Pancreatico-Jejunostomy On Isolated Loop After Pancreatico-Duodenectomy: Is It Worthwhile?

xlomafota.13 shared this article with you from Inoreader Pancreatico-Jejunostomy On Isolated Loop After Pancreatico-Duodenectomy: Is It Worthwhile? Via Latest Results for Journal of Gastrointestinal Surgery Abstract Background Postoperative morbidity remains a significant problem after pancreatico-duodenectomy. The management of pancreatic stump continues to be a challenge, and many technical solutions have been developed over the years. In this study, we report the results obtained with the use of an isolated loop for pancreatico-jejunostomy in patients with soft pancreas and small pancreatic duct diameter. Methods Clinical data of patients submitted to pancreatico-duodenectomy in a period of sixteen years (2005–2020) were extracted from a prospective database. Patients with soft pancreas, main duct diameter < 2 mm and reconstruction by pancreatico-jejunostomy on single loop or isolated loop were selected. Primary end-point was the incidence of clinically relevant fistulas in the two groups of patients. Secondary endpoint was the length of postoperative hospital stay. A propensity score matching analysis was used for the statistics. Results Two hundred and twenty-one patients with the above characteristics were found in the database. One hundred and twelve of these received a single-loop reconstruction and 109 an isolated loop reconstruction. Incidence of clinically relevant fistulas was higher in the first group (41% vs 27%; p = 0.023). Postoperative hospital stay was significantly shorter in the second group (21 days vs 15; p < 0.001). These results were confirmed at the propensity score matching. Conclusion In patients with soft pancreatic texture and small main duct diameter, pancreatico-jejunostomy on isolated loop is associated with a lower incidence of clinically relevant fistulas than after classic reconstruction. The duration of postoperative hospital stay was significantly reduced, with consequent reduction of cost. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Respiratory Events in Surgical Patients Exposed to Opioid Analgesic Shortages Compared to Fully Matched Patients Non-exposed to Shortages

xlomafota.13 shared this article with you from Inoreader Postoperative Respiratory Events in Surgical Patients Exposed to Opioid Analgesic Shortages Compared to Fully Matched Patients Non-exposed to Shortages Via Latest Results for Drug Safety Abstract Introduction Shortages of opioid analgesics critically disrupt clinical practice and are detrimental to patient safety. There is a dearth of studies assessing the safety implications of drug shortages. Objective We aimed to assess perioperative opioid analgesic use and related postoperative hypoxemia (oxygen saturation less than 90%) in surgical patients exposed to prescription opioid shortages compared to propensity score-matched patients non-exposed to opioid shortages. Methods We conducted a retrospective study including adult patients who underwent elective surgery at The University of California San Francisco in the period August 2018–December 2019. We conducted a Gamma log-link generalized linear model to assess the effect of shortages on perioperative use of opioids and a weighted logistic regression to assess the likelihood of experiencing postoperative hypoxemia. Results There were 1119 patients exposed to opioid shortages and 2787 matched non-exposed patients. After full matching, patients exposed to shortages used a greater mean of morphine milligram equivalents/day (146.94; 95% confidence interval 123.96–174.16) than non-exposed patients (117.92; 95% confidence interval 100.48–138.38; p = 0.0001). The estimated effect was a 1.25 (95% confidence interval 1.12–1.40; p = 0.0001) times greater use of opioids in patients exposed to opioid shortages than non-exposed patients. After full matching, a greater proportion of patients exposed to shortages (19.06%) experienced hypoxemia compared with non-exposed patients (16.91%). In addition, a greater proportion of patients exposed to opioid shortages (1.20%) experienced hypoxemia reversed by intravenous naloxone administration compared with non-exposed patients (0.44%). Conclusions Given the shortage prevalence, reliance on opioid medications, and related risk of respiratory depression, harm prevention measures remain critical to prevent postoperative complications that may compromise patients' safety. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MCM-41-supported double metal cyanide nanocomposite catalyst for ring-opening polymerisation of propylene oxide

xlomafota.13 shared this article with you from Inoreader MCM-41-supported double metal cyanide nanocomposite catalyst for ring-opening polymerisation of propylene oxide Via Latest Results for Journal of Nanoparticle Research Abstract The fabrication of low-cost, recyclable, reusable, and heterogeneous catalysts is of considerable significance for green chemistry. In this study, a nanocomposite catalyst, MCM-41-supported Zn–Co double metal cyanide (MCM-41@DMC), was prepared using the synchronous dropping method. Thereafter, the composition, crystal structure, complexing state, morphology, and thermal stability of the catalyst were characterised using scanning electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, Brunauer–Emmett–Teller analysis, and thermogravimetry. The effects of different organic ligands on the catalytic activity of samples were evaluated, and the results showed that ethyl acetoacetate exhibited the best catalytic activity owing to its ketone coordination. The use of the MCM-41 support was beneficial for improving the catalytic activity because it reduced the crystallinity and substantially increased the ex ternal specific surface area of the catalyst. The experimental results pertaining to the use of the MCM-41@DMC catalyst in the fabrication of polypropylene glycol showed that the conversion of propylene oxide and molecular weight reached 90.6% and 2900, respectively. This study provides a new strategy for the green synthesis of poly(propylene glycol) products. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CEBPβ regulation of endogenous IGF-1 in adult sensory neurons can be mobilized to overcome diabetes-induced deficits in bioenergetics and axonal outgrowth

xlomafota.13 shared this article with you from Inoreader CEBPβ regulation of endogenous IGF-1 in adult sensory neurons can be mobilized to overcome diabetes-induced deficits in bioenergetics and axonal outgrowth Via Latest Results for Cellular and Molecular Life Sciences Abstract Aberrant insulin-like growth factor 1 (IGF-1) signaling has been proposed as a contributing factor to the development of neurodegenerative disorders including diabetic neuropathy, and delivery of exogenous IGF-1 has been explored as a treatment for Alzheimer's disease and amyotrophic lateral sclerosis. However, the role of autocrine/paracrine IGF-1 in neuroprotection has not been well established. We therefore used in vitro cell culture systems and animal models of diabetic neuropathy to characterize endogenous IGF-1 in sensory neurons and determine the factors regulating IGF-1 expression and/or affecting neuronal health. Single-cell RNA sequencing (scRNA-Seq) and in situ hybridization analyses revealed high expression of endogenous IGF-1 in non-peptidergic neurons and satellite glial cells (SGCs) of dorsal root ganglia (DRG). Brain cortex and DRG had higher IGF-1 gene expression than sciatic nerve. Bidirectional transport of IGF-1 along sensory nerves was ob served. Despite no difference in IGF-1 receptor levels, IGF-1 gene expression was significantly (P < 0.05) reduced in liver and DRG from streptozotocin (STZ)-induced type 1 diabetic rats, Zucker diabetic fatty (ZDF) rats, mice on a high-fat/ high-sugar diet and db/db type 2 diabetic mice. Hyperglycemia suppressed IGF-1 gene expression in cultured DRG neurons and this was reversed by exogenous IGF-1 or the aldose reductase inhibitor sorbinil. Transcription factors, such as NFAT1 and CEBPβ, were also less enriched at the IGF-1 promoter in DRG from diabetic rats vs control rats. CEBPβ overexpression promoted neurite outgrowth and mitochondrial respiration, both of which were blunted by knocking down or blocking IGF-1. Suppression of endogenous IGF-1 in diabetes may contribute to neuropathy and its upregulation at the transcriptional level by CEBPβ can be a promising therapeutic approach. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Th17 cells and their related cytokines: vital players in progression of malignant pleural effusion

xlomafota.13 shared this article with you from Inoreader Th17 cells and their related cytokines: vital players in progression of malignant pleural effusion Via Latest Results for Cellular and Molecular Life Sciences Abstract Malignant pleural effusion (MPE) is an exudative effusion caused by primary or metastatic pleural carcinosis. Th17 cells and their cytokines are critical components in various disease including MPE. In this review, we summarize current published articles regarding the multifunctional roles of Th17 cells and their related cytokines in MPE. Th17 cells are accumulated in MPE compared with paired serum via certain manners. The upregulation of Th17 cells and the interactions between Th17 cells and other immune cells, such as Th1 cells, Th9 cells, regulatory T cells and B cells, are reported to be involved in the formation and development of MPE. In addition, cytokines, which are elaborated by Th17 cells, including IL-17A, IL-17F, IL-21, IL-22, IL-26, GM-CSF, or associated with Th17 cells differentiation, including IL-1β, IL-6, IL-23, TGF-β, are linked to the pathogenesis of MPE through exerting pro- or anti-tumorigenic functions on their own as well as regulating the generation and differentiation of Th17 cells in MPE. Based on these findings, we proposed that Th17 cells and their cytokines might be diagnostic or prognostic tools and potential therapeutic targets for MPE. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Deep Learning Forecasts the Occurrence of Sleep Apnea from Single-Lead ECG

xlomafota.13 shared this article with you from Inoreader Deep Learning Forecasts the Occurrence of Sleep Apnea from Single-Lead ECG Via Latest Results for Cardiovascular Engineering and Technology Abstract Objectives Sleep apnea is the most common sleep disorder that leads to serious health complications if not treated early. Forecasting apnea occurrence ahead in time provides the opportunity to take appropriate actions to control and manage it. Methods A novel framework for forecasting the occurrence of apnea from single-lead electrocardiogram (ECG) based on deep recurrent neural networks is proposed. ECG R-peak amplitudes and R-R intervals are extracted and aligned using power spectral analysis, and recurrent deep learning models are developed to extract the most predictive ECG features and forecast the occurrence of apnea. Results The performance of the proposed approach was validated in forecasting apnea events up to five minutes in future on a dataset of 70 sleep recordings. A forecasting accuracy of up to 94.95% was achieved which was higher than the performance of conventional multilayer perceptron (p < 0.05) and other state-of-the-art techniques. Conclusions The proposed deep learning approach was successful in forecasting the occurrence of sleep apnea from single-lead ECG. It can therefore be adopted in wearable sleep monitors for the management of sleep apnea. Our developed algorithms are publicly available on GitHub. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spinopelvic alignment and low back pain after total hip arthroplasty: a scoping review

xlomafota.13 shared this article with you from Inoreader Spinopelvic alignment and low back pain after total hip arthroplasty: a scoping review Via Latest Results for BMC Musculoskeletal Disorders Abstract Objective Spinopelvic alignment is increasingly considered as an essential factor for maintaining an energy-efficient posture in individuals with normal or pathological status. Although several previous studies have shown that changes in the sagittal spinopelvic alignment may occur in patients undergoing total hip arthroplasty (THA), no review of this area has been completed so far. Thus, the objective of this scoping review was to summarize the evidence investigating changes in spinopelvic alignment and low back pain (LBP) following THA. Data sources We adhered to the established methodology for scoping reviews. Four electronic databases were systematically searched from inception-December 31, 2021. Study selection We selected prospective or retrospective observational or intervention studies that included patients with THA. Data extraction Data extraction and levels of evidence were independently performed using standardized checklists. Data synthesis A total of 45 papers were included in this scoping review, involving 5185 participants with THA. Pelvic tilt was the most common parameter measured in the eligible studies (n = 26). The results were not consistent across all studies; however, it was demonstrated that the distribution of pelvic tilt following THA had a range of 25° posterior to 20° anterior. Moreover, decreased sacral slope and lower pelvic incidence were associated with increased risk of dislocation in patients with THA. Lumbar spine scoliosis did not change significantly after THA in patients with bilateral hip osteoarthritis (5.50°(1.16°) vs. 3.73°(1.16°); P-value = 0.29). Finally, one study indicated that LBP improvement was not correlated with postoperative changes in spinopelvic alignment parameters. Several methodological issues were addressed in this study, including no sample size calculation and no type-I error adjustment for outcome multiplicity. Conclusions Changes in spinopelvic alignment may occur after THA and may improve with time. Patients with a THA dislocation usually show abnormal spinopelvic alignment compared to patients without a THA dislocation. LBP usually improves markedly over time following THA. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mitochondria in the Pathogenesis of Systemic Lupus Erythematosus

xlomafota.13 shared this article with you from Inoreader Mitochondria in the Pathogenesis of Systemic Lupus Erythematosus Via Latest Results for Current Rheumatology Reports Abstract Purpose of Review Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production and inflammation in multiple organs. In this article, we present data on how various mitochondria pathologies are involved in the pathogenesis of the disease including the fact that they serve as a reservoir of autoantigens which contribute to the upending of lymphocyte tolerance. Recent Findings Mitochondrial DNA from various cell sources, including neutrophil extracellular traps, platelets, and red blood cells, elicits the production of type I interferon which contributes to breaking of peripheral tolerance. Mitochondrial DNA also serves as autoantigen targeted by autoantibodies. Mutations of mitochondrial DNA triggered by reactive oxygen species induce T cell cross-reactivity against self-antigens. Selective gene polymorphisms that regulate mitochondrial apoptosis in autoreactive B and T cells represent another key aspect in the induction of autoimmunity. Summary Various mitochondrial abnormalities, including changes in mitochondrial function, oxidative stress, genetic polymorphism, mitochondrial DNA mutations, and apoptosis pathways, are each linked to different aspects of lupus pathogenesis. However, whether targeting these mitochondrial pathologies can be used to harness autoimmunity remains to be explored. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Luminescent properties of metal–organic frameworks embedded in methacrylated gelatin for its application in biocompatible 3D printable materials

xlomafota.13 shared this article with you from Inoreader Luminescent properties of metal–organic frameworks embedded in methacrylated gelatin for its application in biocompatible 3D printable materials Via Latest Results for Journal of Nanoparticle Research Abstract In this work, nanoparticles of a luminescent metal–organic framework were embedded in a photopolymerized methacrylated gelatin. Steady-state and time-resolved luminescence spectroscopy was used to explore the drying and the photopolymerization processes, as well as the effect the methacrylated gelatin had on the quantum yield and decay time of the nanoparticles. A drying time of 27.5 min was needed for a 20 µL droplet, and the proposed intensity ratio analysis resulted in a minimum irradiation time of 18.6 min, at a lamp intensity of 2.7 W/m2, for the photopolymerization process to end. The presence of the methacrylated gelatin decreased the quantum yield of the nanoparticles and influenced the emission decay time. The intensity ratio showed that a concentration between 1 and 3% w/V of nanoparticles in the solution is required for the luminescence to be observed and to avoid the important quenching effect. Graphical abstract View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of drug delivery technologies in the success of COVID-19 vaccines: a perspective

xlomafota.13 shared this article with you from Inoreader Role of drug delivery technologies in the success of COVID-19 vaccines: a perspective Via Latest Results for Drug Delivery and Translational Research Abstract The triumphant success of mRNA vaccines is a testimony to the important role drug delivery technologies have played in protecting billions of people against SARS-CoV-2 (or the Corona Virus Disease 2019; COVID-19). Several lipid nanoparticle (LNP) mRNA vaccines were developed and have been instrumental in preventing the disease by boosting the immune system against the pathogen, SARS-CoV-2. These vaccines have been built on decades of scientific research in drug delivery of mRNA, vaccines, and other biologicals. In this manuscript, several leading and emerging scientists in the field of drug delivery share their perspective on the role of drug delivery technologies in developing safe and efficacious vaccines, in a roundtable discussion. The authors also discussed their viewpoint on the current challenges, and the key research questions that should drive this important area of research. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Embedded Computational Heart Model for External Ventricular Assist Device Investigations

xlomafota.13 shared this article with you from Inoreader Embedded Computational Heart Model for External Ventricular Assist Device Investigations Via Latest Results for Cardiovascular Engineering and Technology Abstract Purpose External cardiac assist devices are based on a promising and simple concept for treating heart failure, but they are surprisingly difficult to design. Thus, a structured approach combining experiments with computer-based optimization is essential. The latter provides the motivation for the work presented in this paper. Methods We present a computational modeling framework for realistic representation of the heart's tissue structure, electrophysiology and actuation. The passive heart tissue is described by a nonlinear anisotropic material law, considering fiber and sheetlet directions. For muscle contraction, an orthotropic active-strain model is employed, initiated by a periodically propagating electrical potential. The model allows for boundary conditions at the epicardium accounting for external assist devices, and it is coupled to a circulation network providing appropriate pressure boundary conditions inside the ventricles. Results Simulated results from an unsupported healthy and a pathological heart model are presented and reproduce accurate deformations compared to phenomenological measurements. Moreover, cardiac output and ventricular pressure signals are in good agreement too. By investigating the impact of applying an exemplary external actuation to the pathological heart model, it shows that cardiac patches can restore a healthy blood flow. Conclusion We demonstrate that the devised computational modeling framework is capable of predicting characteristic trends (e.g. apex shortening, wall thickening and apex twisting) of a healthy heart, and that it can be used to study pathological hearts and external activation thereof. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.