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1.
Materials (Basel) ; 17(12)2024 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-38930324

RESUMEN

The aim of this study was to evaluate the mobility of copper (Cu) and zinc (Zn) and their impact on the properties of bentonites and unfrozen water content. Limited research in this area necessitates further analysis to prevent the negative effects of metal interactions on bentonite effectiveness. Tests involved American (SWy-3, Stx-1b) and Slovak (BSvk) bentonite samples with Zn or Cu ion exchange. Sequential extraction was performed using the Community Bureau of Reference (BCR) method. Elemental content was analyzed via inductively coupled plasma optical emission spectrometry (ICP-OES). Unfrozen water content was measured using nuclear magnetic resonance (1H-NMR) and differential scanning calorimetry (DSC). Results showed a significant influence of the main cation (Zn or Cu) on ion mobility, with toxic metal concentrations increasing mobility and decreasing residual fractions. Mobile Zn fractions increased with larger particle diameters, lower clay content, and shorter interplanar spacing, while the opposite was observed for Cu. Zn likely accumulated in larger clay pores, while Cu was immobilized in the bentonite complex. The stability of Zn or Cu ions increased with higher clay content or specific surface area. Residual Zn or Cu fractions were highest in uncontaminated bentonites with higher unfrozen water content, suggesting the potential formation of concentrated solutions in sub-zero temperatures, posing a threat to the clay-water environment, especially in cold regions.

2.
J Forensic Leg Med ; 101: 102619, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37988901

RESUMEN

Machine learning methods for the identification of child sexual abuse materials (CSAM) have been previously studied, however, they have serious limitations. Firstly, the training sets used to train the appropriate machine learning algorithms were not previously annotated by a forensic expert in anthropology. Secondly, previously presented solutions have rarely used models trained using real pornographic content involving children. Thirdly, previous studies have not presented a detailed justification for the classification decisions made, which is important due to the recent guidelines of the European Commission (Artificial Intelligence Act). The aim of the study was to train convolution neural networks (CNNs) using expert-labelled CSAM images and thereby identify the elements of the body and/or the environment that are critical for classifications by the neural network. To train and evaluate machine learning models, we used 60,000 images equally divided into four classes (CSAM images, images displaying sexual activity involving adults, images of people without sexual activity, and images not containing people). We used four neural network architectures: MobileNet, ResNet152, xResNet152 and its modification ResNet-s, designed for the purpose of research. The trained models provided high accuracy of classifying CSAM images: xResNet152 (F1 = 0.93, 92,8%), xResNet-s (F1 = 0.93, 93,1%), ResNet152 (F1 = 0.90, 91,39%), MobileNet (F1 ranged from 0.85 to 0.87, accuracy ranged from 86% to 87%). The results of the conducted research suggest that using expert knowledge (in sexology and anthropology) significantly improved the accuracy of the models. In regard to further anthropological analysis, the results indicate that the breasts, face and torso are crucial areas for the classification of pornographic content with children's participation. Results suggests that the ResNet-s neural network may be a reliable tool for clinical work and to support the work of experts witnesses in the field of anthropology. The study design received a positive opinion of the Ethics Committee of the Faculty of Mathematics, Informatics and Mechanics of the University of Warsaw. The clinical material was used for research purposes with the consent of the relevant prosecutor's offices. Authors provided free version of Windows application to classify CSAM for forensic experts, policemen and prosecutors at the OSF repository (DOI: 10.17605/OSF.IO/RU7JX).


Asunto(s)
Inteligencia Artificial , Abuso Sexual Infantil , Niño , Humanos , Redes Neurales de la Computación , Algoritmos , Aprendizaje Automático
3.
Brain Sci ; 13(9)2023 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-37759935

RESUMEN

Five major psychiatric disorders: schizophrenia, major depressive disorder, bipolar disorder, autistic spectrum disorder, and attention-deficit/hyperactivity disorder, show a shared genetic background and probably share common pathobiological mechanisms. S100B is a calcium-binding protein widely studied in psychiatric disorders as a potential biomarker. Our systematic review aimed to compare studies on peripheral S100B levels in five major psychiatric disorders with shared genetic backgrounds to reveal whether S100B alterations are disease-specific. EMBASE, Web of Science, and PubMed databases were searched for relevant studies published until the end of July 2023. This study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA) guidelines. Overall, 1215 publications were identified, of which 111 full-text articles were included in the systematic review. Study designs are very heterogeneous, performed mostly on small groups of participants at different stages of the disease (first-episode or chronic, drug-free or medicated, in the exacerbation of symptoms or in remission), and various clinical variables are analyzed. Published results are inconsistent; most reported elevated S100B levels across disorders included in the review. Alterations in S100B peripheral levels do not seem to be disease-specific.

4.
Am J Transplant ; 23(12): 1980-1989, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37748554

RESUMEN

Older compatible living donor kidney transplant (CLDKT) recipients have higher mortality and death-censored graft failure (DCGF) compared to younger recipients. These risks may be amplified in older incompatible living donor kidney transplant (ILDKT) recipients who undergo desensitization and intense immunosuppression. In a 25-center cohort of ILDKT recipients transplanted between September 24, 1997, and December 15, 2016, we compared mortality, DCGF, delayed graft function (DGF), acute rejection (AR), and length of stay (LOS) between 234 older (age ≥60 years) and 1172 younger (age 18-59 years) recipients. To investigate whether the impact of age was different for ILDKT recipients compared to 17 542 CLDKT recipients, we used an interaction term to determine whether the relationship between posttransplant outcomes and transplant type (ILDKT vs CLDKT) was modified by age. Overall, older recipients had higher mortality (hazard ratio: 1.632.072.65, P < .001), lower DCGF (hazard ratio: 0.360.530.77, P = .001), and AR (odds ratio: 0.390.540.74, P < .001), and similar DGF (odds ratio: 0.461.032.33, P = .9) and LOS (incidence rate ratio: 0.880.981.10, P = 0.8) compared to younger recipients. The impact of age on mortality (interaction P = .052), DCGF (interaction P = .7), AR interaction P = .2), DGF (interaction P = .9), and LOS (interaction P = .5) were similar in ILDKT and CLDKT recipients. Age alone should not preclude eligibility for ILDKT.


Asunto(s)
Trasplante de Riñón , Humanos , Anciano , Persona de Mediana Edad , Adolescente , Adulto Joven , Adulto , Trasplante de Riñón/efectos adversos , Donadores Vivos , Supervivencia de Injerto , Rechazo de Injerto/etiología , Antígenos HLA , Factores de Riesgo
5.
Artículo en Inglés | MEDLINE | ID: mdl-36674088

RESUMEN

The aim of this article is to assess the potential impact of inorganic salt hydrates used as PCM material in solar installations on the environment and human health and to assess the society's approach to this technology. The properties of salt are discussed in two ways: first, by analyzing the environmental and health problems caused by chemical hazards on the basis of the available material safety data sheets. Secondly, by analyzing the potential disadvantages of salt hydrates in terms of environmental hazards based on the results of experimental studies available in the literature. Then, using questionnaires, the public approach to solar installations with a built-in converter containing salt hydrates is assessed. Disodium hydrogen phosphate dodecahydrate turned out to be the most prospective salt in terms of environmental, thermophysical, and economic properties for use in solar installations. Understanding the attitudes of the local community toward technologies using inorganic salt hydrates will enable appropriate action to be taken in the future to promote their development. Surveys have shown great public concern about their impact on the environment and human health. In this regard, it is necessary to implement information and promotion activities.


Asunto(s)
Calor , Humanos , Estudios Prospectivos
6.
Front Endocrinol (Lausanne) ; 13: 1011043, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36246875

RESUMEN

The aim of the study was to assess the total antioxidant/oxidant status in the plasma and urine of patients with adrenal tumors. The study group consisted of 60 patients (31 women and 29 men) with adrenal masses, classified into three subgroups: non-functional incidentaloma, pheochromocytoma and Cushing's/Conn's adenoma. The number of patients was set a priori based on our previous experiment (α = 0.05, test power = 0.9). Antioxidant activity (Total Antioxidant Capacity (TAC), Total Oxidant Status (TOS), Oxidative Stress Index (OSI)) and antiradical activity (Radical-Scavenging Activity Assay (DPPH), Ferric-Reducing Antioxidant Power (FRAP)) were measured using colorimetric methods. FRAP level was decreased in plasma and urine incidentaloma (p<0.0001), pheochromocytoma (p<0.0001) and Cushing's/Conn's adenoma (p<0.0001), while DPPH antiradical activity only in plasma of patients with adrenal masses (p<0.0001). Plasma TAC was increased in incidentaloma patients (p=0.0192), whereas in pheochromocytoma group (p=0.0343) was decreased. Plasma and urine TOS (p<0.0001) and OSI (p<0.01) were significantly higher in patients with adrenal tumors. In pheochromocytoma patients, plasma and urine TAC (p=0.001; p=0.002), as well as plasma plasma DPPH (p=0.007) and urine FRAP (p=0.017) correlated positively with normethanephrine. We are the first who showed reduced radical scavenging capacity in the plasma/urine of patients with adrenal masses. Nevertheless, plasma TAC was significantly higher in the incidentaloma group compared to controls. Therefore, plasma and urinary antioxidant and antiradical activities depend on the presence of the tumor. Lower levels of TAC, DPPH and FRAP clearly indicate a reduced ability to scavenge free radicals and thus a lack of effective protection against oxidative stress in patients with adrenal tumors. Both plasma and urine redox biomarkers can be used to assess systemic antioxidant status in adrenal tumor patients.


Asunto(s)
Adenoma , Neoplasias de las Glándulas Suprarrenales , Feocromocitoma , Antioxidantes , Biomarcadores , Femenino , Humanos , Masculino , Oxidantes
7.
Sci Rep ; 12(1): 7212, 2022 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-35508510

RESUMEN

Diagnostics of conveyor belts used in horizontal transport without the need to take the belt off the conveyor and test it in laboratory conditions is an important aspect in mining plants (Jurdziak et al., Adv Intell Syst Comput, 835:645-654, 2019). Current testing, and thus obtaining knowledge about the current thickness of the conveyor belt covers, allows for control accelerated changes. It also avoids emergency stoppages in the operation of the conveyor and enables economically justified planning of a break in its operation. The article presents the concept of the first in Poland mobile device for measuring the thickness of conveyor belts in motion, implemented as part of the NCBR project (No. 0227 / L-10/2018 [LIDER program, Transport Przemyslowy i Maszyny Robocze, 1(47)/2020, pp. 60-61]), and also presents the measurement results obtained thanks to the laboratory version of the device.

8.
Cancers (Basel) ; 14(4)2022 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-35205784

RESUMEN

Despite the technological advances and improved surgical skills, the incidence of anastomotic leakage following colorectal cancer surgery still ranges from 4% to 19%. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of indocyanine green (ICG) use in colorectal cancer surgery. An online search of the Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases (from inception to 10 November 2021) was performed, in addition to manual screening. Thirty-two studies involving 11,047 patients were considered eligible for the meta-analysis. The anastomotic leak rate in the ICG and non-ICG groups varied and amounted to 3.7% vs. 7.6%, respectively (RR = 0.46; 95% CI: 0.39-0.56; p < 0.001). The rate in randomized controlled trials (RCTs) was 8.1% in the ICG group compared with 12.1% in the non-ICG group (RR = 0.67; 95% CI: 0.46-0.98; p = 0.04). In non-RCTs, it equaled 3.1% vs. 7.3%, respectively (RR = 0.43; 95% CI: 0.35-0.52; p < 0.001). Although the publications encompassed in our meta-analysis present different patients, with different factors influencing the results, a pooled analysis revealed a lower incidence of anastomotic leak in cases with ICG use. There are several other convincing advantages: safety, simplicity, and short time of the method adjustment. The presented meta-analysis indicates ICG perfusion assessment as a tool worth considering to decrease the rate of complications following colorectal surgery-valuable in the context of other, well-known risk factors.

9.
J Inflamm Res ; 14: 6317-6330, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34876829

RESUMEN

BACKGROUND: Adrenal masses are the most common of all human tumors. The role of nitrosative stress and inflammation in cancer development has already been demonstrated. However, it is not known whether they are involved in the pathogenesis of adrenal tumors. The aim of the study was to investigate a cross-talk between nitrosative stress, inflammation and hypoxia-inducible factor (HIF-1α) in 75 patients with different types of adrenal masses (non-functional incidentaloma, pheochromocytoma and Cushing's/Conn's adenoma). METHODS: The plasma concentrations of total nitric oxide (NO), S-nitrosothiols, peroxynitrite nitrotyrosine and the activity of serum myeloperoxidase (MPO) were measured spectrophotometrically, whereas concentrations of interleukin 1 beta (IL-1ß), tumor necrosis factor α (TNF-α) and hypoxia-inducible factor 1 alpha (HIF-1α) were measured using commercial ELISA kits. The control group consisted of 50 healthy people matched by age and sex to the study group. The number of subjects was determined a priori based on our previous experiment (power of the test = 0.9; α = 0.05). RESULTS: We found significantly higher nitrosative stress (↑nitric oxide, ↑peroxynitrite, ↑S-nitrosothiols and ↑nitrotyrosine) in the plasma of patients with adrenal tumors, which was accompanied by increased inflammatory (↑myeloperoxidase, ↑interleukin 1 beta and ↑tumor necrosis factor α) and hypoxia (HIF-1α) biomarkers. Peroxynitrite and nitrotyrosine were positively correlated with aldosterone level. Nitrosative stress was also associated with inflammation and HIF-1α. Interestingly, plasma nitrotyrosine and serum MPO differentiated patients with adrenal tumor from healthy individuals with high sensitivity and specificity. Moreover, using multivariate regression analysis, we showed that ONOO- and IL-1ß depended on cortisol level, while ONOO-, nitrotyrosine and HIF-1α were associated with aldosterone. Unfortunately, none of the assessed biomarkers differentiated between tumor types studied, suggesting that the severity of nitrosative damage and inflammation are similar in patients with incidentaloma, pheochromocytoma, and Cushing's or Conn's adenoma. CONCLUSION: Adrenal tumors are associated with increased protein nitration/S-nitrosylation and inflammation.

10.
J Clin Med ; 10(13)2021 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-34209541

RESUMEN

The Food and Drug Administration (FDA) has been regulating human islets for allotransplantation as a biologic drug in the US. Consequently, the requirement of a biological license application (BLA) approval before clinical use of islet transplantation as a standard of care procedure has stalled the development of the field for the last 20 years. Herein, we provide our commentary to the multiple FDA's position papers and guidance for industry arguing that BLA requirement has been inappropriately applied to allogeneic islets, which was delivered to the FDA Cellular, Tissue and Gene Therapies Advisory Committee on 15 April 2021. We provided evidence that BLA requirement and drug related regulations are inadequate in reassuring islet product quality and potency as well as patient safety and clinical outcomes. As leaders in the field of transplantation and endocrinology under the "Islets for US Collaborative" designation, we examined the current regulatory status of islet transplantation in the US and identified several anticipated negative consequences of the BLA approval. In our commentary we also offer an alternative pathway for islet transplantation under the regulatory framework for organ transplantation, which would address deficiencies of in current system.

11.
Oxid Med Cell Longev ; 2021: 5543531, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34239688

RESUMEN

This study is the first to assess redox balance, glutathione metabolism, and oxidative damage to RNA/DNA, proteins, and lipids in the plasma/serum and urine of patients with adrenal masses. The study included 70 patients with adrenal tumors divided into three subgroups: incidentaloma (n = 30), pheochromocytoma (n = 20), and Cushing's/Conn's adenoma (n = 20), as well as 60 healthy controls. Blood and urine samples were collected before elective endoscopic adrenalectomy. Antioxidant defense capacity was significantly decreased (serum/plasma: superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH), uric acid (UA); urine: SOD, GSH, UA) in patients with adrenal masses. The oxidative damage to proteins (advanced glycation end products (AGE), advanced oxidation protein products (AOPP)) and lipids (lipid hydroperoxides (LOOH), and malondialdehyde (MDA)) was higher in the plasma and urine of these patients. Plasma MDA and DNA/RNA oxidation products, with high sensitivity and specificity, can help to diagnose pheochromocytoma. This biomarker differentiates patients with pheochromocytoma from Cushing's/Conn's adenoma as well as from heathy controls. Plasma RNA/DNA oxidation was also positively correlated with urine metanephrine. Oxidative stress can play a crucial role in adrenal tumors. However, further studies are required to clarify the role of redox signaling in adrenal masses.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/fisiopatología , ADN/metabolismo , Lípidos/sangre , Estrés Oxidativo/efectos de los fármacos , Proteínas/metabolismo , ARN/metabolismo , Anciano , Antioxidantes/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
Sci Rep ; 11(1): 12349, 2021 06 11.
Artículo en Inglés | MEDLINE | ID: mdl-34117324

RESUMEN

Belt conveyors are used for transporting bulk materials over distances. The core of the belt, by transferring the longitudinal stresses and ensuring proper frictional coupling of the belt, enables belt movement and transportation of materials on its surface. As the belt cover and edges are used, the belt becomes abraded, and the core is subject to fatigue. The result is the development of cracks in rubber covers across the belt, which leads to the development of damage not only along the cables (the natural direction of water migration and corrosion) but also in the direction transverse to the belt axis. Conducting a series of scans of the St-type belt operating in one of the underground copper ore mines in Poland allowed identifying the number of failures as well as their size and changes over time. These data were in turn used to determine the measures defining the condition of the belt such as the density of defects (the number of defects per 1 m of the belt), the density of the area of damage (the area of damage per 1 m of the belt) and the change in the average area of a single defect over time. By determining the regression of these measures in time and the rate of damage development in both directions (along the axis of the belt and across the belt), it was possible to forecast future states of the belt, as well as to evaluate the costs of different belt replacement strategies and the economic rationalization of the decision to replace them. This research has become possible owing to the development of the DiagBelt system for two-dimensional imaging of the damage to the core of steel-cord belts with resolution sufficiently high to allow tracking the development of single core defects.

13.
Prog Transplant ; 31(2): 108-116, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34080486

RESUMEN

INTRODUCTION: Living donor transplantation of kidneys accounts for one quarter of transplants performed in the United States. Careful screening of psychiatric history is a standard part of the donor evaluation. Little is known about the impact of psychiatric history on post-donation course and pain experience. RESEARCH QUESTION: This study investigated whether psychiatric history was associated with pain and related outcomes among living kidney donors. DESIGN: A retrospective medical record review was conducted of 75 living kidney donors who underwent laparoscopic donor nephrectomy. All donor candidates completed a psychological evaluation and were approved for donation by a multidisciplinary committee. History of psychiatric diagnosis and psychiatric medication use were obtained from donors' psychological evaluation reports. Data on pain and related outcomes (ie, history of prescribed pain medication, post-donation pain, opioid use, length of hospital stay, post-donation emergency department visits), as well as demographic and donation-related characteristics were also abstracted from medical records. RESULTS: Psychiatric history, including current or historical psychiatric diagnosis or psychiatric medication use, in living kidney donors who were evaluated and approved for donation by a transplant psychologist was not associated with greater perceived pain, greater use of opioid pain medication in the post-operative period, longer hospital stays, or more frequent post-donation emergency department visits. DISCUSSION: The findings demonstrate that carefully screened donors with a psychiatric history have comparable pain-related outcomes as donors without a psychiatric history. This study highlights the importance of the pre-donation psychological evaluation in promoting positive postdonation outcomes through careful selection of donor candidates.


Asunto(s)
Trasplante de Riñón , Donadores Vivos , Humanos , Riñón , Nefrectomía , Dolor , Estudios Retrospectivos
15.
Pol Przegl Chir ; 94(2): 12-18, 2021 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-35485316

RESUMEN

<b>Introduction:</b> Surgery using robotic systems is taking over an increasingly wider field of open surgery and laparoscopy. Recently, this is particularly visible in colorectal surgery, where the advantages include better insight into the hard-to-reach area of the surgical field. Limited access to this method and relatively high costs remain a problem. </br></br> <b>Aim:</b> The aim of the work is to present the results of the introduction of robotic surgery at the regional Oncology Center in Wielkopolska in the field of safety and feasibility and the early oncological results for robotic colorectal surgery. </br></br> <b> Materials and methods:</b> From March 6, 2019 to the end of 2019, we performed 66 robotic colorectal procedures: 54 anterior resections of the sigmoid colon/rectum, 6 right hemicolectomies, 3 left hemicolectomies, 2 abdominoperineal resections, and one Hartmann's procedure. </br></br> <b> Results:</b> The final histopathological examination of all operated patients confirmed the complete resection (R0 procedure). The average age was 64 years and the average duration of surgery was 199 ± 52 min. None of the robotic procedures required conversion to open surgery or laparoscopy once they had started. The average hospitalization time was 6 ± 1 days, including patients with complications. Complications occurred in 8 patients, with the most common being anastomotic leak - 4 (6%). </br></br> <b>Conclusions:</b> The use of the latest da Vinci Xi robot system is a safe and effective alternative to open and laparoscopic surgery. Colorectal surgery confirms its special advantage in the case of low anterior resections of the rectum. Increasing the availability of equipment and training will allow expanding the scope of operations, including upper gastrointestinal tract.


Asunto(s)
Neoplasias Colorrectales , Laparoscopía , Procedimientos Quirúrgicos Robotizados , Robótica , Colectomía/métodos , Neoplasias Colorrectales/cirugía , Humanos , Laparoscopía/métodos , Persona de Mediana Edad , Procedimientos Quirúrgicos Robotizados/métodos , Robótica/métodos
16.
Transplantation ; 105(2): 436-442, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-32235255

RESUMEN

BACKGROUND: Desensitization protocols for HLA-incompatible living donor kidney transplantation (ILDKT) vary across centers. The impact of these, as well as other practice variations, on ILDKT outcomes remains unknown. METHODS: We sought to quantify center-level variation in mortality and graft loss following ILDKT using a 25-center cohort of 1358 ILDKT recipients with linkage to Scientific Registry of Transplant Recipients for accurate outcome ascertainment. We used multilevel Cox regression with shared frailty to determine the variation in post-ILDKT outcomes attributable to between-center differences and to identify any center-level characteristics associated with improved post-ILDKT outcomes. RESULTS: After adjusting for patient-level characteristics, only 6 centers (24%) had lower mortality and 1 (4%) had higher mortality than average. Similarly, only 5 centers (20%) had higher graft loss and 2 had lower graft loss than average. Only 4.7% of the differences in mortality (P < 0.01) and 4.4% of the differences in graft loss (P < 0.01) were attributable to between-center variation. These translated to a median hazard ratio of 1.36 for mortality and 1.34 of graft loss for similar candidates at different centers. Post-ILDKT outcomes were not associated with the following center-level characteristics: ILDKT volume and transplanting a higher proportion of highly sensitized, prior transplant, preemptive, or minority candidates. CONCLUSIONS: Unlike most aspects of transplantation in which center-level variation and volume impact outcomes, we did not find substantial evidence for this in ILDKT. Our findings support the continued practice of ILDKT across these diverse centers.


Asunto(s)
Rechazo de Injerto/prevención & control , Supervivencia de Injerto/efectos de los fármacos , Antígenos HLA/inmunología , Disparidades en Atención de Salud , Histocompatibilidad , Inmunosupresores/uso terapéutico , Isoanticuerpos/sangre , Trasplante de Riñón , Donadores Vivos , Pautas de la Práctica en Medicina , Adulto , Femenino , Rechazo de Injerto/sangre , Rechazo de Injerto/inmunología , Rechazo de Injerto/mortalidad , Humanos , Inmunosupresores/efectos adversos , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/mortalidad , Masculino , Persona de Mediana Edad , Indicadores de Calidad de la Atención de Salud , Sistema de Registros , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Estados Unidos
17.
Am J Transplant ; 21(4): 1365-1375, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33251712

RESUMEN

Islet allotransplantation in the United States (US) is facing an imminent demise. Despite nearly three decades of progress in the field, an archaic regulatory framework has stymied US clinical practice. Current regulations do not reflect the state-of-the-art in clinical or technical practices. In the US, islets are considered biologic drugs and "more than minimally manipulated" human cell and tissue products (HCT/Ps). In contrast, across the world, human islets are appropriately defined as "minimally manipulated tissue" and not regulated as a drug, which has led to islet allotransplantation (allo-ITx) becoming a standard-of-care procedure for selected patients with type 1 diabetes mellitus. This regulatory distinction impedes patient access to islets for transplantation in the US. As a result only 11 patients underwent allo-ITx in the US between 2016 and 2019, and all as investigational procedures in the settings of a clinical trials. Herein, we describe the current regulations pertaining to islet transplantation in the United States. We explore the progress which has been made in the field and demonstrate why the regulatory framework must be updated to both better reflect our current clinical practice and to deal with upcoming challenges. We propose specific updates to current regulations which are required for the renaissance of ethical, safe, effective, and affordable allo-ITx in the United States.


Asunto(s)
Productos Biológicos , Diabetes Mellitus Tipo 1 , Trasplante de Islotes Pancreáticos , Costos y Análisis de Costo , Diabetes Mellitus Tipo 1/cirugía , Humanos , Trasplante Heterólogo , Estados Unidos
18.
Am J Transplant ; 21(4): 1612-1621, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33370502

RESUMEN

Incompatible living donor kidney transplant recipients (ILDKTr) have pre-existing donor-specific antibody (DSA) that, despite desensitization, may persist or reappear with resulting consequences, including delayed graft function (DGF) and acute rejection (AR). To quantify the risk of DGF and AR in ILDKT and downstream effects, we compared 1406 ILDKTr to 17 542 compatible LDKT recipients (CLDKTr) using a 25-center cohort with novel SRTR linkage. We characterized DSA strength as positive Luminex, negative flow crossmatch (PLNF); positive flow, negative cytotoxic crossmatch (PFNC); or positive cytotoxic crossmatch (PCC). DGF occurred in 3.1% of CLDKT, 3.5% of PLNF, 5.7% of PFNC, and 7.6% of PCC recipients, which translated to higher DGF for PCC recipients (aOR = 1.03 1.682.72 ). However, the impact of DGF on mortality and DCGF risk was no higher for ILDKT than CLDKT (p interaction > .1). AR developed in 8.4% of CLDKT, 18.2% of PLNF, 21.3% of PFNC, and 21.7% of PCC recipients, which translated to higher AR (aOR PLNF = 1.45 2.093.02 ; PFNC = 1.67 2.403.46 ; PCC = 1.48 2.243.37 ). Although the impact of AR on mortality was no higher for ILDKT than CLDKT (p interaction = .1), its impact on DCGF risk was less consequential for ILDKT (aHR = 1.34 1.621.95 ) than CLDKT (aHR = 1.96 2.292.67 ) (p interaction = .004). Providers should consider these risks during preoperative counseling, and strategies to mitigate them should be considered.


Asunto(s)
Trasplante de Riñón , Funcionamiento Retardado del Injerto/etiología , Rechazo de Injerto/etiología , Supervivencia de Injerto , Humanos , Trasplante de Riñón/efectos adversos , Donadores Vivos , Estudios Retrospectivos , Factores de Riesgo
19.
Data Brief ; 33: 106538, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33294526

RESUMEN

The data presented in the article consist of petrographic types and grain shape parameters of beach gravels collected along the Pogorzelica-Dziwnów coast section (363.0 to 391.4 km of the coastline), southern Baltic Sea, Poland. Representative gravels with the diameter of 2-5 cm were sampled at 0.25 km intervals, in the middle part of the beach. The contribution of mechanically high resistant crystalline components (igneous and metamorphic rocks: granites and gneisses) and low resistant (sedimentary rocks: limestones, sandstones, and shales) has been presented. The Cailleaux and Zingg grain shape parameters were estimated taking laboratory measurements (3D-axis dimensions, flatness/roundness indices). The calculations have been provided based on the gravels weight and quantity. The obtained grain shape parameters depend on factors such as resistance to mechanical destruction or increased chemical weathering, being evidenced by several indices, such as the proportions between discoidal and ellipsoidal grains, or amount of spindle-shaped gravels. The calculated indices may serve as potential indicators of coastal lithodynamics, including intensity of sediment redeposition or mechanical reworking of the beach.

20.
Heliyon ; 5(7): e02142, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31384685

RESUMEN

The aim of this study was to determine the influence of potentially toxic metals, such as Cu2+ and Zn2+ ions, on the microstructural parameters of bentonites and their hydraulic conductivity (K), calculated based on the empirical formulas for clays according to Hazen-Tkaczukowa (formula 1 based on granulometric parameters) and Kozlowski et al., (2011) (formula 2 based on microstructural parameters). Metal ions influence the microstructure changes of bentonites, which can lead to changes in the geotechnical parameters that are used in empirical K formulas. The research was carried out on model clays (SWy-3, Stx-1b and Slovak bentonite), which were modified by introducing Cu2+ or Zn2+ ions into the structure. A significant dependence was observed between an increase in the Cu2+ ion content in clay and an increase in the pore area. Therefore, the value of the hydraulic conductivity was estimated with the use of formula 2, which proved to be a useful tool for determining hydraulic conductivity in the case of bentonites contaminated with Cu2+ ions. In contrast, the effect of Zn2+ ions on the granulometric parameters was significant, and formula 1 proved to be useful tool for determining hydraulic conductivity in the case of bentonites contaminated with Zn2+ ions. The results showed that the behavior of bentonites saturated with Cu2+ and Zn2+ ions differed. Therefore, the authors believe that the empirical formulas of the hydraulic conductivity of the clays saturated with potentially toxic metals should be based on the selected clay parameters dependent upon the nature of the ion.

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