Endoscopic Sedation in Developing and Developed Countries

( Ariel A. Benson ),( Lawrence B. Cohen ),( Jerome D. Waye ),( Alaleh Akhavan ),( James Aisenberg ) 대한소화기학회 2008 Gut and Liver Vol.2 No.2

Background/Aims: Data are scarce on endoscopic sedation practices outside the United States and Western Europe, particularly from developing nations. An Internet survey was used to assess endoscopic sedation practices in developing and developed countries. Methods: Responses to a Web-based survey of sedation practices from 165 expert endoscopists from 81 countries were analyzed. The most common sedation method was defined as that used for >50% of endoscopies within a country. Results: Responses were received from 84 endoscopists practicing in 46 countries (51% response rate; 32 responses from 22 developing countries and 52 responses from 24 developed countries). A combination of benzodiazepine and opioid was the most common method for esophagogastroduodenoscopy (EGD) in 40% of the countries and for colonoscopy in 56% of the countries. For propofol and unsedated endoscopy, the corresponding figures were 8% and 19% for EGD and 18% and 10% for colonoscopy. No single sedation method accounted for >50% of EGD and colonoscopy cases in 32% and 17% of the countries, respectively. There were no significant differences in the proportions of developing and developed countries using combined benzodiazepine and opioid, propofol, or unsedated endoscopy. Conclusions: Sedation is used for most endoscopic procedures worldwide, with sedation practice not differing significantly between developing and developed countries.

Geo-Tracking of Mushroom Pharming in Nueva Ecija, Central Luzon Region, Philippines

Ariel Joseph J. Barza,Sofronio P. Kalaw,Ryo Sumi,Nobuo Mori,Renato G. Reyes,Noriko Miyazawa,Fumio Eguchi 한국버섯학회 2017 버섯 Vol.21 No.2

Nueva Ecija is a landlocked province in Central Luzon region that is composed of 27 municipalities and 5 cities. It is a province that is rich with biodiversity on its north and east borders, which exhibit a shared ecosystem with the Caraballo mountain range in the north and the Sierra Madre mountain range in the east. Its main economic activity is farming where rice is the main crop. Part of the Sierra Madre mountain range traverses its towns of Bongabon, Laur, Rizal and Pantabangan where most of the locals perform agro – forestry activities as a means of generating income for their families. Due to the accumulation of farm residues as a result of intensive agro-forestry activities, mushroom pharming becomes a very viable agribusiness undertaking in the area. Our research team initiated the establishment of database by tracking the mushroom production activities in the province. Similarly, the prevailing climatic condition in the geographical area and the type of agro-forestry wastes have been tracked. Wastes as a result of intensive agro – forestry activities are being generated which the locals oftentimes burned in the field that posed hazard to the environment. In order to discourage this practice, our research team generated technologies on mushroom pharming using rice straw as the main substrate. The promotion of mushroom pharming is based on the suitability of mushroom species to grow in climatic conditions that prevail in the specific geographical area in the province. As a result of its collaborative research undertakings, the Center for Tropical Mushroom Research and Development of the Central Luzon State University in collaboration with the Laboratory of Forest Products Chemistry of Tokyo University of Agriculture and the Nikken Sohonsha Corporation encouraged the adoption of medicinal mushroom production technologies on rice straw – based formulation. With oyster mushroom (Pleurotus spp) as the most widely cultivated mushroom among the mushroom growers in the province, other ligninolytic mushrooms such as lacquered mushroom (Ganoderma) and wood ear mushroom (Auricularia spp.) are grown by the locals. Similarly, leaf – litter degrading mushrooms such as paddy straw mushroom (Volvariella volvacea) are also being cultivated in the province. However, some mushroom growers in the province adopt sawdust – based mushroom production technology which is not economically appropriate in the province due to the scarcity of its availability compared to rice straw. Majority of the mushroom growers in the province adopt the rice straw – based mushroom technology. Moreover, high value mushroom – based products other than the fresh mushrooms are already in the local market.

Extracts from Lentinula edodes (Shiitake) Edible Mushrooms Enriched with Vitamin D Exert an Anti-Inflammatory Hepatoprotective Effect

Ariel Drori,Yehudit Shabat,Ami Ben Ya’acov,Ofer Danay,Dan Levanon,Lidya Zolotarov,Yaron Ilan 한국식품영양과학회 2016 Journal of medicinal food Vol.19 No.4

Vitamin D has been known for its anti-inflammatory properties. Extracts derived from Lentinula edodes (Shiitake) edible mushroom exert an anti-inflammatory effect. These extracts contain high levels of ergosterol, which converts into ergocalciferol (vitamin D2) following exposure to ultraviolet light, followed by absorption and hydroxylation into the active form 25-hydroxyvitamin D [25(OH)D]. To determine the anti-inflammatory effect of overexpression of vitamin D in edible mushrooms, L. edodes mushrooms were exposed to ultraviolet-B light, freeze-dried, followed by measurement of vitamin D2 contents, in their dry weight. C57B1/6 mice were orally treated with vitamin D2-enriched or nonenriched mushroom extract prior and during concanavalin A-immune-mediated liver injury. Exposure to ultraviolet light increased vitamin D2 content in Shiitake edible mushrooms. Following feeding of vitamin D-enriched mushroom extracts to mice with immune-mediated hepatitis, a significant decrease in liver damage was noted. This was shown by a decrease in alanine aminotransferase and aspartate aminotransferase serum levels, a decrease in proportion of mice with severe liver injury, and by improvement in liver histology. These effects were associated with a decrease in serum interferon gamma levels. A synergistic effect was noted between the anti-inflammatory effect of the mushroom extracts and that of vitamin D. Oral administration of vitamin D-enriched L. edodes edible mushroom exerts a synergistic anti-inflammatory effect in the immunemediated hepatitis. The data support its potential use as safe immunomodulatory adjuvant for the treatment of HCV and nonalcoholic steatohepatitis.

Semiclassical asymptotics of infinitely many solutions for the infinite case of a nonlinear Schr\"odinger equation with critical frequency

Ariel Aguas-Barreno,Jordy Cevallos-Chavez,Juan Mayorga-Zambrano,Leonardo Medina-Espinosa 대한수학회 2022 대한수학회보 Vol.59 No.1

We consider a nonlinear Schr\"odinger equation with critical frequency, $\displaystyle \left( \mathrm{P}_\varepsilon \right): \varepsilon^2 \Delta v(x) - V(x) v(x) + |v(x)|^{p-1} v(x) = 0$, $x\in \mathbb{R}^N$, and $v(x) \rightarrow 0$ as $|x|\rightarrow +\infty$, for the \emph{infinite case} as described by Byeon and Wang. \emph{Critical} means that $0\leq V\in \mathrm{C}(\mathbb{R}^N)$ verifies $\mathcal{Z} = \{V = 0 \} \neq \emptyset$. \emph{Infinite} means that $\mathcal{Z} = \{x_0\}$ and that, grossly speaking, the potential $V$ decays at an exponential rate as $x\rightarrow x_0$. For the semiclassical limit, $\varepsilon \rightarrow 0$, the infinite case has a characteristic limit problem, $\displaystyle \left( \mathrm{P}_{\mathrm{inf}} \right): \Delta u(x) - P(x) \, u(x) + |u(x)|^{p-1}\, u(x)=0$, $x\in \Omega$, with $u(x) = 0$ as $x\in \Omega$, where $\Omega\subseteq \mathbb{R}^N$ is a smooth bounded strictly star-shaped region related to the potential $V$. We prove the existence of an infinite number of solutions for both the original and the limit problem via a Ljusternik-Schnirelman scheme for even functionals. Fixed a topological level $k$ we show that $v_{k,\varepsilon}$, a solution of $(\mathrm{P}_\varepsilon)$, subconverges, up to a scaling, to a corresponding solution of $(\mathrm{P}_{\mathrm{inf}})$, and that $v_{k,\varepsilon}$ exponentially decays out of $\Omega$. Finally, uniform estimates on $\partial \Omega$ for scaled solutions of $(\mathrm{P}_\varepsilon)$ are obtained.

Baclofen-induced Changes in the Resting Brain Modulate Smoking Cue Reactivity: A Double-blind Placebo-controlled Functional Magnetic Resonance Imaging Study in Cigarette Smokers

Ariel Ketcherside,Kanchana Jagannathan,Sudipto Dolui,Nathan Hager,Nathaniel Spilka,Chaela Nutor,Hengyi Rao,Teresa Franklin,Reagan Wetherill 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.2

Objective: Smoking cue-(SC) elicited craving can lead to relapse in SC-vulnerable individuals. Thus, identifying treatments that target SC-elicited craving is a top research priority. Reduced drug cue neural activity is associated with recovery and is marked by a profile of greater tonic (resting) activation in executive control regions, and increased connectivity between executive and salience regions. Evidence suggests the GABA-B agonist baclofen can reduce drug cue-elicited neural activity, potentially through its actions on the resting brain. Based on the literature, we hypothesize that baclofen’s effects in the resting brain can predict its effects during SC exposure. Methods: In this longitudinal, double blind, placebo-controlled neuropharmacological study 43 non-abstinent, sated treatment-seeking cigarette smokers (63% male) participated in an fMRI resting-state scan and a SC-reactivity task prior to (T1) and 3 weeks following randomization (T2; baclofen: 80 mg/day; n = 21). Subjective craving reports were acquired before and after SC exposure to explicitly examine SC-induced craving. Results: Whole-brain full-factorial analysis revealed a group-by-time interaction with greater resting brain activation of the right dorsolateral prefrontal cortex (dlPFC) at T2 in the baclofen group (BAC) (pFWEcorr = 0.02), which was associated with reduced neural responses to SCs in key cue-reactive brain regions; the anterior ventral insula and ventromedial prefrontal cortex (pFWEcorr < 0.01). BAC, but not the placebo group reported decreased SC-elicited craving (p = 0.02). Conclusion: Results suggest that baclofen mitigates the reward response to SCs through an increase in tonic activation of the dlPFC, an executive control region. Through these mechanisms, baclofen may offer SC-vulnerable smokers protection from SC-induced relapse.

Clinical outcomes of combined anterior cruciate ligament and anterolateral ligament reconstruction: a systematic review and meta-analysis

( Diego Ariel De Lima ),( Lana Lacerda De Lima ),( Nayara Gomes Reis De Souza ),( Rodrigo Amorim De Moraes Perez ),( Marcel Faraco Sobrado ),( Tales Mollica Guimaraes ),( Camilo Partezani Helito ) 대한슬관절학회 2021 대한슬관절학회지 Vol.33 No.-

Objectives: To compare the clinical outcomes of isolated anterior cruciate ligament (ACL) reconstruction with combined reconstruction of the ACL and anterolateral ligament (ALL) of the knee. Methods: A search was conducted on the PubMed, Medline, Google Scholar, EMBASE, and Cochrane library databases, in line with the PRISMA protocol. The indexation terms used were “anterior cruciate ligament” OR “acl” AND “anterolateral ligament” AND “reconstruction.” Articles that compared patients submitted to combined ACL and ALL reconstruction with those submitted to isolated reconstruction of the ACL, with levels of evidence I, II, and III, were included. Studies with follow-up of less than 2 years and articles that did not use “anatomical” techniques for ALL reconstruction, such as extraarticular tenodesis, were excluded. A meta-analysis with R software was conducted, with a random effects model, presented as risk ratio (RR) or mean difference (MD), with a 95% confidence level (CI) and statistically significant at p < 0.05. Results: Ten articles were selected, with a total of 1495 patients, most of whom were men, of whom 674 submitted to ACL and ALL reconstruction and 821 to isolated ACL reconstruction. Combined ACL and ALL reconstruction exhibited a statistically significant advantage in residual pivot shift (RR 0.34, 95% CI 0.24-0.47, I² = 0%, p < 0.01), rerupture rate (RR 0.34, 95% CI 0.19-0.62, I² = 0%, p < 0.01), Lachman test (RR 0.59, 95% CI 0.40-0.86, I² = 21%, p < 0.01), and postoperative Lysholm score (MD 2.28, CI 95% 0.75-3.81, I² = 73%, p < 0.01). Conclusions: Combined ACL and ALL reconstruction obtained better postoperative clinical outcomes when compared with isolated ACL reconstruction, especially in reducing residual pivot shift and rerupture rate.

“FITTING IN” YET “STANDING OUT”: A MOTIVATIONAL PERSPECTIVE ON THE RELATION BETWEEN MATERIALISM AND ADOLESCENTS’ ATTITUDES TOWARD ADVERTISING

Hua Ariel Li,Monica Grosso,Tingting Mo,Agnes Nairn 글로벌지식마케팅경영학회 2023 Global Marketing Conference Vol.2023 No.07

Compared to the prevalence of advertising targeted at teens, our understanding of their vulnerability to advertising has been limited due to the cognitive/developmental view adopted by most previous research. However, cognitive development is not the most significant aspect that differentiates adolescents from adults. Adolescence is when teenagers start to take on more responsibility in defining themselves and become more skilled at using consumption to construct and signal their identity. On one hand, teens have a growing desire to express their unique identity as autonomous and distinctive individuals, separate from their family and differentiated from others. On the other hand, they are nearly obsessed with what others think about them, striving to belong to a group and feeling devastated by signs of disapproval from peers. This conflict between the need for assimilation and the need for differentiation is especially pronounced during adolescence when teenagers increasingly seek the approval of their peers while expressing their uniqueness. As a result, their sense of self is in a constant state of flux. This shaky self-identity has been shown in previous research to coincide with low self-esteem, which is associated with a high level of materialism.

B Cell–Intrinsic mTORC1 Promotes Germinal Center–Defining Transcription Factor Gene Expression, Somatic Hypermutation, and Memory B Cell Generation in Humoral Immunity

Raybuck, Ariel L.,Cho, Sung Hoon,Li, Jingxin,Rogers, Meredith C.,Lee, Keunwook,Williams, Christopher L.,Shlomchik, Mark,Thomas, James W.,Chen, Jin,Williams, John V.,Boothby, Mark R. American Association of Immunologists 2018 Journal of Immunology Vol. No.

<P>B lymphocytes migrate among varied microenvironmental niches during diversification, selection, and conversion to memory or Ab-secreting plasma cells. Aspects of the nutrient milieu differ within these lymphoid microenvironments and can influence signaling molecules such as the mechanistic target of rapamycin (mTOR). However, much remains to be elucidated as to the B cell–intrinsic functions of nutrient-sensing signal transducers that modulate B cell differentiation or Ab affinity. We now show that the amino acid–sensing mTOR complex 1 (mTORC1) is vital for induction of Bcl6—a key transcriptional regulator of the germinal center (GC) fate—in activated B lymphocytes. Accordingly, disruption of mTORC1 after B cell development and activation led to reduced populations of Ag-specific memory B cells as well as plasma cells and GC B cells. In addition, induction of the germ line transcript that guides activation-induced deaminase in selection of the IgG1 H chain region during class switching required mTORC1. Expression of the somatic mutator activation-induced deaminase was reduced by a lack of mTORC1 in B cells, whereas point mutation frequencies in Ag-specific GC-phenotype B cells were only halved. These effects culminated in a B cell–intrinsic defect that impacted an antiviral Ab response and drastically impaired generation of high-affinity IgG1. Collectively, these data establish that mTORC1 governs critical B cell–intrinsic mechanisms essential for establishment of GC differentiation and effective Ab production.</P>

Photolysis of an asymmetrically substituted diazene in solution and in the crystalline state

Hoijemberg, Pablo Ariel,Karlen, Steven D.,Sanrame, Carlos Norberto,Aramendia, Pedro Francisco,Garcia-Garibay, Miguel Angel Korean Society of Photoscience 2009 Photochemical & photobiological sciences Vol.8 No.7

In this work we study the product distribution in the steady state photolysis of a diazene, (1-biphenyl-4-yl-1-methyl-ethyl)-tert-butyl diazene, and a ketone, 2,4-bis(biphenyl-4-yl)-2, 4-dimethyl-pentan-3-one, in the solid state and in solution. The two compounds yield 1-biphenyl-4-yl-1-methyl-ethyl (BME$^{\cdot}$) radicals upon photolysis. The ketone yields two units of this radical, whereas the diazene yields one BME$^{\cdot}$ and one tert-butyl radical. Product analysis of the two compounds in solution makes it possible to differentiate their origin from their corresponding geminate cages, and from the different encounter pairs in the case of the asymmetrically substituted diazene photolysis. In this way we obtain a complete reaction scenery for the diazene, a compound with interesting features as a radical photoinitiator and as a cage effect probe in fluid media. The reaction in cages containing two BME$^{\cdot}$ radicals shows a decrease by a factor of 4 in the ratio of combination to disproportionation products upon going from the solid to the liquid phase. On the contrary, the reaction in cages containing a BME$^{\cdot}$ and a tert-butyl radical shows a 30-fold increase in combination to disproportionation ratio in liquid compared to the crystal. We analyze the reasons for these differences considering the differences in the reactivity of the radicals and in cage rigidity.

Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia: An Updated Cochrane Review

Franco Juan Victor Ariel,Garegnani Luis,Escobar Liquitay Camila Micaela,Borofsky Michael,Dahm Philipp 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.1

Purpose: To assess the effects of transurethral microwave thermotherapy (TUMT) for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH). Materials and Methods: We performed a comprehensive search using multiple databases up to May 2021, with no language or publication status restrictions. We included parallel-group randomized controlled trials of participants with BPH who underwent TUMT. We used standard Cochrane methods, including a GRADE assessment of the certainty of the evidence (CoE). Results: In this update of a previous Cochrane review, we included 16 trials with 1,919 participants. TUMT probably results in little to no difference in urologic symptom scores at short-term follow-up compared to transurethral resection of the prostate (TURP). There is likely to be little to no difference in the quality of life. TUMT likely results in fewer major adverse events. TUMT, however, probably results in a large increase in the need for retreatment. There may be little to no difference in erectile function between these interventions. However, TUMT may result in fewer cases of ejaculatory dysfunction compared to TURP. The overall CoE was moderate to low. Conclusions: TUMT provides a similar reduction in urinary symptoms compared to TURP, with fewer major adverse events and fewer cases of ejaculatory dysfunction at short-term follow-up. However, TUMT probably results in a large increase in retreatment rates. Study limitations and imprecision reduced the confidence we can place in these results.