Vinding Schou (peengreek4)

BACKGROUND & AIMS For patients with liver disease from hepatitis C virus (HCV) infection complicated by end-stage renal disease (ESRD), it is important to assess liver fibrosis before kidney transplantation. We evaluated the accuracy of non-invasive tests to identify advanced hepatic fibrosis in patients with HCV and ESRD. METHODS In a retrospective study, we collected data on ratio of aspartate aminotransferasealanine aminotransferase (ASTALT), AST platelet ratio index (APRI), FIB-4 score, fibrosis index score, and King's score from 139 patients with ESRD and HCV infection (mean age, 52.8 y; 76.3% male; 86.4% African American; 45.3% with increased level of ALT). Results were compared with findings from histologic analyses of biopsies (reference standard). The primary outcome was detection of advanced fibrosis, defined as either bridging fibrosis or cirrhosis. Area under the receiver operating characteristic (AUROC) curves were constructed and optimal cut-off values were determined for each test. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated. We repeated the analysis with stratification for normal levels of ALT (≤ 35 U/L for men and ≤ 25 u/L for women) and increased levels of ALT. RESULTS FIB-4 scores identified patients with advanced fibrosis with an AUROC of 0.71 (95% CI, 0.61-0.80), the King's score with an AUROC of 0.69 (95% CI, 0.58-0.80), and the APRI with and AUROC of 0.68 (95% CI, 0.59-0.79). The accuracy of these tests increased when they were used to analyze patients with increased levels of ALT. All tests produced inaccurate results when they were used to assess patients with normal levels of AST and ALT. CONCLUSIONS In patients with ESRD and HCV infection, FIB-4 scores, King's scores, and the APRI identify those with advanced fibrosis with AUROC values ranging from 0.68-0.71. Accuracy increased modestly when patients with increased levels of ALT were tested, but the tests produced inaccurate results for patients with a normal level of ALT. Among many dermal armors, fish scales have become a source of inspiration in the pursuit of "next-generation" structural materials. Although fish scales function in a hydrated environment, the role of water and intermolecular hydrogen bonding to their unique structural behavior has not been elucidated. Water molecules reside within and adjacent to the interpeptide locations of the collagen fibrils of the elasmodine and provide lubrication to the protein molecules during deformation. We evaluated the contributions of this lubrication and the intermolecular bonding to the mechanical behavior of elasmodine scales from the Black Carp (Mylopharyngodon piceus). Scales were exposed to polar solvents, followed by axial loading to failure and the deformation mechanisms were characterized via optical mechanics. Displacement of intermolecular water molecules by liquid polar solvents caused significant (p ≤ 0.05) increases in stiffness, strength and toughness of the scales. Removal of this lubrication decreased the capacd toughness due to an increase in resistance to fibril rotations and sliding as imparted by molecular friction. We show that intermolecular lubrication is a key component of the "protecto-flexibility" of natural armors and it is an essential element of biomimetic approaches to develop flexible armor systems. Globally, chronic wounds impose a notable burden to patients and healthcare systems. Such skin wounds are readily subjected to bacteria that provoke inflammation and hence challenge the healing process. Furthermore, bacteria induce infection impeding re-epithelialization and collagen synthesis. With an estimated global market of $20.4 billion by 2021, appropriate wound dressing materials e.g. those composed of biopolymers originating from nature, are capable of alleviating the infection incidence and of accelerating the healing process. Particularly, biopolymeric nanofibrous dressings are biocomp