Miracle-dz/UniFAR-FTUs huggingface dataset:
Fifteen years and 382 extended right grafts from in situ split livers in a multicenter study: Are these still extended criteria liver grafts?

In situ split liver extended right grafts (SL‐ERGs) are still considered marginal grafts. Our aim was to verify this statement at the present time. From 1997 to 2011, a multicenter, retrospective study based on a prospective database was performed at 9 liver transplantation (LT) centers in northern Italy; it included 382 in situ SL‐ERG transplants in adults. There were 358 primary LTs and 24 retransplantations (RETXs). The 1‐, 3‐, and 5‐year overall graft survival rate for LT with in situ SL‐ERGs were 73.5%, 63.3%, and 60.7%, respectively, from 1997 to 2004 and 83.5%, 80.3%, and 80.3%, respectively, thereafter (P = 0.0001). A shorter total ischemia time and fewer RETX grafts were the main differences between the characteristics of the 2 periods. From 1997 to 2011, the 1‐, 3‐, and 5‐year graft survival rates showed a significant difference between the 358 primary LT in situ SL‐ERGs and the 24 RETX in situ SL‐ERGs (P < 0.001). In a multivariate analysis, the main prognostic factor for 60‐day graft survival was a total ischemia time < 8 hours for the 358 primary in situ SL‐ERGs. From 2005 to 2011, in 2473 LTs, the 5‐year graft survival for 184 in situ SL‐ERGs and 2289 whole grafts was 75% and 80% (P = 0.3), respectively. Univariate and multivariate studies alike failed to indicate that the type of graft was a prognostic factor for graft survival. A donor age > 60 years, RETX grafts, and urgency were the main prognostic factors for failure for all of the grafts. Although caution should be taken regarding the choice of appropriate donors, in situ SL‐ERGs should no longer be considered marginal grafts for experienced LT centers. SL‐ERGs should not be used in RETX settings, and when SL‐ERGs are used as primary grafts, the total ischemia time should be less than 8 hours. Liver Transpl 21:500‐511, 2015. © 2015 AASLD.
Dietary antioxidant restriction affects the inflammatory response in athletes

The purpose of the present study was to determine the effects of dietary antioxidant restriction on plasma concentrations of carotenoids and inflammatory markers at rest and in response to exercise in endurance-trained males. Seventeen males performed two exercise trials 2 weeks apart. Participants followed their habitual antioxidant diet (H-AO) before the first exercise test, then a restricted antioxidant diet (R-AO) for 2 weeks before the second exercise test. Blood was collected pre- and post-exercise. Dietary intakes of fibre, ascorbic acid and β-carotene were lower (P < 0·05) on the R-AO diet, but no other differences were observed. Pre-exercise plasma β-carotene concentrations were lower (H-AO, 195 (sd 92); R-AO, 123 (sd 54) ng/ml; P < 0·05), and TNF-α concentrations were higher (H-AO, 16 (sd 7); R-AO, 613 (sd 325) pg/ml; P < 0·01) on the R-AO diet compared to the H-AO diet. Most plasma carotenoid concentrations decreased with exercise, but this effect was more consistent on the H-AO diet. No differences in plasma IL-6 concentrations were observed pre-exercise, whereas post-exercise plasma IL-6 concentrations (H-AO, 30·3 (sd 16); R-AO, 15·3 (sd 5) pg/ml; P < 0·05) were lower following the R-AO diet. Post-exercise TNF-α concentrations were higher on the R-AO diet. Ratings of perceived effort during submaximal exercise were higher (P < 0·05) on the R-AO diet, but there was no difference in the time to exhaustion between diets. In conclusion, lower dietary intakes of carotenoids alter the plasma concentrations of antioxidants and markers of inflammation at rest and in response to exercise.
Heparin-binding EGF-like growth factor increases intestinal microvascular blood flow in necrotizing enterocolitis.

BACKGROUND & AIMS Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in neonates. Although the exact etiology remains unknown, decreased intestinal blood flow is believed to play a critical role. We have shown that heparin-binding epidermal growth factor-like growth factor (HB-EGF) protects the intestines from injury in a rodent model of NEC. Our current goal was to assess the effect of HB-EGF on intestinal microvascular blood flow and intestinal injury in rat pups subjected to experimental NEC. METHODS Newborn rat pups were subjected to stress by exposure to hypoxia, hypothermia, hypertonic feedings, and lipopolysaccharide, with some pups receiving HB-EGF (800 microg x kg(-1) x dose(-1)) added to the feeds. Control animals received breast milk. Intestinal injury was graded using a standard histologic injury scoring system. Microvascular blood flow was assessed by fluorescein isothiocyanate/dextran angiography, with fluorescent images subjected to quantification, and by scanning electron microscopy. RESULTS Intestinal microvascular blood flow (defined as the extent of vascular filling with fluorescein isothiocyanate/dextran) was significantly decreased in pups subjected to stress compared with breast-fed pups. Stressed pups treated with HB-EGF had significantly increased microvascular blood flow. The changes in villous microvasculature correlated with histologic injury scores, with stressed pups treated with HB-EGF showing decreased histologic injury. CONCLUSIONS HB-EGF significantly preserved intestinal microvascular blood flow in pups subjected to experimental NEC, indicating that HB-EGF may play a critical role in the treatment of various diseases manifested by decreased intestinal blood flow, including NEC.
Urea production during normothermic machine perfusion: Price of success?

Oxygenated normothermic machine perfusion (NMP) has been proposed as a technique that may provide the means to preserve organ function and, moreover, accurately predict clinical outcomes because graft function can be analyzed before the transplant procedure. Promising results have been obtained in several animal models, and a recent pilot study of discarded human donor livers showed that NMP was feasible and that graft viability could be assessed. We have successfully established an ex vivo normothermic oxygenated perfusion circuit using only a single centrifugal pump. We perfused 4 human donor livers that were currently deemed unsuitable for transplantation on the basis of local criteria. Interestingly, we observed high levels of calculated osmolality in the perfusate; we believe this problem should be addressed in order to implement this new technique in clinical practice.
Prevalence of Food Addiction Among Low-Income Reproductive-Aged Women.

BACKGROUND Hyperpalatable foods (i.e., high in salt, sugar, or fat) have been shown to have addictive properties that may contribute to overeating. Prior studies conducted on food addiction behaviors are mostly based on white and middle-aged women. Data are not available, however, on reproductive-aged women from other races/ethnicities or low-income women. The purpose of this study was to examine the prevalence and correlates of food addiction among multiethnic women of low socioeconomic status. METHODS We conducted a cross-sectional survey of health behaviors, including food addiction according to the Yale Food Addiction Scale (YFAS) between July 2010 and February 2011 among 18- to 40-year-old low-income women attending reproductive-health clinics (N = 1,067). RESULTS Overall, 2.8% of women surveyed met the diagnosis of food addiction. The prevalence of food addiction did not differ by age group, race/ethnicity, education, income, or body mass index categories, tobacco and alcohol use, or physical activity. However, it did differ by level of depression (p < 0.01). The YFAS symptom count score significantly differed by race/ethnicity (p < 0.01) with black women having higher scores than Hispanic women. Racial differences were also observed among some of the YFAS symptoms. CONCLUSION These findings demonstrated a low prevalence of food addiction among low-income, reproductive-aged women. Racial differences were observed in the YFAS symptom count score, but not in the overall prevalence of food addition. Additionally, women with food addiction had higher levels of depression than women without food addiction.
Relative glycaemic impact of customarily consumed portions of eighty-three foods measured by digesting in vitro and adjusting for food mass and apparent glucose disposal

Practical values to guide food choices for control of postprandial glycaemia need to refer to entire foods in amounts customarily consumed. We tested an in vitro method for determining the relative glycaemic impact (RGI) of customarily consumed portions of foods. Sugars released during in vitro pancreatic digestion of eighty-three foods were measured as glucose equivalents (GE) per gram of food, adjusted by the glycaemic indexes of the sugars to obtain glycaemic GE (GGE) per gram and multiplied by food portion weight to obtain the GGE contribution of the food portion, its RGI. The results were compared with clinical GGE values from subjects who consumed the same food amounts. In vitro and in vivo GGE values were significantly correlated, but the slope of the regression equation was significantly less than one, meaning in vitro GGE values overestimated in vivo GGE values. Bland–Altman method comparison showed the in vitro–in vivo disparity to increase as mean GGE increased, suggesting the need to allow for different rates of homeostatic blood glucose disposal (GD) due to different GGE doses in the customarily consumed food portions. After GD correction, Bland–Altman method comparison showed that the bias in predicting in vivo GGE values from in vitro GGE values was almost completely removed (y = 0·071x − 0·89; R2 0·01). We conclude that in vitro food values for use in managing the glycaemic impact of customarily consumed food quantities require correction for blood GD that is dependent on the GGE content of the food portions involved.
Strengthening Social Support: Health Professionals' Views of the Health Care Needs of Adolescent Mothers

Abstract Health care and health outcomes for adolescent mothers and their children may be a result of a complex interaction between socioeconomic, psychological, and familial factors. To examine a health professional perspective on the important issues in providing health care for adolescent mothers, transcripts of seventeen interviews with health professionals were analysed. Social support was considered an important aspect influencing the health of adolescent mothers and their children. This included family support, peer support and organisational support. Opportunities for health professionals to promote good social support for young mothers include role modelling supportive care and supporting adolescents' decision making, providing referrals to peer support groups, and understanding barriers to accessing organisational support. The best outcome for adolescent mothers is when their role as mother is supported by the family and wider support network.
Excellent outcomes of liver transplantation using severely steatotic grafts from brain‐dead donors

We rejoice in reading the excellent Hong Kong experience using severely steatotic grafts from brain-dead donors in liver transplantation (LT). When 19 grafts with macrovesicular steatosis>60% were used, they did not report any primary nonfunction, early allograft dysfunction, in-hospital and 30-day mortality, and major vascular or biliary complications. In addition, severely steatotic grafts did not differ from less or nonsteatotic grafts for postreperfusion syndrome, transfusions requirement, post-LT renal failure, and in-hospital stay. The 3-year patient and graft survival rates were 94.7%. We would like to discuss this valuable article in light of our own experience gathered over 25 years of LTs in Turin. Since 2002, we have routinely performed postreperfusion biopsies; between 2002 and 2015, we carried out 1581 first adult LTs using organs from brain-dead donors and 10 (0.6%) patients received grafts with macrovesicular steatosis 60%. Table 1 gives the main features of the donors, recipients, LT procedures, and post-LT courses of those 10 patients. Six patients underwent transplantation for hepatocellular carcinoma arising in compensated cirrhosis. Our grafts had a median donor risk index of 1.44, which is very similar to the Hong Kong series, and our 3-year patient and graft survival rates are close to the Chinese experience, being 91.7% and 83.3%. Nevertheless, we observed 2 (20%) primary nonfunctions requiring urgent re-LT; 1 of those 2 patients died 14 days after re-LT. Postreperfusion syndrome rate was 40% and early allograft dysfunction according to Olthoff et al. occurred in 90% of the patients, especially due to aspartate aminotransferase (AST)/alanine aminotransferase (ALT) peak >2000 IU/L rather than to bilirubin 10 mg/dL on day 7 or international normalized ratio (INR) 1.6 on day 7. The incidence of postoperative renal failure was 90%, and in 6 out of 9 recipients, continuous venovenous hemofiltration was needed. Consequently, the median in-hospital stay in our series was 33 days. The only case of 30-day mortality was related to unwillingly extended total and cold ischemia times (>600 minutes), in accordance with our previous findings that patient survival significantly worsens when a steatotic graft is transplanted after a total ischemia time >10 hours. In conclusion, we do agree that severely steatotic grafts can be safely used for LT if cold ischemia time can be kept short. However, our experience suggests that those grafts, even if transplanted into patients with nondecompensated cirrhosis, are burdened with an extremely high rate of initial poor function and therefore are in need of treatments with novel reconditioning techniques capable of improving their early functional recovery after LT.
Nitrogen deprivation promotes Populus root growth through global transcriptome reprogramming and activation of hierarchical genetic networks.

We show a distinct and previously poorly characterized response of poplar (Populus tremula × Populus alba) roots to low nitrogen (LN), which involves activation of root growth and significant transcriptome reprogramming. Analysis of the temporal patterns of enriched ontologies among the differentially expressed genes revealed an ordered assembly of functionally cohesive biological events that aligned well with growth and morphological responses. A core set of 28 biological processes was significantly enriched across the whole studied period and 21 of these were also enriched in the roots of Arabidopsis thaliana during the LN response. More than half (15) of the 28 processes belong to gene ontology (GO) terms associated with signaling and signal transduction pathways, suggesting the presence of conserved signaling mechanisms triggered by LN. A reconstruction of genetic regulatory network analysis revealed a sub-network centered on a PtaNAC1 (P. tremula × alba NAM, ATAF, CUC 1) transcription factor. PtaNAC1 root-specific up-regulation increased root biomass and significantly changed the expression of the connected hub genes specifically under LN. Our results provide evidence that the root response to LN involves hierarchically structured genetic networks centered on key regulatory factors. Targeting these factors via genetic engineering or breeding approaches can allow dynamic adjustment of root architecture in response to variable nitrogen availabilities in the soil.
The changing face of liver transplantation for acute liver failure: Assessment of current status and implications for future practice

The etiology and outcomes of acute liver failure (ALF) have changed since the definition of this disease entity in the 1970s. In particular, the role of emergency liver transplantation has evolved over time, with the development of prognostic scoring systems to facilitate listing of appropriate patients, and a better understanding of transplant benefit in patients with ALF. This review examines the changing etiology of ALF, transplant benefit, outcomes following transplantation, and future alternatives to emergency liver transplantation in this devastating condition. Liver Transplantation 22 527‐535 2016 AASLD
Splenectomy is not indicated in living donor liver transplantation

Simultaneous splenectomy (SPX) is preferentially performed in living donor liver transplantation (LDLT) to modulate portal flow; increase postoperative platelet count, especially among those with hepatitis C virus (HCV) infection; and modulate the immunologic status in ABO‐incompatible cases. The negative effects of the procedure, however, are not well established. Records of 395 LDLTs performed at our institution, including 169 (42.8%) patients with simultaneous SPX and 226 (57.2%) patients with spleen preservation, were reviewed with special reference to the simultaneous SPX cases. The most common indication for SPX was HCV‐related disease (n = 114), followed by low preoperative platelet count (n = 52), and other reasons (n = 3). Simultaneous splenectomy did not increase the platelet count in the early postoperative period, but the incidence of reoperation for postoperative hemorrhage was increased, mainly at the SPX site, within the first week. In addition, the operative time, intraoperative blood loss, and incidence of lethal infectious disease were significantly higher in the SPX group, whereas the incidence of small‐for‐size syndrome was comparable between groups. Finally, SPX was an independent predictor for both postoperative hemorrhage (odds ratio [OR] = 2.451; 95% confidence interval [CI] = 1.285‐4.815; P = 0.006) and lethal infectious complication (OR = 3.748; 95% CI = 1.148‐14.001; P = 0.03). In conclusion, on the basis of the present findings, we do not recommend simultaneous SPX in LDLT. Liver Transplantation 22 1526–1535 2016 AASLD.
Recurrent primary sclerosing cholangitis in the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study: Comparison of risk factors between living and deceased donor recipients

Primary sclerosing cholangitis (PSC) recurs in 15%‐25% of patients transplanted for PSC. In the United States, PSC transplant patients are more likely to receive an organ from a living donor (LD) than patients without PSC. Our aims were to (1) compare risk of PSC recurrence in LD versus deceased donor recipients and (2) identify risk factors for PSC recurrence. There were 241 living donor liver transplantations (LDLTs) and 65 deceased donor liver transplantation (DDLT) patients transplanted between 1998 and 2013 enrolled in the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study who were evaluated. PSC recurrence risk for LDLT and DDLT recipients was compared using Kaplan‐Meier survival curves and log‐rank tests. Cox models were used to evaluate PSC risk factors. Overall PSC recurrence probabilities were 8.7% and 22.4% at 5 and 10 years after liver transplantation (LT), respectively. The risk of PSC recurrence was not significantly different for DDLT versus LDLT recipients (P = 0.36). For DDLT versus LDLT recipients, unadjusted 5‐ and 10‐year PSC recurrence was 9.4% versus 9.5% and 36.9% versus 21.1%. Higher laboratory Model for End‐Stage Liver Disease (MELD) score at LT, onset of a biliary complication, cholangiocarcinoma, and higher donor age were associated with increased risks of PSC recurrence: for MELD (hazard ratio [HR] = 1.06; 95% confidence interval [CI] 1.02‐1.10 per MELD point, P = 0.002); for biliary complication (HR, 2.82; 95% CI, 1.28‐6.25; P = 0.01); for cholangiocarcinoma (HR, 3.98; 95% CI, 1.43‐11.09; P = 0.008); for donor age (per 5‐years donor age; HR, 1.17; 95% CI, 1.02‐1.35; P = 0.02). Factors not significantly associated with PSC recurrence included the following: first‐degree relative donor (P = 0.11), post‐LT cytomegalovirus infection (P = 0.38), and acute rejection (P = 0.22). Risk of recurrent PSC was not significantly different for DDLT and LDLT recipients. Biliary complications, cholangiocarcinoma, MELD, and donor age were significantly associated with risk of PSC recurrence. Liver Transplantation 22 1214–1222 2016 AASLD
High Initiation of Adjuvant Hormonal Therapy Among Uninsured Stages I-III Breast Cancer Patients Treated in a Safety-Net Healthcare System.

OBJECTIVE Despite benefits of adjuvant hormonal therapy (AHT), many eligible breast cancer patients do not complete therapy as recommended. Patterns of AHT use have not been well studied among uninsured breast cancer patients who fall into coverage gaps or are ineligible for public insurance programs. METHODS We identified 291 patients newly diagnosed with stages I-III hormone receptor-positive breast cancer from January 2008 to December 2012. All patients were treated at a safety-net healthcare system and enrolled in an income-based medical assistance program that fills AHT prescriptions at low cost. We extracted and linked cancer registry, pharmacy claims, and medical record data to assess AHT initiation (defined as a new AHT prescription ≤18 months since diagnosis) and sociodemographic and healthcare utilization variables. Log-binomial regression was used to identify correlates of initiation. RESULTS Overall, 239 (82%) patients initiated AHT. Tamoxifen (42%) and anastrozole (55%) were most commonly prescribed. The mean copay was $4.90 for tamoxifen and $6.00 for anastrozole. Although crude analyses revealed small, statistically significant prevalence ratios for race/ethnicity (Hispanic vs. white, other vs. white), year of diagnosis (2008 vs. 2012), primary care visit before diagnosis (any vs. none), and smoking status (current vs. never), there were no significant correlates of initiation in the adjusted model. CONCLUSION Safety-net healthcare systems providing access to AHT (i.e., through reduced copays) could improve the number of eligible patients initiating therapy. Continuity and integration of care in these settings may reduce disparities frequently observed in uninsured, low-income breast cancer populations.
Dehydroascorbate: a possible surveillance molecule of oxidative stress and programmed cell death in the green alga Chlamydomonas reinhardtii.

Chlamydomonas reinhardtii tolerates relatively high H2 O2 levels that induce an array of antioxidant activities. However, rather than rendering the cells more resistant to oxidative stress, the cells become far more sensitive to an additional H2 O2 dose. If H2 O2 is provided 1.5-9 h after an initial dose, it induces programmed cell death (PCD) in the wild-type, but not in the dum1 mutant impaired in the mitochondrial respiratory complex III. This mutant does not exhibit a secondary oxidative burst 4-5 h after the inducing H2 O2 , nor does it activate metacaspase-1 after the second H2 O2 treatment. The intracellular dehydroascorbate level, a product of ascorbate peroxidase, increases under conditions leading to PCD. The addition of dehydroascorbate induces PCD in the wild-type and dum1 cultures, but higher levels are required in dum1 cells, where it is metabolized faster. The application of dehydroascorbate induces the expression of metacaspase-2, which is much stronger than the expression of metacaspase-1. The presence or absence of oxidative stress, in addition to the rise in internal dehydroascorbate, may determine which metacaspase is activated during Chlamydomonas PCD. Cell death is strongly affected by the timing of H2 O2 or dehydroascorbate admission to synchronously grown cultures, suggesting that the cell cycle phase may distinguish cells that perish from those that do not.