Challenges and Opportunities in the Adoption of p-TIPS for Acute Variceal Bleeding: Insights from a US Tertiary Center.

Background And Aims: Since the overwhelmingly positive results of the 'early use of TIPS' published in 2010, studies in Europe and Asia have confirmed early/pre-emptive transjugular intrahepatic portosystemic shunt (p-TIPS) in high-risk patients with acute variceal bleed (AVB) reduces treatment failure and mortality compared to standard of care (SOC). There are no studies evaluating p-TIPS in a US cohort.

Methods: A review of patients with cirrhosis from June 2010 to June 2020 with AVB was conducted from a single large US center.

Double-Balloon Catheter-Mediated Transarterial Chemotherapy Delivery in a Swine Model: A Mechanism Recruiting the Vasa Vasorum for Localized Therapies.

Purpose: Treatment of hypovascular tumors, such as pancreatic adenocarcinoma, is challenging owing to inefficient drug delivery. This report examines the potential mechanism of localized drug delivery via transarterial microperfusion (TAMP) using a proprietary adjustable double-balloon occlusion catheter in a porcine model.

Materials And Methods: Adult Yorkshire swine (N = 21) were used in the Institutional Animal Care & Use Committee-approved protocols.

Hepatic artery pseudoaneurysms and hepatic ischaemic injury: a rare complication of polyarteritis nodosa.

A woman in her 70s presented with months of intermittent fevers, severe fatigue, headaches, abdominal pain and haematuria. She developed acute onset left-sided weakness and was found to have radiographic evidence of right frontal and left parietal intraparenchymal haemorrhages with subarachnoid haemorrhage. She also had markedly elevated liver transaminases with subsequent abdominal MRI that revealed hepatic artery pseudoaneurysms (HAP) requiring embolisation.

Correcting Coagulopathy for Image-Guided Procedures.

Patients with acquired coagulopathy often require percutaneous image-guided invasive procedures for urgent control of hemorrhage or for elective procedures. Routine preprocedural evaluation of coagulopathy previously focused on absolute prothrombin time, partial thromboplastin time, international normalized ratio, and platelet count values. Now viscoelastic testing and greater understanding of patient- and drug-specific changes in coagulation profiles can yield better coagulation profile data.

Fully automated F-fluorination of N-succinimidyl-4-[F]fluorobenzoate ([F]SFB) for indirect labelling of nanobodies.

N-succinimidyl-4-[F]fluorobenzoate ([F]SFB), a widely used labeling agent to introduce the 4-[F]fluorobenzoyl-prosthetic group, is normally obtained in three consecutive steps from [F]fluoride ion. Here, we describe an efficient one-step labeling procedure of [F]SFB starting from a tin precursor. This method circumvents volatile radioactive side-products and simplifies automatization.

Improvement of functional properties of cow's milk peptides through partial proteins hydrolysis.

Unlabelled: Allergy by cow's milk proteins is among the major food allergies and could be reduced by the partial hydrolysis of these proteins by proteases, without significantly affecting its physicochemical properties. In addition, the peptides generated through enzymatic hydrolysis of the cow's milk can present prebiotic and bioactive properties. In this work, the cow's milk proteins were submitted to a controlled hydrolysis by Novo-Pro D® and the influence of the degree of hydrolysis (DH) on peptide size distribution was evaluated, as well as the prebiotic and antimicrobial properties of milk hydrolysates.

Characterizing Metastable States with the Help of Machine Learning.

Present-day atomistic simulations generate long trajectories of ever more complex systems. Analyzing these data, discovering metastable states, and uncovering their nature are becoming increasingly challenging. In this paper, we first use the variational approach to conformation dynamics to discover the slowest dynamical modes of the simulations.

Moiré-Induced Transport in CVD-Based Small-Angle Twisted Bilayer Graphene.

To realize the applicative potential of 2D twistronic devices, scalable synthesis and assembly techniques need to meet stringent requirements in terms of interface cleanness and twist-angle homogeneity. Here, we show that small-angle twisted bilayer graphene assembled from separated CVD-grown graphene single-crystals can ensure high-quality transport properties, determined by a device-scale-uniform moiré potential. Via low-temperature dual-gated magnetotransport, we demonstrate the hallmarks of a 2.

Pancreatic-Portal Vein Fistula: a Rare Diagnosis with Wide-Ranging Complications-13-Year Experience of a Pancreas Center of Excellence.

Purpose: To determine factors affecting mortality, and long-term patency of portal vein, in patients with pancreatic-portal vein fistula (PPVF).

Methods: Consecutive cases of PPVF at the University of Pittsburgh Medical Center from 2008 to 2020 were retrospectively identified. Clinical history, imaging studies, management strategies, complications, and long-term outcomes were analyzed.

Enzymatic hydrolysis of black cricket (Gryllus assimilis) proteins positively affects their antioxidant properties.

The development of innovative ingredients through biotechnological routes has established insect proteins as an emerging source of bioactive peptides. The current study aimed to evaluate the antioxidant properties of black cricket (Gryllus assimilis) protein hydrolysates produced using the proteases Flavourzyme 500L, Alcalase 2.4L, and Neutrase 0.

A ten-year, single institution experience with percutaneous nephrostomy during pregnancy.

Purpose: To evaluate the safety and efficacy of percutaneous nephrostomy (PCN) in pregnancy.

Materials And Methods: PCN tubes were placed during 52 pregnancies in 49 patients from 2008 to 2018. The medical records during pregnancies were retrospectively reviewed for imaging findings, procedural parameters, outcomes of delivery, and complications.

The role of interventional radiology in the pre-liver transplant patient.

Each year approximately 8500 patients undergo liver transplantation in the USA for acute and chronic liver failure. Over the years, the success of liver transplantation has led to more clinical indications for liver transplantation. These expanded indications, without a proportionate increase in donors, result in increased competition for the limited pool of transplantable whole or partial grafts.

Interventional Therapies for Thoracic Duct Injury and Intractable Chylothorax.

Injury to the thoracic duct with resultant chylothorax can cause significant patient morbidity and mortality. Conservative treatment strategies often fail to address the problem. Open surgical and percutaneous approaches are often required to manage patients with refractory chylothorax.

Failure of Conductance Quantization in Two-Dimensional Topological Insulators due to Nonmagnetic Impurities.

Despite topological protection and the absence of magnetic impurities, two-dimensional topological insulators display quantized conductance only in surprisingly short channels, which can be as short as 100 nm for atomically thin materials. We show that the combined action of short-range nonmagnetic impurities located near the edges and on site electron-electron interactions effectively creates noncollinear magnetic scatterers, and, hence, results in strong backscattering. The mechanism causes deviations from quantization even at zero temperature and for a modest strength of electron-electron interactions.

A proliferating trichilemmal cyst in the perianal region: A case report.

Introduction: Proliferating trichilemmal cysts (PTCs) are rare benign neoplasms originating from the follicular isthmus. They can undergo trichilemmal keratinization and malignant degeneration to form epidermoid carcinoma. They occur on the scalp in more than 90% of patients and are more common in elderly women.

Stereotactic Body Radiation Therapy as an Alternative to Transarterial Chemoembolization for Hepatocellular Carcinoma.

Purpose: To conduct a large single-institution comparison of transarterial chemoembolization (TACE) and stereotactic body radiation therapy (SBRT) outcomes in similar groups of patients with hepatocellular carcinoma (HCC).

Methods And Materials: From 2006 to 2014, 209 patients with 1 to 2 tumors underwent TACE (n=84) to 114 tumors or image guided SBRT (n=125) to 173 tumors. Propensity score analysis with inverse probability of treatment weighting was used to compare outcomes between treatments while adjusting for imbalances in treatment assignment.

Improved quantitative Y bremsstrahlung SPECT/CT reconstruction with Monte Carlo scatter modeling.

Purpose: In Y microsphere radioembolization (RE), accurate post-therapy imaging-based dosimetry is important for establishing absorbed dose versus outcome relationships for developing future treatment planning strategies. Additionally, accurately assessing microsphere distributions is important because of concerns for unexpected activity deposition outside the liver. Quantitative Y imaging by either SPECT or PET is challenging.

Marked long-term decline in ambient CO mixing ratio in SE England, 1997-2014: evidence of policy success in improving air quality.

Atmospheric CO at Egham in SE England has shown a marked and progressive decline since 1997, following adoption of strict controls on emissions. The Egham site is uniquely positioned to allow both assessment and comparison of 'clean Atlantic background' air and CO-enriched air downwind from the London conurbation. The decline is strongest (approximately 50 ppb per year) in the 1997-2003 period but continues post 2003.

Failure mode and effects analysis in a dual-product microsphere brachytherapy environment.

Purpose: We performed a failure mode and effects analysis (FMEA) during the addition of a new microspheres product into our existing microsphere brachytherapy program to identify areas for safety improvements.

Methods And Materials: A diverse group of team members from the microsphere program participated in the project to create a process map, identify and score failure modes, and discuss programmatic changes to address the highest ranking items. We developed custom severity ranking scales for staff- and institution-related failure modes to encompass possible risks that may exist outside of patient-based effects.

Novel inexpensive fungi proteases: Production by solid state fermentation and characterization.

A comparative study was carried out for proteases production using agroindustrial residues as substrate for solid state fermentation (SSF) of several fungal strains. High protease production was observed for most of the microorganisms studied, as well as very different biochemical characteristics, including activities at specific temperatures and a wide range of pH values. The enzymes produced were very different regarding optimum pH and they showed stability at 50 °C.

Two Unusual but Treatable Causes of Refractory Ascites After Liver Transplantation.

Refractory ascites (RA) is thought to complicate the postoperative course of 5-7% (Nishida et al. in Am J Transplant. 6: 140-149, 2006; Gotthardt et al.

Health economic evaluation of paricalcitol(®) versus cinacalcet + calcitriol (oral) in Italy. [corrected].

Background And Objective: Chronic kidney disease (CKD) is a highly morbid disorder. The most severe form of CKD is end-stage renal disease (ESRD), in which the patient requires some form of renal replacement therapy to survive. The increasing incidence, prevalence, and costs of ESRD are major national healthcare concerns.