Problems Experienced by Adolescents with Autism Spectrum Disorder: Exploring Social, Educational and Economic Variables

The study investigates the problems of adolescents with Autism Spectrum Disorder (ASD) from the perspective of ASD specialists and adolescent’s families. It comprises of 228 ASD specialists and 294 families of ASD adolescents. The sample represents all areas of the Kingdom of Saudi Arabia (henceforth – KSA): north, south, east, west and centre. Variables of the study are adolescents’ gender, age, residential area, as well as the qualification of ASD specialists and family members. To accomplish the study, the researchers designed a questionnaire that includes variables regarding six significant problems: Educational, Recreational, Economic, Health, Psychological, and Social. The results reveal that families rate the economic problems higher than average, while the recreational ones – lower; specialists rate economic problems higher than average and educational ones – the lowest. As for gender variable, specialists and families note the differences in favour of females; for age variable, specialists and families note that 15-18 years old ASD adolescents have more problems. The results show that qualification of specialists as well as family members is of significant relevance in relation to ASD adolescents. Both specialists and family members are mostly from the central regions

Pancreatic Allograft Thrombosis: Suggestion for a CT grading system and management algorithm

Pancreatic allograft thrombosis (PAT) remains the leading cause of non-immunological graft failure. Herein we propose a new CT grading system of PAT to identify risk factors for allograft loss and outline a management algorithm by retrospective review of consecutive pancreatic transplants between 2009-2014. Triple-phase CT scans were graded independently by two radiologists as; Grade 0 – no thrombosis, Grade 1 – peripheral thrombosis, Grade 2 – intermediate non-occlusive thrombosis and Grade 3 – central occlusive thrombosis. Twenty-four of 103 (23.3%) recipients were diagnosed with PAT (including grade 1). Three grafts (2.9%) were lost due to portal vein thrombosis. On multivariate analysis, pancreas after SPK/PAK transplant, acute rejection and CT finding peri-pancreatic oedema and/or inflammatory change were significant risk factors of PAT. Retrospective review of CT images revealed more grade 1 and 2 thromboses than were initially reported. There was no significant difference in graft or patient survival, post-operative stay or morbidity of recipients with grade 1 or 2 thrombosis who were or were not anticoagulated. Our data suggest that therapeutic anticoagulation is not necessary for grade 1 and 2 arterial and grade 1 venous thrombosis. The proposed grading system can assist clinicians in decision making and provide standardised reporting for future studies

Engaging Cold to Upregulate Cell Proliferation in Alginate-Encapsulated Liver Spheroids.

For many years, the impact of hyper- and hypothermia on mammalian cells has been examined. With the exception of short, low temperature storage, which has uses in areas such as preservation for transplantation or regenerative medicine, advantages for the use of low temperature treatment in hepatocytes have not been previously reported. We have observed that alginate-encapsulated HepG2 liver spheroids that are cryopreserved or experience a cold reduction in temperature (≤10°C) for periods between 1 and 90 min display an enhanced cell proliferation during culture 7-16 days post-treatment compared with untreated samples. Following 8-12 days post-treatment, alginate-encapsulated liver spheroids experienced a cell density of 1.71 ± 0.35 times that of control samples (p < 0.001). This effect occurred in samples with a variety of cold treatments. This low temperature treatment offers a simple method to rapidly increase cell proliferation rates for extended culture systems, such as bioartificial liver devices. This would allow the manufacture of required biomass more rapidly, and to a higher cell density, reducing final required biomass volume. This could enable bioartificial liver devices to be prepared more cheaply, making them a more cost effective treatment.Funding for this work was provided through a Medical Research Council (United Kingdom) Industrial Case Studentship (9203) and by Innovate UK (101103) between University College London and Asymptote Ltd. and a Medical Research Council Proximity to Discovery Grant (RG79366) between University of Cambridge and Asymptote Ltd

Hemodynamic wall shear stress profiles influence the magnitude and pattern of stenosis in a pig AV fistula

Venous stenosis is a significant problem in arteriovenous fistulae, likely due to anatomical configuration and wall shear stress profiles. To identify linkages between wall shear stress and the magnitude and pattern of vascular stenosis, we produced curved and straight fistulae in a pig model. A complete wall stress profile was calculated for the curved configuration and correlated with luminal stenosis. Computer modeling techniques were then used to derive a wall shear stress profile for the straight arteriovenous fistula. Differences in the wall shear stress profile of the curved and straight fistula were then related to histological findings. There was a marked inverse correlation between the magnitude of wall shear stress within different regions of the curved arteriovenous fistula and luminal stenosis in these same regions. There were also significantly greater differences in wall shear stress between the outer and inner walls of the straight as compared to curved arteriovenous fistula, which translated into a more eccentric histological pattern of intima-media thickening. Our results suggest a clear linkage between anatomical configuration, wall shear stress profiles, and the pattern of luminal stenosis and intima-media thickening in a pig model of arteriovenous fistula stenosis. These results suggest that fistula failure could be reduced by using computer modeling prior to surgical placement to alter the anatomical and, consequently, the wall shear stress profiles in an arteriovenous fistula

Evaluating environmental effects in construction and demolition waste recycling plant with the Iranian Leopold Matrix method

BACKGROUND AND OBJECTIVES: Recycling and reusing construction and demolition debris is a productive step toward solving this problem. Still, the recycling process also leaves industrial effluents, which is evident in producing recycled sand. The present research has investigated the environmental effects of recycling construction debris at sand recycling plants. Considering the negative impacts of sand washing mud produced at the plant in the Aab'Ali Landfill of Tehran in Iran, the material's physicochemical characteristics and environmental impact have also been investigated to regulate practices.                        METHODS: The Environmental Impact Assessment has been carried out in physicochemical, biological, socio-cultural, and economic-technical areas. Due to the large dispersion of the studied soil and the composition diversity in each sampling, 30 samples of the sand washing mud and the material mixed with the surrounding soil have been collected. The exploitation phase during the factory construction plan's implementation stage was considered the current research's main phase. Hence, 13 micro activities and 23 environmental parameters were identified, and the results were analyzed in the Environmental Impact Assessment Plus Software using the Iranian Leopold Matrix method and discussed based on the results of the experiments.FINDINGS: According to the results of the matrix calculation, the three micro-activities included washing the sand through a sand-washing machine, fine sand washing through the EvoWash machine with a score of -3.6, converting concrete pieces and large boulders into smaller pieces by jackhammers, transferring to the jaw crusher machine with a score of -2.8, and transferring the remaining sand washing mud produced by the EvoWash machine to the storage pond with a score of -2.7 had the most negative effects. The three micro-activities of waste processing for green space irrigation (+2.2), selling products (+0.9), and hiring employees with a score of +0.5 have the most positive effects on the environment. As ranking smaller than -31 forming 50% of the total average of rows and columns, the activity of the plant and the sand extraction process in this landfill is approved by providing modification alternatives.CONCLUSION: Considering the positive impact on the economy, increasing green spaces in the region, job creation, and also reducing the amount of increasing debris accumulated in the landfill is evaluated positively and can be done considering the reforms; including the prevention of releasing remnant sand washing mud freely and recycling it instead. Reusing the sand washing mud requires improving the water purification systems used in the EvoWash machine

Ex vivo normothermic perfusion of isolated segmental porcine bowel: a novel functional model of the small intestine.

BACKGROUND: There is an unmet need for suitable ex vivo large animal models in experimental gastroenterology and intestinal transplantation. This study details a reliable and effective technique for ex vivo normothermic perfusion (EVNP) of segmental porcine small intestine. METHODS: Segments of small intestine, 1.5-3.0 m in length, were retrieved from terminally anaesthetized pigs. After a period of cold ischaemia, EVNP was performed for 2 h at 37°C with a mean pressure of 80 mmHg using oxygenated autologous blood diluted with Ringer's solution. The duration of EVNP was extended to 4 h for a second set of experiments in which two segments of proximal to mid-ileum (1.5-3.0 m) were retrieved from each animal and reperfused with whole blood (control) or leucocyte-depleted blood to examine the impact of leucocyte depletion on reperfusion injury. RESULTS: After a mean cold ischaemia time of 5 h and 20 min, EVNP was performed in an initial group of four pigs. In the second set of experiments, five pigs were used in each group. In all experiments bowel segments were well perfused and exhibited peristalsis during EVNP. Venous glucose levels significantly increased following luminal glucose stimulation (mean(s.e.m.) basal level 1.8(0.6) mmol/l versus peak 15.5(5.8) mmol/l; P < 0.001) and glucagon-like peptide 1 (GLP-1) levels increased in all experiments, demonstrating intact absorptive and secretory intestinal functions. There were no significant differences between control and leucocyte-depleted animals regarding blood flow, venous glucose, GLP-1 levels or histopathology at the end of 4 h of EVNP. CONCLUSIONS: This novel model is suitable for the investigation of gastrointestinal physiology, pathology and ischaemia reperfusion injury, along with evaluation of potential therapeutic interventions

In vitro Quantification of Guidewire Flow-Obstruction Effect in MODEL CORONARY STENOSES FOR INTERVENTIONAL DIAGNOSTIC PROCEDURE

The objective is to quantify the guidewire ( and preangioplasty). The diagnostic parameters measured before guidewire insertion (CFR and FFR) and during guidewire insertion (gCFR and gFFR) were validated numerically and correlated with the new diagnostic parameter &quot;lesion flow coefficient (LFC).&quot; There was significant flow reduction with increased trans-stenotic pressure drop due to guidewire insertion. The FFR-gFFR and CFR-gCFR correlations wer

Protocol of a randomised controlled, open-label trial of ex vivo normothermic perfusion versus static cold storage in donation after circulatory death renal transplantation.

Introduction: Ex vivo normothermic perfusion (EVNP) is a novel technique that reconditions the kidney and restores renal function prior to transplantation. Phase I data from a series of EVNP in extended criteria donor kidneys have established the safety and feasibility of the technique in clinical practice. Methods and analysis: This is a UK-based phase II multicentre randomised controlled trial to assess the efficacy of EVNP compared with the conventional static cold storage technique in donation after circulatory death (DCD) kidney transplantation. 400 patients receiving a kidney from a DCD donor (categories III and IV, controlled) will be recruited into the study. On arrival at the transplant centre, kidneys will be randomised to receive either EVNP (n=200) or remain in static cold storage (n=200). Kidneys undergoing EVNP will be perfused with an oxygenated packed red cell solution at near body temperature for 60 min prior to transplantation. The primary outcome measure will be determined by rates of delayed graft function (DGF) defined as the need for dialysis in the first week post-transplant. Secondary outcome measures include incidences of primary non-function, the duration of DGF, functional DGF defined as <10% fall in serum creatinine for 3 consecutive days in the first week post-transplant, creatinine reduction ratio days 2 and 5, length of hospital stay, rates of biopsy-proven acute rejection, serum creatinine and estimated glomerular filtration rate at 1, 3, 6 and 12 months post-transplant and patient and allograft survival. The EVNP assessment score will be recorded and the level of fibrosis and inflammation will also be measured using tissue, blood and urine samples. Ethics and dissemination. The study has been approved by the National Health Service (NHS) Health Research Authority Research Ethics Committee. The results are expected to be published in 2020. Trial registration number: ISRCTN15821205; Pre-results.Kidney Research UK (SP/MEKC/1/2014); University of Cambridge and University Hospitals of Cambridge Foundation Trust, Cambridge CB2 OQQ