Preservation Of Life Research Articles

“There is a crack in everything, That's how the light gets in”. Maintaining hygiene and striving for purity: An interdisciplinary study

ContextThe concept of hygiene plays a significant role in human life, dividing spaces into opposing categories (clean vs. dirty, pure vs. taboo, familiar and uncanny, etc.) in the pursuit of a long and meaningful life. Across multiple disciplines, hygiene encompasses both physical-material and also mental-spiritual-abstract dimensions, and is studied through various lenses—medicine, religious and cultural studies, psychiatry and psychoanalysis, philosophy and more. ObjectivesThe article aims to describe and critically analyze the pattern that defines hygiene maintenance mechanisms in multiple spheres of human activity. The analysis include physical and cultural hygiene in external aspects of our lives, as well as mental-spiritual hygiene in the internal spheres. The investigation explores how the mechanism of pursuing the hygiene works to preserve the “clean” or the “pure” by preventing the intrusion of the “dirty” and “polluting” and examines the implications of strict hygiene practices on life and vitality. MethodThis is a theoretical study drawing on interdisciplinary approaches, including medical research on the formation of the concept of hygiene, leading to the presentation of the “hygiene hypothesis”, religious and cultural analysis of concepts of purity and pollution, as explored by Mary Douglas, and Freud's psychoanalytic theory with focus on the concept of the uncanny (unheimlich) as a sphere of life that seems to “pollute” our inner world. The implications of Freud's ideas are further examined in the works of Winnicott and others. ResultsThe study reveals that the strict enforcement of hygiene mechanisms, while aiming to eliminate the polluting element entirely, can paradoxically threaten the very vitality it seeks to protect. This paradox appears in different ways but follows a common pattern: the excessive pursuit of cleanliness may inadvertently harm the source of life that hygiene is intended to safeguard. InterpretationsThe article interprets the findings within a broader theoretical framework, and poses questions regarding the balance between the aspiration for purity and the preservation of life's essential vitality. Theoretical implications suggest a need for caution in how hygiene is approached in health policy, and also in contexts like psychology or psychoanalysis. Future research should explore how this balance can be maintained across other fields, such as ethics, media policy in consumer-driven society or education.

Isochoric preservation of mammalian livers at high-subzero temperatures

Isochoric preservation of mammalian livers at high-subzero temperatures

Heavy Metals in Water and Sediments and Their Impact on Water Quality in Andean Micro-watersheds: A Study of the Colorado and Alajua Rivers in the Ambato River Watershed, Tungurahua, Ecuador

The present study aims to characterize the water and sediment quality of the Colorado and Alajua rivers within Ecuador’s Ambato River watershed, with a specific focus on the presence of heavy metals. Measurements were conducted at five sampling points along the upper and lower zones of each river, where both physicochemical and microbiological parameters, as well as concentrations of heavy metals in water and sediments, were analyzed. Most parameters exhibited statistically significant differences, as determined by the analysis of variance (ANOVA), between the values observed in the upper and lower zones of the micro-watersheds. Water quality in the mentioned rivers was assessed using specific water quality indices, WQI, namely the NSF-WQI and Dinius WQI. Additionally, the impact of heavy metal presence in the water and sediments was evaluated using the Heavy Metal Evaluation Index (HEI). While most parameters met the Ecuadorian quality standards for water sources intended for human consumption, concerns emerged regarding elevated levels of total and fecal coliforms along both rivers, which could limit the suitability of these rivers as a water source for human use and consumption. At various sampling points, water quality criteria for the preservation of aquatic life were not met for several heavy metals. For example, the Colorado River exhibited elevated levels of zinc (59-76 μg.L-1), copper (12-47 μg.L-1), lead (1.2-3.9 μg.L-1 ), iron (0.33-0.37 mg.L-1 ), and manganese (0.37-0.47 mg.L-1), while the Alajua River showed excess copper (11 μg.L-1), iron (0.61-0.72 mg.L-1), and manganese (0.62-0.98 mg.L-1). Geological factors likely contribute to the concentration of heavy metals in the upper segments of the rivers, while agricultural runoff may contribute to concentrations in the lower segments. Sediments exhibited higher average values of the Heavy Metal Evaluation Index (HEI) (20.6-26.7) compared to water samples (13.9-15.4), indicating a potential accumulation of heavy metals in the river sediments. Overall, both rivers exhibited contamination levels ranging from regular to moderate, as indicated by the calculated average Water Quality Indices (WQI), with certain areas showing slight contamination or meeting acceptable standards. These results highlight the influence of anthropogenic activities on water quality, emphasizing the necessity of continuous monitoring to assess and control their impact.

Harnessing the Blue Economy: India's Path to Sustainable Marine Resource Utilization and Economic Growth

Blue Economy has introduced a completely new array of opportunities for India to expand upon its economy while having keeping an eye on the sustainability of its marine resources. It also helps that this idea implements perfectly with the strategic positioning of the coastline. India’s potential to increase its economic growth with the help of Blue Economy through various policies which could be implemented into its economic framework. India has even taken steps to promote this with various projects like the Sagar Mala Project or the Deep Ocean mission. The main focus right now should be based on the process of upgrading the infrastructure related to port, upgrading marine technology while also focusing and promoting sustainable aquafarming and preservation of marine resources. In simple words it strives to create of balance of both the economic growth as well the conservation of the aquatic resources and marine life. Marine sectors require investments but in return it will certainly lead to the boost in India’s GDP as it will lead to the many benefits like creating major job benefits, and it will improve the lifestyle of coastal communities. However, with such ambition the implementation of these policies remains a huge challenge, it requires more than just discussing policies it requires complete involvement from both the Government and the community. Overall, if India uses its tactically perfect positioning in terms of blue economy it could become of the biggest blue economic models in the world. India’s blue economy could contribute hugely to both the Nation and global efforts to spread the message of economic growth along with the preservation of the ocean life.

Clustering based strategic 3D deployment and trajectory optimization of UAVs with A-star algorithm for enhanced disaster response

A broad spectrum of communication and information technologies is currently being investigated for their potential applications in disaster management. A high level of situational awareness, combined with a prompt and accurate response, is essential for the preservation of life during catastrophe scenarios. This study presents a novel communication strategy employing Unmanned Aerial Vehicles (UAVs) as aerial base stations for providing connectivity to the affected area. The system takes advantage of the flexibility and quick deployment characteristics of UAVs. The main focus is to determine the optimal UAV deployment along with trajectory planning to ensure connectivity in areas where conventional base stations are inaccessible. The proposed system employs two types of UAVs: cluster UAVs which act as stationary base stations and relay UAVs acting as mobile base stations. A three-step strategy is proposed to find the suitable location of cluster UAVs, optimize their height and power, and find the optimal trajectory of the relay UAVs to maximize the percentage of users served. Gaussian Mixture Model (GMM) clustering is employed to determine the optimal horizontal location of cluster UAVs. An optimization problem is framed for finding out the optimal height and power for cluster UAVs. Heuristic-based A-star algorithm is used to find out the trajectory of the relay UAVs which can efficiently minimize the overall path length while avoiding obstacles. The simulation results confirm the effectiveness of the proposed approach and demonstrate the performance enhancement by comparing it with the benchmark schemes.

Targeting the PDE3B-cAMP-autophagy axis prevents liver injury in long-term supercooling liver preservation.

In liver transplantation, donor livers are typically stored in a preservation solution at 4°C for up to 12 hours. However, this short preservation duration can lead to various issues, such as suboptimal donor-recipient matching and limited opportunities for organ sharing. Previous studies have developed a long-term preservation method called supercooling liver preservation (SLP) to address these issues. However, in this study using a rat model, we observed that long-term SLP led to more severe liver damage compared with clinically prevalent traditional static cold storage (SCS) for durations less than 8 hours. To understand the potential mechanism of SLP-induced liver injury, we conducted an integrative metabolomic, transcriptomic, and proteomic analysis. We identified the PDE3B-cAMP-autophagy pathway as a key determinant of SLP-induced liver injury. Specifically, we found that PDE3B was elevated during SLP, which promoted a reduction of cAMP metabolites, triggering an AMPK-dependent autophagy process that led to liver injury in rats. We found that blocking the reduction in cAMP using the PDE3B inhibitor cilostamide inhibited autophagy and substantially ameliorated liver injury during 48-hour SLP in rat livers. Furthermore, we validated the effectiveness of cilostamide treatment in preventing liver injury in pig and human liver 48-hour SLP models. In summary, our results reveal that metabolic reprogramming involving the PDE3B-cAMP-autophagy axis is the key determinant of liver injury in long-term SLP and provide an early therapeutic strategy to prevent liver injury in this setting.

Normothermic machine perfusion of explanted livers: Exploratory study of an alternative translational model forend-stage liver disease.

Normothermic machine perfusion (NMP) is a technique for donor liver preservation and assessment in transplantation. NMP has gained momentum recently by enabling safer use of higher risk organs via organ viability assessment. It also offers a platform for investigating exvivo organ biology. In this exploratory study, we completed a complex vascular reconstruction of explanted, diseased livers from patients undergoing transplantation and then perfused them normothermically on a closed perfusion circuit. We compared these livers to non-diseased donor livers via perfusate samples collected during perfusion. Five hepatectomized grafts and eight donor livers were perfused for 1 h or longer. Four hepatectomized livers cleared lactate, and all consumed glucose; all control livers cleared lactate, and seven utilized glucose. Significantly higher portal vein flows were achieved in the control group. Our findings illustrate the feasibility of using closed-circuit NMP as a platform to study hepatectomized organs, which could reshape the research landscape in mechanisms of disease and applied therapeutics for patients with end-stage liver disease.

Subacute onset rhino-orbital mucormycosis caused by Cunninghamella in a Chinese leukemia patient: A case report and literature review

Purpose We herein report a case of subacute-onset rhino-orbital mucormycosis (ROM) in an acute leukemia patent caused by the rare but most lethal pathogenic fungus - Cunninghamella. To the best of our knowledge, this is the first case of ROM caused by Cunninghamella reported in China. Case description A 50-year-old Chinese female with acute leukemia (M2 type) who, following the completion of two cycles of chemotherapy, began to exhibit naso-ocular symptoms. The patient was initially diagnosed with extramedullary leukemia. As the disease progressed, the patient began to develop specific black crust-like necrosis of the right eyelids. Following multidisciplinary treatment (MDT) consultation and tissue biopsy, the patient was finally diagnosed with a rare type of ROM caused by Cunninghamella infection. Although the mortality associated with Cunninghamella infection was significantly greater than that associated with infections caused by other Mucorales, the infection was eventually controlled through the adjustment of the antifungal drug regimen and timely surgical intervention. Conclusions ROM infection with Cunninghamella is an extremely rare and fatal fungal infection, and early recognition and diagnosis of the disease is critical to the prognosis. The subacute nature of this case may have been a positive factor in the patient's preservation of life.

Hypoxic irreversible brain cells damage, associated risk factors and antihypoxants

It is reported that in the final stage of many diseases the immediate cause of biological death in humans and warm-blooded animals is hypoxic irreversible damage to brain cells. This explains the fact that to prevent biological death in all critical conditions without exception, inhalation with breathing gases containing oxygen has long been successfully used. This is also why oxygenation of the blood is considered one of the main conditions for preserving human life in all critical situations and forms the basis of emergency medical care in the intensive care unit. However, inhalation of oxygen gas and increasing blood oxygen saturation should be carried out as early as possible, and more precisely — before the onset of the stage of hypoxic irreversible damage in brain cells. The fact is that after the onset of irreversible da­mage brain cells die even in the presence of oxygen. In this connection, the mechanisms of adaptation of the organism to oxygen deficiency play a great role for longer preservation of brain cells viability and human life in conditions of hypoxemia. In order to increase resistance to hypoxemia, antihypoxants are traditionally used. But they can preserve the viability of brain cells not always, but only if they are introduced into the body before the onset of hypoxic irreversible damage to brain cells and in the case of unused reserves of adaptation to hypoxemia in the body. Risk factors of hypoxic irreversible damage of brain cells are indicated, among which excessively long duration of hypoxemia and hyperthermia are emphasized. It is shown that the most important circumstance for the development of hypoxic irreversible damage of brain cells is not so much the degree of hypoxemia as the degree of hypoxia of brain tissue and its duration, which exceeds the period of human resistance to hypoxia. It has been shown that human resistance to hypoxia can be assessed using the Stange test. It has been reported that fever and local cerebral hyperthermia decrease, and hibernation and local cerebral hypothermia increase, the resistance of brain cells to hypoxia. In this regard, recommendations not only to eliminate fever and local inflammatory processes in the head, but also recommendations to reduce brain temperature are highly appropriate to improve resistance to hypoxia. It is pointed out that among the methods of local therapeutic hypothermia, targeted temperature management is the most advanced. In addition, it is reported that in recent years a new group of promising antihypoxants — alkaline solutions of hydrogen peroxide — has been created. It is shown that hydrogen peroxide is able to decompose very quickly into water and oxygen gas under the action of catalase, which is found in all tissues. The peculiarities of using alkaline solutions of hydrogen peroxide as antihypoxants we all have to study in the future.

SURG-08. A PHASE III RANDOMIZED TRIAL OF GROSS TOTAL RESECTION VERSUS POSSIBLE RESECTION OF FLAIR HYPERINTENSITY LESION ON MR IMAGE FOR NEWLY DIAGNOSED SUPRATENTORIAL GLIOBLASTOMA (JCOG2209)

Abstract BACKGROUND Complete resection of contrast-enhanced lesion (gross total resection: GTR) without severe neurological deficits has been generally accepted as the goal of surgery. However, it remains unclear if additional resection of surrounding FLAIR hyper-intense lesion combined with GTR (FLAIRectomy) has survival advantage of primary glioblastoma patients. Purpose: Multicenter, open-label, randomized phase III trial was commenced to confirm the superiority of FLAIRectomy to GTR alone followed by radiotherapy with concomitant and adjuvant temozolomide in terms of overall survival (OS) for primary glioblastoma IDH-wildtype patients. This trial investigates not only survival but also postoperative neurological and neurocognitive deficits in detail. METHODS We assumed a 2-year OS of 50% in the GTR arm and expected a 15% improvement in the FLAIRectomy arm. A total of 130 patients is required with a one-sided alpha of 5%, power of 70%, and will be accrued from 49 Japanese institutions in 4 years and follow-up will last 2.5 years. Patients 18-75 years of age will be registered and randomly assigned to each arm with 1:1 allocation. The primary endpoint is OS, and the secondary endpoints are progression-free survival, frequency of adverse events, proportion of Karnofsky performance status preservation, proportion of National Institutes of Health stroke scale preservation, proportion of mini-mental state examination preservation and proportion of health-related quality of life preservation. The Japan Clinical Oncology Group Protocol Review Committee approved this study protocol in May 2023. Ethics approval was granted by the National Cancer Center Hospital Certified Review Board. Patient enrollment began in July 2023. DISCUSSION If FLAIRectomy is superior to GTR alone, aggressive surgery will become a standard surgical treatment for glioblastoma with resectable contrast-enhanced lesion. Trial registration: Registry number: jRCT1031230245. Date of registration: 19/July/2023. Date of first participant enrollment: 28/July/2023. Funding for this study is provided by National Cancer Center Research and Development Fund (2023-J-03).

Accepting the decay of plastic artifacts in museums: pasts and futures surfacing in a life preserver from sunken MS Estonia

ABSTRACT This is a case study of a deformed life preserver originating from the ferryboat MS Estonia that sank in the Baltic Sea in 1994. In this post qualitatively positioned research article, I argue that transformed plastic is an active agent of both the decision-making and interpretation of a museum object made of plastic. This article contributes in a new way to the discussion of how museums of cultural history could manage deteriorating plastic objects. So far, a scientific materialist approach, guided by research in conservation science, has emphasised the need for special conditions to safeguard rapidly deteriorating plastic artefacts for future generations. However, the agency of deteriorating plastic does not only call for conserving the plastic material ‘forever’, but it also requires letting go of the ideal of minimising the further degradation of plastic.

Telemedicine dan Kesehatan: Memahami Dampak Teknologi Kedokteran di Era Digital dalam Konteks Ajaran Islam

In the digital era, telemedicine has revolutionized healthcare by providing faster and more accessible remote medical services. This article explores the transformative impact of this technology on the quality and accessibility of healthcare services, while also examining its compatibility with Islamic values. From an Islamic perspective, telemedicine is reviewed in relation to ethical principles such as the preservation of life, the ease of access to treatment, and respect for patient privacy. The article aims to highlight how telemedicine can serve as an innovative solution that not only supports modern healthcare advancements but also aligns with ethical guidelines within Islamic teachings. This study offers fresh insights into the opportunities and challenges of telemedicine in healthcare, particularly within Muslim communities, and its implications for ethical medical decision-making.

Problematic Ediacaran sail-shaped fossils from eastern Yunnan, China

ABSTRACT This study focuses on a rare sail-shaped macrofossil, Alienum velamenus gen. & sp. nov. from the Jiangchuan Biota in Yunnan Province, China. The new species presented here possesses an unique bipartite body consisting of a wide unbranched, asymmetrical sail-shaped anterior section and a small narrow tail-like posterior section. The macrofossil of the new species is preserved through carbonaceous compression. Its appearance is different from known macroalgae but similar to Vetulicolia from the early Cambrian Chengjiang Biota. The anterior section of the new species, which is broad and smooth, shows only indistinctly arranged suspected gill slits and a nearly horizontal pharyngeal groove, without significant segmented structures. Owing to lack of samples, the specific biological properties and taxa of the new species are still undefined. The discovery of Alienum velamenus indicates that the Jiangchuan Biota is an exceptional lagerstätte with great potential for the preservation of Precambrian early life through carbonaceous compression. Furthermore, the Jiangchuan Biota shows significant differences in species diversity from the Miaohe Biota of the Doushantuo Formation and the Shibantan Biota of the Dengying Formation in the Three Gorges area of Hubei Province.

Coping strategies of intensive care units nurses in alarm management: a qualitative research study

BackgroundIntensive care units are critical environments where various alarm systems play a pivotal role in patient monitoring and safety. Alarm fatigue can lead to slower response times and missed alarms, compromising patient safety and increasing stress and burnout among intensive care unit nurses. Understanding how intensive care unit nurses respond to and manage these alarms is crucial in evaluating their impact on patient care and nursing well-being.MethodsThis descriptive qualitative study explored the experiences of intensive care unit nurses in alarm management. Conducted in the medical and surgical intensive care units of a Northern Taiwan medical center, the study involved 15 nurses. Semi-structured interviews were utilized to investigate the working experiences of ICU nurses in alarm management and to identify their coping strategies for dealing with the constant inundation of medical device alarms. The interviews were transcribed, and content analysis was applied to identify key themes in the responses.ResultsThe study revealed five main themes in intensive care unit nurses’ strategies for managing alarms: (1) Mastering alarm signals and acting; (2) Team monitoring for life preservation; (3) Enhancing senses and distinguishing carefully; (4) Learning from the lessons of incidents for vigilant reflection; and (5) Detach alarms’ influence on daily life. These coping strategies are effective in alarm management, safeguarding patients’ lives, enhancing the serenity of the clinical environment, and mitigating the physical and mental exhaustion caused by alarm fatigue.ConclusionsIntensive Care Unit nurses develop various coping strategies to manage medical device alarms, based on their experience. These strategies are crucial in maintaining patient safety and reducing nurse alarm fatigue. They can also be used for nursing education and clinical training.

Blocking donor liver Pannexin 1 channels facilitates mitochondria protection during liver transplantation

Static cold storage (SCS) is the standard technique for organ preservation during transplantation, resulting in cold ischemic injury. Hypoxia can induce pannexin 1 (Panx1) channels to open, leading to release of adenosine triphosphate. However, it is unknown if Panx1 plays a role in SCS. In this study, livers from Panx1−/− mice exhibited reduced adenosine triphosphate release, resulting in hepatocyte protection during preservation. The donor liver damage was decreased during SCS when Panx1 activity was blocked. Transmission electron microscopy revealed a decrease in mitochondria-associated endoplasmic reticulum membranes and improved mitochondria morphology. Mechanistically, Panx1 blockade upregulated the phosphatidylinositol 3-kinase–protein kinase B pathway and increased B cell leukemia/lymphoma 2 levels to combat apoptosis during liver preservation. The data indicate that blocking Panx1 during preservation of the donor liver can effectively improve mitochondrial function and reduce cellular stress damage thereby decreasing cold ischemia and reperfusion-related injuries in liver transplantation.

Совершенствование правового регулирования использования лекарственных препаратов при оказании первой помощи: проблемные и дискуссионные вопросы

Summary. Investigation purpose – based on the analysis of the range of medicines approved for medical use in the Russian Federation and their practical application in certain types of medical care, identify groups and a list of medicines for their possible use in providing first aid to victims by certain categories of first aid participants, as well as related problems requiring legislative regulation. Material and methods of the investigation. Research materials – normative legal acts reflecting the provision of first aid and medical, including emergency and primary health care, emergency and urgent care, namely: 5 federal laws; 4 Decrees of the President of the Russian Federation; 3 administrative documents of the Government of the Russian Federation; 26 administrative documents of the Ministry of Health of the Russian Federation; 1 administrative document of the Department of Health Moscow; 31 instructions for the use of medicines for medical use. Research methods: analytical, logical and information modeling. Investigation results and their analysis. Groups and a list of medicines that can be used in providing first aid to victims are proposed for consideration and discussion. Problematic issues requiring legislative regulation in the use of medicines at the stage of first aid have been identified. Groups and a list of medicines for first aid to victims are offered for consultations and discussions with representatives of scientific institutions of the medical community and government agencies that determine health policy in the Russian Federation in order to develop management decisions aimed at achieving a high level of preservation of human life and health in emergency situations.

Are there any benefits of prolonged hypothermic oxygenated perfusion? - Results from a national retrospective study.

Dual hypothermic oxygenated perfusion (DHOPE) is increasingly being used to extend liver preservation to improve transplant logistics. However, little is known about its benefits in high-risk liver grafts. This study aimed to investigate whether prolonged DHOPE provides benefits other than improved logistics in all liver types. We performed a national retrospective cohort study of 177 liver transplants from 12 Italian centers preserved with DHOPE for ≥4h between 2015 and 2022. A control group of 177 DHOPEs of <4h during the same period was created using 1:1 propensity score matching. The impact of risk profiles and preservation times on the outcomes was assessed using univariable and multivariable regression models. No significant differences in post-transplant outcomes were found between prolonged and short DHOPEs. However, the prolonged group had a significantly lower incidence of post-transplant acute kidney injury (AKI) compared to the short group (30.5% vs. 44.6%, p=0.008). Among prolonged DHOPEs, no differences in transplant outcomes were observed according to donor risk index (DRI), Eurotransplant definition for marginal grafts, and balance of risk (BAR) score. DHOPE duration was associated with a lower risk of AKI in multivariable models adjusted for DRI, Eutrotransplant marginal grafts, and BAR score. Prolonged HOPE confirmed its protective effect against AKI in a multivariable model adjusted for donor and recipient risk factors [OR: 0.412, 95%CI: 0.200-0.850, p=0.016]. Prolonged DHOPE is widely used to improve transplant logistics, provides good results with high-risk grafts, and appears to be associated with a lower risk of post-transplant AKI. These results provide further insight into the important role of DHOPE in preventing post-transplant complications.

A common law in space for public health

Beyond the gravitational pull of Earth, space travel poses substantial public health hazards pertaining to the physical and mental well-being of astronauts and passengers, in addition to a possible threat to the populace of Earth upon re-entry. Exposure to cosmic radiation, cranial pressure from microgravity, weakened immunity to contagion, and the potential for depression and psychosis are all risks. Public health crises of this nature are to be expected as the duration of missions extends, as is the case with Mars settlement. In contrast to national space programmes, which have regarded these obstacles as human factors effecting the mission, public health law in common law British nations approaches them from the perspective of social justice and the preservation of human life and societal welfare. Countries including Australia, Canada, the United States, and the United Kingdom continue to apply traditional common law principles of public health law, which provide a sensible and enduring method for reconciling competing public and private interests. Common law permits the violation of civil liberties through the use of force in public health restraint, forced medication, and quarantine, but only if necessary, reasonable, and equitable. While the understanding of the health challenges associated with long-duration spaceflight may be in its infancy for national space programmes and civilian space ventures, the application of common law public health principles could aid in the establishment of health and safety protocols in which human reactions to crises in space resemble those observed on Earth. This may, nevertheless, necessitate the enactment of a more comprehensive federal public health statute. Embedded in both public health common law and international space law, the pre-eminence of preserving and respecting human life and well-being continues to be a cornerstone of humane justice despite the perilous conditions of space.

Innovations in Liver Preservation Techniques for Transplants from Donors after Circulatory Death: A Special Focus on Transplant Oncology.

Liver transplantation is the preferred treatment for end-stage liver disease. Emerging evidence suggests a potential role for liver transplantation in treating liver tumors such as colorectal liver metastases and cholangiocarcinoma. However, due to a limited donor pool, the use of marginal grafts from donation after circulatory death (DCD) donors is increasing to meet demand. Machine perfusion is crucial in this context for improving graft acceptance rates and reducing ischemia-reperfusion injury. Few studies have evaluated the role of machine perfusion in the context of transplant oncology. Perfusion machines can be utilized in situ (normothermic regional perfusion-NRP) or ex situ (hypothermic and normothermic machine perfusion), either in combination or as a complement to conventional in situ cold flush and static cold storage. The objective of this analysis is to provide an up-to-date overview of perfusion machines and their function in donation after circulatory death with particular attention to their current and likely potential effects on transplant oncology. A literature review comparing standard cold storage to machine perfusion methods showed that, so far, there is no evidence that these devices can reduce the tumor recurrence rate. However, some evidence suggests that these innovative perfusion techniques can improve graft function, reduce ischemia-reperfusion injury, and, based on this mechanism, may lead to future improvements in cancer recurrence.

A model of religiosity integration in sustainable tourism development (The case of Tenganan Pagringsingan Village, Bali, Indonesia)

The research in Tenganan Pegringsingan village in Bali, Indonesia examines the relationship between religiosity, convention (awig-awig) environmental sustainability, and sustainable tourism development. The study explores how the village's cultural practices and social structures impact its ecological balance. The method used is descriptive qualitative to examine potential challenges faced by the village. The findings emphasize the importance of preserving traditional practices in maintaining the ecological health of the region. The village's commitment to cultural preservation and environmental sustainability is crucial for its sustainability and resilience. The research also identifies five challenges faced by the village, including tourism governance, friction between customs and tourism, preservation of local wisdom, economic life and cultural-based tourism, and informal education for endogamous marriages. To address these challenges, a comprehensive model is proposed that integrates religiosity, traditional conventions, tourism governance, local wisdom, informal education, cultural tourism-based economy, cultural friction, and integration. This model ensures that tourism development aligns with the village's religiosity and traditional practices, maintains cultural integrity, and promotes sustainable economic growth while preserving the community's way of life.