Preliminary results on Trabecular bone score (Tbs) in lumbar vertebrae with experimentally altered microarchitecture.

The aim of this preliminary research is to investigate the reliability of a new qualitative parameter, called Trabecular Bone Score (TBS), recently proposed for evaluating the microarchitectural arrangement of cancellous bone in scans carried out by dual energy X-ray absorptiometry (DXA). Vertebral bodies of 15 fresh samples of lumbar spines of adult pig were analysed either in basal conditions and with altered microarchitecture of the cancellous bone obtained by progressive drilling. The examined bony areas do not show changes in bone mineral density (BMD), whereas TBS values decrease with the increasing alteration of the vertebral microtrabecular structure. Our preliminary data seem to confirm the reliability of TBS as a qualitative parameter useful for evaluating the microarchitectural strength in bony areas quantitatively analysed by DXA

A concept map aiding the knowledge management to build the collective knowledge in a nuclear organization - a case study: IEN

This paper´s proposition is to build and apply a tool to aid the knowledge management based in the intellectual capital as a value and competitiveness aggregator for a science, technology and innovation public organization in the Brazilian’s nuclear area – the “Instituto de Engenharia Nuclear – IEN”. It will be presented the hole survey of the finalistic activities and what has been considered the intellectual capital to be developed and strategically valuated in its decision making practices. It was also surveyed the inter relations between the stakeholders, hereby the maintainer (CNEN), federal government, support foundations, public employees and contributors, in many different aspects focusing the continuity of research and development (R&D) activities and its results. As it’s going to be detailed, the tool has been designed based in the concept map methodology using the Cmap tools software. The hole cognitive basis used here was constructed under disclosed and recognized knowledge models about knowledge, knowledge management, knowledge transference and intellectual capital

Three-Dimensional Printing in Pediatric Living Donor Liver Transplantation Planning

3D printing is not the panacea for LDLT but could lead to a more precise surgical approach in the donor and better outcomes for the recipient, leading to an extremely precise knowledge of future liver remnant as well as the anatomical relationships between the vascular structures and graft’s weigh

A questão liderança em instituto de P, D&I tecnológico: prática toma de decisão, um estudo de caso

Este trabalho apresenta a “Prática de Tomada de Decisão” da Direção, recentemente revista, incorporando fundamentos do Critério Liderança (CE-PNQ). Essas melhorias facilitaram o controle dos planos de ação institucional, decorrentes da análise crítica do desempenho global e demais informações associadas com a Prática Tomada de Decisão

Combined liver kidney transplantation for primary hyperoxaluria type 1: Will there still be a future? Current transplantation strategies and monocentric experience

Combined liver–kidney transplantation is a therapeutic option for children affected by type 1 primary hyperoxaluria. Persistently high plasma oxalate levels may lead to kidney graft failure. It is debated whether pre-emptive liver transplantation, followed by kidney transplantation, might be a better strategy to reduce kidney graft loss. Our experience of 6 pediatric combined liver–kidney transplants for primary hyperoxaluria type 1 in pediatric recipients was retrospectively analyzed. Plasma oxalate levels were monitored before and after transplantation. All the recipients were on hemodialysis at transplantation. Median [IQR] recipient's age at transplantation was 11 [1–14] years; in all cases, a compatible graft from a pediatric brain-dead donor aged 8 [2–16] years was used. In a median follow-up of 7 [2–19] years after combined liver–kidney transplantation, no child died and no liver graft failure was observed; three kidney grafts were lost, due to chronic rejection, primary non-function, and early renal oxalate accumulation. Liver and kidney graft survival remained stable at 1, 3, and 5 years, at 100% and 85%, respectively. Kidney graft loss was the major complication in our series. Risk is higher with very young, low-weight donors. The impact of treatment with glyoxalate pathway enzyme inhibitors treatment in children with advanced disease as well as of donor kidney preservation by ex vivo machine perfusion needs to be evaluated. At present, a case-by-case discussion is needed to establish an optimal treatment strategy

Heterogeneous indications and the need for viability assessment: An international survey on the use of machine perfusion in liver transplantation

Although machine perfusion (MP) is being increasingly adopted in liver transplantation, indications, timing, and modality are debated. To investigate current indications for MP a web-based Google Forms survey was launched in January 2021 and addressed to 127 experts in the field, identified among first and corresponding Authors of MP literature in the last 10 years. The survey presented 10 real-life cases of donor-recipient matching, asking whether the liver would be accepted (Q1), whether MP would be used in that particular setting (Q2) and, if so, by which MP modality (Q3) and at what timing during preservation (Q4). Respondents could also comment on each case. The agreement was evaluated using Krippendorff's alpha coefficient. Answers from 39 (30.1%) participants disclosed significant heterogeneity in graft acceptance, MP indications, technique, and timing. Agreement between respondents was generally poor (Q1, α = 0.11; Q2, α = 0.14; Q3, α = 0.12, Q4, α = 0.11). Overall, respondents preferred hypothermic MP and an end-ischemic approach in 56.3% and 81.1% of cases, respectively. A total of 18 (46.2%) participants considered only one MP approach, whereas 17 (43.6%) and 3 (7.7%) considered using alternatively 2 or 3 different techniques. Of 38 comments, 17 (44.7%) were about the use of MP for graft viability assessment before implantation. This survey shows considerable variability in MP indications, emphasizing the need to identify scenarios of optimal utilization for each technique. Viability assessment emerges as a fundamental need of transplant professionals when considering the use of MP