Individualized immunosuppression in transplant patients: potential role of pharmacogenetics.

The immunosuppressive drugs used to prevent the rejection of transplanted organs have a narrow therapeutic index. Under treatment results in episodes of rejection leading to either damage or loss of the organ. Over immunosuppression increases the risk of infection and malignancy as well as drug specific complications including diabetes mellitus and nephrotoxicity. There is wide variation in the drug dose required to achieve target blood concentrations and there is often dissociation between pharmacokinetics and pharmacodynamics. Currently, immunosuppressive drug treatment is individualized based on a clinical assessment of the risk of rejection or toxicity. Therapeutic drug monitoring is routinely employed for several immunosuppressive drugs. Pharmacogenetics has the potential to complement therapeutic drug monitoring but clinical benefit has yet to be demonstrated. Novel biomarker-based approaches to risk stratification and pharmacodynamic monitoring are under development and are ready for clinical trials

The Effects of Aging on Skeletal Muscle ATP Production

The study of the aging process and its prevention is an incredibly popular field; the natural course of the human body is to age and theories abound on how to avoid it. Age affects every system and pathway of the body and alters many of the bodily functions. This paper, using articles from Touro’s library database examines the different areas in which aging negatively affects ATP production. The multifaceted process associated with the production of ATP in the human body was analyzed. Several features such as the mitochondria, physical activity, and hormones are linked to ATP production and the relationship was further explored. The findings reveal that a dysfunction or lack of these factors, a feature of aging, is the initiator of the decrease in ATP production that is attributed to the natural aging process. Together, a lack of mitochondrial function, physical inactivity, reduced growth hormone levels, and increased insulin sensitivity levels contribute to the decline in ATP production that is concomitant with the progression of age. The diminishing presence of ATP then stimulates further dysfunction or lack of these elements, which in turn drives the aging process even further

Management of erectile dysfunction post-radical prostatectomy

© 2015 Saleh et al.Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients

Effet de la conduction axiale sur le transfert de chaleur conjugué par convection mixte défavorable

International audienceOn présente les résultats d'une simulation numérique de la convection mixte défavorable, transitoire et conjuguée dans une conduite cylindrique verticale. La surface externe de la conduite est soumise à un flux de chaleur constant et uniforme, appliqué sur une section centrale de longueur égale à dix fois le diamètre hydraulique. Les résultats obtenus montrent que la présence du renversement de l'écoulement prés de la paroi a fortement déformé le profile radiale de température. Par ailleurs, nous avons constaté une redistribution du flux de chaleur imposé dans la région de préchauffage. Cette dernière est d'autant plus proche de l'entrée de la section chauffée que les valeurs de l'épaisseur de la paroi au diamètre hydraulique Δ et des conductivités thermiques K du fluide et du solide sont faibles

Influence des conditions thermiques pariétales sur le comportement d'un écoulement de fluide compressible dans une tuyère

International audienceOn analyse numériquement l'influence des conditions thermiques pariétales sur le comportement dynamique et thermique, d'un écoulement de fluide visqueux, laminaire, compressible dans une tuyère axisymétrique. A partir d'une approche instationnaire, on résout les équations complètes de Naviers-Stokes avec une méthode aux différences finies explicite de type MacCormack. L'opérateur de passage bidimensionnel est décomposé en une séquence symétrique d'opérateurs monodimensionnels suivant les deux directions spatiales. La paroi de la tuyère est soumise à une condition d'échange par convection avec le milieu extérieur, pouvant simuler des situations de refroidissement ou d'isolation. Les résultats obtenus montrent l'influence de ces conditions pariétales sur la structure de l'écoulement, en particulier dans les zones où les effets visqueux sont significatifs

Characterisation of Mo–V–N Coatings Deposited on XC100 Substrate by Sputtering Cathodic Magnetron

The aim of this work is the characterization of ternary molybdenum–vana¬dium nitride (Mo–V–N) coatings deposited on silicon and XC100 steel substrates by the reactive radiofrequency dual magnetron sputtering with different contents of the Mo and V targets and nitrogen as reactive gas. The metal-target bias voltages are varied from 300 to 900 V. The hardness, surface morphology, microstructure and composition are studied by nanoindentation, scanning electron microscopy, atomic-force microscopy, and x-ray diffractometry. The Mo–V–N films manifest pyramidal surface morphology, high roughness (of 13.5 nm), but low mechanical properties. Hardness and Young’s modulus are found in the ranges of 10–18 GPa and 100–335 GPa, respectively. The residual stresses of coatings are compressive and varied between 0.8 GPa and 2.5 GPa (calculated with the Stoney formula).Целью этой работы является характеризация покрытий, изготовленных из трёхкомпонентного молибден-ванадиевого нитрида (Mo–V–N), которые наносились на кремниевые и стальные (ХС100) подложки с помощью реактивного радиочастотного магнетронного двухкатодного распыления мишеней с различным содержанием Mo и V с использованием азота в качестве реагирующего газа. Напряжения смещения металлической мишени варьировались от 300 до 900 В. Твёрдость, морфология поверхности, микроструктура и состав изучались при помощи наноиндентирования, сканирующей электронной микроскопии, атомно-силовой микроскопии и рентгеновской дифрактометрии. Плёнки Mo–V–N обладают пирамидальной морфологией поверхности, высокой шероховатостью (13,5 нм), но низкими механическими свойствами. Твёрдость и модуль Юнга находятся в диапазонах 10–18 ГПа и 100–335 ГПа соответственно. Остаточные напряжения в покрытиях (рассчитанные по формуле Стони) являются сжимающими и изменяются в пределах от 0,8 до 2,5 ГПаМетою даної роботи є характеризація покриттів із трикомпонентного молібден-ванадійового нітриду (Mo–V–N), що наносилися на кремнійові та сталеві (XC100) поверхні шляхом реактивного радіочастотного магнетронного двокатодного розпорошення цілей із різним вмістом Мо та V із використанням азоту в якості реакційноздатного газу. Відхили напруги зміщення металевої цілі варіювалися від 300 до 900 В. Твердість, морфологію поверхні, мікроструктуру та склад було досліджено за допомогою метод наноіндентування, сканувальної електронної мікроскопії, атомно-силової мікроскопії та рентґенівської дифрактометрії. Плівки Mo–V–N мають пірамідальну морфологію поверхні, високу шерсткість (13,5 нм), але низькі механічні властивості. Твердість і модуль Юнґа лежать у діяпазонах 10–18 ГПа та 100–335 ГПа відповідно. Залишкові напруження у покриттях (обчислені за формулою Стоні) є стискальними і лежать у межах між 0,8 і 2,5 ГПа

Analyse numérique de la convection forcée turbulente dans les tubes munis des chicanes transversales

International audienceOn présente une étude numérique du comportement dynamique et thermique d'un écoulement d'air turbulent dans un canal horizontal de section rectangulaire muni des chicanes transversales. Les équations gouvernantes, basées sur le modèle k-ε, sont résolues par la méthode des volumes finis à l'aide de l'algorithme SIMPLE. Les profils de vitesse axiale et les champs de vitesse et de température ainsi que la distribution du nombre de Nusselt sont présentés pour un cas d'exemple type

Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery

Background The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. Methods A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. Results 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons’ performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. Conclusions The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator

Estimation of the fuzzy reliability function using two-parameter exponential distribution as prior distribution

In this research, the fuzzy reliability function of the series system has been estimated using Bayes approach and Mellin transformation. It is based on the existence of two parameter exponential distribution as a previous distribution with the existence of a similar quadratic loss function, square loss function and non- asymmetric precautionary loss function. To apply the Bayes approach, the distribution parameters are assumed to be "random variables", and the traditional Bayes approach was used to obtain Bayes fuzzy capabilities by using Resolution Identity Theory in the fuzzy set. The simulation approach has been applied in this study to know the effect of α value on the fuzzy reliability function capabilities. The experiment has been carried out by assuming different values of the parameters as well as the sizes of the different samples. Furthermore, the applied part has dealt with the fuzzy reliability function estimation of both the quadratic loss function and the precautionary loss function with different α values using nonlinear membership functions. Some mathematical equations have been used to calculate the membership scores of the Bayes estimated points. This purpose has been achieved by converting the original problem into a non-linear programming problem and then divided it into eight secondary problems. The results have been obtained using the LINGO and GAMS programs