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Comparative data on percutaneous catheter drainage (PCD) vs EUS-guided drainage (EUS-D) for management of symptomatic walled-off-necrosis (WON), specially infected WON with/without organ failure(OF) is limited.

Patients with symptomatic WON were divided into two groups of PCD and EUS-D, depending on the modality of drainage. Resolution of OF, adverse events, and other outcome measures were recorded. The two modalities were compared among infected WON sub-cohort and also degree of solid component (SC).

218 patients (175 males; 80.3%) were included who underwent either PCD (n=102) or EUS-D (n=116). Clinical success was significantly higher in the EUS-D group (92.1% vs 64.6%; p <0.0001) and even for infected WON (n=128) (p=0.004), with higher (p=0.007) and faster (p<0.0001) OF resolution. Other outcome measures including mortality were significantly higher in the PCD group. Among subgroups, PCD with >40% SC had the worst clinical success/OF resolution rates, while EUS-D with <40% SC had the best outcomes.

EUS-D should be preferred over PCD in the management of WON, infected or otherwise, for higher clinical success, and higher/faster resolution of OF. PCD should be avoided in WON with>40% SC.

40% SC.The role of PM2.5 in the bronchial asthma remains unclear. In this study, the deficient mice of TLR4-/-, TLR2-/- and MyD88 -/- were used to establish asthma model. The effects of PM2.5 on the inflammatory response in lung tissue of these mice were observed. PM2.5 increased alveolar macrophages and neutrophils, up-regulated the IL-12 and KC expression in WT mice, but down-regulated their levels in TLR2 -/-, TLR4 -/- and MyD88 -/- mice. OVA+PM2.5 stimulated neutrophil count in WT mice, but it decreased in TLR2 -/- and TLR4 -/- mice. OVA+PM2.5 also increased the Eotaxin, IL-5, IL-13 and MCP-3 expression levels, and OVA specific IgE and IgG1 in serum also increased in WT group. PM2.5 may activate NF-κB through the TLR2/TLR4/MyD88 signaling pathway and aggravate allergic inflammation of lung in asthmatic mice. The microelements in PM2.5 granules, such as lipopolysaccharide, may be an important factor in the high incidence of asthma.Thoracoabdominal aneurysms pose technical challenges for endovascular repair due to involvement of visceral and renal vessels. We report a case series of four patients diagnosed with thoracoabdominal aneurysm who underwent complex endovascular repair with Fenestrated Device and chimney grafts (FEVARCh). FEVARCh is a technically feasible approach for repair of thoracoabdominal aneurysms that involve renal, superior mesenteric, and celiac arteries for patients not appropriate for open surgical repair. Further studies are needed to understand the implications of resultant Type 1a endoleaks and strategies to minimize the displacement of the main body graft with adjunct chimneys.Abdominal Aortic Aneurysms (AAA) are asymptomatic with advanced age and male sex being risk factors. Due to their significant mortality rate, the NHS AAA Screening programme was introduced in 2012. However, this is not as well-supported compared to other programmes. When it comes to AAA and its screening, health information is also available from different sources potentially leading to confusion. Based on this, our aim was to develop a prototype mobile application on AAA and its screening, centralising all key information, for the general public. Another aim was to assess the app's usability and impact (i.e. users' perceptions about screening attendance and knowledge of AAA). 24 participants completed a pre-app questionnaire followed by app testing and a post-app questionnaire. Ethical approval was granted from the Glasgow School of Art. 75% of participants had never heard of AAA and 92% had never heard of its screening. After app use, the participants' AAA knowledge significantly increased (Z = -4.318, p  less then  0.001). App use and opinion of screening attendance were also statistically associated (X1[1, n = 24] = 6.857, p  less then  0.05). The app's usability was rated positively in the USE questionnaire. Research is needed on public health apps regarding their impact on screening uptake and public knowledge.Two experiments were conducted to investigate the effects of different breeds and dietary nutrient levels on expressions of paired box (Pax) genes and myogenic regulatory factors (MRFs) in pigs. Thirty Large White (LW) barrows and thirty Chenghua (CH, a native breed of China) barrows were performed in experiment 1. Results exhibited that in the CH pigs the abundances of Pax3 at 105 and 220 d of age, Mrf4 at 63 d of age, Myf5 and Mrf4 at 220 d of age were higher than those in the LW pigs (p less then 0.05). Meanwhile, the expressions of MyHC-І and ІІa in the CH pigs were upregulated, and the abundance of MyHC-ІІb were downregulated compared with those in the LW pigs at 105 and 220 d of age (p less then 0.05). Moreover, the meat quality of the CH pigs was better than in the LW pigs (p less then 0.05). In experiment 2, sixty LW pigs were randomly assigned to two dietary treatments meeting their nutrient requirements (NRC) or a diet with moderately reduced digestible energy, crude protein and Lys level by 560 kJ/kg, 1.48% and 0.34%, respectively (LOW diet). The results showed that the reduced dietary nutrient level increased (p less then 0.05) the expressions of MyoG and Mrf4 at 105 d of age, Pax3, Myf5, and Mrf4 at 220 d of age, and upregulated (p less then 0.05) the abundance of MyHC-ІІa at 105 and 220 d of age in LW pigs. In addition, a decrease in dietary nutrient level improved the meat quality in LW pigs (p less then 0.05). selleckchem Collectively, the expressions of Pax genes and MRFs were markedly different between the CH and LW pigs. The CH pigs exhibited higher expression levels of Pax3, Myf5, Mrf4, MyHC-І and ІІa, which may improved the meat quality. A decrease in dietary nutrient level upregulated the abundances Pax3, Mrf4, Myf5, MyoG, and MyHC-ІІa, and might enhance the meat quality in the LW pigs.

To assess the technical outcome and local tumor control of multi-probe stereotactic radiofrequency ablation (SRFA) in a large series of patients. Furthermore, to determine factors accounting for adverse outcomes.

Between 2003 and 2018, 865 patients were treated by SRFA for 2653 primary and metastatic liver tumors with a median tumor size of 2.0 cm (0.5 - 19 cm). Primary technical efficacy (PTE) and local recurrence (LR) were evaluated, and possible predictors for adverse events analyzed using uni- and multi-variable binary logistic regression.

Overall, 2553 of 2653 tumors were successfully ablated at initial SRFA resulting in a PTE rate of 96.2%. Predictors of lower PTE rates were age > 70 years, tumor size > 5 cm, number of probes, location close to liver capsule/organs and segment II. LR occurred in 220 of 2653 tumors (8.3%) with the following predictors age, tumor type/size, conglomerates, segments I/IVa/IVb, number of probes and location close to major vessels/bile duct. Multivariable analysis revealed tumor size > 5 cm (odds ratio [OR] 3.153), age > 70 years (OR 1.559), and location in segment II (OR 1.772) as independent prognostic factors for PTE, whereas tumor location close to major vessels (OR 1.653) and in segment IVb (OR 2.656) were identified as independent prognostic factors of LR.

Stereotactic RFA is an attractive option in the management of primary or metastatic liver tumors with good local tumor control, even in large tumors. The presented prognostic factors for adverse local oncological outcome might help to stratify unfavorable tumors for ablation.

Stereotactic RFA is an attractive option in the management of primary or metastatic liver tumors with good local tumor control, even in large tumors. The presented prognostic factors for adverse local oncological outcome might help to stratify unfavorable tumors for ablation.This document presents the development of the concept of disability in Colombia, specifically within the framework of the armed conflict and the different negotiation attempts. The article analyses the inclusion of people with disabilities in the Colombian peace processes of the XXI century. Despite the numerous peace processes Colombia has had, people with disabilities are still being excluded from the peace agendas and negotiation phases. The analysis of the last peace process of Havana, will provide an opportunity to truly include people with disabilities in future negotiations.Background. The impact of vascular cooling effects in hepatic microwave ablation (MWA) is controversially discussed. The objective of this study was a systematic assessment of vascular cooling effects in hepatic MWA ex vivo. Methods. Microwave ablations were performed in fresh porcine liver ex vivo with a temperature-controlled MWA generator (902-928 MHz) and a non-cooled 14-G-antenna. Energy input was set to 9.0 kJ. Hepatic vessels were simulated by glass tubes. Three different vessel diameters (3.0, 5.0, 8.0 mm) and vessel to antenna distances (5, 10, 20 mm) were examined. Vessels were perfused with saline solution at nine different flow rates (0-500 mL/min). Vascular cooling effects were assessed at the largest cross-sectional ablation area. A quantitative and semi-quantitative/morphologic analysis was carried out. Results. 228 ablations were performed. Vascular cooling effects were observed at close (5 mm) and medium (10 mm) antenna to vessel distances (P .05). Conclusion. Vascular cooling effects occur in hepatic MWA and should be considered in treatment planning. The vascular cooling effect was mainly affected by antenna to vessel distance. Vessel diameter and vascular flow rate played a minor role in vascular cooling effects.Cholesterol crystals participate in cholesterol nucleation; however, the role of cholesterol crystals in gallstone development is unknown. Mucin secretion contributes to increased size of gallstones. Cholesterol crystals activate inflammasomes and participate in many sterile inflammation related human diseases. We investigated the role of cholesterol crystals and mucins in sterile inflammation and gallstone enlargement. We found that expression of mucin 5AC (MUC5AC), NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) and interleukin-1b (IL-1b) was increased significantly in tissues adjacent to gallstones. Experiments in vitro showed that cholesterol crystals promote MUC5AC secretion; they also increase expression of NLRP3, NLR family CARD domain-containing 4 (NLRC4), apoptosis-associated speck-like protein containing caspase recruitment domain (ASC), and cleaved caspase-1 in biliary epithelial cells. Inhibition of Inflammasomes by NLRP3, ASC or caspase-1 small interfering RNAs reduced MUC5AC secretion. Also, the IL-1 receptor antagonist, IL1RA, and caspase-1 inhibitor, Ac-YVAD, both inhibited MUC5AC secretion induced by cholesterol crystals. We found that inflammasome activation participates in cholesterol crystal induced mucin secretion and gallstone development.Amino acid neurotransmitters, including glutamate, phenylalanine, tyrosine, alanine, and glycine, underlie the majority of the excitatory and inhibitory neurotransmission in the nervous system, and acute exercise has been shown to modulate their concentrations. We aimed to determine whether any correlation exists between the above-mentioned amino acid blood concentrations and the neuropsychological performance after an acute exercise intervention. Sixty basketball players were randomly assigned to one of two experimental conditions exercise or inactive resting. All participants underwent a comprehensive neuropsychological assessment and blood samples were taken on a Guthrie card before and after the end of the experimental conditions. Amino acid blood concentrations were significantly elevated and cognitive performance significantly improved post-exercise on specific neuropsychological assessments. Significant intervention × group interaction effects were apparent for Trail Making Test part-B [F(1,58) = 20.46, p less then .