Early detection of coagulopathy is important to prevent bleeding during liver transplantation (LT). Rotation thromboelastometry (ROTEM®) provides the earliest parameter of clot amplitudes at 5 min ...(A5). We evaluated whether A5 correlates with platelet count (PLT) and fibrinogen concentration (Fib) and can predict thrombocytopenia and hypofibrinogenaemia in hypocoagulable patients undergoing living-donor LT (LDLT).
A total of 3446 retrospective ROTEM® measurements, including 1139 EXTEM, 1182 INTEM, and 1125 FIBTEM, with simultaneously measured PLT and Fib, were analysed during LDLT in 239 patients. The correlations between A5 and maximum clot firmness (MCF) index, PLT, and Fib were calculated. Receiver operating characteristic analysis with area under the curve (AUC) was used to assess A5 thresholds predictive of PLT and Fib.
The median PLT was 47 000 mm−3 and the median Fib was 100 mg dl−1 during LDLT. The A5 parameters of EXTEM (A5EXTEM) and INTEM (A5INTEM) were highly correlated with MCF (r=0.96 and r=0.95, respectively), PLT (r=0.76 and r=0.77, respectively), and Fib (r=0.63 and r=0.64, respectively). A5 of FIBTEM (A5FIBTEM) was also correlated with MCF (r=0.91) and Fib (r=0.75). A5EXTEM thresholds of 15 and 19 mm predicted PLT<30 000 mm−3 (AUC=0.90) and <50 000 mm−3 (AUC=0.87), respectively, whereas A5FIBTEM 4 mm predicted Fib<100 mg dl−1 (AUC=0.86). Biases from A5EXTEM and A5FIBTEM to their MCFs were 16.4 and 1.3 mm, respectively.
A5 as an early variable of clot firmness is effective in detecting critically low PLT and Fib. A5 can therefore be a reliable fast index guiding transfusion therapy in hypocoagulable patients undergoing LDLT.
Background and purpose
In 2013, the American College of Cardiology/American Heart Association (ACC/AHA) introduced a novel pooled cohort risk (PCR) model for atherosclerotic cardiovascular disease. ...In this study, we evaluated the relationship between the PCR score and cerebral large‐ and small‐vessel diseases (cLVD and cSVD) in a healthy population,
Methods
We assessed consecutive health check‐up volunteers from 2006 to 2013. We calculated the estimated 10‐year atherosclerotic cardiovascular disease risk as the PCR score based on the 2013 ACC/AHA guidelines. We evaluated both cSVD/cLVD, including the prevalence of cLVD, lacunes and cerebral microbleed (CMB), and the volume of white matter hyperintensity (WMH). In addition to PCR score, the risk factors that were associated with outcome variables at P < 0.10 in univariate analysis were included for further multivariable linear or regression analyses.
Results
A total of 2720 participants were evaluated (mean age, 57 years, male sex, 54%). In multivariable analysis, PCR score was associated with WMH volume β = 0.361; 95% confidence interval (CI), 0.320–0.402, P < 0.001, cLVD adjusted odds ratio (aOR), 1.66; 95% CI, 1.29–2.16, P < 0.001, lacunes (aOR, 1.80; 95% CI, 1.52–2.14, P < 0.001) and CMBs (aOR, 1.75; 95% CI, 1.40–2.19, P < 0.001). Furthermore, PCR score also showed dose‐response tendencies according to the burden of cLVD, WMH, lacunes and CMB.
Conclusions
A higher PCR score based on the ACC/AHA guidelines is closely associated with a higher prevalence and burden of cLVD and cSVD.
More than 2000 mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) have been described that confer a range of molecular cell biological and functional phenotypes. Most of ...these mutations lead to compromised anion conductance at the apical plasma membrane of secretory epithelia and cause cystic fibrosis (CF) with variable disease severity. Based on the molecular phenotypic complexity of CFTR mutants and their susceptibility to pharmacotherapy, it has been recognized that mutations may impose combinatorial defects in CFTR channel biology. This notion led to the conclusion that the combination of pharmacotherapies addressing single defects (e.g., transcription, translation, folding, and/or gating) may show improved clinical benefit over available low-efficacy monotherapies. Indeed, recent phase 3 clinical trials combining ivacaftor (a gating potentiator) and lumacaftor (a folding corrector) have proven efficacious in CF patients harboring the most common mutation (deletion of residue F508, ΔF508, or Phe508del). This drug combination was recently approved by the U.S. Food and Drug Administration for patients homozygous for ΔF508. Emerging studies of the structural, cell biological, and functional defects caused by rare mutations provide a new framework that reveals a mixture of deficiencies in different CFTR alleles. Establishment of a set of combinatorial categories of the previously defined basic defects in CF alleles will aid the design of even more efficacious therapeutic interventions for CF patients.
To determine the immediate and long-term therapeutic efficacies of Gufoni and head-shaking maneuvers in apogeotropic type of benign paroxysmal positional vertigo involving the horizontal semicircular ...canal (HC-BPPV), a randomized, prospective, sham-controlled study was conducted.
In 10 nationwide dizziness clinics in Korea, 157 consecutive patients (95 women, age range: 18-89 years, mean age ± SD = 59.9 ± 13.6) with apogeotropic HC-BPPV were randomized to Gufoni (n = 52), head-shaking (n = 54), or sham maneuver (n = 51). For Gufoni maneuver, patients underwent ipsilesional side-lying and upward head-turn for migration of the debris toward the vestibule. Immediate responses were determined within 1 hour after a maximum of 2 trials of each maneuver and in the following day. The patients also had weekly follow-ups for 1 month after the initial maneuver.
After a maximum of 2 maneuvers on the initial visit day, Gufoni (38/52, 73.1%) and head-shaking (33/53, 62.3%) maneuvers showed better responses than the sham maneuver (17/49, 34.7%). The cumulative therapeutic effects were also better with Gufoni (p < 0.001) and head-shaking (p = 0.026) maneuvers compared with the sham maneuver. However, therapeutic efficacies did not differ between the Gufoni and head-shaking groups in terms of both immediate (p = 0.129) and long-term (p = 0.239) outcomes.
Using a prospective randomized trial, we demonstrated that the Gufoni and head-shaking maneuvers are effective in treating apogeotropic HC-BPPV.
This study provides Class II evidence that Gufoni and head-shaking maneuvers are effective in treating apogeotropic horizontal BPPV up to 1 month after initial treatment.
NCT00810641.
The middle power concept is versatile enough to categorise any states in the middle range of the world order that display certain behavioural characteristics known as middle power behaviours. ...Meanwhile, the adoption of the middle power concept as an explicit policy position by Korean IR scholars and policy researchers can shape and influence the actual policy practice as South Korea's academic discussions on 'middle power diplomacy knowledge' (MPD) have advanced with the purpose of serving its national interests. This research sought to better conceptualise South Korea's middle power diplomacy particularly on the South China Sea disputes between the USA and China and determine whether or not it is essential for its national interests through active Korean IR scholars' and policy researchers' perspectives. It found that there is more uncertainty or concern about employing 'middle power diplomacy' due to their assessment of finding greater drawbacks than benefits. Yet, the utmost reason behind such discrepancy stems from the epistemic fallacies prevalent in the middle power scholarship. Ultimately, discussions on South Korea's middle power diplomacy should begin with the awareness of such fallacies and attempt to address them by critically examining the ontology of South Korea's middle power categorisation, which leads one to question what kind of reality entails South Korea's being a 'middle power' in the SCS disputes and, from there, determine its appropriate role.
In this paper the fabrication and the characterization of heterojunction solar cells based on electrodeposited ZnO and Cu2O is described. The effect of the electrodeposition conditions (pH and ...temperature) on the cell performance has been investigated. The cells made with a Cu2O layer deposited at high pH (12) and moderate temperature (50 deg C) have shown conversion efficiency as high as 0.41%.
The Afterglow and Kilonova of the Short GRB 160821B Troja, E.; Castro-Tirado, A. J.; Gonzalez, J Becerra ...
Monthly notices of the Royal Astronomical Society,
08/2019, Letnik:
489, Številka:
2
Journal Article
Recenzirano
Odprti dostop
GRB 160821B is a short duration gamma-ray burst (GRB) detected and localized by the Neil Gehrels Swift Observatory in the outskirts of a spiral galaxy at z = 0.1613, at a projected physical offset of ...16 kpc from the galaxy’s center. We present X-ray, optical/nIR, and radio observations of its counterpart and model them with two distinct components of emission: a standard afterglow, arising from the interaction of the relativistic jet with the surrounding medium, and a kilonova, powered by the radioactive decay of the sub-relativistic ejecta. Broadband modelling of the afterglow data reveals a weak reverse shock propagating backward into the jet, and a likely jet-break at 3.5 d. This is consistent with a structured jet seen slightly off-axis (θview ∼ θcore) while expanding into a low-density medium (n ≈ 10−3 cm−3). Analysis of the kilonova properties suggests a rapid evolution towards red colours, similar toAT2017gfo, and a low-nIR luminosity, possibly due to the presence of a long-lived neutron star. The global properties of the environment, the inferred low mass (Mej <~ 0.006 Msun) and velocities (vej >~ 0.05c) of lanthanide-rich ejecta are consistent with a binary neutron star merger progenitor.
Background and purpose
Although non‐alcoholic fatty liver disease (NAFLD) shares common cardiovascular risk factors with cerebral white matter hyperintensity (WMH), few studies have reported the ...association between NAFLD and WMH. The association between the presence of NAFLD with its severity and the volume of WMH was investigated.
Methods
This cross‐sectional study was conducted for 2460 subjects who voluntarily participated in health screening check‐ups including brain magnetic resonance imaging and liver ultrasonography at the Health Promotion Center at Seoul National University Hospital from 2009 to 2013. Ultrasonography was used to detect the presence and severity of NAFLD combined with the NAFLD fibrosis score and the FIB‐4 index. The volume of WMH was measured using a semi‐automated quantification method by a trained neurologist.
Results
The prevalence of NAFLD was 36.5%, and the median volume of WMH in all the subjects was 1.1 ml (interquartile range 0.2–2.7 ml). The presence of NAFLD was associated with a smaller volume of WMH β (standard error, SE) −0.051 (0.046); P = 0.012. Moderate to severe NAFLD was associated with a smaller volume of WMH than was non‐NAFLD β (SE) −0.067 (0.061); P = 0.002. The negative correlation observed between NAFLD severity and WMH volume was persistent only in those with low FIB‐4 index and low NAFLD fibrosis scores, whereas there was a positive association in those with high FIB‐4 index and NAFLD fibrosis scores.
Conclusions
Non‐alcoholic fatty liver disease, and its severity, showed a favorable association with WMH volume. However, its causality and mechanism should be evaluated in further relevantly designed studies.
► Natural cellulose as binder in lithium battery electrodes. ► Organic solvent-free processing. ► Development of lower cost and greener Li battery technology.
This manuscript reports on the ...development of lithium-ion battery electrodes based on natural cellulose as the binder. In particular, the cellulose binder is dissolved into fully recyclable ionic liquid to make volatile solvent-free slurries, which are coated on typical battery current collectors. Finally, the ionic liquid solvent is removed by a phase inversion process using water as the co-solvent. In such a way, electrodes can be prepared without using polluting volatile organic compounds. Full lithium-ion cells were made using graphite (SLP30) and carbon coated lithium iron phosphate (LiFePO
4, LFP) as active materials and 1
M LiPF
6 in EC-DEC (3:7
wt. ratio) based electrolyte. The lithium ion cells showed a stable specific capacity of 123
mAh per gram of LiFePO
4 at room temperature. This promising result shows that natural cellulose dissolved in a non-volatile ionic liquid can be used to manufacture battery electrodes thus providing new greener opportunities for the lithium-ion battery technology.
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