Free Portal Research Articles

Every little helps: exploring meat and animal product consumption in the Tesco 1.0 dataset

The production and consumption of meat and animal products have been associated with an array of ethical, health, and environmental issues. While social scientists have increasingly focused on meat reduction and the promotion of meat alternatives in recent years, and have identified a number of regional, seasonal, and sociodemographic variations in consumption, empirical work is often based on self-reported data. To build a greater understanding of actual dietary habits, we seek to provide analysis based on real food purchase data by aggregating data from different sources. To this end, we explore the consumption of meat and animal products in the Tesco 1.0 dataset, an Open Access dataset representing 420 million food item purchases made by 1.6 million loyalty card users at 411 Tesco stores across Greater London in 2015. The data is aggregated most granularly at the level of monthly purchase of 11 broad food categories in 4833 lower super output areas (LSOA—the smallest geographic area). We represented the consumption of meat and animal products graphically for each month of the year and for each of 33 London boroughs. In general, we found that the spring and summer months had the highest consumption of meat and animal products, including poultry, and this decreased in autumn. We also combined the Tesco 1.0 dataset with datasets from the London Datastore (a free and open data-sharing portal that provides over a thousand datasets to understand the city and develop solutions to its problems), and identified several demographic factors as predictors for the meat consumption. Contrary to our hypothesis, areas with older, lower education, and more conservative populations had a lower proportion of meat consumed. In line with our hypotheses, a lower proportion of meat consumed could be observed in areas with higher population density, better health, and more Hindus. The purpose of this paper is to add to knowledge on regional, seasonal, and sociodemographic variations in animal product consumption, as well as provide a valuable overview of animal product consumption using a novel data source that comprises actual purchase data rather than self-reported consumption.

AbDiver: a tool to explore the natural antibody landscape to aid therapeutic design.

MotivationRational design of therapeutic antibodies can be improved by harnessing the natural sequence diversity of these molecules. Our understanding of the diversity of antibodies has recently been greatly facilitated through the deposition of hundreds of millions of human antibody sequences in next-generation sequencing (NGS) repositories. Contrasting a query therapeutic antibody sequence to naturally observed diversity in similar antibody sequences from NGS can provide a mutational roadmap for antibody engineers designing biotherapeutics. Because of the sheer scale of the antibody NGS datasets, performing queries across them is computationally challenging.ResultsTo facilitate harnessing antibody NGS data, we developed AbDiver (http://naturalantibody.com/abdiver), a free portal allowing users to compare their query sequences to those observed in the natural repertoires. AbDiver offers three antibody-specific use-cases: (i) compare a query antibody to positional variability statistics precomputed from multiple independent studies, (ii) retrieve close full variable sequence matches to a query antibody and (iii) retrieve CDR3 or clonotype matches to a query antibody. We applied our system to a set of 742 therapeutic antibodies, demonstrating that for each use-case our system can retrieve relevant results for most sequences. AbDiver facilitates the navigation of vast antibody mutation space for the purpose of rational therapeutic antibody design.Availability and implementationAbDiver is freely accessible at http://naturalantibody.com/abdiver.Supplementary information Supplementary data are available at Bioinformatics online.

Analyzing Citizens' and Health Care Professionals' Searches for Smell/Taste Disorders and Coronavirus in Finland During the COVID-19 Pandemic: Infodemiological Approach Using Database Logs.

BackgroundThe COVID-19 pandemic has prevailed over a year, and log and register data on coronavirus have been utilized to establish models for detecting the pandemic. However, many sources contain unreliable health information on COVID-19 and its symptoms, and platforms cannot characterize the users performing searches. Prior studies have assessed symptom searches from general search engines (Google/Google Trends). Little is known about how modeling log data on smell/taste disorders and coronavirus from the dedicated internet databases used by citizens and health care professionals (HCPs) could enhance disease surveillance. Our material and method provide a novel approach to analyze web-based information seeking to detect infectious disease outbreaks.ObjectiveThe aim of this study was (1) to assess whether citizens’ and professionals’ searches for smell/taste disorders and coronavirus relate to epidemiological data on COVID-19 cases, and (2) to test our negative binomial regression modeling (ie, whether the inclusion of the case count could improve the model).MethodsWe collected weekly log data on searches related to COVID-19 (smell/taste disorders, coronavirus) between December 30, 2019, and November 30, 2020 (49 weeks). Two major medical internet databases in Finland were used: Health Library (HL), a free portal aimed at citizens, and Physician’s Database (PD), a database widely used among HCPs. Log data from databases were combined with register data on the numbers of COVID-19 cases reported in the Finnish National Infectious Diseases Register. We used negative binomial regression modeling to assess whether the case numbers could explain some of the dynamics of searches when plotting database logs.ResultsWe found that coronavirus searches drastically increased in HL (0 to 744,113) and PD (4 to 5375) prior to the first wave of COVID-19 cases between December 2019 and March 2020. Searches for smell disorders in HL doubled from the end of December 2019 to the end of March 2020 (2148 to 4195), and searches for taste disorders in HL increased from mid-May to the end of November (0 to 1980). Case numbers were significantly associated with smell disorders (P<.001) and taste disorders (P<.001) in HL, and with coronavirus searches (P<.001) in PD. We could not identify any other associations between case numbers and searches in either database.ConclusionsNovel infodemiological approaches could be used in analyzing database logs. Modeling log data from web-based sources was seen to improve the model only occasionally. However, search behaviors among citizens and professionals could be used as a supplementary source of information for infectious disease surveillance. Further research is needed to apply statistical models to log data of the dedicated medical databases.

Educating Children and the New Norm

The lockdown from March to November 2020 in its various forms have seriously impacted education of children, both nationally and internationally. In Malaysia; more than 1 million students were affected and 100,000 teachers and 20,438 members of school support staff were forced to stay at home. UNICEF noted that 24 million children around the world will drop out and students from vulnerable communities will be particularly and failed to return to class. This has forced almost all education providers to switch the education deliveries online. While some of the more established educational institutions which are more prepared than others, sailed plainly through this switch, a sizable majority found this switch a devastating blow to the delivery of education especially to children. The Parent Group for Education, Malaysia reported that 66% Malaysian children do not have good internet connectivity at home and the Ministry of Education also reported that 37% do not own devices for online learning. The outcome of these is almost predictable. 20% children were discovered to have lost interest in schoolwork and become demotivated while 7% have indeed dropped out from school. Although most children are no stranger to handphones and other devices, the use of these for education is daunting. For the first 10 weeks of the MCO, online teaching is noted to be adhoc, random, unstructured and even non-existent. Timetable was created in May but not strictly adhered to by teachers who are not familiar with technology. The Ministry of Education set up a free portal such as www.eduwebtv.moe.edu.my and the Digital Educational Learning Initiative Malaysia (DELIMA) as immediate mitigation. The future and the new norm for education is predictable and we have no choice. Online education delivery has to be strengthened by firm efforts to boost connectivity. School digital packages should consist of laptops or tablets, with video cams, telecommunication towers, especially in the rural areas must be built urgently. Mini and micro credentialing of children and teachers must be held to train them on the basics of online teaching, while more immersive applications are being prepared. We have little choice.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S4

A Continental-Scale Assessment of Density, Size, Distribution and Historical Trends of Farm Dams Using Deep Learning Convolutional Neural Networks

Farm dams are a ubiquitous limnological feature of agricultural landscapes worldwide. While their primary function is to capture and store water, they also have disproportionally large effects on biodiversity and biogeochemical cycling, with important relevance to several Sustainable Development Goals (SDGs). However, the abundance and distribution of farm dams is unknown in most parts of the world. Therefore, we used artificial intelligence and remote sensing data to address this critical global information gap. Specifically, we trained a deep learning convolutional neural network (CNN) on high-definition satellite images to detect farm dams and carry out the first continental-scale assessment on density, distribution and historical trends. We found that in Australia there are 1.765 million farm dams that occupy an area larger than Rhode Island (4678 km2) and store over 20 times more water than Sydney Harbour (10,990 GL). The State of New South Wales recorded the highest number of farm dams (654,983; 37% of the total) and Victoria the highest overall density (1.73 dams km−2). We also estimated that 202,119 farm dams (11.5%) remain omitted from any maps, especially in South Australia, Western Australia and the Northern Territory. Three decades of historical records revealed an ongoing decrease in the construction rate of farm dams, from &gt;3% per annum before 2000, to ~1% after 2000, to &lt;0.05% after 2010—except in the Australian Capital Territory where rates have remained relatively high. We also found systematic trends in construction design: farm dams built in 2015 are on average 50% larger in surface area and contain 66% more water than those built in 1989. To facilitate sharing information on sustainable farm dam management with authorities, scientists, managers and local communities, we developed AusDams.org—a free interactive portal to visualise and generate statistics on the physical, environmental and ecological impacts of farm dams.

Random Assignment with a Smile: How to Love \u201cTheRandomiser\u201d

ObjectivesThis note describes a free online portal (www.therandomiser.co.uk) that allows researchers to design randomised controlled trials and then delegate the random assignment process to pracademics delivering the experiment.MethodsObservation of the use of this tool in repeated randomised trials in police agencies.FindingsResearchers are able to design RCTs using the online portal, which offers many ways to customise the experimental design. Results are downloadable in excel or plain text format. Researchers can grant access to treatment providers, enabling them to log in securely, enter identifiers for cases, and assign different treatments to each case. Email notifications of assignment can be sent to designated list of recipients who can track the allocation of treatments. This tool delivers this functionality at zero cost and at the time of writing is being used by 78 researchers, who have set up 70 experiments that have processed 5778 randomisations.ConclusionsTheRandomiser has been used in multiple experiments with feedback suggesting it is a powerful and user-friendly tool. The ability to deliver trickle-flow randomisation with high degrees of researcher control are attractive, as is the ability to edit an unlimited number of qualification questions prior to randomisation.

Assessment of Annotation Needs of Botanists

Annotation (i.e., making comments on a resource) is an important part of the vision for the Semantic Web as defined by the standards set by the World Wide Web Consortium (W3C). Its goal is to make Internet-published information and data, machine-readable to better utilize it. Despite the important role that annotation plays in the Semantic Web, many cultural heritage institutions have been slow to adopt it. The access to open historical biological literature hosted in digital libraries, like the Biodiversity Heritage Library (BHL), has improved the efficiency of biodiversity research, especially in the taxonomic field. This amount of information has even greater potential for research if annotation capabilities are incorporated within those legacy digital repositories. As part of the project Consumers as Creators, developed by the Missouri Botanical Garden (MOBOT) with partners at Saint Louis University (SLU), the Web annotation needs of the botanical community were analyzed. Likewise, the practicality of using existing annotation tools to satisfy this community’s particular needs was assessed, including technical and operational considerations. To do so, 15 users of a botanical virtual library from five institutions were interviewed. Their answers were analyzed and classified taking into account the user role and purpose. Desirable functionalities of annotation software were classified into three orders of priority (Must, Should, and Could). Subsequently, six open-source annotation tools were evaluated (i.e. Digilib, hypothes.is, Pundit Annotator Pro, Recogito, rerum, and VGG Annotator) to explore if they fulfilled the annotation needs of botanists. The selected annotation tools were installed (when necessary), assessed based on different functional aspects, and their advantages and disadvantages were identified. Finally, a proof-of-concept prototype was developed to exemplify how those needs could be met within a digital library platform. Botanicus, a free portal to historic botanical literature from the Peter H. Raven Library at MOBOT, and rerum, functioning as a repository of annotations, were used to explore the implementation of a minimal subset of these requirements. A summary of the results of the assessment, the lessons learned and some of the best practices recommended are presented.

Free CPD portal focused on enamel erosion

Free CPD portal focused on enamel erosion

OChemDb: the free online Open Chemistry Database portal for searching and analysing crystal structure information

The Open Chemistry Database (OChemDb) is a new free online portal which uses an appropriately designed database of already solved crystal structures. It makes freely available computational and graphical tools for searching and analysing crystal-chemical information of organic, metal–organic and inorganic structures, and providing statistics on desired bond distances, bond angles, torsion angles and space groups. Atom types have been classified by an identifier code containing information about the chemical topology and local environment. The crystallographic data used by OChemDb are acquired from the CIFs contained in the free small-molecule Crystallography Open Database (COD). OChemDb offers easy-to-use and intuitive options for searching. It is updated by following the continuous growth of information stored in the COD. It can be of great utility for structural chemistry, in particular in the process of determination of a new crystal structure, and for any discipline involving crystalline structure knowledge. The use of OChemDb requires only a web browser and an internet connection. Every device (mobile or desktop) and every operating system is able to use OChemDb by accessing its web page. Examples of application of OChemDb are reported.

Problematyka biblioteczna na łamach ogólnodostępnego portalu online Polskiej Agencji Prasowej

The article attempts to characterize the contents of information on the activites of libraries appearing in the openly available, free internet portal of the Polish Press Agency, under the address http://www.pap.pl/. The selected materials underwent a content analysis method. The source base of the elaboration comprises only the free website of the PPA, which includes a simple search engine, due to which the selected publications (texts from between 2015-2017) were subject to detailed analysis. The thus selected group of texts was limited to publications wholly or mostly dedicated to the activities of libraries or promotion of readership. The selected publications were divided according to thematic groups and place of origin.

Acoustic Radiation Force Impulse (ARFI) Elastography and Serological Markers in Assessment of Liver Fibrosis and Free Portal Pressure in Patients with Hepatitis B.

BackgroundThe aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) elastography, AST-to-platelet ratio index (APRI), and FIB-4 in assessing liver fibrosis and free portal pressure in patients with hepatitis B.Material/MethodsWe enrolled 126 patients with hepatitis B who underwent liver surgery at the General Surgery Department of the First Affiliated Hospital of Shihezi University Medical School from February 2013 to August 2015. Preoperatively, shear wave velocity (SWV) of the liver was measured with the Siemens S2000 ultrasound system to reflect liver stiffness. Serological markers were collected and fibrosis indices APRI and FIB-4 were calculated. Intraoperatively, liver tissues were harvested and free portal pressure (FPP) was measured. Postoperatively, fibrosis of liver tissues was pathologically staged.ResultsThe results of SWV, APRI, FIB-4, and FPP were all correlated with the degree of liver fibrosis (Spearman correlation coefficients: r=0.777, P<0.001; r=0.526, P<0.001; r=0.471, P<0.001; p<0.000; r=0.675, p<0.000). Receiver operating characteristic curve (ROC) analysis showed that the areas under the curve (AUC) of ARFI, APRI, and FIB-4 in diagnosing liver fibrosis were 0.830, 0.768, and 0.717, respectively, for stage F≥1; 0.861, 0.773, and 0.754, respectively, for stage F≥2; 0.941, 0.793, and 0.779, respectively, for stage F≥3; and 0.945, 0.783, and 0.754, respectively, for stage F=4. SWV, APRI, and FIB-4 were all correlated with FPP (Pearson correlation coefficients: 0.387, P<0.001; 0.446, P<0.001; 0.419, P<0.001).ConclusionsARFI, APRI, and FIB-4 can assess liver fibrosis in patients with hepatitis B when assessing the portal venous pressure. The difference in diagnostic efficacy between the 3 was not significant.

Choline absorption and evaluation of bioavailability markers when supplementing choline to lactating dairy cows.

The metabolites of choline have a central role in many mammalian biological processes, and choline supplementation to the periparturient dairy cow improves hepatic lipid metabolism. However, variability in responses to choline supplementation has highlighted a lack of understanding of choline absorption in the lactating dairy cow. Our objective was to determine net choline absorption by measuring net portal fluxes of choline and choline metabolites in cows receiving either dietary supplements of rumen-protected choline (RPC) or abomasal delivery of choline (ADC). We also evaluated markers for choline bioavailability by examining relationships between net portal absorption of choline and choline metabolites in plasma and milk. Five late-lactation Holstein cows were used in a 5×5 Latin square design, with 5-d treatment periods and a 2-d interval between periods. Treatments were (1) control (0g/d of choline), (2) 12.5g/d of choline fed as RPC, (3) 25g/d of choline fed as RPC, (4) 12.5g/d of choline provided as ADC, and (5) 25g/d of choline provided as ADC. At the end of each 5-d period, milk was sampled and 9 blood samples were collected simultaneously from an artery and portal vein at 30-min intervals. Plasma, milk, and feed ingredient concentrations of acetylcholine, betaine, free choline, glycerophosphocholine, lysophosphatidylcholine, phosphatidylcholine, phosphocholine, and sphingomyelin were quantified by hydrophilic interaction liquid chromatography-tandem mass spectrometry. With an increasing dose of ADC, the net portal flux of free choline increased and regression analysis indicated 61% net absorption of the infused dose. Among the choline metabolites, only concentrations of betaine, free choline, and phosphocholine increased in both arterial plasma (3.9, 1.9, and 0.4 times, respectively) and milk (2.5, 1.4, and 1.0 times, respectively) with 25g/d of ADC relative to the control. For RPC, the net portal flux of free choline was low relative to ADC (13%), which was similar to the relative difference observed in the concentrations and yields of milk free choline and betaine (averaged 21%). When evaluating markers for choline bioavailability, betaine was the leading candidate. Betaine in plasma and milk (alone or in combination with phosphocholine) was strongly associated with net free choline portal flux (coefficient of determination ranging from 0.64 to 0.79). In summary, free choline supply to the lactating dairy cow increases only specific choline metabolites in plasma and milk, which can be potential markers for choline bioavailability.

Establishment of a reversible model of prehepatic portal hypertension in rats.

The aim of the present study was to improve upon the traditional model of pre-hepatic portal hypertension in rats, and simulate the anhepatic phase of orthotopic liver transplantation without veno-venous bypass. A reversible model of portal hypertension was induced by portal vein ligation, with a label ring ligated along the portal vein. A total of 135 male Wistar rats were divided into three groups: i) Normal control (NC) group; ii) portal hypertensive control (PHTC) group; and iii) reperfusion (R) group. In the R group, rats with portal hypertension underwent simultaneous clamping of the portal triad and retrohepatic vena cava for 1 h, followed by removal of the clamps to enable blood reperfusion. Portal venography and portal vein pressure were recorded during the surgery. Arterial oxygen pressure (PaO2), and alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) levels were determined, and pathological changes of the liver were investigated by immunohistochemical staining. The results demonstrated that, 3 weeks after portal vein ligation, the vein area and the free portal pressures in the PHTC group were significantly increased compared with those in the NC group. The serum ALT and AST levels in the R group at different time points were significantly elevated compared with those in the PHTC group, and reached their maximal levels at 24 h after reperfusion. Furthermore, the PaO2 at 24 h after reperfusion was significantly decreased. In conclusion, the reversible model of pre-hepatic portal hypertension in rats was successfully established using the introduction of a label ring. This model may be useful for basic research focusing on the anhepatic phase of orthotopic liver transplantation without veno-venous bypass.

Neonatal research in India: current status, challenges, and the way forward.

The present article systematically reviews the current status of neonatal research in India by examining the research articles published by Indian authors in the last 10 years. It also enlists the major challenges and proposes a few potential solutions to improve the status of neonatal research in the country. The systematic review of 574 eligible articles indicates that majority of the studies were observational in nature, facility-based, and primarily investigator-driven with no external funding, had small sample size, and were published in journals with low impact factor. Only a few select government and non-government academic institutions contributed to most studies. The major challenges include shortage of faculty, no provision for dedicated research time, inadequate knowledge/skills in research methods, lack of funding opportunities, limited access to literature, non-existence of research administrative cell, inappropriately low perks to research staff, and poor support for data management and statistical analysis. The recently revised guidelines on clinical trials involving drugs have further increased the researcher's dilemma. The potential solutions are to increase the faculty strength in medical colleges, allow dedicated research time to them, appoint dedicated research cadre with emoluments at par with clinical faculty, initiate formal training in research methods, create nationwide free portal for access to literature, facilitate development of good protocols through technical guidance at all stages, make the process of funding quick and transparent, and to promote collaborative trans-disciplinary research. Experts from different domains should come together and formulate evidence based research priorities. Regulatory mechanisms should be kept proportionate to plausible risks of research, and detailed ethical guidelines for research in children should be formulated. And last but not least, harnessing postgraduate thesis potential to answer simple and relevant clinical questions in a methodologically rigorous way is the need of the hour.

Online registry for mutations in hereditary amyloidosis including nomenclature recommendations.

Hereditary systemic amyloidosis comprises a group of rare monogenic diseases inherited in an autosomal dominant fashion. It is associated with mutations in genes encoding eight different proteins, including transthyretin, apolipoprotein AI, apolipoprotein AII, lysozyme, fibrinogen A α-chain, cystatin C, gelsolin and beta-2-microglobulin. With support from the EU FP6 EURAMY project we have designed an online registry of genes and mutations in hereditary amyloidosis including their associated clinical phenotypes, with a view to having a single free online portal for the collection and distribution of this information. Users can search the registry by either mutation, phenotype or authors who have published or submitted mutations. It provides a submission form for reporting newly identified mutations. We also wanted to introduce nomenclature which complies with recommendations set out by Human Genome Variation Society and HUGO Gene Nomenclature Committee for description of new and known genetic variants. We hope this registry would be a useful and convenient tool for the medical and scientific community.

17. Neurophyspedia: The wikipedia for intraoperative neurophysiology – Introduction and invitation for authorship and editorship

Introducing Neurophyspedia, a new and ongoing project for the international community of intraoperative neurophysiology. It aims to become the free internet portal for education, research, and exchanging experience in the area of intraoperative neurophysiological monitoring. It will have the most current information, always updated, and it is maintained by experts in neurophysiology and related areas. It will provide an archive of open source literature, images, and multimedia materials. It is in the style of Wikipedia, with easy writing and editing formats. But unlike Wikipedia which can be edited and altered by everyone, Neurophyspedia has secure and limited authorship; all editing member accounts require initial approval. This presentation will introduce the different topics of the project, the basic writing and editing wikitext markup, and the procedure to apply for an editor account. The website is at www.neurophys.org, currently in English only, but pages in different languages will be programmed and added.

EAGLE: Europeana Network of Ancient Greek and Latin Epigraphy. Making the Ancient Inscriptions Accessible

EAGLE is a project whose principal aim is to bring together the most prominent European institutions and archives in the field of Classical Latin and Greek epigraphy in order to provide a single free user-friendly portal to the inscriptions of the Ancient World. Financed by the European Commission, EAGLE was born to endow Europeana, the European digital library, with a comprehensive collection of unique historical sources. EAGLE will thus provide access to the majority of the surviving inscriptions of the ancient Greco-Roman world – a massive resource and a veritable pillar of European culture , made accessible for the first time to everyone, from the curious to the scholar.

The free portal pressure changes of the liver in mini-pig models of hepatic cirrhosis

Objective To assess the free portal pressure changes of the liver during the establishment of mini-pig models of hepatic cirrhosis.Methods Fifty Bama mini-pigs of the same germline,male or female,aged 4 months,weighing 15-20 kg,were included in this study.The mini-pigs were divided at random into an experimental group of 40 and a control group of 10 animals.Compound feed including carbon tetrachloride and phenobarbitone was employed to establish the mini-pig models in the experimental group,and normal feed was given to the control mini-pigs.Liver puncture biopsy was performed and free portal pressures were measured at the end of 0,4th,8th,12th,16th,20th,and 24th week,respectively.Results At the end of 24th week,there were 70 cases of stage 0 hepatic fibrosis in the normal group,while in the experiment group there were 82 cases of slight hepatic fibrosis (stage S1 + S2),62 cases of severe hepatic fibrosis (stage S3 + S4),and 33 cases of hepatic cirrhosis.From the normal to cirrhosis,the free portal pressures were gradually elevated [(4.61 ± 0.84),(7.74 ± 1.94),(12.79 ± 4.00) and (17.03 ±3.41) mmHg (1 mmHg =0.133 kPa)],with statistically significant differences among the different lesion groups (P ＜ 0.01).Conclusion Compound feed including carbon tetrachloride and phenobarbitone can be used to successfully establish mini-pig models of hepatic cirrhosis,showing significant changes of free portal pressures at different stages of the development of hepatic fibrosis. Key words: Mini-pig model; Hepatic cirrhosis; Portal pressures

A study of free portal pressure in cynomolgus monkeys with different degrees of liver fibrosis.

The aim of this study was to investigate the patterns of changes in free portal pressure (FPP) in cynomolgus monkeys with different levels of liver fibrosis and to lay a theoretical foundation for the study of FPP in patients with liver fibrosis. Liver fibrosis models were successfully established in 15 of 20 cynomolgus monkeys using carbon tetrachloride, among which 10 monkeys developed severe liver fibrosis (S4; i.e., early cirrhosis). A randomized block design was used to study FPP in the 10 cynomolgus monkeys that developed complete liver fibrosis. The FPP values and the rates of change at different stages of liver fibrosis were analyzed. The normal FPP value of cynomolgus monkeys was 25.56 ± 2.33 mmHg; the FPP value at S1 was 36.05 ± 2.91 mmHg, with an increase of 41.04 ± 3.02%; the value at S2 was 42.79 ± 2.91 mmHg, with an increase of 67.41 ± 2.98%; the value at S3 was 50.27 ± 3.44 mmHg, with an increase of 96.67 ± 5.24%; and the value at S4 was 62.47 ± 3.75 mmHg, with an increase of 144.41 ± 6.34%. FPP and its increase at S4 were significantly higher than the normal value and those at S1, S2, and S3 (P < 0.01). These results showed that FPP increases along with the severity of liver fibrosis. FPP at S4 of severe liver fibrosis were >2-fold higher compared with the normal value.

Portal stenting for hepatocellular carcinoma extending into the portal vein in cirrhotic patients

Macroscopic portal vein invasion complicating hepatocellular carcinoma in the setting of cirrhosis is associated with a very low survival. To prevent the malignant progression from a portal branch to the main portal trunk, we have placed noncovered metallic stents extending from the portal trunk to the contralateral tumor free portal pedicle. Fifty-Four patients (age: 60 ± 11 years) were treated. Thirty-four (60%) patients were Child A and 20 (40%) were Child B-C. Tumoral thrombosis involved 1st or 2nd order branches in 41 (82%) patients and partially the main trunk in 13 (24%). Open surgical insertion (via ileal vein) as an alternative to a percutaneous approach was used in 14 (24%) patients. Early mortality (<30 days) was 7%. Following stent insertion, a transarterial chemoembolization was performed in 26 (48%) patients. After stenting, overall survival at 6, 12, and 24 months were 47%, 44%, and 36%, respectively. Bilirubin > 30 µmol/L and open surgical insertion were predictive of short-term mortality. In the good group, overall survival at 6, 12, and 24 months were 69%, 61%, and 46%, respectively. The transhepatic deployment of metallic stent seems to improve survival of patients with hepatocellular carcinoma complicated by portal vein tumoral thrombosis and could allow subsequent treatments.