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Background: Mesenteric ischemia is a life-threatening condition with a complex etiology and diagnostics., Objective: Etiology, incidence, symptoms, and diagnostics of acute and chronic mesenteric ischemia., Material and Methods: Literature search via PubMed with a focus on studies on the epidemiology and diagnostics of mesenteric ischemia and analysis of existing international guidelines., Results: The incidence of acute mesenteric ischemia is given as 0.63-12.9 per 100,000 people per year. There are no sufficiently reliable figures for chronic mesenteric ischemia, but an incidence of up to 3 per 100,000 inhabitants per year is generally assumed. The three-phase computed tomography has the highest diagnostic specificity and sensitivity., Conclusion: In the presence of risk factors acute and chronic mesenteric ischemia should be considered as differential diagnoses in the presence of abdominal pain using three-phase computed tomography., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Purpose: Surgery for recurrent glioma provides cytoreduction and tissue for molecularly informed treatment. With mostly heavily pretreated patients involved, it is unclear whether the benefits of repeat surgery outweigh its potential risks., Methods: Patients receiving surgery for recurrent glioma WHO grade 2-4 with the goal of tissue sampling for targeted therapies were analyzed retrospectively. Complication rates (surgical, neurological) were compared to our institutional glioma surgery cohort. Tissue molecular diagnostic yield, targeted therapies and post-surgical survival rates were analyzed., Results: Between 2017 and 2022, tumor board recommendation for targeted therapy through molecular diagnostics was made for 180 patients. Of these, 70 patients (38%) underwent repeat surgery. IDH-wildtype glioblastoma was diagnosed in 48 patients (69%), followed by IDH-mutant astrocytoma (n = 13; 19%) and oligodendroglioma (n = 9; 13%). Gross total resection (GTR) was achieved in 50 patients (71%). Tissue was processed for next-generation sequencing in 64 cases (91%), and for DNA methylation analysis in 58 cases (83%), while immunohistochemistry for mTOR phosphorylation was performed in 24 cases (34%). Targeted therapy was recommended in 35 (50%) and commenced in 21 (30%) cases. Postoperatively, 7 patients (11%) required revision surgery, compared to 7% (p = 0.519) and 6% (p = 0.359) of our reference cohorts of patients undergoing first and second craniotomy, respectively. Non-resolving neurological deterioration was documented in 6 cases (10% vs. 8%, p = 0.612, after first and 4%, p = 0.519, after second craniotomy). Median survival after repeat surgery was 399 days in all patients and 348 days in GBM patients after repeat GTR., Conclusion: Surgery for recurrent glioma provides relevant molecular diagnostic information with a direct consequence for targeted therapy under a reasonable risk of postoperative complications. With satisfactory postoperative survival it can therefore complement a multi-modal glioma therapy approach., (© 2024. The Author(s).)

The aim of this study was to integrate an antibacterial agent into implant materials to prevent infection and to investigate the aging behavior of the plastics in physiological solution as a function of filler type and proportion as well as of the process parameters. The active ingredient that is incorporated into the polymer during compounding should remain effective in the body over a long period of time. With varied melt processing conditions, composites made of a biodegradable polylactide (PLA) were mixed with tricalcium phosphate (TCP) and zinc oxide (ZnO) as an antibacterial agent. Hydroxyapatite (HAP) and zinc oxide were incorporated into a non‐degradable polyetheretherketone (PEEK). The material properties of the composites were characterised and investigated with regard to their in vitro behaviour. The investigations were carried out with gel permeation chromatography (GPC), differential scanning calorimetry (DSC), tensile tests, recording of the mass change during storage and colony forming units test (CFU). Over the investigated ageing period of 9 months in phosphate buffered saline (PBS) at 37 °C the composites showed antibacterial efficacy against Escherichia coli. [ABSTRACT FROM AUTHOR]

Background Neurologic events during primary stay in heart transplant (HTx) recipients may be associated with reduced outcome and survival, which we aim to explore with the current study. Methods and Results We screened and included all patients undergoing HTx in our center between September 2010 and December 2022 (n=268) and checked for the occurrence of neurologic events within their index stay. Neurologic events were defined as ischemic stroke, hemorrhage, hypoxic ischemic injury, or acute symptomatic neurologic dysfunction without central nervous system injury. The cohort was then divided into recipients with (n=33) and without (n=235) neurologic events after HTx. Using a multivariable Cox regression model, the association of neurologic events after HTx and survival was assessed. Recipients with neurologic events displayed a longer intensive care unit stay (30 versus 16 days; P =0.009), longer mechanical ventilation (192 versus 48 hours; P <0.001), and higher need for blood transfusion, and need for hemodialysis after HTx was substantially higher (81% versus 55%; P =0.01). Resternotomy (36% versus 26%; P =0.05) and mechanical life support (extracorporeal life support) after HTx (46% versus 24%; P =0.02) were also significantly higher in patients with neurologic events. Covariable-adjusted multivariable Cox regression analysis revealed a significant independent association of neurologic events and increased 30-day (hazard ratio [HR], 2.5 [95% CI, 1.0-6.0]; P =0.049), 1-year (HR, 2.2 [95% CI, 1.1-4.3]; P =0.019), and overall (HR, 2.5 [95% CI, 1.5-4.2]; P <0.001) mortality after HTx and reduced Kaplan-Meier survival up to 5 years after HTx ( P <0.001). Conclusions Neurologic events after HTx were strongly and independently associated with worse postoperative outcome and reduced survival up to 5 years after HTx.

Background: In patients with neuroendocrine liver metastasis (NELM), liver transplantation (LT) is an alternative to liver resection (LR), although the choice of therapy remains controversial. In this multicenter study, we aim to provide novel insight in this dispute., Methods: Following a systematic literature search, 15 large international centers were contacted to provide comprehensive data on their patients after LR or LT for NELM. Survival analyses were performed with the Kaplan-Meier method, while multivariable Cox regression served to identify factors influencing survival after either transplantation or resection. Inverse probability weighting and propensity score matching was used for analyses with balanced and equalized baseline characteristics., Results: Overall, 455 patients were analyzed, including 230 after LR and 225 after LT, with a median follow-up of 97 months [95% confidence interval (CI): 85-110 months]. Multivariable analysis revealed G3 grading as a negative prognostic factor for LR [hazard ratio (HR)=2.22, 95% CI: 1.04-4.77, P =0.040], while G2 grading (HR=2.52, 95% CI: 1.15-5.52, P =0.021) and LT outside Milan criteria (HR=2.40, 95% CI: 1.16-4.92, P =0.018) were negative prognostic factors in transplanted patients. Inverse probability-weighted multivariate analyses revealed a distinct survival benefit after LT. Matched patients presented a median overall survival (OS) of 197 months (95% CI: 143-not reached) and a 73% 5-year OS after LT, and 119 months (95% CI: 74-133 months) and a 52.8% 5-year OS after LR (HR=0.59, 95% CI: 0.3-0.9, P =0.022). However, the survival benefit after LT was lost if patients were transplanted outside Milan criteria., Conclusions: This multicentric study in patients with NELM demonstrates a survival benefit of LT over LR. This benefit depends on adherence to selection criteria, in particular low-grade tumor biology and Milan criteria, and must be balanced against potential risks of LT., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

The crack propagation rate of environmental stress cracking was studied on high-density polyethylene compact tension specimens under static loading. Selected environmental liquids are distilled water, 2 wt% aqueous Arkopal N100 solution, and two model liquid mixtures, one based on solvents and one on detergents, representing stress cracking test liquids for commercial crop protection products. The different surface tensions and solubilities, which affect the energetic facilitation of void nucleation and craze development, are studied. Crack growth in surface-active media is strongly accelerated as the solvents induce plasticization, followed by strong blunting significantly retarding both crack initiation and crack propagation. The crack propagation rate for static load as a function of the stress intensity factor within all environments is found to follow the Paris-Erdogan law. Scanning electron micrographs of the fracture surface highlight more pronounced structures with both extensive degrees of plasticization and reduced crack propagation rate, addressing the distinct creep behavior of fibrils. Additionally, the limitations of linear elastic fracture mechanisms for visco-elastic polymers exposed to environmental liquids are discussed.

Scanning acoustic microscopy (SAM) was used to investigate disbonding, delamination and blister formation in polymer coatings for different layer structures and initial defect depths during exposure to a corrosive environment. The time evolution of disbonding and blister initiation and their growth was investigated by analysing the SAM images, taken after defined times of exposure to an electrolyte solution (Harrison solution). From investigations of a model system of coatings on steel substrates, it was possible to differentiate between water and/or ion transport (i) through the coating and (ii) along the coating-steel interface. For samples without clear coat randomly distributed blisters appeared at the coating-steel interface after exposure to the electrolyte solution, irrespective of the location of initial defects. The random distribution of growing blisters is related to diffusion of water and/or ions through the coating and 'nucleation' at weak points of the substrate or within the polymer. For samples with clear coat a propagating migration front along the coating-steel interface of 3-4µm height--starting from initial defects--was detected. The linear propagation of this front cannot be explained by Fickian diffusion. Therefore, it is discussed in terms of an accelerated diffusion or crack growth kinetics. Since blistering starts only at sites, where the migration front has passed, the presence of a thin water layer at the coating-steel interface, the loss of adhesion and the following corrosive processes are prerequisites for the nucleation of blisters. The blister growth shows a square-root time dependence. [ABSTRACT FROM AUTHOR]

Cu andCu NMR studies are reported in liquid and solid copper (I) compounds. Ratios of g-factors, nuclear magnetic moments and nuclear magnetic shielding constants in the atomic reference scale are given forCu andCu in a solution of Cu(I)(CHCN)BF in CHCN, which is a reasonable reference sample due to the relatively narrow NMR line. [ABSTRACT FROM AUTHOR]

The slowing down or stalling of replication forks is commonly known as replication stress and arises from multiple causes such as DNA lesions, nucleotide depletion, RNA-DNA hybrids, and oncogene activation. The ataxia telangiectasia and Rad3-related kinase (ATR) plays an essential role in the cellular response to replication stress and inhibition of ATR has emerged as therapeutic strategy for the treatment of cancers that exhibit high levels of replication stress. However, the cellular signaling induced by replication stress and the substrate spectrum of ATR has not been systematically investigated. In this study, we employed quantitative MS-based proteomics to define the cellular signaling after nucleotide depletion-induced replication stress and replication fork collapse following ATR inhibition. We demonstrate that replication stress results in increased phosphorylation of a subset of proteins, many of which are involved in RNA splicing and transcription and have previously not been associated with the cellular replication stress response. Furthermore, our data reveal the ATR-dependent phosphorylation following replication stress and discover novel putative ATR target sites on MCM6, TOPBP1, RAD51AP1, and PSMD4. We establish that ATR inhibition rewires cellular signaling networks induced by replication stress and leads to the activation of the ATM-driven double-strand break repair signaling., (© 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Patients undergoing solid-organ transplantation (SOT) face a tumultuous journey. Prior to transplant, their medical course is characterized by organ dysfunction, diminished quality of life, and reliance on organ support, all of which are endured in hopes of reaching the haven of organ transplantation. Peritransplant altered mental status may indicate neurologic insults acquired during transplant and may have long-lasting consequences. Even years after transplant, these patients are at heightened risk for neurologic dysfunction from a myriad of metabolic, toxic, and infectious causes. This review provides a comprehensive examination of causes, diagnostic approaches, neuroimaging findings, and management strategies for altered mental status in SOT recipients. Given their complexity and the numerous etiologies for neurologic dysfunction, liver transplant patients are a chief focus in this review; however, we also review lesser-known contributors to neurological injury across various transplant types. From hepatic encephalopathy to cerebral edema, seizures, and infections, this review highlights the importance of recognizing and managing pre- and posttransplant neurological complications to optimize patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The transition to or from direct oral anticoagulants (DOACs) is common in clinical practice. Areas covered: A literature search was conducted on PubMed, Google Scholar, and UpToDate up to March 2024 for conditions and approaches for transitioning from one agent to the other. No randomized clinical trials were retrieved except for two studies regarding switching to DOAC in well-conducted vitamin K antagonist (VKA) therapy. A narrative review was conducted addressing the conditions for switching from one agent to the other, such as thromboembolic events and major bleeding during anticoagulation, development or worsening of kidney or liver failure, initiation of interfering drugs, adverse events such as allergic reactions, frailty, patients' preferences, and affordability. During transitions from one anticoagulant to the other, the risk of both thromboembolic and bleeding complications should be minimized. The current approaches for such transitions are derived from those employed in clinical trials evaluating DOAC and from product information. Expert opinion: Many uncertainties remain regarding those circumstances requiring a change in anticoagulant strategies, as they lack evidence-based guidance. It can be envisaged that the problem of switching to and from DOAC will need additional studies especially addressing the conditions and the best approach to such transitions. [ABSTRACT FROM AUTHOR]

Ba andBa Fourier transform nuclear magnetic resonance and nuclear quadrupole resonance investigations are reported in liquids resp. solids. From these measurements ratios of g-factors, hyperfine structure anomalies, magnetic moments, atomic shielding constants and the ratio of the quadrupole moments are evaluated using also data from literature. [ABSTRACT FROM AUTHOR]

In the last years, non-destructive ultrasonic testing methods are more and more frequently employed in order to investigate the drying and curing processes of different coatings. Among them an ultrasonic reflection method was developed allowing the simultaneous measurement with longitudinal and transversal waves. In order to generate the ultrasonic pulse, piezoelectric ceramics or oxides are usually used as transducer materials which are connected to a delay line. Here, we demonstrate a similar approach for the ultrasonic reflection method installing piezoelectric polymers as ultrasonic transducer materials. In detail, poly(vinylidene fluoride and trifluoroethylene) [P(VDF-TrFE)] copolymers were prepared as piezoelectric transducer layers directly onto the metallization of glass delay lines avoiding additional bonding processes. The film preparation was carried out by solvent casting the polymer onto an area with a diameter of 12 mm and is optimized so that relatively homogeneous polymer layers with thicknesses between 14 and 35 μm are adjusted by the deposited amount of the polymer. Electrical poling renders the polymer piezoelectric. The ultrasonic properties of the P(VDF-TrFE) transducer and their usability for the ultrasonic reflection method are described also in comparison to previous measurements using LiNbO(3) transducer.

Adhesive bonds, including car putty coatings, are used in the construction of modern motor vehicles. Therefore, it is important to improve methods that allow nondestructive evaluation of the properties of these joints. The main objective of this study was to evaluate selected properties of putty coatings such as the width of the applied coating and adhesion to the substrate based on changes in ultrasonic wave parameters. The research was carried out in two stages. In the first, the values of the surface wave amplitude were determined as a function of the width of the coating to the substrate. It was found that as the width of the coating increases, the amplitude of the surface wave pulse decreases. The second stage involved correlation studies to relate the reflection coefficient |r| to the adhesion of the coating to the substrate. Based on the results, it was found that as the value of the reflection coefficient decreases, the value of the coating's adhesion to the substrate increases. The determined values of this parameter range from 0.30 to 0.86, which correspond to the adhesion of the range 1.51 to 18.97 MPa. The obtained test results have practical significance and can be used in evaluating the condition of coatings in vehicle body repair shops. [ABSTRACT FROM AUTHOR]

Fragility continues to present major challenges to achieving sustainable development goals (SDGs). International aid, particularly the Official Development Assistance (ODA), is a critical source of finance to deliver humanitarian assistance, development projects, and peace operations in fragile contexts. This study analyses if and how donors are motivated by fragility in their aid allocation across the humanitarian-development-peace nexus. Employing the random-effect Tobit method, the role of fragility as a donors' motive is analysed alongside three conventional categories of motives: self-interest, recipients' needs, and merit. The empirical analysis demonstrates an association between aid allocation across the nexus and fragility, but also a great degree of heterogeneity depending on the donor and the pillar of the nexus. It also detects a significant difference between how the state of fragility correlates with aid allocation and how the degree of fragility does so. [ABSTRACT FROM AUTHOR]

A scanning acoustic microscopy (SAM) system is a common non-destructive instrument which is used to evaluate the material quality in scientific and industrial applications. Technically, the tested sample is immersed in water during the scanning process. Therefore, a robot arm is incorporated into the SAM system to transfer the sample for in-line inspection, which makes the system complex and increases time consumption. The main aim of this study is to develop a novel water probe for the SAM system, that is, a waterstream. During the scanning process, water was supplied using a waterstream instead of immersing the sample in the water, which leads to a simple design of an automotive SAM system and a reduction in time consumption. In addition, using a waterstream in the SAM system can avoid contamination of the sample due to immersion in water for long-time scanning. Waterstream was designed based on the measured focal length calculation of the transducer and simulated to investigate the internal flow characteristics. To validate the simulation results, the waterstream was prototyped and applied to the TSAM-400 and W-FSAM traditional and fast SAM systems to successfully image some samples such as carbon fiber-reinforced polymers, a printed circuit board, and a 6-inch wafer. These results demonstrate the design method of the water probe applied to the SAM system. [ABSTRACT FROM AUTHOR]

Introduction: Liver transplantation (LT) is a well-established method applied for the treatment of various liver diseases, including primary and secondary malignancies, as well as acute liver failure triggered by different mechanisms. In turn, liver failure (PHLF) is the most severe complication observed after liver resection (LR). PHLF is an extremely rare indication for LT. The aim of the present study was to assess the results of LT in patients with PHLF. Methods: Relevant cases were extracted from the prospectively collected database of all LTs performed in our center. All clinical variables, details of the perioperative course of each patient and long-term follow-up data were thoroughly assessed. Results: Between January 2000 and August 2023, 2703 LTs were carried out. Among them, six patients underwent LT for PHLF, which accounted for 0.2% of all patients. The median age of the patients was 38 years (range 24–66 years). All patients underwent major liver resection before listing for LT. The 90-day mortality after LT was 66.7% (4 out of 6 patients), and all patients experienced complications in the posttransplant course. One patient required early retransplantation due to primary non-function (PNF). The last two transplanted patients are alive at 7 years and 12 months after LT, respectively. Conclusions: In an unselected population of patients with PHLF, LT is a very morbid procedure associated with high mortality but should be considered the only life-saving option in this group. [ABSTRACT FROM AUTHOR]