HEGPOL: Randomized, placebo controlled, multicenter, double-blind clinical trial to investigate hepatoprotective effects of glycine in the postoperative phase of liver transplantation [ISRCTN69350312]

BACKGROUND: Kupffer cell-dependent ischemia / reperfusion (I/R) injury after liver transplantation is still of high clinical relevance, as it is strongly associated with primary dysfunction and primary nonfunction of the graft. Glycine, a non-toxic, non-essential amino acid has been conclusively shown in various experiments to prevent both activation of Kupffer cells and reperfusion injury. Based on both experimental and preliminary clinical data this study protocol was designed to further evaluate the early effect of glycine after liver transplantation. METHODS / DESIGN: A prospective double-blinded randomized placebo-controlled multicenter study with two parallel groups in a total of 130 liver transplant recipients was designed to assess the effect of multiple intravenous doses of glycine after transplantation. Primary endpoints in hierarchical order are: peak levels of both aspartat-amino-transaminase (AST) and alanine-amino-transaminase (ALT) as surrogates for the progression of liver related injury, as well as both graft and patient survival up to 2 years after transplantation. Furthermore, the effect of glycine on cyclosporine A-induced nephrotoxicity is evaluated. DISCUSSION: The ongoing clinical trial represents an advanced element of the research chain, along which a scientific hypothesis has to go by, in order to reach the highest level of evidence; a randomized, prospective, controlled double-blinded clinical trial. If the data of this ongoing research project confirm prior findings, glycine would improve the general outcome after liver transplantation

Contribution of Energetically Reactive Surface Features to the Dissolution of CeO2 and ThO2 Analogues for Spent Nuclear Fuel Microstructures

In the safety case for the geological disposal of nuclear waste, the release of radioactivity from the repository is controlled by the dissolution of the spent fuel in groundwater. There remain several uncertainties associated with understanding spent fuel dissolution, including the contribution of energetically reactive surface sites to the dissolution rate. In this study, we investigate how surface features influence the dissolution rate of synthetic CeO2 and ThO2, spent nuclear fuel analogues that approximate as closely as possible the microstructure characteristics of fuel-grade UO2 but are not sensitive to changes in oxidation state of the cation. The morphology of grain boundaries (natural features) and surface facets (specimen preparation-induced features) was investigated during dissolution. The effects of surface polishing on dissolution rate were also investigated. We show that preferential dissolution occurs at grain boundaries, resulting in grain boundary decohesion and enhanced dissolution rates. A strong crystallographic control was exerted, with high misorientation angle grain boundaries retreating more rapidly than those with low misorientation angles, which may be due to the accommodation of defects in the grain boundary structure. The data from these simplified analogue systems support the hypothesis that grain boundaries play a role in the so-called “instant release fraction” of spent fuel, and should be carefully considered, in conjunction with other chemical effects, in safety performance assessements for the geological disposal of spent fuel. Surface facets formed during the sample annealing process also exhibited a strong crystallographic control and were found to dissolve rapidly on initial contact with dissolution medium. Defects and strain induced during sample polishing caused an overestimation of the dissolution rate, by up to 3 orders of magnitude

Effect of surface orientation on dissolution rates and topography of CaF₂

This paper reports how during dissolution differences in surface chemistry affect the evolution of topography of CaF₂ pellets with a microstructure similar to UO₂ spent nuclear fuel. 3D confocal profilometry and atomic force microscopy were used to quantify retreat rates and analyze topography changes on surfaces with different orientations as dissolution proceeds up to 468 h. A NaClO₄ (0.05 M) solution with pH 3.6 which was far from equilibrium relative to CaF₂ was used. Measured dissolution rates depend directly on the orientation of the exposed planes. The {1 1 1} is the most stable plane with a dissolution rate of (1.2 ± 0.8) × 10⁻⁹ mol m⁻² s⁻¹, and {1 1 2} the least stable plane with a dissolution rate 33 times faster that {1 1 1}. Surfaces that expose both Ca and F atoms in the same plane dissolve faster. Dissolution rates were found to be correlated to surface orientation which is characterized by a specific surface chemistry and therefore related to surface energy. It is proposed that every surface is characterized by the relative proportions of the three reference planes {1 1 1}, {1 0 0} and {1 1 0}, and by the high energy sites at their interceptions. Based on the different dissolution rates observed we propose a dissolution model to explain changes of topography during dissolution. Surfaces with slower dissolution rate, and inferred lower surface energy, tend to form while dissolution proceeds leading to an increase of roughness and surface area. This adjustment of the surface suggests that dissolution rates during early stages of dissolution are different from the later stages. The time-dependency of this dynamic system needs to be taken into consideration when predicting long-term dissolution rates.12 page(s

Smart building management vs. intuitive human control—Lessons learnt from an office building in Hungary

Smart building management and control are adopted nowadays to achieve zero-net energy use in buildings. However, without considering the human dimension, technologies alone do not necessarily guarantee high performance in buildings. An office building was designed and built according to state-of-the-art design and energy management principles in 2008. Despite the expectations of high performance, the owner was facing high utility bills and low user comfort in the building located in Budapest, Hungary. The objective of the project was to evaluate the energy performance and comfort indices of the building, to identify the causes of malfunction and to elaborate a comprehensive energy concept. Firstly, current building conditions and operation parameters were evaluated. Our investigation found that the state-of-the-art building management system was in good conditions but it was operated by building operators and occupants who are not aware of the building management practice. The energy consumption patterns of the building were simulated with energy modelling software. The baseline model was calibrated to annual measured energy consumption, using actual occupant behaviour and presence, based on results of self-reported surveys, occupancy sensors and fan-coil usage data. Realistic occupant behaviour models can capture diversity of occupant behaviour and better represent the real energy use of the building. This way our findings and the effect of our proposed improvements could be more reliable. As part of our final comprehensive energy concept, we proposed intervention measures that would increase indoor thermal comfort and decrease energy consumption of the building. A parametric study was carried out to evaluate and quantify energy, comfort and return on investment of each measure. It was found that in the best case the building could save 23% of annual energy use. Future work includes the follow-up of: occupant reactions to intervention measures, the realized energy savings, the measurement of occupant satisfaction and behavioural changes