Single image super-resolution has attracted increasing attention and has a wide range of applications in satellite imaging, medical imaging, computer vision, security surveillance imaging, remote sensing, objection de...Single image super-resolution has attracted increasing attention and has a wide range of applications in satellite imaging, medical imaging, computer vision, security surveillance imaging, remote sensing, objection detection, and recognition. Recently, deep learning techniques have emerged and blossomed, producing " the state-of-the-art” in many domains. Due to their capability in feature extraction and mapping, it is very helpful to predict high-frequency details lost in low-resolution images. In this paper, we give an overview of recent advances in deep learning-based models and methods that have been applied to single image super-resolution tasks. We also summarize, compare and discuss various models from the past and present for comprehensive understanding and finally provide open problems and possible directions for future research.展开更多
Remote sensing is one of the tool which is very important for the production of Land use and land cover maps through a process called image classification. For the image classification process to be successfully, seve...Remote sensing is one of the tool which is very important for the production of Land use and land cover maps through a process called image classification. For the image classification process to be successfully, several factors should be considered including availability of quality Landsat imagery and secondary data, a precise classification process and user’s experiences and expertise of the procedures. The objective of this research was to classify and map land-use/land-cover of the study area using remote sensing and Geospatial Information System (GIS) techniques. This research includes two sections (1) Landuse/Landcover (LULC) classification and (2) accuracy assessment. In this study supervised classification was performed using Non Parametric Rule. The major LULC classified were agriculture (65.0%), water body (4.0%), and built up areas (18.3%), mixed forest (5.2%), shrubs (7.0%), and Barren/bare land (0.5%). The study had an overall classification accuracy of 81.7% and kappa coefficient (K) of 0.722. The kappa coefficient is rated as substantial and hence the classified image found to be fit for further research. This study present essential source of information whereby planners and decision makers can use to sustainably plan the environment.展开更多
Dew has been recognized for its ecological significance and has also been identified as an additional source of water in arid zones. We used factorial control experiment, under dew presence in the field, to explore ph...Dew has been recognized for its ecological significance and has also been identified as an additional source of water in arid zones. We used factorial control experiment, under dew presence in the field, to explore photosynthetic performance, water status and growth response of desert annual herbage. Bassia dasyphylla seedlings were grown in contrasting dew treatments （dew-absent and dew-present） and different watering regimes （normal and deficient）. The effects of dew on the water status and photosynthetic performance of Bassia dasyphylla grown in a desert area of the Hexi Corridor in Northwestern China, were evaluated. The results indicated the pres- ence of dew significantly increased relative water content （RWC） of shoots and total biomass of plants in both water regimes, and enhanced the diurnal shoot water potential and stomatal conductance in the early morning, as well as photosynthetic rate, which reached its maximum only in the water-stressed regime. The presence of dew increased aboveground growth of plants and photosynthate accumulation in leaves, but decreased the root-to-shoot ratio in both water regimes. Dew may have an important role in improving plant water status and ameliorating the adverse effects of plants exposed to prolonged drought.展开更多
AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, labor...AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm<sup>3</sup>. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%C展开更多
Metabolic homeostasis requires dynamic catabolic and anabolic processes. Autophagy, an intracellular lysosomal degradative pathway, can rewire cellular metabolism linking catabolic to anabolic processes and thus susta...Metabolic homeostasis requires dynamic catabolic and anabolic processes. Autophagy, an intracellular lysosomal degradative pathway, can rewire cellular metabolism linking catabolic to anabolic processes and thus sustain homeostasis. This is especially relevant in the liver, a key metabolic organ thatgoverns body energy metabolism. Autophagy’s role in hepatic energy regulation has just begun to emerge and autophagy seems to have a much broader impact than what has been appreciated in the field. Though classically known for selective or bulk degradation of cellular components or energy-dense macromolecules, emerging evidence indicates autophagy selectively regulates various signaling proteins to directly impact the expression levels of metabolic enzymes or their upstream regulators. Hence, we review three specific mechanisms by which autophagy can regulate metabolism: A) nutrient regeneration, B) quality control of organelles, and C) signaling protein regulation. The plasticity of the autophagic function is unraveling a new therapeutic approach. Thus, we will also discuss the potential translation of promising preclinical data on autophagy modulation into therapeutic strategies that can be used in the clinic to treat common metabolic disorders.展开更多
The field of liver transplantation is limited by the availability of donor organs. The use of living donor and split cadaveric grafts is one potential method of expanding the donor pool. However, primary graft dysfunc...The field of liver transplantation is limited by the availability of donor organs. The use of living donor and split cadaveric grafts is one potential method of expanding the donor pool. However, primary graft dysfunction can result from the use of partial livers despite the absence of other causes such as vascular obstruction or sepsis. This increasingly recognised phenomenon is termed "Small-for-size syndrome" (SFSS). Studies in animal models and humans have suggested portal hyperperfusion of the graft combined with poor venous outflow and reduced arterial flow might cause sinusoidal congestion and endothelial dysfunction. Graft related factors such as graft to recipient body weight ratio < 0.8, impaired venous outflow, steatosis > 30% and pro- longed warm/cold ischemia time are positively predictive of SFSS. Donor related factors include deranged liver function tests and prolonged intensive care unit stay greater than five days. Child-Pugh grade C recipients are at relatively greater risk of developing SFSS. Surgi- cal approaches to prevent SFSS fall into two categories: those targeting portal hyperperfusion by reducing inflow to the graft, including splenic artery modulation and portacaval shunts; and those aiming to relieve paren-chymal congestion. This review aims to examine thecontroversial diagnosis of SFSS, including current strate-gies to predict and prevent its occurrence. We will also consider whether such interventions could jeopardize the graft by compromising regeneration.展开更多
Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been compl...Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.展开更多
Sustained inflammation associated with dysregulated macrophage activation prevents tissue formation and healing of chronic wounds.Control of inflammation and immune cell functions thus represents a promising approach ...Sustained inflammation associated with dysregulated macrophage activation prevents tissue formation and healing of chronic wounds.Control of inflammation and immune cell functions thus represents a promising approach in the development of advanced therapeutic strategies.Here we describe immunomodulatory hyaluronan/collagen(HA-AC/coll)-based hydrogels containing high-sulfated hyaluronan(sHA)as immunoregulatory component for the modulation of inflammatory macrophage activities in disturbed wound healing.Solute sHA downregulates inflammatory activities of bone marrow-derived and tissue-resident macrophages in vitro.This further affects macrophage-mediated pro-inflammatory activation of skin cells as shown in skin ex-vivo cultures.In a mouse model of acute skin inflammation,intradermal injection of sHA downregulates the inflammatory processes in the skin.This is associated with the promotion of an anti-inflammatory gene signature in skin macrophages indicating a shift of their activation profile.For in vivo translation,we designed HA-AC/coll hydrogels allowing delivery of sHA into wounds over a period of at least one week.Their immunoregulatory capacity was analyzed in a translational experimental approach in skin wounds of diabetic db/db mice,an established model for disturbed wound healing.The sHA-releasing hydrogels improved defective tissue repair with reduced inflammation,augmented pro-regenerative macrophage activation,increased vascularization,and accelerated new tissue formation and wound closure.展开更多
Mitochondrial biogenesis and function in plants require the expression of over 1000 nuclear genes encoding mitochondrial proteins （NGEMPs）. The expression of these genes is regulated by tissue-specific, developmenta...Mitochondrial biogenesis and function in plants require the expression of over 1000 nuclear genes encoding mitochondrial proteins （NGEMPs）. The expression of these genes is regulated by tissue-specific, developmental, internal, and external stimuli that result in a dynamic organelle involved in both metabolic and a variety of signaling processes. Although the metabolic and biosynthetic machinery of mitochondria is relatively well understood, the factors that regu- late these processes and the various signaling pathways involved are only beginning to be identified at a molecular level. The molecular components of anterograde （nuclear to mitochondrial） and retrograde （mitochondrial to nuclear） signaling pathways that regulate the expression of NGEMPs interact with chloroplast-, growth-, and stress-signaling pathways in the cell at a variety of levels, with common components involved in transmission and execution of these signals. This positions mitochondria as important hubs for signaling in the cell, not only in direct signaling of mitochondrial function per se, but also in sensing and/or integrating a variety of other internal and external signals. This integrates and optimizes growth with energy metabolism and stress responses, which is required in both photosynthetic and non-photosynthetic cells.展开更多
Feasibility of endoscopic retrograde cholangiopancreatography(ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary ...Feasibility of endoscopic retrograde cholangiopancreatography(ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. However,endoscopic ultrasonography-guided biliary drainage represents a valid option to replace percutaneous transhepatic biliary drainage when ERCP fails. According to the access site to the biliary tree,two kinds of approaches may be described: the intrahepatic and the extrahepatic. Endoscopic ultrasonography-guided rendezvous transpapillary drainage is performed where the second portion of the duodenum is easily reached but conventional ERCP fails. The recent introduction of self-expandable metal stents and lumen-apposing metal stents has improved this field. However,the role of the latter is still controversial. Echoendoscopic transmural biliary drainage can be challenging with potential severe adverse events. Therefore,trained endoscopists,in both ERCP and endoscopic ultrasonography are needed with surgical and radiological backup.展开更多
Human induced pluripotent stem cell derived cardiac fibroblasts(hiPSC-CFs)play a critical role in modeling human cardiovascular diseases in vitro.However,current culture substrates used for hiPSC-CF differentiation an...Human induced pluripotent stem cell derived cardiac fibroblasts(hiPSC-CFs)play a critical role in modeling human cardiovascular diseases in vitro.However,current culture substrates used for hiPSC-CF differentiation and expansion,such as Matrigel and tissue culture plastic(TCPs),are tissue mismatched and may provide pathogenic cues.Here,we report that hiPSC-CFs differentiated on Matrigel and expanded on tissue culture plastic(M-TCP-iCFs)exhibit transcriptomic hallmarks of activated fibroblasts limiting their translational potential.To alleviate pathogenic activation of hiPSC-CFs,we utilized decellularized extracellular matrix derived from porcine heart extracellular matrix(HEM)to provide a biomimetic substrate for improving hiPSC-CF phenotypes.We show that hiPSC-CFs differentiated and expanded on HEM(HEM-iCFs)exhibited reduced expression of hallmark activated fibroblast markers versus M-TCP-iCFs while retaining their cardiac fibroblast phenotype.HEM-iCFs also maintained a reduction in expression of hallmark genes associated with pathogenic fibroblasts when seeded onto TCPs.Further,HEM-iCFs more homogenously integrated into an hiPSC-derived cardiac organoid model,resulting in improved cardiomyocyte sarcomere development.In conclusion,HEM provides an improved substrate for the differentiation and propagation of hiPSC-CFs for disease modeling.展开更多
The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opi...The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opioid overdoses. Pharmacists play an important role in the accessibility and education of naloxone in both the community and health system settings. Recent efforts, such as co-dispensing naloxone with opioid prescriptions, naloxone training programs, and approval of naloxone to be over-the-counter, have been implemented in hopes to better control the opioid epidemic. Despite the efforts to make naloxone more accessible, there are still some barriers to overcome such as lack of training, cost, stigma, and patient refusal. This review aims to explore the contributions pharmacists have made thus far and define the barriers that still have to be resolved.展开更多
Background: Gestational diabetes mellitus (GDM) is a temporary form of insulin resistance during pregnancy and is linked to adverse outcomes for both mothers and offspring. Maternal risks include an increased prevalen...Background: Gestational diabetes mellitus (GDM) is a temporary form of insulin resistance during pregnancy and is linked to adverse outcomes for both mothers and offspring. Maternal risks include an increased prevalence of pre-eclampsia, cesarean delivery, and the development of type 2 diabetes within five to ten years post-delivery. For offspring, exposure to elevated maternal glucose levels is associated with macrosomia. A significant challenge in evaluating the prevalence of GDM in Puerto Rico is the lack of recent research quantifying this condition in pregnant women living in Puerto Rico. Objective: This study aimed to estimate the prevalence of Gestational Diabetes Mellitus from 2016 to 2021 by analyzing data collected by Puerto Rico’s Department of Health. Methods: We obtained publicly accessible data from the Division of Children, Mothers, and Adolescents from Puerto Rico’s Department of Health to estimate the prevalence of GDM across the island. Additionally, we correlated the prevalence with socioeconomic, educational, and demographic variables using beta regression models to assess their significance. Results: The prevalence of GDM ranged from 3.2% to 4.5% for the six years studied, with an average prevalence of 3.68%. Regression analysis revealed a significant positive relationship between maternal age and educational level. Higher educational attainment was associated with a reduced risk of GDM, while increasing maternal age was linked to a higher prevalence of the condition. Conclusion: This statistical analysis provides evidence of a steady increase in the prevalence of GDM in Puerto Rico from 2016 to 2021, highlighting the importance of ongoing surveillance and specific interventions to mitigate risk factors.展开更多
AIM:To investigate the effect of age on severity of acute pancreatitis(AP) using biochemical markers,histology and expression of the protective pancreatitisassociated proteins(PAPs).METHODS:AP was induced via intraduc...AIM:To investigate the effect of age on severity of acute pancreatitis(AP) using biochemical markers,histology and expression of the protective pancreatitisassociated proteins(PAPs).METHODS:AP was induced via intraductal injection of 4% sodium taurocholate in young and old rats.Sera and pancreata were assayed at 24 h for the parameters listed above;we also employed a novel molecular technique to assess bacterial infiltration using polymerase chain reaction to measure bacterial genomic ribosomal RNA.RESULTS:At 24 h after induction of AP,the pancreata of older animals had less edema(mean ± SE histologic score of young vs old:3.11 ± 0.16 vs 2.50 ±-0.11,P < 0.05),decreased local inflammatory response(histologic score of stromal infiltrate:3.11 ± 0.27 vs 2.00 ± 0.17,P < 0.05) and increased bacterial infiltration(174% ± 52% increase from sham vs 377% ± 4%,P < 0.05).A decreased expression of PAP1 and PAP2 was demonstrated by Western blotting analysis and immunohistochemical staining.There were no differences in serum amylase and lipase activity,or tissue myeloperoxidase or monocyte chemotactic protein-1 levels.However,in the most-aged group,serum C-reactive protein levels were higher(young vs old:0.249 ± 0.04 mg/dL vs 2.45 ± 0.68 mg/dL,P < 0.05).CONCLUSION:In older animals,there is depressed PAP expression related to a blunted inflammatory response in AP which is associated with worsened bacterial infiltration and higher C-reactive protein level;this may explain the more aggressive clinical course.展开更多
基金the support from the Shanxi Hundred People Plan of China
文摘Single image super-resolution has attracted increasing attention and has a wide range of applications in satellite imaging, medical imaging, computer vision, security surveillance imaging, remote sensing, objection detection, and recognition. Recently, deep learning techniques have emerged and blossomed, producing " the state-of-the-art” in many domains. Due to their capability in feature extraction and mapping, it is very helpful to predict high-frequency details lost in low-resolution images. In this paper, we give an overview of recent advances in deep learning-based models and methods that have been applied to single image super-resolution tasks. We also summarize, compare and discuss various models from the past and present for comprehensive understanding and finally provide open problems and possible directions for future research.
文摘Remote sensing is one of the tool which is very important for the production of Land use and land cover maps through a process called image classification. For the image classification process to be successfully, several factors should be considered including availability of quality Landsat imagery and secondary data, a precise classification process and user’s experiences and expertise of the procedures. The objective of this research was to classify and map land-use/land-cover of the study area using remote sensing and Geospatial Information System (GIS) techniques. This research includes two sections (1) Landuse/Landcover (LULC) classification and (2) accuracy assessment. In this study supervised classification was performed using Non Parametric Rule. The major LULC classified were agriculture (65.0%), water body (4.0%), and built up areas (18.3%), mixed forest (5.2%), shrubs (7.0%), and Barren/bare land (0.5%). The study had an overall classification accuracy of 81.7% and kappa coefficient (K) of 0.722. The kappa coefficient is rated as substantial and hence the classified image found to be fit for further research. This study present essential source of information whereby planners and decision makers can use to sustainably plan the environment.
基金financially supported by the National Natural Sciences Foundation of China (30771767 and 40601016)
文摘Dew has been recognized for its ecological significance and has also been identified as an additional source of water in arid zones. We used factorial control experiment, under dew presence in the field, to explore photosynthetic performance, water status and growth response of desert annual herbage. Bassia dasyphylla seedlings were grown in contrasting dew treatments （dew-absent and dew-present） and different watering regimes （normal and deficient）. The effects of dew on the water status and photosynthetic performance of Bassia dasyphylla grown in a desert area of the Hexi Corridor in Northwestern China, were evaluated. The results indicated the pres- ence of dew significantly increased relative water content （RWC） of shoots and total biomass of plants in both water regimes, and enhanced the diurnal shoot water potential and stomatal conductance in the early morning, as well as photosynthetic rate, which reached its maximum only in the water-stressed regime. The presence of dew increased aboveground growth of plants and photosynthate accumulation in leaves, but decreased the root-to-shoot ratio in both water regimes. Dew may have an important role in improving plant water status and ameliorating the adverse effects of plants exposed to prolonged drought.
文摘AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm<sup>3</sup>. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%C
基金supported by the Tulane University School of Medicine Endowment Fund(BK,USA)American Society for Investigative Pathology(ASIP/SROPP)(KB&SB,USA)Be HEARD Rare Disease challenge 2020(BK,USA)。
文摘Metabolic homeostasis requires dynamic catabolic and anabolic processes. Autophagy, an intracellular lysosomal degradative pathway, can rewire cellular metabolism linking catabolic to anabolic processes and thus sustain homeostasis. This is especially relevant in the liver, a key metabolic organ thatgoverns body energy metabolism. Autophagy’s role in hepatic energy regulation has just begun to emerge and autophagy seems to have a much broader impact than what has been appreciated in the field. Though classically known for selective or bulk degradation of cellular components or energy-dense macromolecules, emerging evidence indicates autophagy selectively regulates various signaling proteins to directly impact the expression levels of metabolic enzymes or their upstream regulators. Hence, we review three specific mechanisms by which autophagy can regulate metabolism: A) nutrient regeneration, B) quality control of organelles, and C) signaling protein regulation. The plasticity of the autophagic function is unraveling a new therapeutic approach. Thus, we will also discuss the potential translation of promising preclinical data on autophagy modulation into therapeutic strategies that can be used in the clinic to treat common metabolic disorders.
文摘The field of liver transplantation is limited by the availability of donor organs. The use of living donor and split cadaveric grafts is one potential method of expanding the donor pool. However, primary graft dysfunction can result from the use of partial livers despite the absence of other causes such as vascular obstruction or sepsis. This increasingly recognised phenomenon is termed "Small-for-size syndrome" (SFSS). Studies in animal models and humans have suggested portal hyperperfusion of the graft combined with poor venous outflow and reduced arterial flow might cause sinusoidal congestion and endothelial dysfunction. Graft related factors such as graft to recipient body weight ratio < 0.8, impaired venous outflow, steatosis > 30% and pro- longed warm/cold ischemia time are positively predictive of SFSS. Donor related factors include deranged liver function tests and prolonged intensive care unit stay greater than five days. Child-Pugh grade C recipients are at relatively greater risk of developing SFSS. Surgi- cal approaches to prevent SFSS fall into two categories: those targeting portal hyperperfusion by reducing inflow to the graft, including splenic artery modulation and portacaval shunts; and those aiming to relieve paren-chymal congestion. This review aims to examine thecontroversial diagnosis of SFSS, including current strate-gies to predict and prevent its occurrence. We will also consider whether such interventions could jeopardize the graft by compromising regeneration.
文摘Obstructive sleep apnea syndrome(OSAS) is a common medical condition, associated with atherosclerosis and cardiovascular disease(CVD). The underlying pathophysiologic mechanisms of this association have not been completely understood and may be multifactorial in origin. A number of studies suggest that inflammatory processes have emerged critical in the pathogenesis of CVD in OSAS. A range of circulating inflammatory molecules has been identified and measured, with a view to assess inflammation and predict vascular damage risk, such as plasma cytokines, adhesion molecules, and C-reactive protein(CRP). CRP is a relevant marker worthy of further study, because not only is elevated in patients with OSAS, but also is rapidly becoming a risk factor for cardiac disease. Furthermore, in selected OSAS patients, aggressive treatment of the disorder may lead to retarding or even improvement of CVD progression. However, still there is a debate on the true correlation between CRP and OSAS, as well as the clinical effect of any reduction after OSAS treatment. Further research is required to define those OSAS patients who will have a considerable reduction with treatment, as well as to understand the significance of the interaction between cardiovascular risk factor and CRP reduction in patients with OSAS.
基金This work was funded by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation)project number 59307082-TRR67 subprojects A3,B3,Z3project FR2671/4-1 to SFproject 420160411 to SR.
文摘Sustained inflammation associated with dysregulated macrophage activation prevents tissue formation and healing of chronic wounds.Control of inflammation and immune cell functions thus represents a promising approach in the development of advanced therapeutic strategies.Here we describe immunomodulatory hyaluronan/collagen(HA-AC/coll)-based hydrogels containing high-sulfated hyaluronan(sHA)as immunoregulatory component for the modulation of inflammatory macrophage activities in disturbed wound healing.Solute sHA downregulates inflammatory activities of bone marrow-derived and tissue-resident macrophages in vitro.This further affects macrophage-mediated pro-inflammatory activation of skin cells as shown in skin ex-vivo cultures.In a mouse model of acute skin inflammation,intradermal injection of sHA downregulates the inflammatory processes in the skin.This is associated with the promotion of an anti-inflammatory gene signature in skin macrophages indicating a shift of their activation profile.For in vivo translation,we designed HA-AC/coll hydrogels allowing delivery of sHA into wounds over a period of at least one week.Their immunoregulatory capacity was analyzed in a translational experimental approach in skin wounds of diabetic db/db mice,an established model for disturbed wound healing.The sHA-releasing hydrogels improved defective tissue repair with reduced inflammation,augmented pro-regenerative macrophage activation,increased vascularization,and accelerated new tissue formation and wound closure.
文摘Mitochondrial biogenesis and function in plants require the expression of over 1000 nuclear genes encoding mitochondrial proteins （NGEMPs）. The expression of these genes is regulated by tissue-specific, developmental, internal, and external stimuli that result in a dynamic organelle involved in both metabolic and a variety of signaling processes. Although the metabolic and biosynthetic machinery of mitochondria is relatively well understood, the factors that regu- late these processes and the various signaling pathways involved are only beginning to be identified at a molecular level. The molecular components of anterograde （nuclear to mitochondrial） and retrograde （mitochondrial to nuclear） signaling pathways that regulate the expression of NGEMPs interact with chloroplast-, growth-, and stress-signaling pathways in the cell at a variety of levels, with common components involved in transmission and execution of these signals. This positions mitochondria as important hubs for signaling in the cell, not only in direct signaling of mitochondrial function per se, but also in sensing and/or integrating a variety of other internal and external signals. This integrates and optimizes growth with energy metabolism and stress responses, which is required in both photosynthetic and non-photosynthetic cells.
文摘Feasibility of endoscopic retrograde cholangiopancreatography(ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. However,endoscopic ultrasonography-guided biliary drainage represents a valid option to replace percutaneous transhepatic biliary drainage when ERCP fails. According to the access site to the biliary tree,two kinds of approaches may be described: the intrahepatic and the extrahepatic. Endoscopic ultrasonography-guided rendezvous transpapillary drainage is performed where the second portion of the duodenum is easily reached but conventional ERCP fails. The recent introduction of self-expandable metal stents and lumen-apposing metal stents has improved this field. However,the role of the latter is still controversial. Echoendoscopic transmural biliary drainage can be challenging with potential severe adverse events. Therefore,trained endoscopists,in both ERCP and endoscopic ultrasonography are needed with surgical and radiological backup.
基金funded by the National Institutes of Health(NIH)F31 HL154665,R01 HL133308,8P20 GM103444,R21 HL167211,R01 HL168255,U01 HL169361,R01 HL148059the NIH Cardiovascular Training Grant T32 HL007260+2 种基金the National Science Foundation(NSF)(CBET-1743346),the NSF Engineering Research Center for Cell Manufacturing Technologies(CMaT,NSF EEC-1648035)the VA Merit I01 BX005943-01A1supported by the grants,2021R1A2C3004262,2022M3A9B6082675,of the National Research Foundation of Korea(NRF)funded by the Korean government,the Ministry of Science and ICT(MSIT).
文摘Human induced pluripotent stem cell derived cardiac fibroblasts(hiPSC-CFs)play a critical role in modeling human cardiovascular diseases in vitro.However,current culture substrates used for hiPSC-CF differentiation and expansion,such as Matrigel and tissue culture plastic(TCPs),are tissue mismatched and may provide pathogenic cues.Here,we report that hiPSC-CFs differentiated on Matrigel and expanded on tissue culture plastic(M-TCP-iCFs)exhibit transcriptomic hallmarks of activated fibroblasts limiting their translational potential.To alleviate pathogenic activation of hiPSC-CFs,we utilized decellularized extracellular matrix derived from porcine heart extracellular matrix(HEM)to provide a biomimetic substrate for improving hiPSC-CF phenotypes.We show that hiPSC-CFs differentiated and expanded on HEM(HEM-iCFs)exhibited reduced expression of hallmark activated fibroblast markers versus M-TCP-iCFs while retaining their cardiac fibroblast phenotype.HEM-iCFs also maintained a reduction in expression of hallmark genes associated with pathogenic fibroblasts when seeded onto TCPs.Further,HEM-iCFs more homogenously integrated into an hiPSC-derived cardiac organoid model,resulting in improved cardiomyocyte sarcomere development.In conclusion,HEM provides an improved substrate for the differentiation and propagation of hiPSC-CFs for disease modeling.
文摘The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opioid overdoses. Pharmacists play an important role in the accessibility and education of naloxone in both the community and health system settings. Recent efforts, such as co-dispensing naloxone with opioid prescriptions, naloxone training programs, and approval of naloxone to be over-the-counter, have been implemented in hopes to better control the opioid epidemic. Despite the efforts to make naloxone more accessible, there are still some barriers to overcome such as lack of training, cost, stigma, and patient refusal. This review aims to explore the contributions pharmacists have made thus far and define the barriers that still have to be resolved.
文摘Background: Gestational diabetes mellitus (GDM) is a temporary form of insulin resistance during pregnancy and is linked to adverse outcomes for both mothers and offspring. Maternal risks include an increased prevalence of pre-eclampsia, cesarean delivery, and the development of type 2 diabetes within five to ten years post-delivery. For offspring, exposure to elevated maternal glucose levels is associated with macrosomia. A significant challenge in evaluating the prevalence of GDM in Puerto Rico is the lack of recent research quantifying this condition in pregnant women living in Puerto Rico. Objective: This study aimed to estimate the prevalence of Gestational Diabetes Mellitus from 2016 to 2021 by analyzing data collected by Puerto Rico’s Department of Health. Methods: We obtained publicly accessible data from the Division of Children, Mothers, and Adolescents from Puerto Rico’s Department of Health to estimate the prevalence of GDM across the island. Additionally, we correlated the prevalence with socioeconomic, educational, and demographic variables using beta regression models to assess their significance. Results: The prevalence of GDM ranged from 3.2% to 4.5% for the six years studied, with an average prevalence of 3.68%. Regression analysis revealed a significant positive relationship between maternal age and educational level. Higher educational attainment was associated with a reduced risk of GDM, while increasing maternal age was linked to a higher prevalence of the condition. Conclusion: This statistical analysis provides evidence of a steady increase in the prevalence of GDM in Puerto Rico from 2016 to 2021, highlighting the importance of ongoing surveillance and specific interventions to mitigate risk factors.
文摘AIM:To investigate the effect of age on severity of acute pancreatitis(AP) using biochemical markers,histology and expression of the protective pancreatitisassociated proteins(PAPs).METHODS:AP was induced via intraductal injection of 4% sodium taurocholate in young and old rats.Sera and pancreata were assayed at 24 h for the parameters listed above;we also employed a novel molecular technique to assess bacterial infiltration using polymerase chain reaction to measure bacterial genomic ribosomal RNA.RESULTS:At 24 h after induction of AP,the pancreata of older animals had less edema(mean ± SE histologic score of young vs old:3.11 ± 0.16 vs 2.50 ±-0.11,P < 0.05),decreased local inflammatory response(histologic score of stromal infiltrate:3.11 ± 0.27 vs 2.00 ± 0.17,P < 0.05) and increased bacterial infiltration(174% ± 52% increase from sham vs 377% ± 4%,P < 0.05).A decreased expression of PAP1 and PAP2 was demonstrated by Western blotting analysis and immunohistochemical staining.There were no differences in serum amylase and lipase activity,or tissue myeloperoxidase or monocyte chemotactic protein-1 levels.However,in the most-aged group,serum C-reactive protein levels were higher(young vs old:0.249 ± 0.04 mg/dL vs 2.45 ± 0.68 mg/dL,P < 0.05).CONCLUSION:In older animals,there is depressed PAP expression related to a blunted inflammatory response in AP which is associated with worsened bacterial infiltration and higher C-reactive protein level;this may explain the more aggressive clinical course.
