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BACKGROUND: Despite significant improvements in surgical techniques and medical care, thrombotic complications still represent the primary cause of early graft failure and re-transplantation following paediatric liver transplantation. There is still no standardized approach for thrombosis prevention. MATERIALS AND METHODS: The study aimed to evaluate the effectiveness of early intravenous unfractionated heparin started 12 hours postoperatively at 10 UI/kg per hour and used a retrospective "before and after" design to compare the incidence of early thrombotic complications prior to (2002-2010) and after (2011-2016) the introduction of heparin in our institute. RESULTS: From 2002 to 2016, 479 paediatric patients received liver transplantation in our institution with an overall survival rate over one year of 0.91 (95% CI: 0.87-0.94). Of 365 eligible patients, 244 did not receive heparin while 121 did receive heparin. We reported a lower incidence of venous thrombosis (VT) in the group treated with heparin: 2.5% (3/121) vs 7.9% (19/244) (p=0.038). All clinical and laboratory variables considered potential risk factors for VT were studied. By multivariate stepwise Cox proportional hazards models, heparin prophylaxis resulted significantly associated to a reduction in VT (HR=0.29 [95% CI: 0.08-0.97], p=0.045), while age <1 year was found to be an independent risk factor for VT (HR=2.62 [95% CI: 1.11-6.21]; p=0.028). DISCUSSION: Early postoperative heparin could be considered a valid and safe strategy to prevent early VT after paediatric liver transplantation without a concomitant increase in bleeding. A future randomised control trial is mandatory in order to strengthen this conclusion.

Background: The goal of this study was to evaluate with a three-dimensional method the long-term quality of alveolar ossification in unilateral cleft lip and palate patients who underwent early secondary gingivoalveoloplasty according to the Milan surgical protocol. Methods: The sample consisted of 63 computed tomographic scans of unilateral cleft lip and palate patients in permanent dentition. The average age at the time of assessment was 15.7 years. Alveolar thickness, nasoalveolar height, nasal floor ossification, and hard palate morphology were evaluated using dental, axial, and coronal cuts on computed tomographic scans and three-dimensional models. All measurements were normalized and ratios of the affected side versus the nonaffected side were provided. Volume measurements and ratios of each hemimaxilla were added. The presence or absence of the permanent lateral incisor on the cleft side was also recorded. Results: Alveolar thickness and height were ideal or good, respectively, in 89.5 and 91.4 percent of the sample. Insufficient ossification (<25 percent) was found in three patients (5.2 percent), and only one of them (1.7 percent) presented no bone bridging. A statistically significant association was detected between the degree of alveolar ossification, the type of nasal floor ossification, and volume ratio. Conclusions: Early secondary gingivoalveoloplasty seemed to allow an adequate ossification of both the alveolar and nasal region. Three-dimensional evaluation of the alveolar cleft ossification provided further information on alveolar bridging and allowed evaluation of the bone availability for implant placement. Clinical Question/Level of Evidence: Therapeutic, IV.

Lactoferrin (LF) exhibits a wide range of immunomodulatory activities including modulation of cytokine and chemokine secretion. In this study, we demonstrate that bovine LF (bLF) up-modulates, in a concentration- and time-dependent manner, CCL1 secretion in monocytes (Mo) at the early stage of differentiation toward dendritic cells (DCs), and in fully differentiated immature Mo-derived DCs (MoDCs). In both cell types, up-modulation of CCL1 secretion is an early event following bLF-mediated enhanced accumulation of CCL1 transcripts. Notably, bLF-mediated up-regulation of CCL1 involves the engagement of distinct surface receptors in MoDCs and their Mo precursors. We show that bLF-mediated engagement of CD36 contributes to CCL1 induction in differentiating Mo. Conversely, toll-like receptor (TLR)2 blocking markedly reduces bLF-induced CCL1 production in MoDCs. These findings add further evidence for cell-specific differential responses elicited by bLF through the engagement of distinct TLRs and surface receptors. Furthermore, the different responses observed at early and late stages of Mo differentiation towards DCs may be relevant in mediating bLF effects in specific body districts, where these cell types may be differently represented in physiopathological conditions.

This paper presents a driving simulator experiment, which evaluates a road-departure prevention (RDP) system in an emergency situation. Two levels of automation are evaluated: 1) haptic feedback (HF) where the RDP provides advisory steering torque such that the human and the machine carry out the maneuver cooperatively, and 2) drive by wire (DBW) where the RDP automatically corrects the front-wheels angle, overriding the steering-wheel input provided by the human. Thirty participants are instructed to avoid a pylon-confined area while keeping the vehicle on the road. The results show that HF has a significant impact on the measured steering wheel torque, but no significant effect on steering-wheel angle or vehicle path. DBW prevents road departure and tends to reduce self-reported workload, but leads to inadvertent human-initiated steering resulting in pylon collisions. It is concluded that a low level of automation, in the form of HF, does not prevent road departures in an emergency situation. A high level of automation, on the other hand, is effective in preventing road departures. However, more research may have to be done on the human response while driving with systems that alter the relationship between steering-wheel angle and front-wheels angle., Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public., Medical Instruments & Bio-Inspired Technology, DISC, Dynamics of Micro and Nano Systems, Biomechatronics & Human-Machine Control

H(2)O adsorption on hexagonal hydroxyapatite (001) and (010) stoichiometric surfaces has been studied at B3LYP level with a localized Gaussian basis set of polarized double-zeta quality using the periodic CRYSTAL06 code. Because four Ca(2+) cations are available at both surfaces, the considered H(2)O coverages span the 1/4 <= theta <= 5/4 range. The affinity of both HA surfaces for H(2)O is large: on the (001) surface, H(2)O adsorbs molecularly (binding energies BE approximate to 80 U mol(-1) per adsorbed molecule), whereas it dissociates on the (010) surface, giving rise to new surface terminations (CaO(w)H(w) and POH(w)). The highly negative reaction energy for H(2)O dissociation (between -250 and -320 kJ mol(-1) per adsorbed H(2)O molecule) strongly suggests that the pristine (010) surface "as cut" from the hydroxyapatite bulk cannot survive in aqueous environment. Conversely, on the reacted surface, H(2)O adsorbs molecularly with BE similar to those computed for the (001) surface. The B3LYP BEs have been contrasted to the experimental water adsorption enthalpies measured by microcalorimetry on polycrystalline hydroxyapatite samples, showing a fairly good agreement and supporting the suggestion that H(2)O vapor adsorbs on the already reacted (010) crystalline faces. Harmonic B3LYP vibrational features of adsorbed H(2)O show, when compared to modes of the gas-phase H(2)O, a hypsochromic shift of the HOH bending mode ( = 49 cm(-1)) and a bathochromic shift of the OH stretching modes larger than 1700 cm(-1) ( = 427 cm(-1)), which are both in good agreement with literature experimental data