There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way...There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.展开更多
Objective:To determine the relationship between the early embryo viability assessment(EEVA)and blastocyst morphological parameters and pregnancy outcomes.Methods:This retrospective cohort study was conducted on 291 in...Objective:To determine the relationship between the early embryo viability assessment(EEVA)and blastocyst morphological parameters and pregnancy outcomes.Methods:This retrospective cohort study was conducted on 291 intracytoplasmic sperm injection cycles including 2522 embryos with indications of prolonging embryo culture to the blastocyst stage in the Genea embryo review incubator,and 511 single vitrified-warmed blastocyst transfer cycles from January 2020 to June 2023.The EEVA system produced an EEVA score from E1(best)to E5(worse)for the potential of blastocyst formation.Blastocyst morphology was evaluated.The association between the EEVA score and each type of blastocyst morphology,implantation rate,clinical pregnancy,and ongoing pregnancy were assessed using generalized estimating equations.Results:The inner cell mass A(ICM A),trophectoderm A(TE A),blastocoele expansion degree of 3,4,5,6,7 rates were higher with lower the EEVA score.The adjusted odd ratio(aOR)(E5 vs E1)was 0.3 for ICM A,0.174 for TE A and 0.210 for BL3,4,5,6,7(all P<0.001),suggesting a significant association between lower EEVA scores and improved embryo quality.The implantation,clinical pregnancy,and ongoing pregnancy rate were also higher with lower the EEVA score.The aOR of E5 vs E1 was 0.245 for implantation,0.185 for clinical pregnancy and 0.200 for ongoing pregnancy rate(P<0.001).Conclusions:There were associations between blastocyst morphology,pregnancy outcome and EEVA scores.The good blastocyst morphology and pregnancy outcomes are higher with lower the EEVA score.展开更多
The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver preservation.Robust evidence from numerous randomized controlled trials has been pooled by ...The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver preservation.Robust evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ preservation.This editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.展开更多
Climate financing is a key issue in current negotiations on climate protection. This study establishes a climate financing model based on a mechanism in which donor countries set up funds for climate financing and rec...Climate financing is a key issue in current negotiations on climate protection. This study establishes a climate financing model based on a mechanism in which donor countries set up funds for climate financing and recipient countries use the funds exclusively for carbon emission reduction. The burden-sharing principles are based on GDP, historical emissions, and consumption- based emissions. Using this model, we develop and analyze a series of scenario simulations, including a financing program negotiated at the Cancun Climate Change Conference （2010） and several subsequent programs. Results show that sustained climate financing can help to combat global climate change. However, the Cancun Agreements are projected to result in a reduction of only 0.0I^C in global warming by 2100 compared to the scenario without climate financing. Longer-term climate financing programs should be established to achieve more significant benefits. Our model and simulations also show that climate financing has economic benefits for develop- ing countries. Developed countries will suffer a slight GDP loss in the early stages of climate financing, but the long- term economic growth and the eventual benefits of climate mitigation will compensate for this slight loss. Different burden-sharing principles have very similar effects on global temperature change and economic growth of recipient countries, but they do result in differences in GDP changes for Japan and the FSU. The GDP-based principle results in a larger share of financial burden for Japan, while the historical emissions-based principle results in a larger share of financial burden for the FSU. A larger burden share leads to a greater GDP loss.展开更多
Machine perfusion is a hot topic in liver transplantation and several new perfusion conceptsare currently developed.Prior to introduction into routine clinical practice,however,such perfusionapproaches need to demonst...Machine perfusion is a hot topic in liver transplantation and several new perfusion conceptsare currently developed.Prior to introduction into routine clinical practice,however,such perfusionapproaches need to demonstrate their impact on liver function,post-transplant complications,utilizationrates of high-risk organs,and cost benefits.Therefore,based on results of experimental and clinical studies,the community has to recognize the limitations of this technology.In this review,we summarize currentperfusion concepts and differences between protective mechanisms of ex-and in-situ perfusion techniques.Next,we discuss which graft types may benefit most from perfusion techniques,and highlight the currentunderstanding of liver viability testing.Finally,we present results from recent clinical trials involvingmachine liver perfusion,and analyze the value of different outcome parameters,currently used as endpointsfor randomized controlled trials in the field.展开更多
Potato cyst nematodes (PCNs), Globodera pallida and Globodera rostochiensis, are quarantine pests of potato which cause significant damage to production and farm gate revenue worldwide. Accurately assessing viability ...Potato cyst nematodes (PCNs), Globodera pallida and Globodera rostochiensis, are quarantine pests of potato which cause significant damage to production and farm gate revenue worldwide. Accurately assessing viability of PCN eggs is important for eradication and management programs. The goal of this study was to develop a quick and reliable fluorescent staining method to evaluate viability of G. pallida and Globodera ellingtonae eggs. The staining efficiency of eight fluorescent stains was evaluated using G. pallida eggs compared with the conventional Meldola’s Blue (MB) staining method. The staining efficiency of the fluorescent stains ranged from 80.33 ± 2.99 (Sytox Green) to 100% (Acridine Orange) for non-viable eggs. Two stains were further evaluated for their efficiency in assessing viability of encysted eggs from five different greenhouse-reared G. pallida cyst sources which contained both viable and non-viable eggs. For the G. pallida cyst sources, viability ofencysted eggs were estimated to be 41.02 ± 3.81 to 62.66% ± 3.12% when stained with Acridine Orange (AO) and 79.52% ± 1.54% viability for G. ellingtonae. Both staining time and stain concentration were significant for staining efficiency of released and encysted eggs. Staining time and concentration were optimized for released eggs at 4 h at 10 μg/ml and for encysted eggs at 16 h at 25 μg/ml respectively for AO. Fluorescent stains accurately and rapidly assessed percent egg viability and were determined to be as sensitive as a seven-day incubation with the Meldola’s Blue staining method.展开更多
文摘There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.
文摘Objective:To determine the relationship between the early embryo viability assessment(EEVA)and blastocyst morphological parameters and pregnancy outcomes.Methods:This retrospective cohort study was conducted on 291 intracytoplasmic sperm injection cycles including 2522 embryos with indications of prolonging embryo culture to the blastocyst stage in the Genea embryo review incubator,and 511 single vitrified-warmed blastocyst transfer cycles from January 2020 to June 2023.The EEVA system produced an EEVA score from E1(best)to E5(worse)for the potential of blastocyst formation.Blastocyst morphology was evaluated.The association between the EEVA score and each type of blastocyst morphology,implantation rate,clinical pregnancy,and ongoing pregnancy were assessed using generalized estimating equations.Results:The inner cell mass A(ICM A),trophectoderm A(TE A),blastocoele expansion degree of 3,4,5,6,7 rates were higher with lower the EEVA score.The adjusted odd ratio(aOR)(E5 vs E1)was 0.3 for ICM A,0.174 for TE A and 0.210 for BL3,4,5,6,7(all P<0.001),suggesting a significant association between lower EEVA scores and improved embryo quality.The implantation,clinical pregnancy,and ongoing pregnancy rate were also higher with lower the EEVA score.The aOR of E5 vs E1 was 0.245 for implantation,0.185 for clinical pregnancy and 0.200 for ongoing pregnancy rate(P<0.001).Conclusions:There were associations between blastocyst morphology,pregnancy outcome and EEVA scores.The good blastocyst morphology and pregnancy outcomes are higher with lower the EEVA score.
文摘The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver preservation.Robust evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ preservation.This editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.
基金This work was supported by the National Basic Research Program of China （No. 2012CB955800）, the National Social Science Foundation of China （Grant No. 14CGJ025） and the CAS Strategic Priority Research Program （Grant No. XDA05150900）.
文摘Climate financing is a key issue in current negotiations on climate protection. This study establishes a climate financing model based on a mechanism in which donor countries set up funds for climate financing and recipient countries use the funds exclusively for carbon emission reduction. The burden-sharing principles are based on GDP, historical emissions, and consumption- based emissions. Using this model, we develop and analyze a series of scenario simulations, including a financing program negotiated at the Cancun Climate Change Conference （2010） and several subsequent programs. Results show that sustained climate financing can help to combat global climate change. However, the Cancun Agreements are projected to result in a reduction of only 0.0I^C in global warming by 2100 compared to the scenario without climate financing. Longer-term climate financing programs should be established to achieve more significant benefits. Our model and simulations also show that climate financing has economic benefits for develop- ing countries. Developed countries will suffer a slight GDP loss in the early stages of climate financing, but the long- term economic growth and the eventual benefits of climate mitigation will compensate for this slight loss. Different burden-sharing principles have very similar effects on global temperature change and economic growth of recipient countries, but they do result in differences in GDP changes for Japan and the FSU. The GDP-based principle results in a larger share of financial burden for Japan, while the historical emissions-based principle results in a larger share of financial burden for the FSU. A larger burden share leads to a greater GDP loss.
文摘Machine perfusion is a hot topic in liver transplantation and several new perfusion conceptsare currently developed.Prior to introduction into routine clinical practice,however,such perfusionapproaches need to demonstrate their impact on liver function,post-transplant complications,utilizationrates of high-risk organs,and cost benefits.Therefore,based on results of experimental and clinical studies,the community has to recognize the limitations of this technology.In this review,we summarize currentperfusion concepts and differences between protective mechanisms of ex-and in-situ perfusion techniques.Next,we discuss which graft types may benefit most from perfusion techniques,and highlight the currentunderstanding of liver viability testing.Finally,we present results from recent clinical trials involvingmachine liver perfusion,and analyze the value of different outcome parameters,currently used as endpointsfor randomized controlled trials in the field.
文摘Potato cyst nematodes (PCNs), Globodera pallida and Globodera rostochiensis, are quarantine pests of potato which cause significant damage to production and farm gate revenue worldwide. Accurately assessing viability of PCN eggs is important for eradication and management programs. The goal of this study was to develop a quick and reliable fluorescent staining method to evaluate viability of G. pallida and Globodera ellingtonae eggs. The staining efficiency of eight fluorescent stains was evaluated using G. pallida eggs compared with the conventional Meldola’s Blue (MB) staining method. The staining efficiency of the fluorescent stains ranged from 80.33 ± 2.99 (Sytox Green) to 100% (Acridine Orange) for non-viable eggs. Two stains were further evaluated for their efficiency in assessing viability of encysted eggs from five different greenhouse-reared G. pallida cyst sources which contained both viable and non-viable eggs. For the G. pallida cyst sources, viability ofencysted eggs were estimated to be 41.02 ± 3.81 to 62.66% ± 3.12% when stained with Acridine Orange (AO) and 79.52% ± 1.54% viability for G. ellingtonae. Both staining time and stain concentration were significant for staining efficiency of released and encysted eggs. Staining time and concentration were optimized for released eggs at 4 h at 10 μg/ml and for encysted eggs at 16 h at 25 μg/ml respectively for AO. Fluorescent stains accurately and rapidly assessed percent egg viability and were determined to be as sensitive as a seven-day incubation with the Meldola’s Blue staining method.
