| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Pauwels, A, et al.
(author)
-
How to select patients for antireflux surgery? The ICARUS guidelines (international consensus regarding preoperative examinations and clinical characteristics assessment to select adult patients for antireflux surgery)
- 2019
-
In: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 68:11, s. 1928-1941
-
Journal article (peer-reviewed)abstract
- Antireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, to date, international consensus guidelines on the clinical criteria and additional technical examinations used in patient selection for antireflux surgery are lacking. We aimed at generating key recommendations in the selection of patients for antireflux surgery.DesignWe included 35 international experts (gastroenterologists, surgeons and physiologists) in a Delphi process and developed 37 statements that were revised by the Consensus Group, to start the Delphi process. Three voting rounds followed where each statement was presented with the evidence summary. The panel indicated the degree of agreement for the statement. When 80% of the Consensus Group agreed (A+/A) with a statement, this was defined as consensus. All votes were mutually anonymous.ResultsPatients with heartburn with a satisfactory response to PPIs, patients with a hiatal hernia (HH), patients with oesophagitis Los Angeles (LA) grade B or higher and patients with Barrett’s oesophagus are good candidates for antireflux surgery. An endoscopy prior to antireflux surgery is mandatory and a barium swallow should be performed in patients with suspicion of a HH or short oesophagus. Oesophageal manometry is mandatory to rule out major motility disorders. Finally, oesophageal pH (±impedance) monitoring of PPI is mandatory to select patients for antireflux surgery, if endoscopy is negative for unequivocal reflux oesophagitis.ConclusionWith the ICARUS guidelines, we generated key recommendations for selection of patients for antireflux surgery.
|
|
| 8. |
- Al Khatib, O, et al.
(author)
-
Workplace Violence against Health Care Providers in Emergency Departments of Public Hospitals in Jordan: A Cross-Sectional Study
- 2023
-
In: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 20:4
-
Journal article (peer-reviewed)abstract
- Workplace violence (WPV) against healthcare providers is a serious problem that carries health, safety, and legal consequences. Healthcare providers working in emergency departments (ED) are more susceptible to WPV compared to other healthcare settings. This study aimed to assess the prevalence of physical and verbal violence against ED physicians and nurses in public hospitals in Amman, Jordan, and to explore the relationship between WPV and the socio-demographic characteristics of the participants. A quantitative descriptive cross-sectional study design was used to assess physical and verbal violence against ED physicians and nurses. A self-administered questionnaire was completed by 67 physicians and 96 nurses from three public hospitals in Amman. In the past year, 33% and 53% of the participants experienced physical and verbal violence, respectively. Compared to their female counterparts, males were more frequently physically (43.7% vs. 2.3%, p-value < 0.001) and verbally (61.3% vs. 29.5%, p-value < 0.001) abused. The main perpetrators of physical and verbal violence were the patients’ relatives. Out of 53 physical and 86 verbal abuse incidents, only 15 cases (10.8%) were followed up with legal persecution. In conclusion, there is a widespread occurrence of physical and verbal violence against ED physicians and nurses in the public sector hospitals in Jordan. A collaborative effort by all stakeholders should be instituted to ensure the safety of the physicians and nurses and to improve the quality of the healthcare provided.
|
|
| 9. |
- Bountra, K., et al.
(author)
-
Structural basis for antibacterial peptide self-immunity by the bacterial ABC transporter McjD
- 2017
-
In: Embo Journal. - : EMBO. - 0261-4189 .- 1460-2075. ; 36:20, s. 3062-3079
-
Journal article (peer-reviewed)abstract
- Certain pathogenic bacteria produce and release toxic peptides to ensure either nutrient availability or evasion from the immune system. These peptides are also toxic to the producing bacteria that utilize dedicated ABC transporters to provide self-immunity. The ABC transporter McjD exports the antibacterial peptide MccJ25 in Escherichia coli. Our previously determined McjD structure provided some mechanistic insights into antibacterial peptide efflux. In this study, we have determined its structure in a novel conformation, apo inward-occluded and a new nucleotide-bound state, high-energy outward-occluded intermediate state, with a defined ligand binding cavity. Predictive cysteine cross-linking in E.coli membranes and PELDOR measurements along the transport cycle indicate that McjD does not undergo major conformational changes as previously proposed for multi-drug ABC exporters. Combined with transport assays and molecular dynamics simulations, we propose a novel mechanism for toxic peptide ABC exporters that only requires the transient opening of the cavity for release of the peptide. We propose that shielding of the cavity ensures that the transporter is available to export the newly synthesized peptides, preventing toxic-level build-up.
|
|
| 10. |
- Cock, C., et al.
(author)
-
Effects of remifentanil on esophageal and esophagogastric junction (EGJ) bolus transit in healthy volunteers using novel pressure-flow analysis
- 2018
-
In: Neurogastroenterology and Motility. - : John Wiley & Sons. - 1350-1925 .- 1365-2982. ; 30:2
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Remifentanil is associated with subjective dysphagia and an objective increase in aspiration risk. Studies of opioid effects have shown decreased lower esophageal sphincter relaxation. We assessed bolus transit through the esophagus and esophagogastric junction (EGJ) during remifentanil administration using objective pressure-flow analysis.METHODS: Data from 11 healthy young participants (23±3 years, 7 M) were assessed for bolus flow through the esophagus and EGJ using high-resolution impedance manometry (Manoscan™, Sierra Scientific Instruments, Inc., LES Angeles, CA, USA) with 36 pressure and 18 impedance segments. Data were analyzed for esophageal pressure topography and pressure-flow analysis using custom Matlab analyses (Mathworks, Natick, USA). Paired t tests were performed with a P-value of < .05 regarded as significant.KEY RESULTS: Duration of bolus flow through (remifentanil/R 3.0±0.3 vs baseline/B 5.0 ± 0.4 seconds; P < .001) and presence at the EGJ (R 5.1 ± 0.5 vs B 7.1 ± 0.5 seconds; P = .001) both decreased during remifentanil administration. Distal latency (R 5.2 ± 0.4 vs B 7.5 ± 0.2 seconds; P < .001) and distal esophageal distension-contraction latency (R 3.5 ± 0.1 vs B 4.7 ± 0.2 seconds; P < .001) were both reduced. Intrabolus pressures were increased in both the proximal (R 5.3 ± 0.9 vs B 2.6 ± 1.3 mm Hg; P = .01) and distal esophagus (R 8.6 ± 1.7 vs B 3.1 ± 0.8 mm Hg; P = .001). There was no evidence of increased esophageal bolus residue.CONCLUSIONS AND INFERENCES: Remifentanil-induced effects were different for proximal and distal esophagus, with a reduced time for trans-sphincteric bolus flow at the EGJ, suggestive of central and peripheral μ-opioid agonism. There were no functional consequences in healthy subjects.
|
|
| 11. |
- Doeltgen, Sebastian H., et al.
(author)
-
Remifentanil alters sensory neuromodulation of swallowing in healthy volunteers : Quantification by a novel pressure-impedance analysis
- 2016
-
In: American Journal of Physiology - Gastrointestinal and Liver Physiology. - Bethesda, USA : American Physiological Society. - 0193-1857 .- 1522-1547. ; 310:11, s. G1176-G1182
-
Journal article (peer-reviewed)abstract
- Exposure to remifentanil contributes to an increased risk of pulmonary aspiration, likely through reduced pharyngeal contractile vigour and diminished bolus propulsion during swallowing. Here, we employed a novel high resolution pressure-flow analysis to quantify the biomechanical changes across the upper esophageal sphincter (UES). Eleven healthy young participants (mean age 23.3±3.1 years, 7 male) received remifentanil via intravenous target controlled infusion with an effect-site concentration of 3 ng/ml. Before and 30 min following commencement of remifentanil administration, participants performed ten 10 ml saline swallows while pharyngo-esophageal manometry and electrical impedance data were recorded using a 4.2 mm diameter catheter housing 36 circumferential pressure sensors. Remifentanil significantly shortened the time period of UES opening (p<0.001) and increased residual UES pressure (p=0.003). At the level of the hypopharynx, remifentanil significantly shortened the time latency from maximum bolus distension to peak contraction (p=0.004) and significantly increased intrabolus distension pressure (p=0.024). Novel mechanical states analysis revealed that the latencies between the different phases of the stereotypical UES relaxation sequence were shortened by remifentanil. Reduced duration of bolus flow during shortened UES opening in concert with increased hypopharyngeal distension pressures are mechanically consistent with increased flow resistance due to a more rapid bolus flow rate. These biomechanical changes are congruent with modification of the physiologic neuro-regulatory mechanism governing accommodation to bolus volume.
|
|
| 12. |
- El Maroufy, H., et al.
(author)
-
TRANSITION PROBABILITIES FOR GENERALIZED SIR EPIDEMIC MODEL
- 2012
-
In: Stochastic Models. - : Informa UK Limited. - 1532-6349 .- 1532-4214. ; 28:1, s. 15-28
-
Journal article (peer-reviewed)abstract
- Gani and Purdue outlined a matrix-geometric method for determining the total size distribution of an epidemic in a recursive manner. In this article, we explore how this method can be used to study an SIR epidemic model with a generalized mechanism of infection. We are able to obtain an explicit formula for the Laplace transform of the transition probabilities. Using this we derive various other quantities explicitly. Examples of such quantities are the transition probabilities and the expectation of the duration of the epidemic.
|
|
| 13. |
- Savvidou, Georgia, 1991, et al.
(author)
-
Quantifying international public finance for climate change adaptation in Africa
- 2021
-
In: Climate Policy. - : Informa UK Limited. - 1752-7457 .- 1469-3062. ; 21:8, s. 1020-1036
-
Journal article (peer-reviewed)abstract
- Under the United Nations Framework Convention on Climate Change, international financial assistance is expected to support African and other developing countries as they prepare for and adapt to the impacts of climate change. The impact of this finance depends on how much finance is mobilized and where it is targeted. However, there has been no comprehensive quantitative mapping of adaptation-related finance flows to African countries to date. Here we track development finance principally targeting adaptation from bilateral and multilateral funders to Africa between 2014 and 2018. We find that the amounts of finance are well below the scale of investment needed for adaptation in Africa, which is a region with high vulnerability to climate change and low adaptation capacity. Finance targeting mitigation (US$30.6 billion) was almost double that for adaptation (US$16.5 billion). The relative share of each varies greatly among African countries. More adaptation-related finance was provided as loans (57%) than grants (42%) and half the adaptation finance has targeted just two sectors: agriculture; and water supply and sanitation. Disbursement ratios for adaptation in this period are 46%, much lower than for total development finance in Africa (at 96%). These are all problematic patterns for Africa, highlighting that more adaptation finance and targeted efforts are needed to ensure that financial commitments translate into meaningful change on the ground for African communities.
|
|
| 14. |
|
|
| 15. |
- van Leeuwen, Marieke, et al.
(author)
-
Phase III study of the European Organisation for Research and Treatment of Cancer Quality of Life cancer survivorship core questionnaire
- 2023
-
In: Journal of Cancer Survivorship. - : Springer Science and Business Media LLC. - 1932-2259 .- 1932-2267. ; 17:4, s. 1111-1130
-
Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study is to develop a European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) questionnaire that captures the full range of physical, mental, and social health-related quality of life (HRQOL) issues relevant to disease-free cancer survivors. In this phase III study, we pretested the provisional core questionnaire (QLQ-SURV111) and aimed to identify essential and optional scales. Methods: We pretested the QLQ-SURV111 in 492 cancer survivors from 17 countries with one of 11 cancer diagnoses. We applied the EORTC QLG decision rules and employed factor analysis and item response theory (IRT) analysis to assess and, where necessary, modify the hypothesized questionnaire scales. We calculated correlations between the survivorship scales and the QLQ-C30 summary score and carried out a Delphi survey among healthcare professionals, patient representatives, and cancer researchers to distinguish between essential and optional scales. Results: Fifty-four percent of the sample was male, mean age was 60 years, and, on average, time since completion of treatment was 3.8 years. Eleven items were excluded, resulting in the QLQ-SURV100, with 12 functional and 9 symptom scales, a symptom checklist, 4 single items, and 10 conditional items. The essential survivorship scales consist of 73 items. Conclusions: The QLQ-SURV100 has been developed to assess comprehensively the HRQOL of disease-free cancer survivors. It includes essential and optional scales and will be validated further in an international phase IV study. Implications for Cancer Survivors: The availability of this questionnaire will facilitate a standardized and robust assessment of the HRQOL of disease-free cancer survivors.
|
|
