Eslam Ali | Cairo Higher Institute (original) (raw)

Papers by Eslam Ali

Research paper thumbnail of Weight Disorders

Integrative Gastroenterology

Obesity and its associated comorbidities remain a significant global health issue. Despite the we... more Obesity and its associated comorbidities remain a significant global health issue. Despite the well-known consequences and related comorbidities associated with being overweight and obese, the prevalence remains alarmingly high and is increasing. In 2011–2014, the prevalence of obesity was 36.5% in adults and 17% in youth. The exact reasons for the prevalence and increase are multifactorial but reflect the overall lack of success of standard treatments. It is therefore not surprising that individuals often seek alternative therapies, including a variety of fibers, minerals, teas, and herbal supplements. Aside from the financial implications, many of these products have very little supporting evidence; some are unsafe. This chapter will review some of these alternative therapies with emphasis on the scientific evidence that supports or refutes their use.

Research paper thumbnail of Impact of process parameters (temperature & pH) and salts on kinetics and rheological properties of Hibiscus sabdariffa L. leave puree

Thermal kinetics of Hibiscus sabdariffa L. leaves puree (HSLP) were measured to determine the ene... more Thermal kinetics of Hibiscus sabdariffa L. leaves puree (HSLP) were measured to determine the energy of kinetic degradation of chlorophyll a (Chl a) & chlorophyll b (Chl b) of puree at pH (1.4 to 5.8) and temperature (343 K to 363 K). Degradation curves were fitted using first-order reaction kinetic models & the activation energy (Ea) for Chl a & Chl b was found to be 44.623±0.18, 39.158±0.25 & 35.775±0.11 kJ mol-1 and 6.086±0.14, 5.174±0.24 & 4.328±0.20 kJ mol-1 at pH 1.43, 3.8 & 5.8, respectively. Every single rheological estimation was done at different shear rates, temperatures, pH, & in the presence of various salts for the product development, quality control, and engineering applications. Rheological data fitted with the Herschel-Buckley model revealed that puree exhibit non-Newtonian, shear-thinning behavior at all tested concentrations and temperatures. The viscosity reached a maximum value at pH 5.8 and it decreased at lower pH values. Salts caused a reduction in viscosity. Comparatively, NaCl had a more pronounced effect than CaCl 2 at a similar concentration.

Research paper thumbnail of S230 More Colonoscopies, but at What Cost? Determinants of Healthcare Utilization for Patients Requiring Inpatient Colonoscopy

American Journal of Gastroenterology, 2021

Research paper thumbnail of Spatiotemporal Variability of Dune Velocities and Corresponding Uncertainties, Detected from Optical Image Matching in the North Sinai Sand Sea, Egypt

Remote Sensing, 2021

Understanding the relationship between climatic conditions and dune ecosystems requires the large... more Understanding the relationship between climatic conditions and dune ecosystems requires the large-scale monitoring of spatiotemporal patterns of dune velocities. Due to their large extent and remoteness, dune fields are ideal for remote sensing techniques. Dune velocities in the Sand Sea North Sinai are characterized by large spatial and temporal variability. To this end, a total of 265 pairs from four Landsat-8 images from April 2013 to April 2018 were automatically matched with the COSI Corr engine to determine the dune velocities. These pairs were selected so that differences in the solar angles were small and spanned at least one year. This helps to reduce shadowing in the deformation fields and the error budget in converting displacements to annual velocities. To improve spatial coverage and reduce measurement uncertainty, the fusion of individual offset maps is considered feasible. We compared the performance of two methods (i.e., inversion and temporal median fusion) in perfo...

Research paper thumbnail of Diagnostic Accuracy for Per-Patient Polyp Detection of Second-Generation Capsule Endoscopy Compared to Colonoscopy: A Meta-Analysis of Multicenter Studies

Cureus, 2021

Ali et al. This is an open access article distributed under the terms of the Creative Commons Att... more Ali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Research paper thumbnail of Evaluation of Physical and Geomechanical characteristics at a Steel Rolling Factory at Ataqa industrial zone, Suez, Egypt using Seismic Methods

Journal of Petroleum and Mining Engineering, 2021

Our investigations are aimed to calculate the physical and geomechanical characteristics needed t... more Our investigations are aimed to calculate the physical and geomechanical characteristics needed to assess the geotechnical suitability of the subsurface at Ataqa industrial zone, Suez, Egypt for constructing some industerial facilities. To accomplish our target, four seismic profiles are conducted using the refraction technique to estimate the primary seismic wave velocity as well as four profiles using the method of "Multichannel Analysis of Surface Waves" for estimating the velocity of shear waves. The stage of processing and interpretation are performed through using the "SeisImager/2D" Software. The results clarify the existence of two layers to a depth of 18 m. The top layer ranges in thickness between 2 and 4m and has a primary wave velocity ranging between 924 and 1247 m/s and a shear wave velocity ranging between 530 and 745 m/s. On the other hand, the second layer possesses an average primary velocity ranging between 1277 and 1573 m/s and a shear wave velocity ranging between 684 and 853 m/s. The measured velocities are utilized to calculate many physical and geomechanical properties of the earth materials comprising the two layers in our study area. The integration between all these parameters proves the suitability of both layers for erecting the proposed constructions.

Research paper thumbnail of Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding: A review

World Journal of Gastrointestinal Endoscopy, 2020

Upper gastrointestinal bleeding is defined as the bleeding originating from the esophagus to the ... more Upper gastrointestinal bleeding is defined as the bleeding originating from the esophagus to the ligament of Treitz and further classified into variceal and nonvariceal gastrointestinal bleeding. Non-variceal upper gastrointestinal bleeding remains a common clinical problem globally. It is associated with high mortality, morbidity, and cost of the health care system. Despite the continuous improvement of therapeutic endoscopy, the 30-d readmission rate secondary to rebleeding and associated mortality is an ongoing issue. Available Food and Drug Administration approved traditional or conventional therapeutic endoscopic modalities includes epinephrine injection, argon plasma coagulation, heater probe, and placement of through the scope clip, which can be used alone or in combination to decrease the risk of rebleeding. Recently, more attention has been paid to the novel advanced endoscopic devices for primary treatment of the bleeding lesion and as a secondary measure when conventional therapies fail to achieve hemostasis. This review highlights emerging endoscopic modalities used in the management of non-variceal upper gastrointestinal related bleeding such as over-the-scope clip, Coagrasper, hemostatic sprays, radiofrequency ablation, cryotherapy, endoscopic suturing devices, and endoscopic ultrasound-guided angiotherapy. In this review article, we will also discuss the technical aspects of the common procedures, outcomes in terms of safety and efficacy, and their advantages and limitations in the setting of non-variceal upper gastrointestinal bleeding.

Research paper thumbnail of P031 A Rare Case of Crohn’s Disease and Hemophilia Presenting With Acute Massive Gastrointestinal Bleeding

The American Journal of Gastroenterology, 2019

Research paper thumbnail of A Puzzling Case of Rising Salicylate Levels

American Journal of Gastroenterology, 2019

ecological impact of global change is generated by multiple synchronous or asynchronous drivers w... more ecological impact of global change is generated by multiple synchronous or asynchronous drivers which interact with each other and with intraspecific variability of sensitivities. In three near-natural experiments, we explored response correlations of full-sibling germling families of the seaweed Fucus vesiculosus towards four global change drivers: elevated co 2 (ocean acidification, OA), ocean warming (OW), combined OA and warming (OAW), nutrient enrichment and hypoxic upwelling. Among families, performance responses to oA and oW as well as to oAW and nutrient enrichment correlated positively whereas performance responses to OAW and hypoxia anti-correlated. This indicates (i) that families robust to one of the three drivers (OA, OW, nutrients) will also not suffer from the two other shifts, and vice versa and (ii) families benefitting from OAW will more easily succumb to hypoxia. Our results may imply that selection under either oA, oW or eutrophication would enhance performance under the other two drivers but simultaneously render the population more susceptible to hypoxia. We conclude that intraspecific response correlations have a high potential to boost or hinder adaptation to multifactorial global change scenarios. Marine primary producers contribute about 50% of the world's carbon fixation 1. In coastal regions, seaweeds contribute a substantial proportion to this production and to sequestration 2 , but are threatened at a global scale 3. Many seaweeds are forced to either perish or shift their distributional range 4 if their acclimation and adaptation to a changing environment is not fast enough. Faced with rapid and multifactorial global change, naturally diverse populations of marine primary producers will respond differently from those with low diversity 5 , as the multifactorial nature of stressors and the intraspecific diversity of populations do interact. Thus, the outcome of simultaneous or sequential selection by multiple drivers will depend on whether the variation in sensitivity among individuals towards drivers A and B are independent of each other or, rather, correlate positively or negatively 6,7. Positive correlation of sensitivities towards two or more drivers would accelerate positive selection of individuals which are robust to compound change 8. Conversely, negative correlation would limit adaptive evolution 9. Negative correlations among sensitivities may further indicate that adaptation in one fitness-trait comes at a cost of another trait by evolutionary trade-offs 10. There is an urgent need to experimentally explore how different functionally important traits are impacted by synchronously or sequentially acting multiple drivers in a natural context 11. This will improve understanding and predicting global change impacts on acclimation and adaptation processes in marine populations 12-14. Fluctuating drivers may facilitate the selection of robust populations 15,16. As selection acts on the phenotype, both plastic and adaptive components of the phenotype may contribute to acclimation and adaptation potentials in marine organisms 17. Response correlations among traits measured on phenotypes are thus only relevant for adaptation potentials if they are based on genetic correlation or functionally related, heritable traits 14,18. Many aquatic ecosystems presently face a simultaneous shift of several environmental drivers such as temperature (leading to ocean warming "OW"), pCO 2 and pH (leading to ocean acidification "OA"), nutrients (leading to eutrophication) and pO 2 (leading to hypoxia). Interactions among multiple abiotic factors may be complex 19 .

Research paper thumbnail of Pseudomembranous Colitis, Bowel Ischemia, and Phentermine: A Case Report

American Journal of Gastroenterology, 2019

BhDMf5ePHKbH4TTImqenVJsWiCZ2rfmUiKnNAAPfkaVjwcmZGi02TFSWtluedYl4 on 02/26/2020 nodularity. Diagno... more BhDMf5ePHKbH4TTImqenVJsWiCZ2rfmUiKnNAAPfkaVjwcmZGi02TFSWtluedYl4 on 02/26/2020 nodularity. Diagnosis requires demonstration of non necrotizing granulomas in the involved organ, evidence of sarcoidosis in at least one other organ system and exclusion of other granulomatous disorders such as tuberculosis, fungal infections, inflammatory bowel disease and malignancy. While no therapy is warranted for inactive disease, steroids are the initial treatment of choice in symptomatic patients.

Research paper thumbnail of Cholecystocolic Fistula: An Unusual Cause of Abdominal Pain

American Journal of Gastroenterology, 2019

Research paper thumbnail of Hyperemesis Gravidarum Syndrome Mimicking Recurrent Pancreatitis

American Journal of Gastroenterology, 2019

Research paper thumbnail of An Uncommon Cause of Lower GI Bleeding in the Elderly: Blue Rubber Bleb Nevus Syndrome

American Journal of Gastroenterology, 2014

Research paper thumbnail of Comparison of Compliance to Scheduled Out-patient Endoscopy Among Black and Hispanic Patients in a Minority Serving Institution

American Journal of Gastroenterology, 2011

Methods: Subjects meeting the operational definition of central fatigue (CF; CESD>7 and SF-36 ... more Methods: Subjects meeting the operational definition of central fatigue (CF; CESD>7 and SF-36 Vitality Subscale <45) were compared to those who did not meet the criteria (NCF) across all stages of treatment with PEG-IFN+RBV (pre-treatment, treatment weeks 4, 12, 24, 36, 48 with IFN-RBV and follow-up weeks 4, 12, and 24). Analysis included standard demographics (gender, race, body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), obesity (OB), history of depression, laboratory values (AST, ALT, iron saturation, platelets, hemoglobin, hematocrit, ANC, and HCV RNA), and self-reports of depression (CES-D) and health-related quality of life (HRQL; Medical Outcomes Survey SF-36). T-tests with Levene’s test for equal variances were used. Results: 367 subjects with CH-C were included in the analysis (311 NCF and 56 CF subjects, 58.6% Male, 59.8% Caucasian, 17.2% Asian, 11.5% African American, 11.5% Other, BMI 28.6 ± 6.0, 20.9% hypertension, 35.4% obese, 11.6% diabetes mellitus, 30.2% history of depression, 49.7 ± 46.6 AST, 45.2 ± 32.9 ALT). CH-C patients with central fatigue (CF) were worse on all significant measures except HCV RNA level (2.8E5 ± 5.7E6 NCF versus 7.7E5 ± 1.9E6, p=0.001). In particular, CF subjects with CH-C had a significantly higher history of depression (41% vs. 24%, p=.024) and significantly lower HRQL scores on all SF-36 measures (.0001, all) than NCF subjects. CH-C patients with the CF group tended to have lower platelet count (139.5 ± 80.5 vs 164.4 ± 84.2, p=0.056). All metabolic syndrome-related variables (HTN, DM, BMI, OB) as well as gender, race were not significantly different between CF and NCF groups. Conclusion: This definition of central fatigue (CF) identifies a group of CH-C patients with significantly poorer health-related quality of life that does not appear to be impacted by gender, race, metabolic syndrome criteria, or physical functioning ability.

Research paper thumbnail of Preoperative Infliximab Use and Postoperative Infectious Complications in Crohnʼs Disease: An Updated Meta-analysis

American Journal of Gastroenterology, 2015

More than 120 exposed salt diapirs in southern Iran are connected to the adjacent aquifers and li... more More than 120 exposed salt diapirs in southern Iran are connected to the adjacent aquifers and likely constitute the main sources of groundwater salinization in the region. Located in southern Iran, the Korsia salt diapir is surrounded by alluvial and karst groundwater aquifers. To investigate the impact of the salt body of Korsia on the groundwater quality of surrounding aquifers, electrical conductivity, total dissolved solids and dissolved calcium, magnesium, sodium, potassium, chloride, bromide, and sulfate concentrations were measured at 41 sampling points, including 32 exploitation wells, 7 springs and 2 surface water stations. Additionally, oxygen-18 and deuterium isotopes were analyzed at 7 sampling points to investigate the source of the salinity in the area. Our hydrogeological, hydrogeochemical, and isotopic evaluations show that the Korsia diapir deteriorates groundwater quality of the eastern karst and southern alluvial aquifers through infiltration of a spring's brine into limestone, and flow of the surface brine originated from the diapir, respectively. A karst aquifer west of the diapir is not influenced by the diapir brine because its hydraulic connectivity is interrupted by an impermeable geological formation. Construction of salt basins or diversion of brine is suggested to increase water quality of the surrounding aquifers. These procedures can be applied not only in the Korsia diapir, but also in tens of diapirs of southern Iran as remediation methods to improve water quality of their adjacent aquifers in this arid region.

Research paper thumbnail of Colonic Thickening and Abdominal Pain: Etiology Unfolded!

American Journal of Gastroenterology, 2017

Research paper thumbnail of Association of BMI and Barrettʼs Esophagus/Esophageal Adenocarcinoma in African American population from an Inner City Hospital

American Journal of Gastroenterology, 2011

Research paper thumbnail of Spectrum of Liver Pathology in AIDS/HIV-Infected African American Patients: An Autopsy Study

American Journal of Gastroenterology, 2011

Research paper thumbnail of A Giant Gallbladder

American Journal of Gastroenterology, 2018

Research paper thumbnail of A Curious Case of Massive Splenomegaly: Overlap of Autoimmune Hepatitis and Primary Biliary Cholangitis

American Journal of Gastroenterology, 2018

Research paper thumbnail of Weight Disorders

Integrative Gastroenterology

Obesity and its associated comorbidities remain a significant global health issue. Despite the we... more Obesity and its associated comorbidities remain a significant global health issue. Despite the well-known consequences and related comorbidities associated with being overweight and obese, the prevalence remains alarmingly high and is increasing. In 2011–2014, the prevalence of obesity was 36.5% in adults and 17% in youth. The exact reasons for the prevalence and increase are multifactorial but reflect the overall lack of success of standard treatments. It is therefore not surprising that individuals often seek alternative therapies, including a variety of fibers, minerals, teas, and herbal supplements. Aside from the financial implications, many of these products have very little supporting evidence; some are unsafe. This chapter will review some of these alternative therapies with emphasis on the scientific evidence that supports or refutes their use.

Research paper thumbnail of Impact of process parameters (temperature & pH) and salts on kinetics and rheological properties of Hibiscus sabdariffa L. leave puree

Thermal kinetics of Hibiscus sabdariffa L. leaves puree (HSLP) were measured to determine the ene... more Thermal kinetics of Hibiscus sabdariffa L. leaves puree (HSLP) were measured to determine the energy of kinetic degradation of chlorophyll a (Chl a) & chlorophyll b (Chl b) of puree at pH (1.4 to 5.8) and temperature (343 K to 363 K). Degradation curves were fitted using first-order reaction kinetic models & the activation energy (Ea) for Chl a & Chl b was found to be 44.623±0.18, 39.158±0.25 & 35.775±0.11 kJ mol-1 and 6.086±0.14, 5.174±0.24 & 4.328±0.20 kJ mol-1 at pH 1.43, 3.8 & 5.8, respectively. Every single rheological estimation was done at different shear rates, temperatures, pH, & in the presence of various salts for the product development, quality control, and engineering applications. Rheological data fitted with the Herschel-Buckley model revealed that puree exhibit non-Newtonian, shear-thinning behavior at all tested concentrations and temperatures. The viscosity reached a maximum value at pH 5.8 and it decreased at lower pH values. Salts caused a reduction in viscosity. Comparatively, NaCl had a more pronounced effect than CaCl 2 at a similar concentration.

Research paper thumbnail of S230 More Colonoscopies, but at What Cost? Determinants of Healthcare Utilization for Patients Requiring Inpatient Colonoscopy

American Journal of Gastroenterology, 2021

Research paper thumbnail of Spatiotemporal Variability of Dune Velocities and Corresponding Uncertainties, Detected from Optical Image Matching in the North Sinai Sand Sea, Egypt

Remote Sensing, 2021

Understanding the relationship between climatic conditions and dune ecosystems requires the large... more Understanding the relationship between climatic conditions and dune ecosystems requires the large-scale monitoring of spatiotemporal patterns of dune velocities. Due to their large extent and remoteness, dune fields are ideal for remote sensing techniques. Dune velocities in the Sand Sea North Sinai are characterized by large spatial and temporal variability. To this end, a total of 265 pairs from four Landsat-8 images from April 2013 to April 2018 were automatically matched with the COSI Corr engine to determine the dune velocities. These pairs were selected so that differences in the solar angles were small and spanned at least one year. This helps to reduce shadowing in the deformation fields and the error budget in converting displacements to annual velocities. To improve spatial coverage and reduce measurement uncertainty, the fusion of individual offset maps is considered feasible. We compared the performance of two methods (i.e., inversion and temporal median fusion) in perfo...

Research paper thumbnail of Diagnostic Accuracy for Per-Patient Polyp Detection of Second-Generation Capsule Endoscopy Compared to Colonoscopy: A Meta-Analysis of Multicenter Studies

Cureus, 2021

Ali et al. This is an open access article distributed under the terms of the Creative Commons Att... more Ali et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Research paper thumbnail of Evaluation of Physical and Geomechanical characteristics at a Steel Rolling Factory at Ataqa industrial zone, Suez, Egypt using Seismic Methods

Journal of Petroleum and Mining Engineering, 2021

Our investigations are aimed to calculate the physical and geomechanical characteristics needed t... more Our investigations are aimed to calculate the physical and geomechanical characteristics needed to assess the geotechnical suitability of the subsurface at Ataqa industrial zone, Suez, Egypt for constructing some industerial facilities. To accomplish our target, four seismic profiles are conducted using the refraction technique to estimate the primary seismic wave velocity as well as four profiles using the method of "Multichannel Analysis of Surface Waves" for estimating the velocity of shear waves. The stage of processing and interpretation are performed through using the "SeisImager/2D" Software. The results clarify the existence of two layers to a depth of 18 m. The top layer ranges in thickness between 2 and 4m and has a primary wave velocity ranging between 924 and 1247 m/s and a shear wave velocity ranging between 530 and 745 m/s. On the other hand, the second layer possesses an average primary velocity ranging between 1277 and 1573 m/s and a shear wave velocity ranging between 684 and 853 m/s. The measured velocities are utilized to calculate many physical and geomechanical properties of the earth materials comprising the two layers in our study area. The integration between all these parameters proves the suitability of both layers for erecting the proposed constructions.

Research paper thumbnail of Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding: A review

World Journal of Gastrointestinal Endoscopy, 2020

Upper gastrointestinal bleeding is defined as the bleeding originating from the esophagus to the ... more Upper gastrointestinal bleeding is defined as the bleeding originating from the esophagus to the ligament of Treitz and further classified into variceal and nonvariceal gastrointestinal bleeding. Non-variceal upper gastrointestinal bleeding remains a common clinical problem globally. It is associated with high mortality, morbidity, and cost of the health care system. Despite the continuous improvement of therapeutic endoscopy, the 30-d readmission rate secondary to rebleeding and associated mortality is an ongoing issue. Available Food and Drug Administration approved traditional or conventional therapeutic endoscopic modalities includes epinephrine injection, argon plasma coagulation, heater probe, and placement of through the scope clip, which can be used alone or in combination to decrease the risk of rebleeding. Recently, more attention has been paid to the novel advanced endoscopic devices for primary treatment of the bleeding lesion and as a secondary measure when conventional therapies fail to achieve hemostasis. This review highlights emerging endoscopic modalities used in the management of non-variceal upper gastrointestinal related bleeding such as over-the-scope clip, Coagrasper, hemostatic sprays, radiofrequency ablation, cryotherapy, endoscopic suturing devices, and endoscopic ultrasound-guided angiotherapy. In this review article, we will also discuss the technical aspects of the common procedures, outcomes in terms of safety and efficacy, and their advantages and limitations in the setting of non-variceal upper gastrointestinal bleeding.

Research paper thumbnail of P031 A Rare Case of Crohn’s Disease and Hemophilia Presenting With Acute Massive Gastrointestinal Bleeding

The American Journal of Gastroenterology, 2019

Research paper thumbnail of A Puzzling Case of Rising Salicylate Levels

American Journal of Gastroenterology, 2019

ecological impact of global change is generated by multiple synchronous or asynchronous drivers w... more ecological impact of global change is generated by multiple synchronous or asynchronous drivers which interact with each other and with intraspecific variability of sensitivities. In three near-natural experiments, we explored response correlations of full-sibling germling families of the seaweed Fucus vesiculosus towards four global change drivers: elevated co 2 (ocean acidification, OA), ocean warming (OW), combined OA and warming (OAW), nutrient enrichment and hypoxic upwelling. Among families, performance responses to oA and oW as well as to oAW and nutrient enrichment correlated positively whereas performance responses to OAW and hypoxia anti-correlated. This indicates (i) that families robust to one of the three drivers (OA, OW, nutrients) will also not suffer from the two other shifts, and vice versa and (ii) families benefitting from OAW will more easily succumb to hypoxia. Our results may imply that selection under either oA, oW or eutrophication would enhance performance under the other two drivers but simultaneously render the population more susceptible to hypoxia. We conclude that intraspecific response correlations have a high potential to boost or hinder adaptation to multifactorial global change scenarios. Marine primary producers contribute about 50% of the world's carbon fixation 1. In coastal regions, seaweeds contribute a substantial proportion to this production and to sequestration 2 , but are threatened at a global scale 3. Many seaweeds are forced to either perish or shift their distributional range 4 if their acclimation and adaptation to a changing environment is not fast enough. Faced with rapid and multifactorial global change, naturally diverse populations of marine primary producers will respond differently from those with low diversity 5 , as the multifactorial nature of stressors and the intraspecific diversity of populations do interact. Thus, the outcome of simultaneous or sequential selection by multiple drivers will depend on whether the variation in sensitivity among individuals towards drivers A and B are independent of each other or, rather, correlate positively or negatively 6,7. Positive correlation of sensitivities towards two or more drivers would accelerate positive selection of individuals which are robust to compound change 8. Conversely, negative correlation would limit adaptive evolution 9. Negative correlations among sensitivities may further indicate that adaptation in one fitness-trait comes at a cost of another trait by evolutionary trade-offs 10. There is an urgent need to experimentally explore how different functionally important traits are impacted by synchronously or sequentially acting multiple drivers in a natural context 11. This will improve understanding and predicting global change impacts on acclimation and adaptation processes in marine populations 12-14. Fluctuating drivers may facilitate the selection of robust populations 15,16. As selection acts on the phenotype, both plastic and adaptive components of the phenotype may contribute to acclimation and adaptation potentials in marine organisms 17. Response correlations among traits measured on phenotypes are thus only relevant for adaptation potentials if they are based on genetic correlation or functionally related, heritable traits 14,18. Many aquatic ecosystems presently face a simultaneous shift of several environmental drivers such as temperature (leading to ocean warming "OW"), pCO 2 and pH (leading to ocean acidification "OA"), nutrients (leading to eutrophication) and pO 2 (leading to hypoxia). Interactions among multiple abiotic factors may be complex 19 .

Research paper thumbnail of Pseudomembranous Colitis, Bowel Ischemia, and Phentermine: A Case Report

American Journal of Gastroenterology, 2019

BhDMf5ePHKbH4TTImqenVJsWiCZ2rfmUiKnNAAPfkaVjwcmZGi02TFSWtluedYl4 on 02/26/2020 nodularity. Diagno... more BhDMf5ePHKbH4TTImqenVJsWiCZ2rfmUiKnNAAPfkaVjwcmZGi02TFSWtluedYl4 on 02/26/2020 nodularity. Diagnosis requires demonstration of non necrotizing granulomas in the involved organ, evidence of sarcoidosis in at least one other organ system and exclusion of other granulomatous disorders such as tuberculosis, fungal infections, inflammatory bowel disease and malignancy. While no therapy is warranted for inactive disease, steroids are the initial treatment of choice in symptomatic patients.

Research paper thumbnail of Cholecystocolic Fistula: An Unusual Cause of Abdominal Pain

American Journal of Gastroenterology, 2019

Research paper thumbnail of Hyperemesis Gravidarum Syndrome Mimicking Recurrent Pancreatitis

American Journal of Gastroenterology, 2019

Research paper thumbnail of An Uncommon Cause of Lower GI Bleeding in the Elderly: Blue Rubber Bleb Nevus Syndrome

American Journal of Gastroenterology, 2014

Research paper thumbnail of Comparison of Compliance to Scheduled Out-patient Endoscopy Among Black and Hispanic Patients in a Minority Serving Institution

American Journal of Gastroenterology, 2011

Methods: Subjects meeting the operational definition of central fatigue (CF; CESD>7 and SF-36 ... more Methods: Subjects meeting the operational definition of central fatigue (CF; CESD>7 and SF-36 Vitality Subscale <45) were compared to those who did not meet the criteria (NCF) across all stages of treatment with PEG-IFN+RBV (pre-treatment, treatment weeks 4, 12, 24, 36, 48 with IFN-RBV and follow-up weeks 4, 12, and 24). Analysis included standard demographics (gender, race, body mass index (BMI), hypertension (HTN), diabetes mellitus (DM), obesity (OB), history of depression, laboratory values (AST, ALT, iron saturation, platelets, hemoglobin, hematocrit, ANC, and HCV RNA), and self-reports of depression (CES-D) and health-related quality of life (HRQL; Medical Outcomes Survey SF-36). T-tests with Levene’s test for equal variances were used. Results: 367 subjects with CH-C were included in the analysis (311 NCF and 56 CF subjects, 58.6% Male, 59.8% Caucasian, 17.2% Asian, 11.5% African American, 11.5% Other, BMI 28.6 ± 6.0, 20.9% hypertension, 35.4% obese, 11.6% diabetes mellitus, 30.2% history of depression, 49.7 ± 46.6 AST, 45.2 ± 32.9 ALT). CH-C patients with central fatigue (CF) were worse on all significant measures except HCV RNA level (2.8E5 ± 5.7E6 NCF versus 7.7E5 ± 1.9E6, p=0.001). In particular, CF subjects with CH-C had a significantly higher history of depression (41% vs. 24%, p=.024) and significantly lower HRQL scores on all SF-36 measures (.0001, all) than NCF subjects. CH-C patients with the CF group tended to have lower platelet count (139.5 ± 80.5 vs 164.4 ± 84.2, p=0.056). All metabolic syndrome-related variables (HTN, DM, BMI, OB) as well as gender, race were not significantly different between CF and NCF groups. Conclusion: This definition of central fatigue (CF) identifies a group of CH-C patients with significantly poorer health-related quality of life that does not appear to be impacted by gender, race, metabolic syndrome criteria, or physical functioning ability.

Research paper thumbnail of Preoperative Infliximab Use and Postoperative Infectious Complications in Crohnʼs Disease: An Updated Meta-analysis

American Journal of Gastroenterology, 2015

More than 120 exposed salt diapirs in southern Iran are connected to the adjacent aquifers and li... more More than 120 exposed salt diapirs in southern Iran are connected to the adjacent aquifers and likely constitute the main sources of groundwater salinization in the region. Located in southern Iran, the Korsia salt diapir is surrounded by alluvial and karst groundwater aquifers. To investigate the impact of the salt body of Korsia on the groundwater quality of surrounding aquifers, electrical conductivity, total dissolved solids and dissolved calcium, magnesium, sodium, potassium, chloride, bromide, and sulfate concentrations were measured at 41 sampling points, including 32 exploitation wells, 7 springs and 2 surface water stations. Additionally, oxygen-18 and deuterium isotopes were analyzed at 7 sampling points to investigate the source of the salinity in the area. Our hydrogeological, hydrogeochemical, and isotopic evaluations show that the Korsia diapir deteriorates groundwater quality of the eastern karst and southern alluvial aquifers through infiltration of a spring's brine into limestone, and flow of the surface brine originated from the diapir, respectively. A karst aquifer west of the diapir is not influenced by the diapir brine because its hydraulic connectivity is interrupted by an impermeable geological formation. Construction of salt basins or diversion of brine is suggested to increase water quality of the surrounding aquifers. These procedures can be applied not only in the Korsia diapir, but also in tens of diapirs of southern Iran as remediation methods to improve water quality of their adjacent aquifers in this arid region.

Research paper thumbnail of Colonic Thickening and Abdominal Pain: Etiology Unfolded!

American Journal of Gastroenterology, 2017

Research paper thumbnail of Association of BMI and Barrettʼs Esophagus/Esophageal Adenocarcinoma in African American population from an Inner City Hospital

American Journal of Gastroenterology, 2011

Research paper thumbnail of Spectrum of Liver Pathology in AIDS/HIV-Infected African American Patients: An Autopsy Study

American Journal of Gastroenterology, 2011

Research paper thumbnail of A Giant Gallbladder

American Journal of Gastroenterology, 2018

Research paper thumbnail of A Curious Case of Massive Splenomegaly: Overlap of Autoimmune Hepatitis and Primary Biliary Cholangitis

American Journal of Gastroenterology, 2018