent TAVR for severe AS between De- cember 2015 and December 2016. Of these, 85 consecutive patients who underwent TAVR using the SAPIEN 3 were included. According to the age, patients were classified into age 〉 90 years group (17 patients) or age 〈 90 years group (68 patients). The clinical outcomes in- cluding all-cause mortality and composite endpoint of early safety at 30 days were evaluated. Results The Society of Thoracic Surgeons score in age 〉 90 years group was higher than age 〈 90 years group (12.3 ±6.1% vs. 8.5 ± 5.1%, P 〈 0.01). There was no significant difference in 30-day mortality between the two groups. However, the life-threatening bleeding and major vascular complications in age 〉 90 years group were greater than age 〈 90 years group (11.8% vs. 1.5%, P = 0.04 and 11.8% vs. 1.5%, P = 0.04, respectively). The composite endpoint of early safety at 30 days was similar between the two groups. Multivariate logistic regression analysis showed that prior myocardial infarction was an independent predictor of the composite endpoint of early safety (odds ratio: 4.76, 95% confidence interval: 1.02-22.21, P = 0.047). Conclusions The early mortality and safety after TAVR using the SAPIEN 3 in nonagenarians were similar and acceptable despite of higher operative risk.展开更多
Corn steep liquor(CSL) is an important raw material that has high nutritional value and serves as a nitrogen source.Biotin in CSL is especially of great importance to fermentation.In order to develop a fast,versatile,...Corn steep liquor(CSL) is an important raw material that has high nutritional value and serves as a nitrogen source.Biotin in CSL is especially of great importance to fermentation.In order to develop a fast,versatile,cheap,and environmentally safe analytical method for quantifying vitamins B2(VB2),B3(VB3),B6(VB6) and B7(VB7) in CSL,the near-infrared spectroscopy(NIR) measurements of 66 samples(22 batches) of CSL were analyzed by partial least-square regression(PLSR).Multivariate models developed in the NIR regions showed good predictive abilities for VB2,VB3,VB6 and VB7.Results confirmed the probability of the multivariate spectroscopic approach as a replacement for expensive and time-consuming conventional chemical methods.展开更多
AIM:To test the efficacy and safety of Profermin in inducing remission in patients with active ulcerative colitis(UC).METHODS:The study included 39 patients with mild to moderate UC defined as a Simple Clinical Coliti...AIM:To test the efficacy and safety of Profermin in inducing remission in patients with active ulcerative colitis(UC).METHODS:The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index(SCCAI)>4 and<12(median:7.5),who were treated open-label with Profermintwice daily for 24 wk.Daily SCCAI was reported observer blinded via the Internet.RESULTS:In an intention to treat(ITT)analysis,the mean reduction in SCCAI score was 56.5%.Of the 39 patients,24(62%)reached the primary endpoint,which was proportion of patients with≥50%reduction in SCCAI.Our secondary endpoint,the proportion of patients in remission defined as SCCAI≤2.5,was in ITT analysis reached in 18 of the 39 patients(46%).In a repeated-measure regression analysis,the estimated mean reduction in score was 5.0 points(95%CI:4.1-5.9,P<0.001)and the estimated mean time taken to obtain half the reduction in score was 28 d(95%CI:26-30).There were no serious adverse events(AEs)or withdrawals due to AEs.Profermin was generally well tolerated.CONCLUSION:Profermin is safe and may be effective in inducing remission of active UC.展开更多
The study reveals that 10.2% of the sampled households in Nepal suffer from chronic food insecurity,i.e.,neither are they able to produce sufficient food from their farms nor earn the food security threshold income fo...The study reveals that 10.2% of the sampled households in Nepal suffer from chronic food insecurity,i.e.,neither are they able to produce sufficient food from their farms nor earn the food security threshold income for deficit months.With the highest and the lowest exponential value of coefficient obtained from binary logistic regression model,it is concluded that any program targeting occupational caste and small landholding farm category or landless will contribute significantly to reduce food-insecurity.The provision of employment opportunities for economically active age group,thus,reducing dependency ratio from 1.2 (economically active population) to 0.7 (economically active age group) can also contribute significantly to reduce food insecurity.Significant positive coefficient of family size squared shows the increase in the probability of being foodinsecure with the increase in family size.In addition,an increase in irrigation availability can contribute significantly to reduce food insecurity.A significant proportion of male-headed households and households residing in Tarai are food-secure.This justifies the need to target female-headed households and households residing in Mountain and Hill in any program aimed at resolving food insecurity.A negative and significant association of household's participation in community organizations and food insecurity fortifies the need for inclusion of vulnerable groups such as occupational caste,female-headed households,households with illiterate heads,small landholding farm category or landless,and households residing in Mountain and Hill (including some target communities in Tarai) in community organizations.Furthermore,making these communities a target of food security programs can help significantly to reduce the incidence of food insecurity.展开更多
文摘AIM: To examine the predictive factors of capsule en- doscopy (CE) completion rate (CECR) including the ef- fect of inpatient and outpatient status.METHODS: We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient (OP), 70 in-patient (IP)], CE indications, findings, location of the patients [IP vs OP and intensive care unit (ICU) vs general medical floor (GMF)] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 (Chicago, IL). Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS: The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs (P = 0.07). The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding (OGB) was significantly more com- mon for the IP CE (P = 0.0001), while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams (P = 0.002 and P = 0.01, respec- tively). Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel (SB) in 6/70 IPs and 8/264 OPs (P = 0.04). The capsule never reached the cecum in 31.4% (22/70) of IP vs 9.5% (25/ 264) of OP ex- aminations (P 〈 0.001). The mean gastric transit time (GTT) was delayed in IPs compared to OPs, 98.5 ± 139.5 min vs 60.4 ± 92.6 min (P = 0.008). Minimal SB transit time was significantly prolonged in the IP com- pared to the OP setting [IP = 275.1±111.6 min vs OP = 244.0 ± 104.3 min (P = 0.037)]. CECR was also sig- nificantly higher in the subgroup of patients with OGB who had OP vs IP exams (95% vs 80% respectively, P = 0.001). The proportion of patients with incomplete exams was higher in the ICU (n = 7/13, 54%) as com- pared to the GMF (n = 15/57, 26%) (P = 0.05). There was only a single permanent SB retention case which was secondary to a previously unknown SB stricture, and the remaining incomplete SB exams were due to slow transit. Medications which affect gastrointesti- nal system motility were tested both individually and also in aggregate in univariate analysis in hospitalized patients (ICU and GMF) and were not predictive of incomplete capsule passage (P 〉 0.05). Patient loca- tion (IP vs OP) and GTT were independent predictors of incomplete CE exams (P 〈 0.001 and P = 0.008, respectively). CONCLUSION: Incomplete CE is a multifactorial prob- lem. Patient location and related factors such as sever- ity of illness and sedentary status may contribute to incomplete exams.
文摘Background Transcatheter aortic valve replacement (TAVR) has been performed for many elderly patients with severe aortic stenosis (AS). The SAPIEN 3 is one of the latest balloon-expandable prosthesis. This study aimed to investigate the early clinical outcomes after TAVR using the SAPIEN 3 in nonagenarians. Methods A total of 97 consecutive patients underwent TAVR for severe AS between De- cember 2015 and December 2016. Of these, 85 consecutive patients who underwent TAVR using the SAPIEN 3 were included. According to the age, patients were classified into age 〉 90 years group (17 patients) or age 〈 90 years group (68 patients). The clinical outcomes in- cluding all-cause mortality and composite endpoint of early safety at 30 days were evaluated. Results The Society of Thoracic Surgeons score in age 〉 90 years group was higher than age 〈 90 years group (12.3 ±6.1% vs. 8.5 ± 5.1%, P 〈 0.01). There was no significant difference in 30-day mortality between the two groups. However, the life-threatening bleeding and major vascular complications in age 〉 90 years group were greater than age 〈 90 years group (11.8% vs. 1.5%, P = 0.04 and 11.8% vs. 1.5%, P = 0.04, respectively). The composite endpoint of early safety at 30 days was similar between the two groups. Multivariate logistic regression analysis showed that prior myocardial infarction was an independent predictor of the composite endpoint of early safety (odds ratio: 4.76, 95% confidence interval: 1.02-22.21, P = 0.047). Conclusions The early mortality and safety after TAVR using the SAPIEN 3 in nonagenarians were similar and acceptable despite of higher operative risk.
基金Supported by Foundation of Tianjin City Science and Technology Project (No.09ZCKFSH00900)
文摘Corn steep liquor(CSL) is an important raw material that has high nutritional value and serves as a nitrogen source.Biotin in CSL is especially of great importance to fermentation.In order to develop a fast,versatile,cheap,and environmentally safe analytical method for quantifying vitamins B2(VB2),B3(VB3),B6(VB6) and B7(VB7) in CSL,the near-infrared spectroscopy(NIR) measurements of 66 samples(22 batches) of CSL were analyzed by partial least-square regression(PLSR).Multivariate models developed in the NIR regions showed good predictive abilities for VB2,VB3,VB6 and VB7.Results confirmed the probability of the multivariate spectroscopic approach as a replacement for expensive and time-consuming conventional chemical methods.
基金Supported by Danish Innovation Law Grant,J.nr.3414-06-01530from the Danish Food Industry Agency under the Ministry of Food,Agriculture and FisheriesNordisk Rebalance,who developed and manufactured Profermin,and partly financed the study
文摘AIM:To test the efficacy and safety of Profermin in inducing remission in patients with active ulcerative colitis(UC).METHODS:The study included 39 patients with mild to moderate UC defined as a Simple Clinical Colitis Activity Index(SCCAI)>4 and<12(median:7.5),who were treated open-label with Profermintwice daily for 24 wk.Daily SCCAI was reported observer blinded via the Internet.RESULTS:In an intention to treat(ITT)analysis,the mean reduction in SCCAI score was 56.5%.Of the 39 patients,24(62%)reached the primary endpoint,which was proportion of patients with≥50%reduction in SCCAI.Our secondary endpoint,the proportion of patients in remission defined as SCCAI≤2.5,was in ITT analysis reached in 18 of the 39 patients(46%).In a repeated-measure regression analysis,the estimated mean reduction in score was 5.0 points(95%CI:4.1-5.9,P<0.001)and the estimated mean time taken to obtain half the reduction in score was 28 d(95%CI:26-30).There were no serious adverse events(AEs)or withdrawals due to AEs.Profermin was generally well tolerated.CONCLUSION:Profermin is safe and may be effective in inducing remission of active UC.
文摘The study reveals that 10.2% of the sampled households in Nepal suffer from chronic food insecurity,i.e.,neither are they able to produce sufficient food from their farms nor earn the food security threshold income for deficit months.With the highest and the lowest exponential value of coefficient obtained from binary logistic regression model,it is concluded that any program targeting occupational caste and small landholding farm category or landless will contribute significantly to reduce food-insecurity.The provision of employment opportunities for economically active age group,thus,reducing dependency ratio from 1.2 (economically active population) to 0.7 (economically active age group) can also contribute significantly to reduce food insecurity.Significant positive coefficient of family size squared shows the increase in the probability of being foodinsecure with the increase in family size.In addition,an increase in irrigation availability can contribute significantly to reduce food insecurity.A significant proportion of male-headed households and households residing in Tarai are food-secure.This justifies the need to target female-headed households and households residing in Mountain and Hill in any program aimed at resolving food insecurity.A negative and significant association of household's participation in community organizations and food insecurity fortifies the need for inclusion of vulnerable groups such as occupational caste,female-headed households,households with illiterate heads,small landholding farm category or landless,and households residing in Mountain and Hill (including some target communities in Tarai) in community organizations.Furthermore,making these communities a target of food security programs can help significantly to reduce the incidence of food insecurity.