Improving Door-to-ECG Time in Acute Myocardial Infarction: A Closed-Loop Audit from a Tertiary Care Center in Peshawar.

Background & Objective: Acute myocardial infarction is the leading cause of heart disease worldwide. Timely diagnosis and decision of management plan is paramount which is pinned on early electrocardiogram to minimize the door-to-electrocardiogram time. Our objective was to evaluate the current practice of timing of initial electrocardiogram of patients presenting with Acute myocardial infarction at our local cardiac hospital in Pakistan and implement changes with a complete closed loop audit.

Role of Invertebrate Biological Origin in Chitin Nanocrystal's Morphology, Chirality, and Self-Assembly.

The mention of chitin often evokes the Bouligand structure, which is a unique twisted configuration featuring a uniaxial planar organization of fibers. Although a large number of studies focused on Arthropoda, the architecture of chitin in many other invertebrate phyla remains largely unexplored. Herein, we unveil the distinctive architectures of chitin in both Arthropoda and Bryozoa, offering a comparative analysis of the morphological properties of native fibers and chitin nanocrystals sourced from these divergent organisms.

Chitosan-metal and metal oxide nanocomposites for active and intelligent food packaging; a comprehensive review of emerging trends and associated challenges.

In recent years, significant advancements in biopolymer-based packaging have emerged as a response to the environmental challenges posed by traditional petroleum-based materials. The drive for sustainable, renewable, and degradable alternatives to fossil-based components in the packaging industry has led to an increased focus on chitosan, the second most abundant biopolymer after cellulose. Chitosan offers intrinsic properties such as biodegradability, biocompatibility, antimicrobial activity, excellent barrier and film-forming capabilities, positioning it as an ideal candidate for food packaging applications.

Donor hepatitis C status is not associated with an increased risk of acute rejection in kidney transplantation.

Introduction: In renal transplantation, donor hepatitis C virus (HCV) status is crucial to consider when selecting a recipient given the high likelihood of transmission. We analyzed the effect of donor HCV status on post-renal transplant rejection and virologic infectious outcomes using electronic health record data from multiple US health care organizations.

Methods: Using real world data from electronic health records of renal transplant recipients, a propensity score-matched case-control study of one-year renal transplant outcomes was conducted on cohorts of HCV-negative recipients who received an organ from an HCV-positive donor (HCV D+/R-) versus from an HCV-negative donor (HCV D-/R-).

Defining Renal Recovery in Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies.

Introduction: The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.

Methods: A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of > 30% improvement in SCr and its association with clinical outcomes.

Understanding the correlation between source and chiral, physichochemical properties of chitin nanocrystals; insights from beetle (Cetonia aurata) skeletal segments.

Chitin properties are known to vary depending on animal taxa, organismal source, and specific skeletal segments; However, the influence of these source-dependent variations on the physicochemical characteristics of chitin nanocrystals, particularly their Bouligand architecture, remains largely unexplored. Herein, chitin nanocrystals were isolated from seven different skeletal segments of C. aurata and characterized.

Precision in Immune Management: Balancing Steroid Exposure, Rejection Risk, and Infectious Outcomes in Adult Kidney Transplant Recipients.

Background/objectives: With kidney transplant immunosuppression, physicians must balance preventing rejection with minimizing infection and malignancy risks. Steroids have been a mainstay of these immunosuppression regimens since the early days of kidney transplantation, yet their risks remain debated. Our study looks at the clinical outcomes of patients undergoing early steroid withdrawal (ESW) vs.

The learning curve of COVID-19 and organ donation: Potential missed opportunities in the COVID era.

Background: Early in the COVID-19 pandemic, positive COVID-19 status often disqualified potential organ donors due to perceived risks, despite limited evidence. Subsequent studies have clarified that the COVID-19 status of donors, particularly when incidental and not the cause of death, does not adversely affect non-lung transplant outcomes. This study quantifies the potential loss of eligible organ donors and the corresponding impact on organ availability during the initial phase of the pandemic.

N-doped 3D carbon encapsulating nickel selenide nanoarchitecture with cation defect engineering: An ultrafast and long-life anode for sodium-ion batteries.

Transition metal chalcogenides (TMCs) hold great potential for sodium-ion batteries (SIBs) owing to their multielectron conversion reactions, yet face challenges of poor intrinsic conductivity, sluggish diffusion kinetics, severe phase transitions, and structural collapse during cycling. Herein, a self-templating strategy is proposed for the synthesis of a class of metal cobalt-doped NiSe nanoparticles confined within three-dimensional (3D) N-doped macroporous carbon matrix nanohybrids (Co-NiSe/NMC). The cation defect engineering within the developed Co-NiSe and 3D N-doped carbon plays a crucial role in enhancing intrinsic conductivity, reinforcing structural stability, and reducing the barrier to sodium ion diffusion, which are verified by a series of electrochemical kinetic analyses and density functional theory calculations.

Beyond prevention: Unveiling the benefits of triple vaccination on COVID-19 severity and resource utilization in solid organ transplant recipients.

Objective: Despite the widespread reduction in COVID-19-related morbidity and mortality attributed to vaccination in the general population, vaccine efficacy in solid organ transplant recipients (SOTR) remains under-characterized. This study aimed to investigate clinically relevant outcomes on double and triple-vaccinated versus unvaccinated SOTR with COVID-19.

Study Design And Setting: A retrospective propensity score-matched cohort study was performed utilizing data from the US Collaborative Network Database within TriNetX (n = 117,905,631).

Lignin beyond the : recent and emerging composite applications.

The demand for biodegradable materials across various industries has recently surged due to environmental concerns and the need for the adoption of renewable materials. In this context, lignin has emerged as a promising alternative, garnering significant attention as a biogenic resource that endows functional properties. This is primarily ascribed to its remarkable origin and structure that explains lignin's capacity to bind other molecules, reinforce composites, act as an antioxidant, and endow antimicrobial effects.

Kidney Allograft Monitoring by Combining Donor-Derived Cell-Free DNA and Molecular Gene Expression: A Clinical Management Perspective.

Donor-derived cell-free DNA (dd-cfDNA) may safely assess kidney allograft rejection. Molecular Microscope (MMDx) gene expression may offer increased precision to histology. This single-center retrospective study monitored kidney transplant recipients for rejection at specified time intervals by utilizing creatinine (SCr), proteinuria, donor-specific antibodies (DSAs), and dd-cfDNA.

Antibody Therapeutics as Interfering Agents in Flow Cytometry Crossmatch for Organ Transplantation.

Donor-recipient matching is a highly individualized and complex component of solid organ transplantation. Flowcytometry crossmatching (FC-XM) is an integral step in the matching process that is used to detect pre-formed deleterious anti-donor immunoglobulin. Despite high sensitivity in detecting cell-bound immunoglobulin, FC-XM is not able to determine the source or function of immunoglobulins detected.

Terlipressin in combination with albumin as a therapy for hepatorenal syndrome in patients aged 65 years or older.

Introduction And Objectives: Clinical data for older patients with advanced liver disease are limited. This post hoc analysis evaluated the efficacy and safety of terlipressin in patients aged ≥65 years with hepatorenal syndrome using data from 3 Phase III, randomized, placebo-controlled studies (OT-0401, REVERSE, CONFIRM).

Patients And Methods: The pooled population of patients aged ≥65 years (terlipressin, n = 54; placebo, n = 36) was evaluated for hepatorenal syndrome reversal-defined as a serum creatinine level ≤1.

Understanding the effects of chitosan, chia mucilage, levan based composite coatings on the shelf life of sweet cherry.

Sweet cherry (Prunus avium L.) fruits are prone to quality and quantity loss in shelf-life conditions and cold storage due to their short post-harvest life. Until now efforts have been made to extend the shelf life of the sweet cherry.

The Current State of Donor-Derived Cell-Free DNA Use in Allograft Monitoring in Kidney Transplantation.

Renal transplantation is the definitive therapy for patients suffering from end-stage renal disease. Though there have been significant advances in immunosuppression in these patients, there is still up to 30% acute and subclinical rejection. Current standards employ lab markers of renal function and biopsy results for accurate diagnosis.

A case series of perioperative anaphylaxis to cefazolin during kidney transplant and review of literature.

Background: Intraoperative anaphylaxis is a life threatening and multiorgan system hypersensitivity reaction that frequently leads to cessation of operations. Despite the incidence of Cefazolin allergy being on the rise, the cases of anaphylaxis to Cefazolin during surgeries and its management are seldom reported.

Case Presentation: We present two patients with no known beta-lactam allergy and end stage kidney disease who received perioperative intravenous Cefazolin for planned deceased kidney transplant surgery at our academic medical center.

Trends and challenges in the development of bio-based barrier coating materials for paper/cardboard food packaging; a review.

Currently, petroleum-based synthetic plastics are used as a key barrier material in the paper-based packaging of several food and nonfood goods. This widespread usage of plastic as a barrier lining is not only harmful to human and marine health, but it is also polluting the ecosystem. Researchers and food manufacturers are focused on biobased alternatives because of its numerous advantages, including biodegradability, biocompatibility, non-toxicity, and structural flexibility.

Donor-directed immunologic safety of COVID-19 vaccination in renal transplant recipients.

Infection risk and COVID-19 outcomes make SARS-CoV-2 vaccination essential forsolid-organ transplant recipients. Reports of immune activation after vaccination causing graft failure raise concerns, but data are limited. Here, we document graft function, donor-derived-cell-free-DNA(dd-cfDNA), and donor-specific antibodies (DSA) in solid-organ renal transplant recipients after vaccination.

Multisite biologic tissue SARS-CoV-2 PCR testing in kidney transplantation from a COVID-positive donor.

With a high community transmission rate, SARS-CoV-2 has profoundly exacerbated the shortage of organs. Although the risk of donor-recipient transmission of SARS-CoV-2 is anecdotally low, an organ-specific infection analysis of procured organs from SARS-CoV-2 positive donors has yet to be established. Using a combination of clinically available and research-only polymerase chain reaction methods, organ preservation fluid and renal parenchymal tissues were tested for SARS-CoV-2 from the kidney of a SARS-CoV-2-positive donor prior to transplantation.