166 research outputs found
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 donorârecipient 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
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 donorârecipient 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.</p
Home and healthcare. The prospect of home adaptation through a computational design decision-support system
This paper presents an ongoing research to define the framework of a computational
design approach based on the idea of spatial analysis and spatial synthesis to implement multicriteria
evaluations and provide evidence of the performance of the design alternatives in the
specific case of home adaptation for healthcare at home. The European health systems place
among the priority objectives the strengthening of the provision of healthcare at home to
guarantee the aging in place of elderly people and to limit, at the same time, the unnecessary use of
resources. Therefore, existing homes must provide adequate safety, comfort, and accessibility
features to ensure a high quality of life for the care receivers and facilitate the caregivers' tasks. To
address the complexity of the requirements to be met, we propose a spatial decision support
system (SDSS) to implement multi-criteria assessments to ergonomic design problems at a spatial
scale of apartment homes. The system is intended to streamline and assist designers and
homeowners in planning interventions for home adaptations for healthcare. Such design problems
can be formulated as decision problems with costs and benefits modeled within constraints of
validity and quality criteria/objectives. Concerning the specific field of study, the system evaluates
the degree of compliance with the accessibility and visibility quality criteria of each design
alternative. The reiteration of the evaluation mechanism allows for the classification and supports
the selection of satisfactory technical solutions identified with an informed and well-balanced
trade-off between the relevant quality criteria
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 donorârecipient 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.</p
Modularity and customisation for home care â Configuration and multicriteria analysis of furnishings
Given the ageing population and the growing interest in prior verification of the compatibility of existing housing to accommodate home care activities, this paper reports the results of a research aimed at implementing tools to support the design of housing adaptation in anticipation of flexibility to accompany the evolving needs of the elderly cared for. An evaluation system was structured starting with the definition of requirements connoting the home space for home care, which was useful for selecting and verifying, on a performance basis, the compliance of furniture available on the market, also in relation to modularity and readiness for customisation. The best-performing furniture solutions were entered into a database that will be made interoperable in future research developments in a BIM environment.
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Article info
Received: 10/09/2023; Revised: 08/10/2023; Accepted: 19/10/202
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.
Keywords: ex situ organ perfusion; machine perfusion; normothermic regional perfusion; organ preservation; viability assessment
How to improve smallholder market access: Evaluation of Mercados Campesinos in Colombia
This paper presents an analysis of the results obtained in the project called "Mercados Campesinos" carried out in the central region of Colombia between 2004 and 2015. This analysis was performed to evaluate the impacts of this short food value chain experience and its influence on economic, social and political dimensions of smallholders' market access.The analysis included two complementary research methods: quantitative and qualitative approaches. These methods were stated to identify the benefits accrued to participants usingthree different methodologies: i) t-test analysis; ii) an impact evaluation known as difference-in-difference and iii) multilevel regressions. On the other hand, qualitative analysis was based on semi-structured interviews and informal dialogues to investigate the perceptions of a selected group of beneficiaries regarding how project goals have been achieved. The results showed that one of the most influential elements in smallholders'market access has been the role of peasant organizations, associations and local farmer committees. These administrative structures greatly affected the economic efficiency, political participation and, to a lesser extent, commercial improvements. Project outcomes have been extremely influenced by participants' expectations of improvements in wellbeing, life quality, production rates, and income. The project was not able to reach a good level of financial sustainability; however, it provided peasants with well-designed tools to self-coordinate their actions. Proof of that is that farmers started to organize themselves autonomously to exert pressure at municipal and local levels
Aurea diagnosis of pneumomediastinum. A case report
Pericarditis and spontaneous pneumomediastinum are among the pathologies that are in differential diagnoses when a patient describes dorsal irradiated chest pain: if the patient is young, male, and long-limbed, it is necessary to exclude an acute aortic syndrome firstly. We present the case of a young man who arrived at the Emergency Department for chest pain: an echocardiogram performed an immediate diagnosis of pericarditis. However, if the patient had performed a chest X-ray, this would have enabled the observation of pneumomediastinum, allowing a correct diagnosis of pneumomediastinum and treatment. The purpose of this report is to highlight the importance of the diagnostic process
Discontinuously supervised aerobic training vs. physical activity promotion in the self-management of type 2 diabetes in older Italian patients: design and methods of the 'TRIPL-A' randomized controlled trial
Physical activity (PA) has health benefits for people with type 2 diabetes (T2D). Indeed, regular PA is considered an important part of any T2D management plan, yet most patients adopt a sedentary lifestyle. Exercise referral schemes (ERS) have the potential to effectively promote physical activity among T2D patients, and their effectiveness may be enhanced when they are supported by computer-based technologies. The 'TRIPL-A' study (i.e., a TRIal to promote PhysicaL Activity among patients in the young-old age affected by T2D) aims to assess if realizing an innovative ERS, based on a strong partnership among general practitioners, specialist physicians, exercise specialists, and patients, and supported by a web-based application (WBA), can effectively lead sedentary older T2D patients to adopt an active lifestyle
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