Influence of cholestasis on portal vein embolization-induced hypertrophy of the future liver remnant.

PURPOSE: In the pre-clinical setting, hepatocellular bile salt accumulation impairs liver regeneration following partial hepatectomy. Here, we study the impact of cholestasis on portal vein embolization (PVE)-induced hypertrophy of the future liver remnant (FLR). METHODS: Patients were enrolled with perihilar cholangiocarcinoma (pCCA) or colorectal liver metastases (CRLM) undergoing PVE before a (extended) right hemihepatectomy. Volume of segments II/III was considered FLR and assessed on pre-embolization and post-embolization CT scans. The degree of hypertrophy (DH, percentual increase) and kinetic growth rate (KGR, percentage/week) were used to assess PVE-induced hypertrophy. RESULTS: A total of 50 patients (31 CRLM, 19 pCCA) were included. After PVE, the DH and KGR were similar in patients with CRLM and pCCA (5.2 [3.3-6.9] versus 5.7 [3.2-7.4] %, respectively, p = 0.960 for DH; 1.4 [0.9-2.5] versus 1.9 [1.0-2.4] %/week, respectively, p = 0.742 for KGR). Moreover, pCCA patients with or without hyperbilirubinemia had comparable DH (5.6 [3.0-7.5] versus 5.7 [2.4-7.0] %, respectively, p = 0.806) and KGR (1.7 [1.0-2.4] versus 1.9 [0.8-2.4] %/week, respectively, p = 1.000). For patients with pCCA, unilateral drainage in FLR induced a higher DH than bilateral drainage (6.7 [4.9-7.9] versus 2.7 [1.5-4.2] %, p = 0.012). C-reactive protein before PVE was negatively correlated with DH (ρ = - 0.539, p = 0.038) and KGR (ρ = - 0.532, p = 0.041) in patients with pCCA. CONCLUSIONS: There was no influence of cholestasis on FLR hypertrophy in patients undergoing PVE. Bilateral drainage and inflammation appeared to be negatively associated with FLR hypertrophy. Further prospective studies with larger and more homogenous patient cohorts are desirable.

Chyme Reinfusion Restores the Regulatory Bile Salt-FGF19 Axis in Patients With Intestinal Failure.

BACKGROUND AND AIMS: Automated chyme reinfusion (CR) in patients with intestinal failure (IF) and a temporary double enterostomy (TDE) restores intestinal function and protects against liver injury, but the mechanisms are incompletely understood. The aim was to investigate whether the beneficial effects of CR relate to functional recovery of enterohepatic signaling through the bile salt-FGF19 axis. APPROACH AND RESULTS: Blood samples were collected from 12 patients, 3 days before, at start, and 1, 3, 5, and 7 weeks after CR initiation. Plasma FGF19, total bile salts (TBS), 7-α-hydroxy-4-cholesten-3-one (C4; a marker of bile salt synthesis), citrulline (CIT), bile salt composition, liver tests, and nutritional risk indices were determined. Paired small bowel biopsies prior to CR and after 21 days were taken, and genes related to bile salt homeostasis and enterocyte function were assessed. CR induced an increase in plasma FGF19 and decreased C4 levels, indicating restored regulation of bile salt synthesis through endocrine FGF19 action. TBS remained unaltered during CR. Intestinal farnesoid X receptor was up-regulated after 21 days of CR. Secondary and deconjugated bile salt fractions were increased after CR, reflecting restored microbial metabolism of host bile salts. Furthermore, CIT and albumin levels gradually rose after CR, while abnormal serum liver tests normalized after CR, indicating restored intestinal function, improved nutritional status, and amelioration of liver injury. CR increased gene transcripts related to enterocyte number, carbohydrate handling, and bile salt homeostasis. Finally, the reciprocal FGF19/C4 response after 7 days predicted the plasma CIT time course. CONCLUSIONS: CR in patients with IF-TDE restored bile salt-FGF19 signaling and improved gut-liver function. Beneficial effects of CR are partly mediated by recovery of the bile salt-FGF19 axis and subsequent homeostatic regulation of bile salt synthesis.

Electronic Health Self-Management Interventions for Patients With Chronic Kidney Disease: Systematic Review of Quantitative and Qualitative Evidence.

BACKGROUND: Chronic kidney disease (CKD) poses a major challenge to public health. In CKD patients, adequate disease self-management has been shown to improve both proximal and distal outcomes. Currently, electronic health (eHealth) interventions are increasingly used to optimize patients' self-management skills. OBJECTIVE: This study aimed to systematically review the existing evidence regarding the implementation and effectiveness of eHealth self-management interventions for patients with CKD. METHODS: Following a search in 8 databases (up to November 2017), quantitative and qualitative data on process and effect outcomes were extracted from relevant studies. Quality was appraised using the Crowe Critical Appraisal Tool; narrative synthesis was performed to analyze the data extracted. RESULTS: Of the 3307 articles retrieved, 24 (comprising 23 studies) were included in this review; of these, almost half were appraised to be of low to moderate quality. There was considerable heterogeneity in the types of interventions used and the outcomes measured. A total of 10 effect and 9 process outcome indicators were identified. The most frequently reported effect outcome indicators were specific laboratory tests and blood pressure (BP), whereas satisfaction was the most frequently reported process outcome indicator. Positive effects were found for proximal outcomes (eg, BP control and medication adherence), and mixed effects were found for more distal outcomes (eg, quality of life). High feasibility, usability, and acceptability of and satisfaction with eHealth self-management interventions were reported. The determinant ability of health care professionals to monitor and, if necessary, anticipate on patient measurements online was mostly cited to influence patients' adherence to interventions. CONCLUSIONS: eHealth self-management interventions have the potential to improve disease management and health outcomes. To broaden the evidence base and facilitate intervention upscaling, more detailed descriptions and thorough analysis of the intervention components used are required. In addition, our review reveals that outcomes closely related to the scope and duration of the intervention implemented are most likely to be impacted. For instance, if a 4-week Web-based training to optimize disease management skills is implemented, the outcome perceived control would more likely be affected than kidney function. Although this seems obvious, most studies evaluate only distal outcomes and thereby fail to capture intervention effects that might contribute to long-term health improvement. We advise future researchers to carefully consider their choice of outcomes based on their sensitivity for change. In this way, we ensure that relevant effects are captured and legitimate conclusions are drawn.

Porous prussian blue analogs derived nickel-iron bimetallic phosphide nanocubes on conductive hollow mesoporous carbon nanospheres for stable and flexible high-performance supercapacitor electrode.

Nickel-iron bimetallic phosphide (Ni-Fe-P) is the ideal battery-type materials for supercapacitor in virtue of high theoretical specific capacitance. Nevertheless, its actual adhibition is astricted on account of inferior rate capability and cyclic stability. Herein, we constructed hierarchical core-shell nanocomposites with hollow mesoporous carbon nanospheres (HMCS) packaged via prussian blue analogs derived Ni-Fe-P nanocubes (Ni-Fe-P@HMCS), as a positive electrode for hybrid supercapacitor (HSC). Profiting from the cooperative effects of Ni-Fe-P nanocubes with small size and good dispersibility, and HMCS with continuously conductive network, the Ni-Fe-P@HMCS composite electrode with abundantly porous architectures presents an ultrahigh gravimetric specific capacity for 739.8 C g-1 under 1 A g-1. Specially, the Ni-Fe-P@HMCS electrode presents outstanding rate capability of 78.4% (1 A g-1 to 20 A g-1) and cyclic constancy for 105% after 5000 cycles. Density functional theory implies that the composite electrode possesses higher electrical conductivity than bare Ni-Fe-P electrode by reason of the incremental charge density, and the electrons transferring from NiFe3P4 to HMCS layers. Additionally, the assembled Ni-Fe-P@HMCS//HMCS HSC facility delivers the high energy density for 64.1 Wh kg-1, remarkable flexibility and mechanical stability. Thus, this work proffers a viable and efficacious measure to construct ultra-stability electrode for high-performance portable electronic facilities.

Dual modulation of the morphology and electric conductivity of NiCoP on nickel foam by Fe doping as a superior stability electrode for high energy supercapacitors.

Nickel-cobalt bimetallic phosphide (NiCoP) is a potential electrode material for supercapacitors on account of its high theoretical specific capacitance. However, its practical application is restricted because of its relatively poor cycling stability and rate performance. Herein, we constructed self-standing NiCoP nanowires and Fe doped NiCoP nanoarrays with different iron ion concentrations on nickel foam (Fe-NiCoP/NF-x%, x = 4, 6.25, 12.5, 25) as a positive electrode for asymmetric supercapacitors (ASCs). The morphological result reveals that the nanostructure of the material evolves from nanowires to nanosheets with the iron doping concentration, and the Fe-NiCoP/NF-12.5% nanosheets possess a more stable structure than NiCoP/NF nanowires. The density functional theory analysis implies that the conductivity of the material enhances after Fe doping because of the increased charge density and electron states. The combination of multicomponents and structural advantages endows the optimal Fe-NiCoP/NF-12.5% electrode with an ultrahigh areal capacitance of 9.93 F cm-2 (2758.34 F cm-3) under 1 mA cm-2, excellent rate capability (82.58% from 1 mA cm-2 to 50 mA cm-2) and superior cycling stability (95.72% retention over 5000 cycles under 20 mA cm-2), and the areal capacitance of Fe-NiCoP/NF-12.5% is 2.27 times higher than that of the pristine NiCoP/NF electrode at 1 mA cm-2. Moreover, the assembled Fe-NiCoP/NF-12.5%//activated carbon ASC device delivers a high energy density of 0.327 mW h cm-2 (60.43 mW h cm-3) at 1.10 mW cm-2 (202.54 mW cm-3). Therefore, this strategy may provide a novel route for the application of NiCoP with its intrinsic advantages in the energy storage field.

MoSe2 nanoflakes-decorated vertically aligned carbon nanotube film on nickel foam as a binder-free supercapacitor electrode with high rate capability.

A new type of composite electrode material, MoSe2 nanoflakes grown on the vertically aligned carbon nanotube array film (VACNTF) with binder-free nickel foam as current collector (VACNTF@MoSe2/NF), was fabricated by a simple spraying chemical vapor deposition method combined with the solvothermal technique. Owing to the introduction of the VACNTF with ordered channels and appropriate intertube spacing, which facilitate electrolyte ions quickly transferring and alleviate the volume changes in the electrochemical measurements, the VACNTF@MoSe2/NF sample presents superior electrochemical performance compared to pure MoSe2/NF sample. The VACNTF@MoSe2/NF sample exhibits high specific capacitance of 435 F·g-1 at 1 A·g-1, remarkable cycling stability (92% of the original capacitance maintaining over 5000 cycles) and especially excellent rate capability (84.1% capacitance retention with the current density changed from 1 to 15 A·g-1). Moreover, the VACNTF@MoSe2/NF based asymmetric supercapacitor exhibits a high energy density with 22 Wh·kg-1 for a power density of 330 W·kg-1. This paper offers a new strategy to prepare transition metal dichalcogenides based electrode materials with high rate performance.

Hierarchical NiCo2S4@NiCoP core-shell nanocolumn arrays on nickel foam as a binder-free supercapacitor electrode with enhanced electrochemical performance.

A novel hierarchical core-shell nanocolumn array, with NiCo2S4 hollow nanowire (NiCo2S4 H-NW) as the core and NiCoP nanosheet (NiCoP NS) as the shell, has been directly synthesized on nickel foam (NF) as self-supported, binder-free electrode for high-performance supercapacitors. The morphological characterizations reveal that the diameter of NiCo2S4 H-NW core is ∼100 nm and the diameter of single NiCo2S4@NiCoP core-shell nanocolumn is ∼250 nm. Through a series of electrochemical tests and the analysis of charge storage kinetics, hierarchical NiCo2S4@NiCoP/NF electrode presents high areal specific capacitance of 5.98 F/cm2 at 1 mA/cm2, outstanding rate capability (70.29% capacitance retention with the current density increased from 1 to 50 mA/cm2) and superior cycling stability (92.94% of original capacity is retained after 5000 cycles at 10 mA/cm2). The prominent performance of NiCo2S4@NiCoP/NF electrode could be resulted from their unique hierarchical core-shell nanocolumn structure, which could offer abundant active sites near the interface for fast electrochemical reaction, and validly avoid the collapse of internal structure for the stability of whole structure in the repeated electrochemical measurement. The novel NiCo2S4@NiCoP/NF electrode offers a new method for future electrochemical energy storage devices with high-stability.