Background
There is no consensus on the best method of preventing postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). This multicentre, parallel group, randomized equivalence ...trial investigated the effect of two ways of pancreatic stenting after PD on the rate of POPF.
Methods
Patients undergoing elective PD or pylorus‐preserving PD with duct‐to‐mucosa pancreaticojejunostomy were enrolled from four tertiary referral hospitals. Randomization was stratified according to surgeon with a 1 : 1 allocation ratio to avoid any related technical factors. The primary endpoint was clinically relevant POPF rate. Secondary endpoints were nutritional index, remnant pancreatic volume, long‐term complications and quality of life 2 years after PD.
Results
A total of 328 patients were randomized to the external (164 patients) or internal (164) stent group between August 2010 and January 2014. The rates of clinically relevant POPF were 24·4 per cent in the external and 18·9 per cent in the internal stent group (risk difference 5·5 per cent). As the 90 per cent confidence interval (−2·0 to 13·0 per cent) did not fall within the predefined equivalence limits (−10 to 10 per cent), the clinically relevant POPF rates in the two groups were not equivalent. Similar results were observed for patients with soft pancreatic texture and high fistula risk score. Other postoperative outcomes were comparable between the two groups. Five stent‐related complications occurred in the external stent group. Multivariable analysis revealed that soft pancreatic texture, non‐pancreatic disease and high body mass index (23·3 kg/m2 or above) predicted clinically relevant POPF.
Conclusion
External stenting after PD was associated with a higher rate of clinically relevant POPF than internal stenting. Registration number: NCT01023594 (https://www.clinicaltrials.gov).
Internal stenting is better
Potential antioxidative activities of enzymatic extracts from seven species of brown seaweeds were evaluated using four different reactive oxygen species (ROS) scavenging assays containing DPPH ...(1,1-diphenyl-2-pricrylhydrazyl) free radical, superoxide anion, hydroxyl radical and hydrogen peroxide scavenging assay. The brown seaweeds were enzymatically hydrolyzed to prepare water-soluble extracts by using five carbohydrate degrading enzymes (Viscozyme, Celluclast, AMG, Termamyl and Ultraflo) and five proteases (Protamex, Kojizyme, Neutrase, Flavourzyme and Alcalase) of commercial and inexpensive enzymes obtained from Novozyme Co. (Novozyme Nordisk, Bagsvaerd, Denmark). The enzymatic extracts exhibited more prominent effects in hydrogen peroxide scavenging activity (approximately 90%) compared to the other scavenging activities and the activity of enzymatic extracts was even higher than that of the commercial antioxidants. In particular, Ultraflo and Alcalase extracts of
S. horneri were dose-dependent and thermally stable. Moreover the two enzymatic extracts strongly inhibited DNA damage (approximately 50%). Those extracts showed significantly (
p
<
0.05) remarkable scavenging effects in DPPH free radical scavenging assay and the activity indicated a marked correlation with phenolic contents. From the results, enzymatic extracts of the brown seaweeds might be valuable antioxidative sources.
Depending on the phosphorus bulk content, the phosphorus segregation profile at the grain boundary/carbide interface of heat-resistant ferritic steels is composed of a convex profile or two maximum ...peaks and one minimum peak during rupture test at 650°C. In the higher phosphorus bulk content steel, the smaller pre-formed non-equilibrium M3C carbides, which arise from the higher phosphorus segregation concentration at the carbide interface and thus its carbide growth retardation, are massively dissolved into the matrix after the first maximum peak. While the dissolved carbon is consumed in forming the equilibrium M7C3 carbides, the carbon segregates at the same time to the grain boundary/formed M7C3 carbide interface and the matrix/formed M7C3 carbide interface, resulting in a strong repulsive segregation between carbon and phosphorus. However, because the transformation of the thermally unstable M3C carbides to the M7C3 carbides is very early finished in the lower phosphorus bulk content steel, such a repulsive segregation is not observed. Meanwhile, the decrease in phosphorus segregation concentration after the second maximum segregation peak in the former steel or a plateau in segregation concentration of the latter steel is due to the formation of equilibrium MX carbides which results in the increase in total interface area. Due to the finer and denser MX particles formed on the M7C3 carbide surface of the former steel, the phosphorus segregation concentration decreases abruptly with increasing rupture time after the second maximum. The difference in rupture behavior of the steels is understood from the viewpoint of such a correlation.
Surface energy and hydrophilicity of implant surfaces have been known to play an important role in subsequent cellular responses on the implant surface. The aim of the present study was to evaluate ...the effects of biomimetic deposition of anodized surfaces on surface wettability, surface energy, and osteoblast responses. Ti discs with 2 different surface topographies (machined and anodized) were immersed in Hanks’ balanced salt solution (HBSS) and modified simulated body fluid (SBF) solution for 2 weeks at physiologic conditions of 37°C, initial pH of 7.4, and p(CO2) of 0.05 atm. Scanning electron microscopic (SEM) observation and energy-dispersive spectroscopic (EDS) microanalysis showed the deposition of calcium phosphate (CaP) onto anodized Ti surfaces immersed in modified SBF. Surface energy, surface wettability, and osteoblast responses, including cell attachment capacity, cell proliferation rate, and cell differentiation level, significantly increased on anodized Ti surfaces immersed in modified SBF. The effects of biomimetic deposition with modified SBF on physiochemical surface characteristics and cell biological responses were greater on anodized surfaces than on machined surfaces. These results indicate that biomimetic deposition with effective SBF may enhance the interaction between anodized Ti surfaces and their biological environment, consequently improving bone healing of dental Ti implants.
The large surface area of ZnO nanorods makes them attractive for gas and chemical sensing, and the ability to control their nucleation sites makes them candidates for micro-lasers or memory arrays. ...In addition, they might be doped with transition metal (TM) ions to make spin-polarized light sources. To date, most of the work on ZnO nanostructures has focused on the synthesis methods and there have been only a few reports of the electrical characteristics. We review fabrication methods for obtaining device functionality from single ZnO nanorods. A key aspect is the use of sonication to facilitate transfer of the nanorods from the initial substrate on which they are grown to another substrate for device fabrication. Examples of devices fabricated using this method are briefly described, including metal-oxide semiconductor field effect depletion-mode transistors with good saturation behavior, a threshold voltage of ∼−3
V and a maximum transconductance of order 0.3
mS/mm and Pt Schottky diodes with excellent ideality factors of 1.1 at 25
°C and very low (1.5
×
10
−10
A, equivalent to 2.35
A
cm
−2, at −10
V) reverse currents. The photoresponse showed only a minor component with long decay times (tens of seconds) thought to originate from surface states. These results show the ability to manipulate the electron transport in nanoscale ZnO devices.
Graphical abstract Highlights ► Human bone marrow-derived mesenchymal stem cells were differentiated to neural lineage cells. ► MSCs differentiated to neurosphere-like aggregates (NS-MSC) efficiently ...on DTOPV-coated surface. ► NS-MSCs via paracrine action contributed to functional recovery and reduction in infarct area. ► NS-MSCs could be a promising stem source for cell therapy in neurodegeneration.
This experiment was conducted to investigate the effects of dried mealworm (Tenebrio molitor larva) on growth performance, nutrient digestibility and blood profiles in weaning pigs. A total of 120 ...weaning pigs (28±3 days and 8.04±0.08 kg of body weight) were allotted to one of five treatments, based on sex and body weight, in 6 replicates with 4 pigs per pen by a randomized complete block design. Supplementation level of dried mealworm was 0%, 1.5%, 3.0%, 4.5%, or 6.0% in experimental diet as treatment. Two phase feeding programs (phase I from 0 day to 14 day, phase II from 14 day to 35 day) were used in this experiment. All animals were allowed to access diet and water ad libitum. During phase I, increasing level of dried mealworm in diet linearly improved the body weight (p<0.01), average daily gain (ADG) (p<0.01) and average daily feed intake (ADFI) (p<0.01). During phase II, ADG also tended to increase linearly when pigs were fed higher level of dried mealworm (p = 0.08). In addition, increasing level of dried mealworm improved the ADG (p<0.01), ADFI (p<0.05) and tended to increase gain to feed ratio (p = 0.07) during the whole experimental period. As dried mealworm level was increased, nitrogen retention and digestibility of dry matter as well as crude protein were linearly increased (p = 0.05). In the results of blood profiles, decrease of blood urea nitrogen (linear, p = 0.05) and increase of insulin-like growth factor (linear, p = 0.03) were observed as dried mealworm was increased in diet during phase II. However, there were no significant differences in immunoglobulin A (IgA) and IgG concentration by addition of dried mealworm in the growth trial. Consequently, supplementation of dried mealworm up to 6% in weaning pigs' diet improves growth performance and nutrient digestibility without any detrimental effect on immune responses.
Summary The aim of this study was to determine whether resonance frequency analysis can be integrated into the routine clinical evaluation of the initial healing of dental implants. In addition, ...this study was designed to verify whether there was a correlation between implant stability quotient (ISQ) values, maximum insertion torque values, angular momentum and energy, and to evaluate the importance of different clinical factors in the determination of ISQ values and maximum insertion torque values at implant insertion. Two different implant designs of 81 dental implants in 41 patients were evaluated using ISQ values. Maximum insertion torque values were obtained during the placement procedure. Two new methods were used to calculate the angular momentum developed due to implant installation as well as the energy absorbed by the bone. A linear correlation between ISQ values and maximum insertion torque values at the initial implant surgery was found (P < 0·01). There was a correlation between ISQ values and angular momentum (P < 0·05), although ISQ values and energy did not show a significant linear correlation at the initial surgery (P > 0·05). There was a correlation between maximum insertion torque values, each part’s angular momentum, and their energies during installation (P < 0·01). The sequence of the variables that influenced ISQ values was implant location, design, diameter, and gender of the patient. The results of this experiment suggest that both ISQ values and new methods to calculate angular momentum and energy can help to predict implant stability.
Dilute magnetic semiconducting oxides Pearton, S J; Heo, W H; Ivill, M ...
Semiconductor science and technology,
10/2004, Letnik:
19, Številka:
10
Journal Article
The endeavor to reduce the multiple risks of climate extremes takes the future of civil society. Many global climate models (GCMs) and regional climate models (RCMs) have been developed to project ...the future changing climate. To quantitatively evaluate future flood risks, the results of the current hydrological model based on simulated data from the climate model should be analyzed. This paper focuses the connection of technological and policy aspects for the future flood management in South Korea. Accordingly, this study assesses the changes in flood quantiles based on the two representative concentration pathways (RCP4.5 and RCP8.5) scenarios. The HadGEM3-RA regional climate model is used to predict future changes in extreme rainfall events, and the regional quantile delta mapping (RQDM) method is adopted to correct for any inherent bias in the climate models. The climate change scenario is divided into the following four periods: S0 (1976–2005), S1 (2011–2040), S2 (2041–2070), and S3 (2071–2100). A regional frequency analysis (RFA) is applied to estimate the rainfall quantiles as input data in rainfall-runoff model. The flood quantiles are simulated using the HEC-1 (rainfall-runoff) model for historical and future periods, and the variations in the flood quantiles are calculated quantitatively for the five major river basins (Hangang, HAN; Nakdonggang, NAK; Geumgang, GUM; Seomjingang, SJG; Yeongsangang, YSG) in South Korea. As a result, it is found that the highest flood risk can occur in the YSG basin, and the YSG basin should be considered the most urgent and important river basin for climate change adaptation plans compared with other major basins in South Korea.
•Extreme event of climate change directly impact the infrastructure in water resources system, and future flood risk.•Hydrological (rainfall-runoff) model was applied with climate change scenarios to prospect the future impacts.•Future floods of 100 and 200-years will significantly increase in the five major river basins of South Korea.
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