Importance of Timed and Detailed Evaluation of Kidney Transplantation Candidates

Kidney transplant recipients are at increased risk of cardiovascular morbidity and malignant neoplasm, and meticulous evaluation of potential recipients is needed to minimize risks of complications after transplantation. The purpose of this study was to analyze the results of preoperative assessments and document the importance of timed and detailed examinations.

METHODS

Medical records of patients evaluated as kidney transplant candidates from January 2015 to September 2017 were retrospectively collected and analyzed.

RESULTS

Of the 216 patients evaluated during the study period, 135 (62.5%) were male, 112 (51.9%) had diabetes mellitus, 163 (75.5%) had hypertension, 31 (14.4%) had a cardiovascular event history, and 7 (3.2%) had previous history of malignant neoplasms. Mean (SD) patient age was 50.7 (10.8) years. All 216 recipient candidates underwent echocardiography. Mean (SD) ejection fraction was 57.8% (5.9%), and 48 candidates (22.2%) showed regional wall motional abnormality. Coronary angiography was performed on 81 candidates, and in 57 (70.4%) of these, coronary artery disease was detected. Malignant neoplasms were detected in 10 (4.6%) candidates. Kidney transplantation was performed on 55 candidates. One recipient died of Pneumocystis jirovecii pneumonia at 15 months after kidney transplant, but there was no death-censored graft failure, newly detected malignant neoplasm, or cardiovascular event over a mean (SD) follow-up duration of 15.5 (8.6) months.

CONCLUSION

Evaluation of kidney transplant candidates resulted in diagnoses of malignant neoplasms in 4.6% of patients and coronary artery disease in 26.4% of patients. The results of this study demonstrate candidates for kidney transplant should undergo detailed preoperative evaluation.

Multidelay Arterial Spin-Labeling MRI in Neonates and Infants: Cerebral Perfusion Changes during Brain Maturation

BACKGROUND AND PURPOSE

Arterial spin-labeling with multiple postlabeling delays can correct transit times. We tried to evaluate CBF in neonates and infants using multidelay arterial spin-labeling.

MATERIALS AND METHODS

Multidelay arterial spin-labeling was applied to 13 preterm neonates (mean postmenstrual age, 34.9 weeks), 13 term-equivalent-age neonates (mean postmenstrual age, 39.2 weeks), and 6 infants (mean postmenstrual age, 57.8 weeks). Transit time-corrected CBF in the caudate, thalamus, frontal GM, occipital GM, frontal WM, and occipital WM was measured, and relative CBF compared with the whole-brain CBF was calculated. Inter- and intragroup comparisons were performed among the 3 age groups. A correlation and nonlinear regression analysis were performed between postmenstrual age and CBF.

RESULTS

Intergroup comparisons showed significantly higher whole-brain CBF in infants (38.3 mL/100 g/min) compared with preterm (15.5 mL/100 g/min) and term-equivalent-age (18.3 mL/100 g/min) neonates (P < .001). In the intragroup comparison, all 3 groups showed significantly higher relative CBF values in the occipital WM (63.6%-90.3%) compared with the frontal WM (46.3%-73.9%). In term-equivalent-age neonates, the occipital GM (120.8%) had significantly higher relative CBF values than the frontal GM (103.5%). There was a significant negative correlation between postmenstrual age and the relative CBF of the thalamus (r = - 0.449, P = .010). There were significant positive relationships between postmenstrual age and the relative CBF of the frontal WM (R ² = 0.298, P = .001) and occipital WM (R ² = 0.452, P < .001).

CONCLUSIONS

Multidelay arterial spin-labeling with transit time-corrected CBF showed developmental changes and regional differences of CBF in neonates and infants.

Non-malignant pathological results on transthoracic CT guided core-needle biopsy: when is benign really benign?

AIM

To determine true negatives and characterise the variables associated with false-negative results when interpreting non-malignant results of computed tomography (CT)-guided lung biopsy.

MATERIALS AND METHODS

Nine hundred and fifty patients with initial non-malignant findings on their first transthoracic CT-guided core-needle biopsy (TTNB) were included in the study. Initial biopsy results were compared to definitive diagnoses established later.

RESULTS

The negative predictive value (NPV) of non-malignant diseases upon initial TTNB was 83.6%. When the biopsy results indicated specific infection or benign tumour (n=225, 26.1%), they all were confirmed true negative for malignancy later. Only one inconclusive "granuloma" diagnosis was false negative. All 141 patients (141/861, 16.4%) who were false negative for malignancy were from the "infection not otherwise specified (NOS)", "inflammatory diseases", or "inconclusive" groups. Age (p=0.002), cancer history (p<0.001), target size (p=0.003), and pneumothorax during lung biopsy (p=0.003) were found to be significant predictors of false-negative results; 47.6% (410/861) of patients underwent additional invasive examinations to reach a final diagnosis. Ultimately, 52.7% (216/410) were successfully diagnosed.

CONCLUSION

Specific infection, benign tumour, and granulomatous inflammation of first TTNBs were mostly true negative. Older age, history of cancer, larger target size, and pneumothorax were highly predictive of false-negative results for malignancies. In such cases, additional invasive examinations were frequently necessary to obtain final diagnoses.

Development and Validation of a Nomogram for Predicting Incidence of Early Allograft Dysfunction Following Liver Transplantation

OBJECTIVE

Early allograft dysfunction (EAD) is frequent complication post-liver transplantation and is closely related to recipient's mortality and morbidity. We sought to develop a nomogram for predicting incidence of EAD.

METHODS

Based on multivariate analysis of donor, recipient, and operation data of 199 liver transplants from deceased donors between 2013 and 2015, we identified 5 significant risk factors for EAD to build a nomogram. The model was subjected to prospective validation with a cohort of 42 patients who was recruited between January and June 2016. The predictive accuracy and discriminative ability were measured by area under the receiver operating characteristic curve (AUC). The agreement between nomogram prediction and actual observation was showed by the calibration curve.

RESULTS

Incidence rate of EAD in the training set and validation cohort were 55.91% (104/199) and 54.76% (23/42), respectively. In the training set, according to the results of univariable and multivariable analysis, 5 independent risk factors including donor gender, donor serum gamma-glutamyl transpeptidase level, donor serum urea level, donor comorbidities (respiratory, cardiac, and renal dysfunction), and recipient Model for End-stage Liver Disease score were identified and assembled into the nomogram. The AUC of internal validation using bootstrap resampling and prospective validation using the external cohort of 42 patients was 0.74 and 0.60, respectively. The calibration curves for probability of EAD showed acceptable agreement between nomogram prediction and actual observation. According to the score table, the probability of EAD was under 30% when the total point tally was under 72. But when the total was up to 139, the risk of EAD increased to 60%.

CONCLUSION

We've established and validated a nomogram that can provide individual prediction of EAD for liver transplant recipients. The practical prognostic model may help clinicians to qualify the liver graft accurately, making a more reasonable allocation of organs.

A novel affordable reagent for room temperature storage and transport of fecal samples for metagenomic analyses

BACKGROUND

The number of large-scale studies on the gut microbiota in human cohorts is rapidly increasing. However, the few and expensive options for storage of fecal samples at room temperature have been an obstacle for large-scale metagenomic studies and the development of clinical/commercial personal metagenomic sequencing.

RESULTS

In this study, we systematically tested a novel N-octylpyridinium bromide-based fecal sample preservation method and compared it with other currently used storage methods. We found that the N-octylpyridinium bromide-based method enabled preservation of the bacterial composition in fecal samples transported and stored at room temperature for up to at least 14 days.

CONCLUSIONS

We describe a novel chemical stabilizer that allows cost-effective transportation and storage at room temperature for several days with preservation of bacterial composition. This method will facilitate sample collection even in remote area and also enable transport via normal commercial transportation routes.

Porphyrin-Based Symmetric Redox-Flow Batteries towards Cold-Climate Energy Storage

Electrochemical energy storage with redox-flow batteries (RFBs) under subzero temperature is of great significance for the use of renewable energy in cold regions. However, RFBs are generally used above 10 °C. Herein we present non-aqueous organic RFBs based on 5,10,15,20-tetraphenylporphyrin (H₂ TPP) as a bipolar redox-active material (anode: [H₂ TPP]^2- /H₂ TPP, cathode: H₂ TPP/[H₂ TPP]²⁺ ) and a Y-zeolite-poly(vinylidene fluoride) (Y-PVDF) ion-selective membrane with high ionic conductivity as a separator. The constructed RFBs exhibit a high volumetric capacity of 8.72 Ah L^-1 with a high voltage of 2.83 V and excellent cycling stability (capacity retention exceeding 99.98 % per cycle) in the temperature range between 20 and -40 °C. Our study highlights principles for the design of RFBs that operate at low temperatures, thus offering a promising approach to electrochemical energy storage under cold-climate conditions.

Rechargeable Na-CO2 Batteries Starting from Cathode of Na2CO3 and Carbon Nanotubes

Na-CO₂ batteries have attracted significant attentions due to their high energy density and effective utilization of greenhouse gas CO₂. However, all reported Na-CO₂ batteries employ excessive preloaded metal Na, which will lead to safety issues such as dendrite formation and short circuit. In addition, the charging mechanism of reported Na-CO₂ batteries is not very clear. Here we report the Na-CO₂ batteries, starting from the cathode of cheap Na₂CO₃ and multiwalled carbon nanotubes (CNTs). Due to the effective electron transfer and high reactivity, the decomposition of Na₂CO₃ and CNTs could take place under 3.8 V. The charging mechanism of 2Na₂CO₃ + C → 4Na + 3CO₂ without any side reactions is revealed by in/ex situ techniques such as Raman, gas chromatograph, and optical microscope. Dendrite-free Na can quantitatively deposit on the Super P/Al anode because of large specific surface area and low nucleation barrier of the anode for Na plating. The batteries could deliver an energy density of 183 Wh kg^-1 (based on the whole mass of the pouch-type batteries, 4 g) with stable cycling performance. This work reveals that safe rechargeable Na-CO₂ batteries could be constructed by cheap Na₂CO₃ and multiwalled carbon nanotubes.

In situ atomic force microscopy study of nano–micro sodium deposition in ester-based electrolytes

This communication reports an in situ atomic force microscopy study of sodium deposition and the effect of additives in an ester-based electrolyte.

Efficacy and Safety of Ethanol Ablation for Branchial Cleft Cysts

BACKGROUND AND PURPOSE

Branchial cleft cyst is a common congenital lesion of the neck. This study evaluated the efficacy and safety of ethanol ablation as an alternative treatment to surgery for branchial cleft cyst.

MATERIALS AND METHODS

Between September 2006 and October 2016, ethanol ablation was performed in 22 patients who refused an operation for a second branchial cleft cyst. After the exclusion of 2 patients who were lost to follow-up, the data of 20 patients were retrospectively evaluated. All index masses were confirmed as benign before treatment. Sonography-guided aspiration of the cystic fluid was followed by injection of absolute ethanol (99%) into the lesion. The injected volume of ethanol was 50%-80% of the volume of fluid aspirated. Therapeutic outcome, including the volume reduction ratio, therapeutic success rate (volume reduction ratio of >50% and/or no palpable mass), and complications, was evaluated.

RESULTS

The mean index volume of the cysts was 26.4 ± 15.7 mL (range, 3.8-49.9 mL). After ablation, the mean volume of the cysts decreased to 1.2 ± 1.1 mL (range, 0.0-3.5 mL). The mean volume reduction ratio at last follow-up was 93.9% ± 7.9% (range, 75.5%-100.0%; P < .001). Therapeutic success was achieved in all nodules (20/20, 100%), and the symptomatic (P < .001) and cosmetic (P < .001) scores had improved significantly by the last follow-up. In 1 patient, intracystic hemorrhage developed during the aspiration; however, no major complications occurred in any patient.

CONCLUSIONS

Ethanol ablation is an effective and safe treatment for patients with branchial cleft cysts who refuse, or are ineligible for, an operation.

In Situ Atomic Force Microscopic Studies of Single Tin Nanoparticle: Sodiation and Desodiation in Liquid Electrolyte

Probing electrodes at a nanometer scale is challenging but desirable to reveal the structural evolution of materials in electrochemical reactions. Herein, we present an atomic force microscopic method for an in situ analysis of a single Sn nanoparticle during sodiation and desodiation, which is conducted in an aprotic liquid electrolyte akin to a real electrochemical environment of the Na-ion cells. The morphological evolution of different-sized single Sn nanoparticle is visualized during the charge/discharge cycles by using a homemade planar electrode. All of the Sn nanoparticles exhibit a dramatic initial volume expansion of about 420% after sodiation to Na₁₅Sn₄. Interestingly, we find that the smaller Sn nanoparticles show a lower rate of irreversible volume change and a better shape maintenance than the larger ones after desodiation. This finding suggests the importance of downsizing in improving the mechanical stability and the cycling performance of the Sn-based anodes in sodium-ion batteries.

A Consecutive Spray Printing Strategy to Construct and Integrate Diverse Supercapacitors on Various Substrates

The rapid development of printable electronic devices with flexible and wearable characteristics requires supercapacitor devices to be printable, light, thin, integrated macro- and micro-devices with flexibility. Herein, we developed a consecutive spray printing strategy to controllably construct and integrate diverse supercapacitors on various substrates. In such a strategy, all supercapacitor components are fully printable, and their thicknesses and shapes are well controlled. As a result, supercapacitors obtained by this strategy achieve diverse structures and shapes. In addition, different nanocarbon and pseudocapacitive materials are applicable for the fabrication of these diverse supercapacitors. Furthermore, the diverse supercapacitors can be readily constructed on various objects with planar, curved, or even rough surfaces (e.g., plastic film, glass, cloth, and paper). More importantly, the consecutive spray printing process can integrate several supercapacitors together in the perpendicular and parallel directions of one substrate by designing the structure of electrodes and separators. This enlightens the construction and integration of fully printable supercapacitors with diverse configurations to be compatible with fully printable electronics on various substrates.

Correction: Systematic investigation of the SERS efficiency and SERS hotspots in gas-phase deposited Ag nanoparticle assemblies

Correction for 'Systematic investigation of the SERS efficiency and SERS hotspots in gas-phase deposited Ag nanoparticle assemblies' by L. B. He et al., Phys. Chem. Chem. Phys., 2017, 19, 5091-5101.