British societies guideline on the management of emergencies in implantable left ventricular assist device recipients in transplant centres

\ua9 The Author(s) 2024.An implantable left ventricular assist device (LVAD) is indicated as a bridge to transplantation or recovery in the United Kingdom (UK). The mechanism of action of the LVAD results in a unique state of haemodynamic stability with diminished arterial pulsatility. The clinical assessment of an LVAD recipient can be challenging because non-invasive blood pressure, pulse and oxygen saturation measurements may be hard to obtain. As a result of this unusual situation and complex interplay between the device and the native circulation, resuscitation of LVAD recipients requires bespoke guidelines. Through collaboration with key UK stakeholders, we assessed the current evidence base and developed guidelines for the recognition of clinical deterioration, inadequate circulation and time-critical interventions. Such guidelines, intended for use in transplant centres, are designed to be deployed by those providing immediate care of LVAD patients under conditions of precipitous clinical deterioration. In summary, the Joint British Societies and Transplant Centres LVAD Working Group present the UK guideline on management of emergencies in implantable LVAD recipients for use in advanced heart failure centres. These recommendations have been made with a UK resuscitation focus but are widely applicable to professionals regularly managing patients with implantable LVADs

Development of a real-time quantitative PCR assay for detection of a stable genomic region of BK virus

<p>Abstract</p> <p>Background</p> <p>BK virus infections can have clinically significant consequences in immunocompromised individuals. Detection and monitoring of active BK virus infections in certain situations is recommended and therefore PCR assays for detection of BK virus have been developed. The performance of current BK PCR detection assays is limited by the existence of viral polymorphisms, unknown at the time of assay development, resulting in inconsistent detection of BK virus. The objective of this study was to identify a stable region of the BK viral genome for detection by PCR that would be minimally affected by polymorphisms as more sequence data for BK virus becomes available.</p> <p>Results</p> <p>Employing a combination of techniques, including amino acid and DNA sequence alignment and interspecies analysis, a conserved, stable PCR target region of the BK viral genomic region was identified within the VP2 gene. A real-time quantitative PCR assay was then developed that is specific for BK virus, has an analytical sensitivity of 15 copies/reaction (450 copies/ml) and is highly reproducible (CV ≤ 5.0%).</p> <p>Conclusion</p> <p>Identifying stable PCR target regions when limited DNA sequence data is available may be possible by combining multiple analysis techniques to elucidate potential functional constraints on genomic regions. Applying this approach to the development of a real-time quantitative PCR assay for BK virus resulted in an accurate method with potential clinical applications and advantages over existing BK assays.</p

Perbandingan Proses Pengasapan Ikan Cakalang Menggunakan Alat Konvensional dan Lemari Pengasapan di Desa Daruba Pantai Kabupaten Pulau Morotai

Ikan merupakan produk usaha tangkap perikanan yang mudah membusuk dan cepat rusak, sehingga sering diawetkan. Terhadap beberapa cara untuk mengawetkan ikan, salah satunya dengan cara pengasapan. Pada umumnya masyarakat Kabupaten Pulau Morotai melakukan proses pengasapan ikan secara tradisional. Tujuan penelitian ini adalah untuk mengetahui dan menggunakan proses pembuatan ikan asap dengan alat konvensional dan lemari pengasapan dalam pengolahannya di Desa Daruba Pantai, Kabupaten Pulau Morotai. PKL ini dilakukan pada bulan September 2019 di tempat Bapak Rahim dan mengukur efisiensi. Tahap pengasapan ikan dengan alat konvensional dan lemari pengasapan di Desa Daruba Pantai secara umum sama. Proses ikan asap meliputi ikan dibelah, dibuang isang dan isi Perut, dicuci, dijepit dengan bambu, dicuci kembali, disiangi, diasap dan dioles minyak. Membutuhkan bahan bakar lebih banyak (30kg) dibandingkan dengan menggunakan lemari pengasapan (15kg). Selain itu, waktu pengasapan dengan menggunakan alat konvensional lebih lama (48 jam) dibandingkan dengan menggunakan lemari pengasapan (23 jam). (Kata kunci:ikan cakalang asap, alat Konvensional, dan Lemari pengasapan)

In Vivo Flow Cytometry of Circulating Tumor-Associated Exosomes

Circulating tumor cells (CTCs) demonstrated the potential as prognostic markers of metastatic development. However, the incurable metastasis can already be developed at the time of initial diagnosis with the existing CTC assays. Alternatively, tumor-associated particles (CTPs) including exosomes can be a more valuable prognostic marker because they can be released from the primary tumor long before CTCs and in larger amount. However, little progress has been made in high sensitivity detection of CTPs, especially in vivo. We show here that in vivo integrated photoacoustic (PA) and fluorescence flow cytometry (PAFFC) platform can provide the detection of melanoma and breast-cancer-associated single CTPs with endogenously expressed melanin and genetically engineered proteins or exogenous dyes as PA and fluorescent contrast agents. The two-beam, time-of-light PAFFC can measure the sizes of CTCs and CTPs and identify bulk and rolling CTCs and CTC clusters, with no influence on blood flow instability. This technique revealed a higher concentration of CTPs than CTCs at an early cancer stage. Because a single tumor cell can release many CTPs and in vivo PAFFC can examine the whole blood volume, PAFFC diagnostic platform has the potential to dramatically improve (up to 105-fold) the sensitivity of cancer diagnosis