Life-saving Solutions Research Articles

Gender Dynamics In Organ Donation And Transplantation: An Analysis Of Donor And Recipient Trends

Organ donation and transplantation represent critical components of modern medicine, offering life-saving solutions for individuals with organ failure. Despite advancements in medical practices, significant gender disparities exist within these processes, where women disproportionately contribute as donors while men are predominantly recipients. This study integrates an in-depth statistical analysis of data from major registries like the United Network for Organ Sharing (UNOS) and the Organ Procurement and Transplantation Network (OPTN), utilizing chi-square tests, logistic regression, multivariate analysis, and stratified sampling to elucidate these trends. By combining quantitative data with socio-cultural theories, this research aims to uncover the multifaceted causes behind these gender-based discrepancies, revealing that social conditioning, altruistic behaviour, and systemic biases in medical practices play crucial roles. The results indicate statistically significant correlations between gender and donor/recipient status, suggesting that both traditional gender roles and healthcare biases need to be addressed to create a more equitable organ donation system. The study concludes by proposing policy reforms and advocacy strategies to foster gender neutrality in organ transplantation, ultimately promoting a fairer healthcare paradigm.

Upper Limb Compartment Syndrome-An Extremely Rare Life-Threatening Complication of Cutaneous Anthrax.

(1) Background: Cutaneous anthrax is a disease caused by a Gram-positive bacillus, spore-forming Bacillus anthracis (BA). Cutaneous anthrax accounts for 95% of all anthrax cases, with mortality between 10-40% in untreated forms. The most feared complication, which can be life-threatening and is rarely encountered and described in the literature, is compartment syndrome. (2) Methods: We report a series of six cases of cutaneous anthrax from the same endemic area. In two of the cases, the disease was complicated by compartment syndrome. The systematic review was conducted according to systematic review guidelines, and the PubMed, Google Scholar, and Web of Science databases were searched for publications from 1 January 2008 to 31 December 2023. The keywords used were: "cutaneous anthrax" and "compartment syndrome by cutaneous anthrax". (3) Results: For compartment syndrome, emergency surgical intervention for decompression was required, along with another three surgeries, with hospitalization between 21 and 23 days. In the systematic review, among the 37 articles, 29 did not contain cases focusing on compartment syndrome of the thoracic limb in cutaneous anthrax. The results were included in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram. (4) Conclusions: Early recognition of the characteristic cutaneous lesions and compartment syndrome with early initiation of antibiotics and urgent surgical treatment is the lifesaving solution.

Completion pancreatectomy during pancreatoduodenectomy: A lifesaving solution in high-risk patients.

Postoperative pancreatic fistula (POPF) is responsible of most major complications and fatalities after PD. By avoiding POPF, TP may improve operative outcomes in high-risk patients. The aim was to compare total pancreatectomy (TP) and pancreatoduodenectomy (PD) in high-risk patients and evaluate results of implementing a risk-tailored strategy in clinical practice. Between 2014 and 2023, 139 patients (76 men, median age 67years) underwent resection of disease located in the head of the pancreas. Starting January 1, 2022, we offered TP to patients at high POPF risks (fistula risk score (FRS) ≥7) and to patients with intermediate POPF risks (FRS: 3-6) and high risks of failure to rescue (age> 75years, ASA score ≥3). We compared outcomes of TP and PD and evaluated the results of the new strategy implementation on operative outcomes. Propensity score-based analysis was performed to limit bias of between-group comparison. Eventually, 26 (19%) patients underwent TP and 113 (81%) patients underwent PD. Severe complications occurred in 42 (30%) patients and 13 (9%) patients died. TP resulted in shorter lengths of hospital stay (median: 14days [11; 18] vs. 17days [13; 24], p=0.016) and less risks of post-pancreatectomy hemorrhage (PPH) (0% vs. 20%, p<0.001) compared to PD. Crude and propensity match analysis showed that the implementation of a risk-tailored strategy led to significant reduction of reoperation, POPF, PPH and mortality rates. The use of TP as part of a risk-tailored strategy in high-risk patients can be lifesaving.

Prognostic Factors in Liver Transplant with Marginal Grafts - Review of the Literature.

Liver transplantation is the last life-saving solution for patients with end stage liver disease. The low number of available liver grafts and the increasing waiting time on transplant lists have led to the appearance of extended donation criteria and the marginal grafs, initially considered suboptimal. Allocation of grafts and identification of the most suitable "donor-recipient" pair is still under development. The fact is that the appearance of marginal grafts has expanded the donation lists and seems to have a prognosis at least comparable to the use of ideal grafts.

Abstract 4108: Transient epigenetic reprogramming enhances T-cell proliferation and tumor clearance

Abstract Manufacturing-induced differentiation and accelerated T-cell exhaustion prevent CAR-T therapies from reaching their full therapeutic potential and broader application in the treatment of cancer. To combat these inherent challenges, Turn Biotechnologies is developing its novel and proprietary mRNA-based technology, Epigenetic Reprogramming of Aging (ERATM), to i) preserve a less differentiated status; ii) diminish (or even eliminate) exhaustion; and iii) improve the cytotoxicity and efficacy of CAR-T cell cells. Prolonged CAR-T cell manufacturing process leads to a more differentiated and effector-like phenotype, which is susceptible to accelerated exhaustion in vivo. Unfortunately, clinical evidence suggests that less differentiated and stem-cell like CAR-T products have increased proliferative capacity, reduced exhaustion, and greater efficacy. Additionally, aging is known to compromise T-cell function, reducing chances of CAR-T therapy candidacy for older patients. These compounded effects of manufacturing and aging severely limit CAR-T cell functionality in terms of proliferation, perdurance, and cytotoxic capacity, as well as precluding wider patient access. Leveraging our previous work with other aged human cells, we hypothesized that the transient expression of ERATM factors could impact manufacturing of CAR-T cells by mitigating their differentiation, promoting T stem cell memory (Tscm) phenotype, reducing/eliminating exhaustion, and resetting the epigenetic clock in CAR-T cells. Here, we present preclinical data showing that ERATM treatment of T cells delivered using our proprietary eTurnaTM platform can restore youthful functionality, reducing exhaustion and effects of aging, improving their ability to fight cancer while safely maintaining cellular identity. ERATM -treated T cells have higher proliferation capacity and cytotoxicity upon tumor cell engagement in vitro compared to control cells. Treatment of ERATM -treated T-cells also increases the production of beneficial cytokines to support their survival and cytotoxic activity. Importantly, ERATM treatment preserves T-cell identity and T-cell repertoire, while avoiding unwanted hyperproliferation or clonal expansion. In murine models of hematological cancers, these effects of ERATM treatment on T-cells results in superior cancer cell killing and clearance. These benefits of ERATM technology to current CAR-T manufacturing processes have the potential to translate into the clinic as improved patient outcomes and survival with reduced side effects, thereby expanding patient access and enabling immunotherapies to serve as a first-in-line lifesaving solution. Citation Format: Alec McQuiston, Junbao Yang, Jason Romero, Naveen Bojjireddy, Travis McQuiston, Vittorio Sebastiano, Mustafa Turkoz. Transient epigenetic reprogramming enhances T-cell proliferation and tumor clearance. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4108.

Diverse Applications of Three-Dimensional Printing in Biomedical Engineering: A Review.

A three-dimensional (3D) printing is a robotically controlled state-of-the-art technology that is promising for all branches of engineering with a meritorious emphasis to biomedical engineering. The purpose of 3D printing (3DP) is to create exact superstructures without any framework in a brief period with high reproducibility to create intricate and complex patient-tailored structures for organ regeneration, drug delivery, imaging processes, designing personalized dose-specific tablets, developing 3D models of organs to plan surgery and to understand the pathology of disease, manufacturing cost-effective surgical tools, and fabricating implants and organ substitute devices for prolonging the lives of patients, etc. The formulation of bioinks and programmed G codes help to obtain precise 3D structures, which determines the stability and functioning of the 3D-printed structures. Three-dimensional printing for medical applications is ambitious and challenging but made possible with the culmination of research expertise from various fields. Exploring and expanding 3DP for biomedical and clinical applications can be life-saving solutions. The 3D printers are cost-effective and eco-friendly, as they do not release any toxic pollutants or waste materials that pollute the environment. The sampling requirements and processing parameters are amenable, which further eases the production. This review highlights the role of 3D printers in the health care sector, focusing on their roles in tablet development, imaging techniques, disease model development, and tissue regeneration.

Efficient Removal of Phosphate from Wastewater by a Novel Phyto-Graphene Composite Derived from Palm Byproducts.

The increased demand for clean water especially in overpopulated countries is of great concern; thus, the development of eco-friendly and cost-effective techniques and materials that can remediate polluted water for possible reuse in agricultural purposes can offer a life-saving solution to improve human welfare, especially in view of climate change impacts. In the current study, the agricultural byproducts of palm trees have been used for the first time as a carbon source to produce graphene functionalized with ferrocene in a composite form to enhance its water treatment potential. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy, X-ray diffraction (XRD), ultraviolet-visible, Fourier transform infrared spectroscopy, zeta potential, thermogravimetric analysis, and Raman techniques have been used to characterize the produced materials. SEM investigations confirmed the formation of multiple sheets of the graphene composite. Data collected from the zeta potential revealed that graphene was supported with a negative surface charge that maintains its stability while XRD elucidated that graphene characteristic peaks were evident at 2θ = 22.4 and 22.08° using palm leaves and fibers, respectively. Batch adsorption experiments were conducted to find out the most suitable conditions to remove PO4 3- from wastewater by applying different parameters, including pH, adsorbent dose, initial concentration, and time. Their effect on the adsorption process was also investigated. Results demonstrated that the best adsorption capacity was 58.93 mg/g (removal percentage: 78.57%) using graphene derived from palm fibers at 15 mg L-1 initial concentration, pH = 3, dose = 10 mg, and 60 min contact time. Both linear and non-linear forms of kinetic and isotherm models were investigated. The adsorption process obeyed the pseudo-second-order kinetic model and was well fitted to the Langmuir isotherm.

Reinventing the Business Model in the Tourism Industry based on Sustainable Circular Economy and Innovation

Today, the whole globe is facing a series of crises unprecedented in modern histories, such as health, social, economic, environmental, etc. All these crises result from an unsustainable development model based on the misuse of the planet's natural resources, threats such as climate change, and conflicts with economic, social, and environmental impacts. The crisis caused by the pandemic has accentuated new patterns of behaviour and consumption, accelerated the technological revolution, and grown concerned for sustainability. Tourism is an industry that is particularly vulnerable to the effects of climate change, the consequences of which vary widely. Therefore, sustainable solutions are in the interest of the tourism sector, and the circular economy is a life-saving solution for the tourism industry. The transition from a linear to a circular economy is presented throughout the European Union as one of the major drivers of change and Innovation. This article aims to move towards a new business model in the tourism industry based on the circular economy and Innovation by setting out the principles for applying the circular economy in tourism. New business models can help us transform the tourism industry in this disruptive process.

The Art of Reprogramming for Regenerative Medicine.

Traditional pharmaceuticals in the forms of small chemical compounds or macromolecules such as proteins or RNAs have provided lifesaving solutions to many acute and chronic conditions to date. However, there are still many unmet medical needs, especially those of degenerative nature. The advent of cell-based therapy holds the promise to meet these challenges. In this review, we highlight a relatively new paradigm for generating or regenerating functional cells for replacement therapy against conditions such as type I diabetes, myocardial infarction, neurodegenerative diseases and liver fibrosis. We focus on the latest progresses in cellular reprogramming for generating diverse functional cell types. We will also discuss the mechanisms involved and conclude with likely general principles underlying reprogramming.

Perspectives on the management of non-compressible torso hemorrhage: A narrative review

LAY SUMMARY Hemorrhage is one of the leading causes of death after trauma. A significant proportion of these fatalities could be prevented with appropriate bleeding control. This is more easily achieved with direct pressure in compressible areas such as the extremities or major joints. However, bleeding in the chest, abdomen, or pelvis cannot be as easily controlled without advanced procedures that are only available in hospitals. This article describes several technologies to control bleeding in the chest, abdomen, and pelvis that are potentially applicable in combat and pre-hospital settings. However, a review of existing studies quickly shows that convincing clinical evidence is lacking to support most pre-existing technologies, and the majority of studies are in the investigational stage. A universal, effective, and life-saving solution has not yet been identified. Accordingly, research in this area should continue to focus on both refining existing technologies and developing new approaches.

Wind load evaluation on storm shelters using wind tunnel testing and North American design codes

In Canada, the number of extreme wind events is increasing due to climate change. Accordingly, storm shelters are becoming more popular, as it provides a life-saving solution during wind events. Currently, the National Building code of Canada (NBCC 2015) and the American Society of Civil Engineers (ASCE 7-16) codes consider storm shelters as low-rise buildings with high importance factor with no specific guidelines for their smaller scale. The current study aims at comparing North American codes for designing wind shelters to a detailed experimental wind simulation using boundary layer wind tunnel testing under the synoptic wind. Wind tunnel tests were conducted at Ryerson University for three commonly used shapes of storm shelters. The governing wind loads from the wind tunnel results were compared to the design codes for both structural forces and cladding pressures. The study also illustrates and quantifies critical zones that may exceed the codes provided values due to being flow separation regions.

Predictive Model for the Factors Influencing International Project Success: A Data Mining Approach

Considering that international projects with teams in the virtual environment (IPTVEs) contribute to the reduction in the carbon footprint and, at the same time, become life-saving solutions in extreme global situations, such as the COVID-19 pandemic, organizations familiar with this type of project will have a substantial advantage in their ability to operate efficiently and to achieve their sustainable goals. An important aspect of project management is to identify the factors that influence the success of an international project, increasing its performance. Our first research hypothesis was that the decision to create a project team in the virtual environment is a factor with a major influence on international project success. Data collection was performed through an online survey conducted within international project team members and managers. The success factors were explained through factorial analysis which revealed two main factors and the neural network algorithm on a dataset through IBM SPSS Modeler software. The predictive model revealed that the most important field is setting up a virtual team, followed by organizational culture. These results support our hypothesis.

Development of E-Dialysis Database Management System (DBMS) for Computer-Based Documentation and Mobile Application with RFID Technology

This paper outlined the development of E-dialysis Database Management System (DBMS) for electronic-based documentation, which is applied to computer device and mobile application, integrated with RFID technology. Digital transformation of data is critical as it offers a better approach in documenting and storing the crucial medical records. Issues related to human error such as losing or misplacing the documents could be prevented and these records are more protected. The general system encompasses local and cloud databases, a computer Graphical User Interface (GUI) and a mobile application for normal dialysis patients. The system also includes 13.56MHz High Frequency (HF) RFID technology which is inferred as an effective life-saving solution for the smallest percent of the unfortunate dialysis patients who have disabilities or in the End Stage Renal Disease (ESRD). In a way, they can communicate with their doctors or caregivers just by simply providing their RFID tagsthat contain their medical records. Not only that, RFID technology was used for the purposes of patient identification and medical data tracking. The tags are scanned on RFID reader which is linked to the Database Management System (DBMS) that are developed with MYSQL. A PC Graphical User Interface (GUI), created with Visual Basic, and a mobile application using AppSheet act as the monitoring tools of this proposed research. A dialysis monitoring system integrated with Database Management System (DBMS) using RFID technology has been successfully developed to help and provide increased security and convenience for the users.

Gaps in Training: Misunderstandings of Airway Management in Medical Students and Internal Medicine Residents.

(1) Evaluate baseline airway knowledge of medical students (MSs) and internal medicine (IM) residents. (2) Improve MS and IM resident understanding of airway anatomy, general tracheostomy and laryngectomy care, and management of airway emergencies. A before-and-after survey study was carried out over a single academic year. MS and IM resident knowledge was evaluated before and after an educational, grand rounds-style lecture reviewing airway anatomy, tracheostomy tube components, tracheostomy and laryngectomy care, and clinical vignettes. The primary outcome measure was change in pre- and postlecture survey scores. Prelecture surveys were completed by 90 participants, and 83 completed a postlecture assessment. Postlecture scores were statistically improved for all questions on the assessment (P < .001). Level of training did not confer an improved pre- or postlecture survey score. While the majority of participants in our study had previously cared for patients with a tracheostomy or laryngectomy, less than half were able to correctly address basic airway emergencies. Senior IM residents were no more proficient than MSs in addressing airway emergencies. The lack of formal airway training places patients at risk with routine care and in emergencies, demonstrating the need for formal airway education for early medical trainees. Our data demonstrate a serious gap in MS and IM resident knowledge with respect to emergent airway care in patients with tracheostomies and laryngectomies. An interdepartmental collaborative curriculum offers a realistic and potentially life-saving solution for medical trainees.

Case report of endoprosthesis -Y implantation in severe respiratory failure in the MPSII patient; comparison with literature data

BackgroundThe tracheobronchomalacia is a life-threatening complication of mucopolysaccharidosis (MPS) without known effective, optimal treatment. The severe expiratory collapse of the trachea and bronchi is one of causes of the high rate of deaths in the course of airway impairment in MPSII patients.Case presentationDue to the adynamic tracheobronchomalacia despite of enzymatic treatment (ERT) in our MPSII patient, a life-saving tracheal bifurcated type-Y endoprosthesis (a self-expanding, metal stent for the prosthesis of tracheal and bronchial stenosis) was implanted. In the followed months, the breathing efficiency improved, but then gradual worsening, progression of bronchi occlusion at the stent border resulted in patient’s death.ConclusionThe Y-stent implantation appears to be a short-term, life-saving solution without satisfactory long-term effects due to the progress of peripheral bronchomalacia and increased tissue proliferation and granulation, that arises during the illness’ course.

One-Year Mortality and Associated Factors in Patients Receiving Out-of-Hospital Naloxone for Presumed Opioid Overdose

Out-of-hospital naloxone has been championed as a lifesaving solution during the opioid epidemic. However, the long-term outcomes of out-of-hospital naloxone recipients are unknown. The objectives of this study are to describe the 1-year mortality of presumed opioid overdose victims identified by receiving out-of-hospital naloxone and to determine which patient factors are associated with subsequent mortality. This was a regional retrospective cohort study of out-of-hospital records from 7 North Carolina counties from January 1, 2015 to February 28, 2017. Patients who received out-of-hospital naloxone were included. Out-of-hospital providers subjectively assessed patients for improvement after administering naloxone. Naloxone recipients were cross-referenced with the North Carolina death index to examine mortality at days 0, 1, 30, and 365. Naloxone recipient mortality was compared with the age-adjusted, at-large population's mortality rate in 2017. Generalized estimating equations and Cox proportional hazards models were used to assess for mortality-associated factors. Of 3,085 out-of-hospital naloxone encounters, 72.7% of patients (n=2,244) improved, whereas 27.3% (n=841) had no improvement with naloxone. At day 365, 12.0% (n=269) of the improved subgroup, 22.6% (n=190) of the no improvement subgroup, and 14.9% (n=459) of the whole population were dead. Naloxone recipients who improved were 13.2 times (95% confidence interval 13.0 to 13.3) more likely to be dead at 1 year than a member of the general populace after age adjusting of the at-large population to match this study population. Older age and being black were associated with 1-year mortality, whereas sex and multiple overdoses were not. Opioid overdose identified by receiving out-of-hospital naloxone with clinical improvement carries a 13-fold increase inmortality compared to the general population. This suggests that this is a high-risk population that deserves attention from public health officials, policymakers, and health care providers in regard to the development of long-term solutions.

Reaching informed decisions: Corporate governance, knowledge asymmetry and intellectual capital influences in the international and romanian business environment, before and after the financial crisis

The scientific research centers on the sensible aspects represented by reaching informed decisions both in the private and public sectors, while being under the influence of three key factors, namely: corporate governance, knowledge asymmetry, and intellectual capital. In continuation, this scientific work points out the powerful role played by the economic, financial, political and social crisis in the international and Romanian business environment, and underlines the most dramatic changes brought by this crisis into individuals’ and entities’ daily lives. In addition, this study aims at providing valuable insights on numerous life-saving solutions meant to enable both individuals and entities to cope with the future, in the attempt to create more and deeper connections with our environment, thus becoming more aware of the dangers of continuously exploiting and neglecting the needs of our Planet. Researchers have shown an increased interest in analyzing and discussing the aspects concerning (yet, not limited to) biodiversity, circular economy, corporate social responsibility, corporate governance, good governance, and smart cities, in particular due to the unprecedented changes experienced by our society, which prompted the authors of this article to adopt the following approach in this paper: (a) the first part is dedicated to the literature review, which describes the most relevant terms associated with corporate governance, knowledge asymmetry and intellectual capital;(b) the second part is consecrated to the methodology, which stresses on the most significant instruments used in order to facilitate the in-depth examination of corporate governance, knowledge asymmetry and intellectual capital;(c) the next sections are devoted to presenting the most important elements attributed to corporate governance, knowledge asymmetry and intellectual capital, in order to accelerate positive changes in our society;(d) the section dedicated to the case study is keen on describing the case of Romanian business environment in the context where corporate governance, knowledge and intellectual capital become a priority in the process of reaching informed decisions;(e) the results and discussions section is meant to show the most relevant solutions in reaching informed decisions at both a national and international level, keeping in mind the main influences derived from corporate governance, knowledge asymmetry and intellectual capital;(f) the conclusions section accentuates, once again, the role that corporate governance, knowledge and intellectual capital must play in order to support growth, development and sustainability at a worldwide level. There are several important areas where this study makes an original contribution, namely: the literature revised, the subject taken into discussion, the implications of reaching informed and sustainable decisions, the case of Romania and its position on corporate governance, knowledge asymmetry and intellectual capital, in turbulent times. Copyright © 2020. Cristina Raluca GH. POPESCU and Mihail DUMITRESCU. Distributed under Creative Commons Attribution 4.0 International CC-BY 4.0

Mesangioproliferative glomerulonephritis with extracapillary crescents – unexpected fatal complication in a 17-year-old patient with implanted left ventricular assist device

The continuous flow left ventricular assist device (cf-LVAD) is the life-saving solution for patients with end-stage global heart failure. We present the case of a young patient with biventricular dilated cardiomyopathy, who had a cf-LVAD implantation and died as result of progressive renal failure. In the first year after implantation, he suffered repeated strokes and episodes of pneumonia with Klebsiella pneumoniae and Escherichia coli. The patient had hypertension, which was kept under control with angiotensin-converting enzyme (ACE) inhibitors and beta-blockers. After multiple bleeding episodes, the patient died at 21 months after the LVAD implant. At autopsy, parenchymatous brain hemorrhage was found to be associated with pulmonary hemorrhages. The unexpected features related to mesangioproliferative and extracapillary glomerulonephritis, with focal glomerulosclerosis. The proliferated parietal cells of Bowman’s capsule proved to express cluster of differentiation 44 (CD44), whereas remnant podocytes and mesangial cells showed Wilms tumor 1 (WT1) positivity. Since CD44 might be involved in fibrogenesis, but ACE inhibitors can exert a protective role against glomerular deterioration, we performed a synthesis of literature data which enabled us to propose a hypothesis with a potential clinical impact. We conclude that, in patients with LVAD implants, high blood pressure and high serum level of angiotensin II, the association between ACE inhibitors and anti-CD44 agents might exert glomerular protection and increase the survival time. Experimental studies are necessary to support our hypothesis and to explain the mechanism of possible glomerulopathy installed after LVAD implant.

A Standard Reversed Y-piece Technique for Fixation of the Laryngeal Mask Airway

Airway management becomes a challenging task in subglottic stenosis due to noncompliant stricture. Location and extent of stricture also pose difficulty in securing front of neck access. management with use of available resources provides immediate lifesaving solution for anticipated or unanticipated life threatening conditions especially causing airway compromise.

Kaplı Stent Trombozu Sonrası Perikardiyal Kanama: İki Ucu Keskin Bıçak

Advancements in coronary stent technology encourage interventional Cardiologists in performing more complex, percutaneous interventions. Coronary perforation is a lethal complication of percutaneous coronary artery interventions and should be managed within seconds to minutes. Despite technological advancements, coronary perforation incidence has not declined over the years. This consistent incidence of coronary perforation may be related to increased number of complex, percutaneous coronary artery interventions. Covered stent implantation is a life-saving solution during the course of this emergent complication but also carries its own short and long term risks in the follow-up of these patients. Herein this report, we aimed to present a successful management of a case of coronary perforation by covered stent implantation but complicated during in-hospital period in the following days.