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Esophageal Motility Patterns After Peroral Endoscopic Myotomy in Patients With Achalasia
( Zuzana Vackova ),( Jan Mares ),( Jana Krajciova ),( Zuzana Rabekova ),( Lucie Zdrhova ),( Pavla Loudova ),( Julius Spicak ),( Petr Stirand ),( Tomas Hucl ),( Jan Martinek ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.2
Background/Aims Several studies have reported partial recovery of peristalsis in patients with achalasia after myotomy. The aim of our study is to analyze esophageal motility patterns after peroral endoscopic myotomy (POEM) and to assess the potential predictors and clinical impact of peristaltic recovery. Methods We performed a retrospective analysis of prospectively collected data of consecutive patients with achalasia undergoing POEM at a tertiary center. High-resolution manometry (HRM) studies prior to and after POEM were reviewed and the Chicago classification was applied. Results A total of 237 patients were analyzed. The initial HRM diagnoses were achalasia type I, 42 (17.7%); type II, 173 (73.0%); and type III, 22 (9.3%). Before POEM, peristaltic fragments were present in 23 (9.7%) patients. After POEM the Chicago classification diagnoses were: 112 absent contractility, 42 type I achalasia, 15 type II, 11 type III, 26 ineffective esophageal motility, 18 esophagogastric junction outflow obstruction, 10 fragmented peristalsis, and 3 distal esophageal spasm. Altogether 68 patients (28.7%) had signs of contractile activity, but the contractions newly appeared in 47 patients (47/214, 22.0%). Type II achalasia showed a trend for appearance of contractions (P = 0.097). Logistic regression analysis did not identify any predictors of peristaltic recovery. The post-POEM Eckardt score did not differ between patients with and without contractions nor did the parameters of timed barium esophagogram. Conclusions More than 20% of achalasia patients have signs of partial recovery of esophageal peristalsis after POEM. It occurs predominantly in type II achalasia but the clinical relevance seems to be negligible. (J Neurogastroenterol Motil 2021;27:205-214)
Fuzzy Decision Based Energy-Evolutionary System for Sustainable Transport in Ubiquitous Fog Network
Lakhan Abdullah,Mohammed Mazin Abed,Abdulkareem Karrar Hameed,Jaber Mustafa Musa,Kadry Seifedine,Nedoma Jan,Martinek Radek 한국컴퓨터산업협회 2023 Human-centric Computing and Information Sciences Vol.13 No.-
These days, the usage of sustainable transport applications has been growing in practice and has minimized global environmental issues as fuel vehicles did. Sustainable transport applications are distributed and can access data from anywhere in the network. However, due to sustainable electrical transport, much digital data is offloaded to the server to obtain the electricity stations. Therefore, many factors challenge sustainable vehicle applications, such as battery power consumption, service searching cost, execution delay, and execution accuracy. Thus, the existing decision support methods, such as TOPSIS multi-criteria decision method (MCDM), only support the fixed and accurate. Therefore, the fuzzy-based strategy will be more optimal for sustainable transport. The study devises the fuzzy-based energy-efficient decision support system (FBEES), which minimizes energy consumption, delay, and cost and increases scheduling accuracy for sustainable applications. These vehicles are connecting to the ubiquitous fog servers at different data centers in the system and offload their data for their processing. Simulation results show that FBEES minimizes energy by 30%, cost by 29%, delay by 31%, and improves accuracy compared to existing methods for sustainable transport applications.