40 research outputs found
A Narrative Review of the Applications of Ex-vivo Human Liver Perfusion
No full textEx-vivo perfusion describes the extra-corporeal delivery of fluid to an organ or tissue. Although it has been widely studied in the context of organ preservation and transplantation, it has also proven to be an invaluable tool in the development of novel models for translational pre-clinical research. Here, we review the literature reporting ex-vivo human liver perfusion experiments to further understand current perfusion techniques and protocols together with their applications. A computerised search was made of Ovid, MEDLINE, and Embase using the search words “ex-vivo liver or hepatic perfusion”. All relevant studies in English describing experiments using ex-vivo perfusion of human livers between 2016 and 2021, inclusive,
were included. Of 21 reviewed studies, 19 used ex-vivo human liver perfusion in the context of allogeneic liver transplantation. The quality and size of the studies varied considerably. Human liver perfusion was almost exclusively limited to whole organs and “split” livers, although one study did describe the successful perfusion of tissue sections following a partial hepatectomy. This review of recent literature involving ex vivo human liver perfusion demonstrates that the technique is not limited to whole liver perfusion. Split liver perfusion is extremely valuable allowing one lobe to act as a control and increasing the number available for research. This review also highlights the present lack of any reports of segmental liver perfusion. The discarded donor liver is a scarce resource, and the successful use of segmental perfusion has
the potential to expand the available experimental models to facilitate pre-clinical experimentation
Pharmacotherapy of Nonalcoholic Fatty Liver Disease (MASLD)
No full textMetabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), represents the most prevalent chronic liver disorder globally, affecting nearly 30% of adults. MASLD encompasses a spectrum of hepatic abnormalities, ranging from benign fat accumulation (steatosis) to more advanced stages such as metabolic dysfunction-associated steatohepatitis (MASH), progressive fibrosis, cirrhosis, and even hepatocellular carcinoma. The pathogenesis of MASLD is multifactorial, shaped by metabolic imbalances, genetic predispositions, and environmental influences. Major risk factors include insulin resistance, obesity, type 2 diabetes mellitus, and dyslipidemia. Diagnosis is commonly achieved through imaging studies, non-invasive biomarkers, and, in some cases, liver biopsy. While lifestyle modification remains the first-line intervention, pharmacologic treatment is indicated in individuals with MASH or significant fibrosis. Recent therapeutic advances include agents such as GLP-1 receptor agonists, SGLT2 inhibitors, PPAR agonists, and resmetirom—a thyroid hormone receptor-β agonist that has recently gained approval. Additional compounds targeting hepatic inflammation, fibrosis, and gut microbiota are under clinical investigation. Innovative approaches like combination regimens and individualized therapy are being explored to accommodate the heterogeneous nature of the disease and improve outcomes. Ongoing research efforts are focused on refining diagnostic tools, enhancing patient stratification, and expanding the therapeutic arsenal for MASLD.egységes, osztatlanáltalános orvosango
Correction to: Metabolic reprogramming of T regulatory cells in the hypoxic tumor microenvironment (Cancer Immunology, Immunotherapy, (2021), 70, 8, (2103-2121), 10.1007/s00262-020-02842-y)
No full textin the hypoxic tumor microenvironment, written by Varun Sasidharan Nair, Reem Saleh, Salman M. Toor, Farhan S. Cyprian and Eyad Elkord, was originally published electronically on the publisher’s internet portal on 03 February 2021 without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 25 May 2021 to © The Author(s) 2021 and this article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The original article has been corrected
Ageing effect on the relaxation properties of bitumen
No full textThe ageing of bitumen has a significant impact on the mechanical behavior of asphalt concrete. In this study, Dynamic Shear Rheometer (DSR) tests were utilized to investigate the effect of ageing on the relaxation properties of bituminous materials. PEN 70/100 bitumen films with thickness of 2 mm were exposed to laboratory ageing at various conditions. Specifically, different combinations of ageing time, temperature and pressure were applied on the bitumen films. Three evaluation indices, explicitly the shear stress at 0 s and 100 s, the ratio of shear stress at 0 s and 100 s and the time that shear stress reduces to 50% and 25% of the initial value, were used to determine the evolution of the relaxation properties of bitumen. The results show that, in comparison to fresh bitumen, aged samples show higher residual shear stresses after relaxation and are more susceptible to stress accumulation thus cracking. In addition, temperature, followed by pressure and ageing time, was found to have the stronger impact on bitumen ageing.Pavement Engineerin
Framework for replacing steel with aluminum fibers in bituminous mixes
No full textThis research explores the incentives for replacing steel fibers with aluminum fibers in fiber modified bituminous mixes. In this work the focus is on fiber modified bituminous mixes especially designed for induction heating. Inductive fibers are heated up because eddy currents are generated - according to Joule’s law - when alternating magnetic field is applied by electro-magnetic induction coil. Aluminum fiber-type particles are proposed as an alternative solution for developing corrosion resistant and lightweight bituminous mixes capable to be induced by electro-magnetic fields. In another publication (Pavlatos et al., Inductive bituminous mortar with steel and aluminum fibers, Advances in Materials and Pavement Performance Prediction, Submitted, 2018), a finite element three-dimensional model is developed in order to determine the effective electrical conductivity of steel and aluminum fiber modified bituminous mortar, as well as to show the potential utilization of alternative particles for developing multi-functional paving materials with improved properties.Pavement Engineerin
A comparison of the inflammatory response following autologous compared with allogenic islet cell transplantation.
No full textBackground: The initial response to islet transplantation and the subsequent acute inflammation is responsible for significant attrition of islets following both autologous and allogenic procedures. This multicentre study compares this inflammatory response using cytokine profiles and complement activation. Methods: Inflammatory cytokine and complement pathway activity were examined in two cohorts of patients undergoing total pancreatectomy followed either by autologous (n=11) or allogenic (n=6) islet transplantation. Two patients who underwent total pancreatectomy alone (n=2) served as controls. Results: The peak of cytokine production occurred immediately following induction of anaesthesia and during surgery. There was found to be a greater elevation of the following cytokines: TNF-alpha (P<0.01), MCP-1 (P=0.0013), MIP-1α (P=0.001), MIP-1β (P=0.00020), IP-10 (P=0.001), IL-8 (P=0.004), IL-1α (P=0.001), IL-1ra (0.0018), IL-10 (P=0.001), GM-CSF (P=0.001), G-CSF (P=0.0198), and Eotaxin (P=0.01) in the allogenic group compared to autografts and controls. Complement activation and consumption was observed in all three pathways, and there were no significant differences in between the groups although following allogenic transplantation ΔIL-10 and ΔVEGF levels were significantly elevated those patients who became insulin-independent compared with those who were insulin-dependent. Conclusions: The cytokine profiles following islet transplantation suggests a significantly greater acute inflammatory response following allogenic islet transplantation compared with auto-transplantation although a significant, non-specific inflammatory response occurs following both forms of islet transplantation.Wen Yuan Chung, Cristina A. Pollard, Rohan Kumar, Christopher J. Drogemuller, Bashoo Naziruddin, Cordula Stover, Eyad Issa, John Isherwood, Jill Cooke, Marlon F. Levy, P. Toby H. Coates, Giuseppe Garcea, Ashley R. Denniso
Impact of COVID-19, gender, race, specialty and seniority on mental health during surgical training: an international study
No full textBackground: Superior patient outcomes rely on surgical training being optimized. Accordingly, we conducted an international, prospective, cross-sectional study determining relative impacts of COVID-19, gender, race, specialty and seniority on mental health of surgical trainees. Method: Trainees across Australia, New Zealand and UK enrolled in surgical training accredited by the Royal Australasian College of Surgeons or Royal College of Surgeons were included. Outcomes included the short version of the Perceived Stress Scale, Oxford Happiness Questionnaire short scale, Patient Health Questionnaire-2 and the effect on individual stress levels of training experiences affected by COVID-19. Predictors included trainee characteristics and local COVID-19 prevalence. Multivariable linear regression analyses were conducted to assess association between outcomes and predictors. Results: Two hundred and five surgical trainees were included. Increased stress was associated with number of COVID-19 patients treated (P = 0.0127), female gender (P = 0.0293), minority race (P = 0.0012), less seniority (P = 0.001), and greater COVID-19 prevalence (P = 0.0122). Lower happiness was associated with training country (P = 0.0026), minority race (P = 0.0258) and more seniority (P < 0.0001). Greater depression was associated with more seniority (P < 0.0001). Greater COVID-19 prevalence was associated with greater reported loss of training opportunities (P = 0.0038), poor working conditions (P = 0.0079), personal protective equipment availability (P = 0.0008), relocation to areas of little experience (P < 0.0001), difficulties with career progression (P = 0.0172), loss of supervision (P = 0.0211), difficulties with pay (P = 0.0034), and difficulties with leave (P = 0.0002). Conclusion: This is the first study to specifically describe the relative impacts of COVID-19 community prevalence, gender, race, surgical specialty and level of seniority on stress, happiness and depression of surgical trainees on an international scale.https://onlinelibrary.wiley.com/doi/10.1111/ans.1798
Engineering and Management Experience at Texas A&M Transportation Institute
No full textThis manuscript presents the author���s engineering and management experience during his internship in the Materials and Pavements (M&P) Division at the Texas A&M Transportation Institute (TTI), and is a record of study for the Doctor of Engineering at Texas A&M University. Through this internship, he met his established internship objectives of gaining technical knowledge as well as knowledge and skills in project management, organizational communication, and quality management of pavement condition data, and of attaining professional development.
In meeting these objectives, the author describes the history, mission, and organizational structure of his workplace. He also presents his experience of developing and delivering a two-week training course on pavement design and construction in Kosovo. Participating in a number of professional development training courses and other activities prepared him for working as an engineering manager. These activities include Delta-T leadership training, an instructor development course, a time management and organizational skills course, and the M&P Division lecture series. Leadership and skills learned through the Delta-T program were beneficial for the employee as well as the employer. For the class project, the author and his teammates performed a study dealing with improving TTI���s deliverables. The Delta-T team composed a report summarizing their efforts of examining the current state of TTI���s project deliverables, the deliverables��� shortcomings, and potential enhancements to expand the deliverables��� appeal to additional types of potential users outside the traditional research community. The team also developed a prototype web-based model of deliverables and presented some implementation recommendations.
Participating in the Texas Department of Transportation���s (TxDOT���s) pavement surface distress data collection program enabled the author to become familiar with pavement distress data quality management and thus attain the technical and nontechnical skills required for project management. He noticed some areas for improvement in TxDOT���s rater���s manual, rater���s training class, and acceptance criteria for visual distress data
Epoxy modified bitumen: Chemical hardening and its interpretation
No full textEpoxy modified bitumen (EMB) is a promising technology for long lasting paving materials ensuring higher resistance to rutting, oxygen- and moisture-induced damage. In this paper, an analysis of the chemical reactions that take place during the chemical hardening process (curing) of epoxy modified bitumenwas conducted by means of Fourier Transform Infrared (FT-IR) spectrometer. For various amount of epoxy resin modification in bitumen, the hardening process was evaluated under various conditions. The fluctuation of the most crucial chemical groups occurring during the hardening process was identified and discussed. After the interpretation of chemical hardening, the critical hardening conditions were determined and fatigue tests were performed by Dynamic Shear Rheometer (DSR). Comparison with the unmodified bitumen shows that the fatigue resistance of epoxy modified binders improved significantly with increasing the amount of the epoxy resin in bitumen.Pavement Engineerin
Improving Colorectal Cancer Screening in the Latino Population: A Quality Improvement Project
No full textAbstractPurpose of Project: This quality improvement project aimed to increase the number of Latino patients receiving a routine colonoscopy at a gastroenterology practice in Passaic County, NJ.
Methods: An in-service training for staff on best practices for educating patients on the importance of colorectal cancer screening was conducted and an updated patient informational packet that had information in English and Spanish was distributed. Secondary data collected from chart reviews was used to measure outcomes. Measures included the number of individuals, 45 years and older, who had a consultation for routine colonoscopy, the number who underwent a colonoscopy, number of patients with colorectal cancer or malignant polypectomy, and the number of patient informational packets distributed.
Results: In the pre-implementation period, 32 people met eligibility criteria and had an office consultation for a colonoscopy. Of those, 13 had a colonoscopy, yielding a CRC screening rate of 40.6%. During the post-implementation period, 30 people were eligible, had an office consultation, and received an informational packet. Of those, 25 had a colonoscopy yielding a screening rate of 83.3%. A Chi-square test was used to assess the difference between the groups with regards to the CRC screening rates (x2 = 11.904, p < 0.001). Based on this result, it suggests that the intervention was successful in improving CRC screening rates within the target population.
Implications: Early colorectal screening screens can prevent colorectal cancers. Use of a culturally tailored educational intervention to increase preventive screening is beneficial. Patient education aligning with Healthy People 2030 objectives to promote and increase personal health literacy for at-risk populations was key and contributed to the success of this project.
Keywords: colonoscopy, colorectal cancer, improvement, interventions, Latino, screeningD.N.P.Includes bibliographical referencesIncludes vit
