Gastrointestinal(GI)bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit(ICU).This literature review consolidates current insights on the epidemiology,etiolo...Gastrointestinal(GI)bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit(ICU).This literature review consolidates current insights on the epidemiology,etiology,management,and outcomes of GI bleeding in critically ill patients.GI bleeding remains a significant concern,especially among patients with underlying risk factors such as coagulopathy,mechanical ventilation,and renal failure.Managing GI bleeding in the ICU requires a multidisciplinary approach,including resuscitation,endoscopic intervention,pharmacologic therapy,and sometimes surgical procedures.Even with enhanced management strategies,GI bleeding in the ICU is associated with considerable morbidity and mortality,particularly when complicated by multi-organ failure.This review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients,aiming to enhance survival rates and improve the quality of care within the ICU setting.展开更多
The pyramid wavefront sensor(PWFS)can provide the sensitivity needed for demanding adaptive optics applications,such as imaging exoplanets using the future extremely large telescopes of over 30 m of diameter(D).Howeve...The pyramid wavefront sensor(PWFS)can provide the sensitivity needed for demanding adaptive optics applications,such as imaging exoplanets using the future extremely large telescopes of over 30 m of diameter(D).However,its exquisite sensitivity has a limited linear range of operation,or dynamic range,although it can be extended through the use of beam modulation—despite sacrificing sensitivity and requiring additional optical hardware.Inspired by artificial intelligence techniques,this work proposes to train an optical layer—comprising a passive diffractive element placed at a conjugated Fourier plane of the pyramid prism—to boost the linear response of the pyramid sensor without the need for cumbersome modulation.We develop an end-2-end simulation to train the diffractive element,which acts as an optical preconditioner to the traditional least-square modal phase estimation process.Simulation results with a large range of turbulence conditions show a noticeable improvement in the aberration estimation performance equivalent to over 3λ∕D of modulation when using the optically preconditioned deep PWFS(DPWFS).Experimental results validate the advantages of using the designed optical layer,where the DPWFS can pair the performance of a traditional PWFS with 2λ∕D of modulation.Designing and adding an optical preconditioner to the PWFS is just the tip of the iceberg,since the proposed deep optics methodology can be used for the design of a completely new generation of wavefront sensors that can better fit the demands of sophisticated adaptive optics applications such as ground-to-space and underwater optical communications and imaging through scattering media.展开更多
Purpose: To evaluate the use of releasable sutures in filtration surgery by comparing the results and the rate of post-operative complications in eyes which underwent filtration surgery with and without releasable sut...Purpose: To evaluate the use of releasable sutures in filtration surgery by comparing the results and the rate of post-operative complications in eyes which underwent filtration surgery with and without releasable sutures. Methods: A retrospective evaluation of 74 eyes with glaucoma (COAG, CNAG, PXFG) of 74 patients who underwent filtration surgery in our department during 1999. All the patients included in the study had 6-12展开更多
The purpose of this study was to evaluate the characteristics of automated perimetry exams at a large diagnostic institute. We describe the model of operation of this institue that provides greater than 80% of the vis...The purpose of this study was to evaluate the characteristics of automated perimetry exams at a large diagnostic institute. We describe the model of operation of this institue that provides greater than 80% of the visual field examinations, with interpretation, for a population of 2 million people. The institute展开更多
Seaweed bioinvasions increasingly affect coastal environments around the world, which increases the need for predictive models and mitigation strategies. The biotic interactions between seaweed invaders and invaded co...Seaweed bioinvasions increasingly affect coastal environments around the world, which increases the need for predictive models and mitigation strategies. The biotic interactions between seaweed invaders and invaded communities are often considered a key determinant of invasion success and failure and we here revise the current evidence that the capacity of seaweed invaders to deter enemies in newly reached environments correlates with their invasion success. Particularly efficient chemical defences have been described for several of the more problematic seaweed invaders during the last decades. However, confirmed cases in which seaweed invaders confronted un-adapted enemies in newly gained environments with deterrents that were absent from these environments prior to the invasion (so-called “novel weapons”) are scarce, although an increasing number of invasive and non-invasive seaweeds are screened for defence compounds. More evidence exists that seaweeds may adapt defence intensities to changing pressure by biological enemies in newly invaded habitats. However, most of this evidence of shifting defence was gathered with only one particular model seaweed, the Asia-endemic red alga Agarophyton vermiculophyllum, which is particularly accessible for direct comparisons of native and non-native populations in common garden experiments. A. vermiculophyllum interacts with consumers, epibionts and bacterial pathogens and in most of these interactions, non-native populations have rather gained than lost defensive capacity relative to native conspecifics. The increases in the few examined cases were due to an increased production of broad-spectrum deterrents and the relative scarcity of specialized deterrents perhaps reflects the circumstance that seaweed consumers and epibionts are overwhelmingly generalists.展开更多
Purpose: To report the practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (A RMD) over 1 year. Methods: The consecutive interventional c...Purpose: To report the practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (A RMD) over 1 year. Methods: The consecutive interventional case series included 5 6 patients with exudative ARMD. During vitrectomy the submacular neovascular mem brane (CNV) was removed and IPE cells, harvested from a peripheral iridectomy, w ere injected into the submacular space. Included were patients with subfoveal oc cult CNV (11 eyes), classic CNV (10 eyes), mixed CNV (17 eyes), CNV with a pigme nt epithelial detachment (13 eyes) or CNV with a hemorrhage (5 eyes). Outcome me asures were visual acuity, foveal fixation, size of CNV and rate of recurrence b ased on fluorescence angiographic imaging. Results: All patients underwent succe ssful surgical removal of the CNV with consecutive subretinal IPE injection. Vis ual acuity was better than 20/100 in 19 patients preoperatively and in 18 patien ts postoperatively. A visual acuity of 20/100 or less was found in 37 patients p reoperatively and in 38 patients postoperatively. Mean preoperative visual acuit y (1.0±0.3 logMAR units) did not change significantly after 1 year (1.0±0.3 lo gMAR units). Ten eyes (18%) developed a recurrence. Fixation within the surgica lly denuded area could be demonstrated in 25 eyes (45%). Conclusions: Autologou s IPE translocation for ARMD over one year can preserve foveal function on a low level, but cannot improve visual acuity. IPE translocation is technically feasi ble with a low rate of complications. Continued research seems justified to impr ove functional outcome.展开更多
To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome ...To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome and the age at treatment. Interventional case series. Retrospective comparative study. setting: Outpatient ophthalmology clinic. patients: Twenty- nine consecutive patients (30 eyes) with subfoveal CNV caused by pathologic myopia who were treated with verteporfin PDT from January 2000 to May 2003. intervention: All the patients received verteporfin PDT and were followed clinically and with fluorescein angiography (FA). Review of the medical records and angiograms was performed. Patients were divided into two groups by age, using the median age (60 years) as the cutoff. main outcome measures: Visual acuity (VA) at the end of follow- up in the older- patient group compared with the younger- patient group. The mean age was 63.1 years. Mean follow- up was 11.5 months. Patients received a mean of 3.48 treatments. Mean VA improved in the younger group from 0.63 to 0.39 logMAR (P=.02, paired t test) and deteriorated in the older group from 0.71 to 0.99 logMAR (P=.03, paired t test). In the whole cohort, 33% of eyes lost 3 or more lines of Snellen best- corrected VA; in the older age group, 50% of eyes lost 3 or more lines, whereas in the younger age group, only 8% of eyes did so (P=.024, Fisher’ s exact test). In our consecutive case series, visual prognosis of myopic CNV after PDT was found to be influenced by age at treatment.展开更多
Objective: To estimate the frequency of pneumococcal meningitis among patients with bacterial meningitis in Iran. Methods: PubMed, Embase, Web of Science and Scientific Information Database (www. sid.ir) were searched...Objective: To estimate the frequency of pneumococcal meningitis among patients with bacterial meningitis in Iran. Methods: PubMed, Embase, Web of Science and Scientific Information Database (www. sid.ir) were searched from 2000 to 2016 to identify studies on the frequency or prevalence of pneumococcal meningitis in Iran. Stata 14.0 (StataCorp, College Station, Texas, USA) was used to analyze the data. Results: Of the 131 records identified from the databases, 21 studies fulfilled the eligibility criteria. The analyses showed that 25.0% (95% CI: 19.0-32.0;I2=71%) of the confirmed bacterial meningitis (including children and adults) cases were caused by pneumococcus. Conclusions: The large fraction of meningitis cases caused by pneumococcus demonstrates that pneumococcal meningitis is a major public health problem in Iran, and the introduction of pneumococcal vaccines merits further attention from health authorities.展开更多
文摘红藻真江蓠(Gracilaria vermiculophylla)是西北太平洋地区特有种,但在过去100年间它借助海运(太平洋牡蛎养殖)快速入侵到北美、欧洲和地中海等沿海栖息地,对当地的生物多样性、海洋环境和生态系统等造成重大影响。为从分子水平初步了解真江蓠成功入侵的潜在机制,文章对其入侵起源地——日本北部的真江蓠及非入侵种——绳状龙须菜(Gracilariopsis chorda)进行了同质园实验(common garden experiment)处理后的比较转录组研究,以探究该地区入侵属性不同的两种红藻间的基因表达差异。结果表明,真江蓠和绳状龙须菜共有基因序列集(Universal Gene,unigene)主要集中在核糖体、嘌呤和嘧啶代谢等通路。其中,在真江蓠中光系统II反应中心蛋白D1(photosystem II reaction center protein D1)、细胞色素P450单加氧酶(cytochrome P450 monooxygenase)和核酮糖1,5二磷酸羧化酶大亚基(Ribulose bisphosphate carboxylase large subunit,rbcL)等基因的表达量显著上调,而逆转录转座子蛋白(retrotransposon protein)、细胞壁相关的水解酶(cell wall-associated hydrolase)和金属离子转运蛋白Nramp5的表达既上调也下调。与光合作用过程相关基因的大量表达可能有助于真江蓠应对逆境胁迫,特别是光系统ⅡD1反应中心蛋白表达量升高可能有助于藻体修复光系统Ⅱ复合体,从而制造更多的有机物以备藻体生长所需。而金属离子转运蛋白Nramp5等的上调和下调则表明江蓠等红藻可能通过某些基因表达量的增减对不同的环境变动作出响应。总体而言,代谢过程中的资源再分配很可能是驱动真江蓠适应和耐受新的生境的主要分子机制。
文摘Gastrointestinal(GI)bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit(ICU).This literature review consolidates current insights on the epidemiology,etiology,management,and outcomes of GI bleeding in critically ill patients.GI bleeding remains a significant concern,especially among patients with underlying risk factors such as coagulopathy,mechanical ventilation,and renal failure.Managing GI bleeding in the ICU requires a multidisciplinary approach,including resuscitation,endoscopic intervention,pharmacologic therapy,and sometimes surgical procedures.Even with enhanced management strategies,GI bleeding in the ICU is associated with considerable morbidity and mortality,particularly when complicated by multi-organ failure.This review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients,aiming to enhance survival rates and improve the quality of care within the ICU setting.
基金Fondos de Desarrollo de la Astronomía Nacional(ALMA200008,QUIMAL220006)Agencia Nacional de Investigación y Desarrollo(ANILLO ATE220022,DOCTORADO NACIONAL 2022-21221399,ECOS200010,MAGISTER NACIONAL 2023-22230841,STIC2020004)Fondo Nacional de Desarrollo Científico y Tecnológico(EXPLORACION 13220234,POSTDOCTORADO 3220561)。
文摘The pyramid wavefront sensor(PWFS)can provide the sensitivity needed for demanding adaptive optics applications,such as imaging exoplanets using the future extremely large telescopes of over 30 m of diameter(D).However,its exquisite sensitivity has a limited linear range of operation,or dynamic range,although it can be extended through the use of beam modulation—despite sacrificing sensitivity and requiring additional optical hardware.Inspired by artificial intelligence techniques,this work proposes to train an optical layer—comprising a passive diffractive element placed at a conjugated Fourier plane of the pyramid prism—to boost the linear response of the pyramid sensor without the need for cumbersome modulation.We develop an end-2-end simulation to train the diffractive element,which acts as an optical preconditioner to the traditional least-square modal phase estimation process.Simulation results with a large range of turbulence conditions show a noticeable improvement in the aberration estimation performance equivalent to over 3λ∕D of modulation when using the optically preconditioned deep PWFS(DPWFS).Experimental results validate the advantages of using the designed optical layer,where the DPWFS can pair the performance of a traditional PWFS with 2λ∕D of modulation.Designing and adding an optical preconditioner to the PWFS is just the tip of the iceberg,since the proposed deep optics methodology can be used for the design of a completely new generation of wavefront sensors that can better fit the demands of sophisticated adaptive optics applications such as ground-to-space and underwater optical communications and imaging through scattering media.
文摘Purpose: To evaluate the use of releasable sutures in filtration surgery by comparing the results and the rate of post-operative complications in eyes which underwent filtration surgery with and without releasable sutures. Methods: A retrospective evaluation of 74 eyes with glaucoma (COAG, CNAG, PXFG) of 74 patients who underwent filtration surgery in our department during 1999. All the patients included in the study had 6-12
文摘The purpose of this study was to evaluate the characteristics of automated perimetry exams at a large diagnostic institute. We describe the model of operation of this institue that provides greater than 80% of the visual field examinations, with interpretation, for a population of 2 million people. The institute
基金sponsored by the Sino-German Center Science Center,Beijing,China,(GZ1357)the National Key R&D Program of China(2018YFD0900305).
文摘Seaweed bioinvasions increasingly affect coastal environments around the world, which increases the need for predictive models and mitigation strategies. The biotic interactions between seaweed invaders and invaded communities are often considered a key determinant of invasion success and failure and we here revise the current evidence that the capacity of seaweed invaders to deter enemies in newly reached environments correlates with their invasion success. Particularly efficient chemical defences have been described for several of the more problematic seaweed invaders during the last decades. However, confirmed cases in which seaweed invaders confronted un-adapted enemies in newly gained environments with deterrents that were absent from these environments prior to the invasion (so-called “novel weapons”) are scarce, although an increasing number of invasive and non-invasive seaweeds are screened for defence compounds. More evidence exists that seaweeds may adapt defence intensities to changing pressure by biological enemies in newly invaded habitats. However, most of this evidence of shifting defence was gathered with only one particular model seaweed, the Asia-endemic red alga Agarophyton vermiculophyllum, which is particularly accessible for direct comparisons of native and non-native populations in common garden experiments. A. vermiculophyllum interacts with consumers, epibionts and bacterial pathogens and in most of these interactions, non-native populations have rather gained than lost defensive capacity relative to native conspecifics. The increases in the few examined cases were due to an increased production of broad-spectrum deterrents and the relative scarcity of specialized deterrents perhaps reflects the circumstance that seaweed consumers and epibionts are overwhelmingly generalists.
文摘Purpose: To report the practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (A RMD) over 1 year. Methods: The consecutive interventional case series included 5 6 patients with exudative ARMD. During vitrectomy the submacular neovascular mem brane (CNV) was removed and IPE cells, harvested from a peripheral iridectomy, w ere injected into the submacular space. Included were patients with subfoveal oc cult CNV (11 eyes), classic CNV (10 eyes), mixed CNV (17 eyes), CNV with a pigme nt epithelial detachment (13 eyes) or CNV with a hemorrhage (5 eyes). Outcome me asures were visual acuity, foveal fixation, size of CNV and rate of recurrence b ased on fluorescence angiographic imaging. Results: All patients underwent succe ssful surgical removal of the CNV with consecutive subretinal IPE injection. Vis ual acuity was better than 20/100 in 19 patients preoperatively and in 18 patien ts postoperatively. A visual acuity of 20/100 or less was found in 37 patients p reoperatively and in 38 patients postoperatively. Mean preoperative visual acuit y (1.0±0.3 logMAR units) did not change significantly after 1 year (1.0±0.3 lo gMAR units). Ten eyes (18%) developed a recurrence. Fixation within the surgica lly denuded area could be demonstrated in 25 eyes (45%). Conclusions: Autologou s IPE translocation for ARMD over one year can preserve foveal function on a low level, but cannot improve visual acuity. IPE translocation is technically feasi ble with a low rate of complications. Continued research seems justified to impr ove functional outcome.
文摘To evaluatethe visual outcome of patients with myopic subfoveal choroidal neovascularization (CNV) given photodynamic therapy (PDT) in a clinical setting, and to identify potential relation between the visual outcome and the age at treatment. Interventional case series. Retrospective comparative study. setting: Outpatient ophthalmology clinic. patients: Twenty- nine consecutive patients (30 eyes) with subfoveal CNV caused by pathologic myopia who were treated with verteporfin PDT from January 2000 to May 2003. intervention: All the patients received verteporfin PDT and were followed clinically and with fluorescein angiography (FA). Review of the medical records and angiograms was performed. Patients were divided into two groups by age, using the median age (60 years) as the cutoff. main outcome measures: Visual acuity (VA) at the end of follow- up in the older- patient group compared with the younger- patient group. The mean age was 63.1 years. Mean follow- up was 11.5 months. Patients received a mean of 3.48 treatments. Mean VA improved in the younger group from 0.63 to 0.39 logMAR (P=.02, paired t test) and deteriorated in the older group from 0.71 to 0.99 logMAR (P=.03, paired t test). In the whole cohort, 33% of eyes lost 3 or more lines of Snellen best- corrected VA; in the older age group, 50% of eyes lost 3 or more lines, whereas in the younger age group, only 8% of eyes did so (P=.024, Fisher’ s exact test). In our consecutive case series, visual prognosis of myopic CNV after PDT was found to be influenced by age at treatment.
文摘Objective: To estimate the frequency of pneumococcal meningitis among patients with bacterial meningitis in Iran. Methods: PubMed, Embase, Web of Science and Scientific Information Database (www. sid.ir) were searched from 2000 to 2016 to identify studies on the frequency or prevalence of pneumococcal meningitis in Iran. Stata 14.0 (StataCorp, College Station, Texas, USA) was used to analyze the data. Results: Of the 131 records identified from the databases, 21 studies fulfilled the eligibility criteria. The analyses showed that 25.0% (95% CI: 19.0-32.0;I2=71%) of the confirmed bacterial meningitis (including children and adults) cases were caused by pneumococcus. Conclusions: The large fraction of meningitis cases caused by pneumococcus demonstrates that pneumococcal meningitis is a major public health problem in Iran, and the introduction of pneumococcal vaccines merits further attention from health authorities.
