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    3714 research outputs found

    Features of mitochondrial dynamics in monocytes in inflammatory and metabolic disorders

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    Mitochondria do not exist as separate formations in the cell; they form a homogeneous network in which the processes of division and fusion continuously occur. A shift in this balance, as well as mitochondrial dysfunction, leads to the development of chronic and metabolic disorders. Metabolic changes in mitochondria control the formation and differentiation of monocytes. Pro-inflammatory activation of monocytes/macrophages leads to a decrease in oxidative phosphorylation and an increase in mitochondrial fusion. To date, the molecular mechanisms that regulate mitochondrial dynamics to control life and death in monocytes are not well understood. In addition, there is ample evidence that abnormal mitochondrial metabolism is involved in the pathogenesis of many diseases. Mitochondrial stress and damage contribute to cell death, metabolic disorders, and inflammation. In this review, we consider in detail the involvement of mitochondrial processes in the development of pathologies and discuss how mitochondria can be therapeutically affected. Attention is also drawn to possible diagnostic studies that target mitochondrial dynamics of disorders in monocytes

    Vascular graft infections

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    Vascular graft infections are rare complications after surgical and endovascular treatment of aortic diseases. This condition is characterized by complexity in diagnosis and medico-surgical management. Moreover, even if properly treated, morbidity and mortality rates are high. Although several advances have been made over the years and guidelines of treatment have been published, there is still debate on the optimal care for this disease. With local microbiological patterns and multiresistant strains conditioning antimicrobial treatment as well as several surgical debridement techniques in the armamentarium, it is difficult to offer recommendations that can be generalized for every single case. In this review, we aim at describing thoracic and abdominal vascular graft infections and providing current information on diagnosis, medical treatment, and surgical management

    Which is the best algorithm for evaluating a patient’s candidate to sleeve with suspected reflux or hiatal hernia: is manometry or reflux assessment always necessary

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    Laparoscopic sleeve gastrectomy (SG) has reached wide popularity during the last 15 years, owing to limited morbidity and mortality rates, very successful weight loss results, and impact on comorbidities. However, the postoperative development or worsening of gastroesophageal reflux disease (GERD) is one of the most important drawbacks of this surgical procedure. To date, there is great heterogeneity concerning the definition of GERD, the indication for SG in patients with GERD, and the standardization of pre and postoperative diagnostic pathways. In patients with severe obesity, a strictly symptom-based diagnosis of GERD is unreliable. In fact, a high rate of silent GERD (s-GERD, asymptomatic patients despite objective evidence of GERD) has been reported. Moreover, patients with preoperative s-GERD have a significantly higher risk of experiencing GERD symptoms after SG. For these reasons, the reflux burden and the competence of the anti-reflux barrier should be carefully assessed during the preoperative work-up of patients undergoing SG. Ambulatory pH monitoring (APM) and high-resolution manometry (HRM) are useful diagnostic tools that could provide valuable evidence in the guidance of surgical strategy. In this review, we evaluate the current literature concerning the use of APM and HRM in the diagnostic pathway before SG, as well as their predictive value for the evolution of GERD in the postoperative course. Moreover, we propose a diagnostic algorithm for preoperative GERD assessment, which includes validated symptom questionnaires, upper gastrointestinal endoscopy, APM, and HRM

    Prevention and management of internal hernias after bariatric surgery: an expert review

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    Internal hernia formation is a feared complication following bariatric surgery. Protrusion of the small bowel through mesenteric defects can result in volvulus presenting with symptoms of bowel obstruction. If left untreated, patients may go on to develop bowel ischemia with possible perforation or necrosis necessitating emergent surgical exploration with resection. In severe cases, extensive bowel resection is required, leading to short-gut syndrome, which can have devastating consequences for the already nutritionally vulnerable bariatric patient. This review presents a comprehensive summary of various surgical techniques and technical factors implicated in the formation of internal hernias. The clinical presentation of patients with internal hernias, appropriate diagnostic work-up, and effective management and treatment strategies are discussed based on the established literature

    Laparoscopic hepaticojejunostomy for the treatment of bile duct injuries in difficult scenarios (with video)

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    Open Roux-en-Y hepaticojejunostomy (RYHJ) is the treatment of choice for bile duct injuries (BDI) sustained during laparoscopic cholecystectomy. Although in recent years the mini-invasive approach has been explored at expert centers, laparoscopic RYHJ for challenging surgical scenarios has rarely been attempted. We herein report two cases of RYHJ for BDI in highly complex surgical scenarios, such as right posterior BDI or failure of previous repairs, with special emphasis on the technical aspects through the embedded videos. The first was an intraoperative repair in a 55-year-old female who suffered a Strasberg type C (transection of the aberrant right hepatic duct) thermal lesion. The second was an iterative repair in a 54-year-old female with a history of a Strasberg type E1 lesion (injury of the main hepatic duct more than 2 cm from the confluence) that had been repaired intraoperatively with an end-to-end anastomosis over a T-tube nine months before referral. Both patients had an uneventful recovery and were discharged four and five days after surgery. After 2.5 and 4 years of follow-up, both patients are asymptomatic and have normal imaging and laboratory tests. To our knowledge, there is no other report in the literature regarding intraoperative laparoscopic right posterior RYHJ for BDI. Laparoscopic RYHJ for BDI repair in the hands of expert laparoscopic biliary surgeons is feasible and safe, even in very challenging surgical scenarios, as herein reported, offering the benefits of mini-invasive surgery. Future high-quality and long-term comparative studies are necessary to elucidate its potential superiority against the standard open approach

    Advanced fault-tolerant visual multi-secret sharing scheme

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    Aim: In visual cryptography, a secret image is encrypted into two meaningless random images called shares. These two shares can be stacked to recover the secret image without any calculations. However, because of the alignment problem in the decryption phase, risk of poor quality of the restored image exists. Encrypting multiple secrets on two images simultaneously can improve execution efficiency.Methods: Let 7 × 7 pixels be a unit; this paper designs a codebook for any unit in the secret images by using a random grid. Besides, this paper shows a general shifting approach that can embed N (≥ 2) secret images simultaneously with adjustable distortion.Results: This paper provides a visual multi-secret sharing scheme without pixel expansion; the proposed scheme can encrypt more than two secret images into two shares simultaneously. During decoding, aligning the shares precisely is not necessary.Conclusion: Theoretical analysis and simulation results indicate the effectiveness and practicality of the proposed scheme

    Expanded knowledge of cell-free DNA biology: potential to broaden the clinical utility

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    Noninvasive sampling of an individual’s body fluids is an easy means to capture circulating cell-free DNA (cfDNA). These small fragments of DNA carry information on the contributing cell’s genome, epigenome, and nuclease content. Analysis of cfDNA for the assessment of genetic risk has already revolutionized clinical practice, and a compendium of increasingly higher-resolution approaches based on epigenetic and fragmentomic cfDNA signatures continues to expand. Profiling cfDNA has unlocked a wealth of molecular information that can be translated to the clinic. This review covers the biological characteristics of cfDNA, recent advances in liquid biopsy and the clinical utility of cfDNA

    Different approaches of bibliometric analysis for data analytics applications in non-profit organisations

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    Aim: Profitable companies that used data analytics have a double gain in cost reduction, demand prediction, and decision-making. However, using data analysis in non-profit organisations (NPOs) can help understand and identify more patterns of donors, volunteers, and anticipated future cash, gifts, and grants. This article presents a bibliometric study of 2673 to discover the use of data analytics in different NPOs and understand its contribution.Methods: We characterise the associations between data analysis techniques and NPOs using, Bibliometrics R tool, a co-term analysis and scientific evolutionary pathways analysis, as well as identify the research topic changes in this field throughout time.Results: The findings revealed three key conclusions may be drawn from the findings: (1) In the sphere of NPOs, robust and conventional statistical methods-based data analysis procedures are dominantly common at all times; (2) Healthcare and public affairs are two crucial sectors that involve data analytics to support decision-making and problem-solving; (3) Artificial Intelligence (AI) based data analytics is a recently emerging trending, especially in the healthcare-related sector; however, it is still at an immature stage, and more efforts are needed to nourish its development.Conclusion: The research findings can leverage future research and add value to the existing literature on the subject of data analytics

    Onchocercal skin disease in Benue state, Nigeria: integrated assessment of burden and psychosocial impact, and associated factors

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    Aim: We aimed to measure the degree to which onchocercal skin disease (OSD) impairs quality of life (QoL) in endemic resource-poor communities in the Ushongo, Kwande, and Katsina-ale local government areas of Benue State, Nigeria. Methods: We evaluated the skin characteristics and QoL of 307 children and adults with OSD using a modified dermatological life quality index (mDLQI). Assessment of OSD was conducted and scored using mDLQI from 0 (no effects) to 18 (large effects). Thereafter, structured questionnaires were applied to assess the knowledge, attitudes, and predictors of moderate and severe OSD patients. Results: In total, 235/307 (76.5%) participants presented onchocercal nodules; chronic papular dermatitis was found in 68 (22.1%). A total of 288 (93.8%) had two or more OSD-associated symptoms. The median mDLQI score was 0 [interquartile range (IQR): 0-0] in children and 5 in adults (IQR: 2-8). A higher mDLQI median score was observed in farmers. There was a statistically significant difference between children and adults (P < 0.001). The most frequently reported impairments were social exclusion, embarrassment/shame, and restriction from work/leisure activities. In logistic regression analysis, there was a significant association with increasing age (adjusted odds ratio (AOR) = 1.44; 95%CI: 1.21-1.71; P < 0.001) and visual impairment (AOR = 1.78; 95%CI: 1.02-3.10; P = 0.040) with severe mDLQI. Papular rash was an independent protective factor (AOR = 0.50; 95%CI: 0.27-0.93; P = 0.030).Conclusion: Onchocerciasis-related morbidity has a profound measurable impact on the individual QoL, affecting the overall socioeconomic well-being of the affected community, if left untreated. Therefore, strict supervision and follow-up of home-based mass treatment with ivermectin are vital for successful control of the disease and to reduce the burden on affected communities

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