Based on ’Theoryof Electron Donating, Accepting and Exchanging’whichtheauthorpub lishedin 1989 ,thispaperexplainsin detailsaboutthesuperconductivityof metallicelements,metalliccompoundsand alloys. Italso providesa ...Based on ’Theoryof Electron Donating, Accepting and Exchanging’whichtheauthorpub lishedin 1989 ,thispaperexplainsin detailsaboutthesuperconductivityof metallicelements,metalliccompoundsand alloys. Italso providesa methodto raise Tc.展开更多
First-principles calculations are applied for investigating influence of electron donating ability of donor groups in eight thermally activated delayed fluorescence（TADF） molecules on their geometrical structures an...First-principles calculations are applied for investigating influence of electron donating ability of donor groups in eight thermally activated delayed fluorescence（TADF） molecules on their geometrical structures and transition properties as well as reverse intersystem crossing（RISC） processes. Results show that the diphenylamine substitution in the donor part can slightly change the bond angle but decrease bond length between donor and acceptor unit except for the lowest triplet state（Ti） of carbazole-xanthone molecule. As the electron donating ability of donor groups is increased, the overlap between the highest occupied molecular orbital（HOMO） and the lowest unoccupied molecular orbital（LUMO） is decreased. As the diphenylamine groups are added in donor part, the delocalization of HOMO is enlarged,which brings a decreased energy gap(△ES1-T1) between the lowest singlet excited state（S1）and T1 state. Furthermore, with the calculated spin-orbit coupling coefficient(HSO), one finds that the larger value of ■ is, the faster the RISC is. The results show that all investigated molecules are promising candidates as TADF molecules. Overall, a wise molecular design strategy for TADF molecules,in which a small △ES1-T1 can be achieved by enlarging the delocalization of frontier molecular orbitals with large separation between HOMO and LUMO, is proposed.展开更多
The catalytic activity of Perovskite-type mixed oxides (LaCoO3, PrCoO3 and SmCoO3) for the reduction of cyclohexanone to cyclohexanol with 2-propanol (Meerwein-PonndorfVerley reduction) has been studied. The data have...The catalytic activity of Perovskite-type mixed oxides (LaCoO3, PrCoO3 and SmCoO3) for the reduction of cyclohexanone to cyclohexanol with 2-propanol (Meerwein-PonndorfVerley reduction) has been studied. The data have been correlated with the surface electron donor properties of these mixed oxides展开更多
A policy adopted in Pujiang County, east China＇s Zhejiang Province, has triggered an online debate as it says students can get additional scores in the high school entrance examination if their parents donate blood t...A policy adopted in Pujiang County, east China＇s Zhejiang Province, has triggered an online debate as it says students can get additional scores in the high school entrance examination if their parents donate blood to the local blood bank. According to the controversial regulation, students can receive additiona one to three scores if their parents donate 4,000-8,000 milliliters of blood.展开更多
There is worldwide shortage of organs for solid-organ transplantation. Many obstacles to deceased and live donation have been described and addressed, such as lack of understanding of the medical process, the issue of...There is worldwide shortage of organs for solid-organ transplantation. Many obstacles to deceased and live donation have been described and addressed, such as lack of understanding of the medical process, the issue of the definition of brain death, public awareness of the need for transplants, and many others. However, it is clear that the striking differences in deceased and live donation rates between different countries are only partly explained by these factors and many cultural and social reasons have been invoked to explain these observations. We believe that one obstacle to both deceased and live donation that is less well appreciated is that of religious concerns. Looking at the major faiths and religions worldwide, it is reassuring to see that most of them encourage donation. However, there is also scepticism amongst some of them, often relating to the concept of brain death and/or the processes surrounding death itself. It is worthwhile for transplant teams to be broadly aware of the issues and also to be mindful of resources for counselling. We believe that increased awareness of these issues within the transplant community will enable us to discuss these openly with patients, if they so wish.展开更多
BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparosc...BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.展开更多
The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established b...The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established by the World Health Organization(WHO). Reform in China has demonstrated the unwavering confidence and utmost determination of the Chinese government and the Chinese transplantation community. The year 2015 marked a historic turning point when voluntary donations from Chinese citizens became the sole legitimate source for organ transplantation. Since 2015, China has gradually established and refined the “Chinese Mode” and “China System” for organ donation and transplantation, fulfilling its political pledge of reform, and has garnered international recognition, and fostered a social culture which promotes organ donation. This article reviewed the history of reform on organ donation and transplantation in China, presented a new pattern of establishment of organ donation system in the new era of the country, and the direction of advances in the future.展开更多
Although national transplant organizations share common visions and goals,the creation of a unified global organization remains impractical.Differences in ethnicity,culture,religion,and education shape local practices...Although national transplant organizations share common visions and goals,the creation of a unified global organization remains impractical.Differences in ethnicity,culture,religion,and education shape local practices and infrastructure,making the establishment of a single global entity unfeasible.Even with these social disparities aside,logistical factors such as time and distance between organ procurement and transplantation sites pose significant challenges.While technological advancements have extended organ preservation times,they have yet to support the demands of transcontinental transplantations effectively.This review presents a comparative analysis of the structures,operational frameworks,policies,and legislation governing various transplant organizations around the world.Key differences pertain to the administration of these organizations,trends in organ donation,and organ allocation policies,which reflect the financial,cultural,and religious diversity across different regions.While a global transplant organization may be out of reach,agreeing on best practices for the benefit of patients is essential.展开更多
April 2025 China has over 7 million registered organ donors More than 7.05 million people in China have registered as voluntary organ donors,according to data released during an awareness-raising event for organ donat...April 2025 China has over 7 million registered organ donors More than 7.05 million people in China have registered as voluntary organ donors,according to data released during an awareness-raising event for organ donation held on April 1.To date,58,000 posthumous organ donation surgeries,more than 63,000 body donations and over 110,000 corneal donations have been carried out.These donations have saved the lives of more than 170,000 people experiencing organ failure,and restored sight to over 100,000 individuals.To honor the donors,over 280 memorial sites have been established around China.During the Qingming Festival each year,commemorative events will be held across the country to promote awareness of and encourage greater public participation in this life-saving initiative.展开更多
BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes...BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.展开更多
China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning ...China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning that China had donated 1,610 tonnes of rice to his people.展开更多
On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom P...On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom Province.Over 150 participants including Kemreat Viseth,Deputy Director of the Council of Ministers of Cambodia and President of Civil Society Alliance Forum(CSAF),Nhek Ban Kheng,Deputy Governor of Kampong Thom Province.展开更多
BACKGROUND Liver disease is a major cause of mortality in Mexico.Liver transplantation(LT)remains severely limited,and there are no reports on equity of access.AIM To analyze geographical disparities in LT access in M...BACKGROUND Liver disease is a major cause of mortality in Mexico.Liver transplantation(LT)remains severely limited,and there are no reports on equity of access.AIM To analyze geographical disparities in LT access in Mexico.METHODS LT waitlist registrations and LT rates in Mexico from 2014 to 2023 were assessed.LT listings per million persons(pmp)were calculated.Observed-to-expected listings were calculated by controlling listings pmp and mortality rate per 10000.LT and waitlist mortality was calculated as 90-day rate,overall rate and rate per 100 person-years.We compared access to waitlist,transplantation and mortality between patients living in Mexican States with higher LT activity and those living in other States.RESULTS There were 2600 new waitlist registrations;1572 registrations(60.4%)living in Mexico City and State,Jalisco and Nuevo Leon.There were 1755 LT;92.5%of them performed in States with higher LT activity,and 1101(62.7%vs 37.3%;P<0.001)done in patients living in those States.Listings pmp in the Mexican States with high LT activity were 3.8,1.5 vs 1.2,0.6(P<0.001);observed-to-expected listings were 1.3,0.4 vs 0.4,0.2(P<0.001);LT pmp were 2.7,0.9 vs 0.7,0.5(P<0.001).After controlling for other variables,patients living in high LT activity States had a HR 1.14(95%CI:1.03-1.26;P=0.009)to be a case of transplantation after listing.CONCLUSION Geographic disparities substantially affect LT access in Mexico.The population living near Transplant Centers has a 3.2-fold higher access to the waiting list and a 3.8-fold higher likelihood of LT.Current referral system,and resource allocation need urgent revision to remove the barriers associated with geographic disparity.展开更多
BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vom...BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vomiting,and constipation which may delay discharge.Liposomal bupivacaine,ketorolac,and scheduled acetaminophen have all demonstrated efficacy for management of post-operative pain in this population.AIM To assess the efficacy and safety of an opioid-sparing protocol utilizing a multimodal pain management approach in living kidney donors post-nephrectomy.METHODS Single-center,retrospective chart review study examining 52 living kidney donors(26 pre-protocol implementation,26 post-protocol implementation)from May 24th,2019 to September 27th,2023.Patients in the post-protocol group received intraoperative liposomal bupivacaine,hydromorphone PCA(until able to tolerate oral medications),15 mg of intravenous ketorolac every 6 hours for 3 doses,and scheduled oral acetaminophen,in addition to oxycodone as needed for moderate to severe pain.The primary endpoint was oral morphine equivalent(OME)use within 48 hours post-surgery.Secondary endpoints include average daily pain scale within 48 hours post-surgery,length of stay(LOS)(days),and incidence of new acute kidney injury(AKI)or gastrointestinal(GI)bleed during admission per provider.Differences between the pre-and post-protocol implementation groups were compared utilizing the exact Wilcoxon test for continuous variables and either the Fisher’s Exact orχ^(2) test for categorical variables.RESULTS Patients in the pre-protocol implementation group received more OME(mg)within 48 hours post-surgery when compared to the post-protocol group(median:84.5 vs 69.0).The median of total OME over the course of admission was numerically greater the pre-protocol group(105.0 vs 69.0),and was significantly more per LOS(41.3 vs 25.7,P=0.02).Average daily pain score was not statistically significantly different between the two groups on postoperative day 1(median:5.3 vs 4.4;P=0.43)and post-operative day 2(median:4.7 vs 5.2;P=0.96).No significant differences were found in provider-identified incidences of AKI or GI bleeding during admission.There was no difference in serum creatinine at the time of discharge between the two groups.CONCLUSION A multimodal,opioid-sparing pain management protocol was as effective for pain control and resulted in significantly less opioid daily exposure over LOS.No adverse events were found related to use of ketorolac in patients undergoing donor nephrectomy.Our findings suggest that an opioid-sparing protocol is both safe and effective at minimizing opioid exposure and managing post-operative pain within the first 48 hours post-surgery.展开更多
好题精选阅读下面短文,从每题所给的A、B、C、D四个选项中选出最佳选项。Two years ago,I came across a collection of loose and dusty photos.I thought that if these were mine,or my family's,I'd want someone to 1 them...好题精选阅读下面短文,从每题所给的A、B、C、D四个选项中选出最佳选项。Two years ago,I came across a collection of loose and dusty photos.I thought that if these were mine,or my family's,I'd want someone to 1 them to me.展开更多
BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-ma...BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.展开更多
In a crumbling tech hub near the marginal coastline,young Angolan developers,despite the challenges of unreliable Internet and dependence on foreign APIs(application programming interfaces),are tapping on donated lapt...In a crumbling tech hub near the marginal coastline,young Angolan developers,despite the challenges of unreliable Internet and dependence on foreign APIs(application programming interfaces),are tapping on donated laptops,debugging health apps that alert rural clinics of disease outbreaks.Their resilience and determination in the face of such obstacles are not just a source of innovation,but also of inspiration and hope.展开更多
BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury...BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines(CK).The machine perfusion(MP)is a promising device to rescue these grafts.AIM To analyze the role of MP connected to a sorbent cartridge(PerSorb®)and used for very damaged DCD pig livers.METHODS Seven grafts were procured from pigs from a slaughterhouse.Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time:(1)3 grafts were perfused in hypothermic MP with PerSorb(Sorb);(2)2 other grafts in hypothermic MP(HMP)without the cartridge(NoSorb);and(3)The other 2 livers stored in the ice box(NoTreat).The CK were measured at HMP start(T0)and at the end(Tend).Biopsies were taken at T0 and Tend.RESULTS All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment(8.83 at T0 vs 6.4 at Tend of Sorb;15 at T0 vs 5.45 at Tend for NoSorb,P value>0.05).At Tend,both Sorb and NoSorb groups had better hemodynamic parameters,comparable between the two groups.Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1,tumor necrosis factor-alpha and interleukin-1βfor NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment.Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.CONCLUSION These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.展开更多
Khan et al’single-centre,retrospective study on the use of right or left kidneys in living-donor renal transplantation,offers the opportunity to further discuss a complex and debated topic in clinical transplantation...Khan et al’single-centre,retrospective study on the use of right or left kidneys in living-donor renal transplantation,offers the opportunity to further discuss a complex and debated topic in clinical transplantation.In brief,the authors confirm that,despite the historical preference for left kidneys,attributed to their anatomical advantages during donor nephrectomy and recipient transplantation,right kidneys can provide excellent outcomes when donors and recipients are carefully selected,and a meticulous surgical technique is applied in every step of the process.Usefully,the article includes some practical tips to help less experienced surgeons address the technical challenges of right kidney transplantation,such as extended renal vein dissection or full mobilization of the iliac vein of the recipient to minimize tension during anastomosis.Although limited by the selective use of minimally invasive(MI)nephrectomy for left kidneys,this work underscores the importance of expanding the living-donor pool,challenging the traditional taboos,and facilitating access to transplantation for a wider population of patients around the globe.Properly designed studies with larger sample size,comparable MI surgical techniques,prospective data collection,and long-term donor and recipient outcomes are warranted.展开更多
基金This work was supported by the National Natural Science Foundation of China(No.11374195 and No.21403133),the Taishan Scholar Project of Shandong Province,the Promotive Research Fund for Excellent Young and Middle-aged Scientists of Shandong Province(No.BS2014CL001),and the General Financial Grant from the China Postdoctoral Science Foundation(No.2014M560571).
文摘First-principles calculations are applied for investigating influence of electron donating ability of donor groups in eight thermally activated delayed fluorescence（TADF） molecules on their geometrical structures and transition properties as well as reverse intersystem crossing（RISC） processes. Results show that the diphenylamine substitution in the donor part can slightly change the bond angle but decrease bond length between donor and acceptor unit except for the lowest triplet state（Ti） of carbazole-xanthone molecule. As the electron donating ability of donor groups is increased, the overlap between the highest occupied molecular orbital（HOMO） and the lowest unoccupied molecular orbital（LUMO） is decreased. As the diphenylamine groups are added in donor part, the delocalization of HOMO is enlarged,which brings a decreased energy gap(△ES1-T1) between the lowest singlet excited state（S1）and T1 state. Furthermore, with the calculated spin-orbit coupling coefficient(HSO), one finds that the larger value of ■ is, the faster the RISC is. The results show that all investigated molecules are promising candidates as TADF molecules. Overall, a wise molecular design strategy for TADF molecules,in which a small △ES1-T1 can be achieved by enlarging the delocalization of frontier molecular orbitals with large separation between HOMO and LUMO, is proposed.
文摘The catalytic activity of Perovskite-type mixed oxides (LaCoO3, PrCoO3 and SmCoO3) for the reduction of cyclohexanone to cyclohexanol with 2-propanol (Meerwein-PonndorfVerley reduction) has been studied. The data have been correlated with the surface electron donor properties of these mixed oxides
文摘A policy adopted in Pujiang County, east China＇s Zhejiang Province, has triggered an online debate as it says students can get additional scores in the high school entrance examination if their parents donate blood to the local blood bank. According to the controversial regulation, students can receive additiona one to three scores if their parents donate 4,000-8,000 milliliters of blood.
文摘There is worldwide shortage of organs for solid-organ transplantation. Many obstacles to deceased and live donation have been described and addressed, such as lack of understanding of the medical process, the issue of the definition of brain death, public awareness of the need for transplants, and many others. However, it is clear that the striking differences in deceased and live donation rates between different countries are only partly explained by these factors and many cultural and social reasons have been invoked to explain these observations. We believe that one obstacle to both deceased and live donation that is less well appreciated is that of religious concerns. Looking at the major faiths and religions worldwide, it is reassuring to see that most of them encourage donation. However, there is also scepticism amongst some of them, often relating to the concept of brain death and/or the processes surrounding death itself. It is worthwhile for transplant teams to be broadly aware of the issues and also to be mindful of resources for counselling. We believe that increased awareness of these issues within the transplant community will enable us to discuss these openly with patients, if they so wish.
文摘BACKGROUND Living donor kidney transplantation is the optimal method of long-term renal replacement therapy.Minimally invasive donor nephrectomy techniques,such as robot-assisted(RALDN)and hand-assisted(HALDN)laparoscopic procedures,are well-established in high-income countries and are being increasingly adopted worldwide.Nevertheless,no studies have reported surgical outcomes of RALDN donor nephrectomy from a United Kingdom center to date.AIM To compare surgical outcomes between RALDN and HALDN laparoscopic donor nephrectomy in a United Kingdom high-volume living kidney donor transplant program.METHODS A case-control matching analysis was performed based on the following parameters:Sex,age,body mass index,procedure laterality,number of renal arteries,and previous abdominal surgeries.Key surgical outcomes,including primary warm ischemia time,operative duration,and post-operative recovery,were evaluated.RESULTS In this cohort of 140 living donors(70 RALDN vs 70 HALDN),donor and recipient outcomes were equivalent across key metrics:Pain scores,overall complication rates,readmissions,reoperations,and creatinine levels at 30 days and 1 year.Recipient long-term renal function did not differ between groups.Operative time for RALDN decreased significantly over the study period,indicating progressive improvement along the learning curve.Although RALDN was associated with a modestly longer mean warm ischaemia time(3.53 minutes vs 2.76 minutes,P<0.001)and extended hospital stay(4.21 days vs 3.17 days,P<0.001),these did not translate into any disadvantage in clinical outcomes.CONCLUSION In this first United Kingdom comparative cohort,RALDN demonstrated excellent safety and efficacy,even in the early phase of our programme,matching the outcomes of the well-established,gold-standard HALDN approach.Moreover,the pronounced learning-curve trajectory suggests considerable potential for further improvements in robotic surgical outcomes as the programme matures.
文摘The reform stems from honesty and determination. Since 2005, organ donation and transplantation in China has undergone thorough reform, which complies with legislation requirements and ethical principles established by the World Health Organization(WHO). Reform in China has demonstrated the unwavering confidence and utmost determination of the Chinese government and the Chinese transplantation community. The year 2015 marked a historic turning point when voluntary donations from Chinese citizens became the sole legitimate source for organ transplantation. Since 2015, China has gradually established and refined the “Chinese Mode” and “China System” for organ donation and transplantation, fulfilling its political pledge of reform, and has garnered international recognition, and fostered a social culture which promotes organ donation. This article reviewed the history of reform on organ donation and transplantation in China, presented a new pattern of establishment of organ donation system in the new era of the country, and the direction of advances in the future.
文摘Although national transplant organizations share common visions and goals,the creation of a unified global organization remains impractical.Differences in ethnicity,culture,religion,and education shape local practices and infrastructure,making the establishment of a single global entity unfeasible.Even with these social disparities aside,logistical factors such as time and distance between organ procurement and transplantation sites pose significant challenges.While technological advancements have extended organ preservation times,they have yet to support the demands of transcontinental transplantations effectively.This review presents a comparative analysis of the structures,operational frameworks,policies,and legislation governing various transplant organizations around the world.Key differences pertain to the administration of these organizations,trends in organ donation,and organ allocation policies,which reflect the financial,cultural,and religious diversity across different regions.While a global transplant organization may be out of reach,agreeing on best practices for the benefit of patients is essential.
文摘April 2025 China has over 7 million registered organ donors More than 7.05 million people in China have registered as voluntary organ donors,according to data released during an awareness-raising event for organ donation held on April 1.To date,58,000 posthumous organ donation surgeries,more than 63,000 body donations and over 110,000 corneal donations have been carried out.These donations have saved the lives of more than 170,000 people experiencing organ failure,and restored sight to over 100,000 individuals.To honor the donors,over 280 memorial sites have been established around China.During the Qingming Festival each year,commemorative events will be held across the country to promote awareness of and encourage greater public participation in this life-saving initiative.
文摘BACKGROUNDLimited research exists on attitudes and barriers to organ donation in the UnitedArab Emirates, highlighting the need for a deeper understanding of public perceptionsand challenges.AIMTo assess the attitudes and barriers toward organ donation.METHODSA cross-sectional study was adopted and included 607 samples consisting ofstudents, faculty, and staff who were selected from three universities in Ajmanand who had signed consent forms. A validated self-administered questionnairethat included 13 attitudes and 14 barrier items was used as a tool. The reliabilityof the tool was 0.89 (Cronbach's alpha). In the analysis of attitude scores, responseswere rated on a scale from 0 to 4, with 0 representing 'strongly disagree'and 4 representing 'strongly agree' for supportive attitudes towards organdonation. Participants with a total attitude score of 39 or higher indicated agreementor strong agreement with all items, reflecting a generally supportiveattitude toward organ donation. Lower scores suggested that the respondent wasneutral or disagreed with one or more items, indicating a less supportive attitudetoward organ donation. Knowledge about organ donation was assessed by selfadministeredquestionnaire that included 13 items. Analysis was done using SPSSversion 29. χ2 was used to assess associations between variables.RESULTSMost participants were young (≤ 30 years old, 83.7%), female (79.2%), from World Health Organization Eastern Mediterranean Region countries (69.5%), Muslim (82.4%), students (80.6%), single(83.9%), and from a nursing college (33.1%). The majority had no personal or family history of organ donation(93.2% and 93.9%, respectively). Supportive attitudes toward organ donation were significantly associated withreligion (P = 0.003), working status (P = 0.009), university (P = 0.019), and knowledge (P < 0.001). Additionally,those with a personal or family history of organ donation were significantly more supportive (56.8% vs 33.3%, P =0.004). Lack of awareness was the most reported barrier for organ donation (64.1%) followed by being afraid oforgan donation due to medical procedures required (51.9%).CONCLUSIONThe findings suggest that supportive attitudes toward organ donation are influenced by demographic factors,personal experiences, and knowledge levels. Lack of awareness and fear of medical procedures were the mostreported barriers to organ donation. These results highlight the need for targeted educational programs to increaseawareness and promote positive attitudes toward organ donation.
文摘China’s rice donation to Uganda’s drought-stricken Karamoja sub-region saves thousands from starvation.Afriend in need is a friend indeed,said Thomas Lokirut,an elder from Uganda’s Karamojong people after learning that China had donated 1,610 tonnes of rice to his people.
文摘On the morning of 23 December 2024,the Panda Pack and Bike Donation Ceremony in Cambodia under the Action Plan on Silk Road People-to-People Connectivity was held at Balaing Khang Lech Primary School in Kampong Thom Province.Over 150 participants including Kemreat Viseth,Deputy Director of the Council of Ministers of Cambodia and President of Civil Society Alliance Forum(CSAF),Nhek Ban Kheng,Deputy Governor of Kampong Thom Province.
文摘BACKGROUND Liver disease is a major cause of mortality in Mexico.Liver transplantation(LT)remains severely limited,and there are no reports on equity of access.AIM To analyze geographical disparities in LT access in Mexico.METHODS LT waitlist registrations and LT rates in Mexico from 2014 to 2023 were assessed.LT listings per million persons(pmp)were calculated.Observed-to-expected listings were calculated by controlling listings pmp and mortality rate per 10000.LT and waitlist mortality was calculated as 90-day rate,overall rate and rate per 100 person-years.We compared access to waitlist,transplantation and mortality between patients living in Mexican States with higher LT activity and those living in other States.RESULTS There were 2600 new waitlist registrations;1572 registrations(60.4%)living in Mexico City and State,Jalisco and Nuevo Leon.There were 1755 LT;92.5%of them performed in States with higher LT activity,and 1101(62.7%vs 37.3%;P<0.001)done in patients living in those States.Listings pmp in the Mexican States with high LT activity were 3.8,1.5 vs 1.2,0.6(P<0.001);observed-to-expected listings were 1.3,0.4 vs 0.4,0.2(P<0.001);LT pmp were 2.7,0.9 vs 0.7,0.5(P<0.001).After controlling for other variables,patients living in high LT activity States had a HR 1.14(95%CI:1.03-1.26;P=0.009)to be a case of transplantation after listing.CONCLUSION Geographic disparities substantially affect LT access in Mexico.The population living near Transplant Centers has a 3.2-fold higher access to the waiting list and a 3.8-fold higher likelihood of LT.Current referral system,and resource allocation need urgent revision to remove the barriers associated with geographic disparity.
文摘BACKGROUND Opioids are commonly used for management of post-operative pain in living kidney donors.Reducing exposure to opioids is desirable to minimize risk of dependence and potential side effects such as nausea,vomiting,and constipation which may delay discharge.Liposomal bupivacaine,ketorolac,and scheduled acetaminophen have all demonstrated efficacy for management of post-operative pain in this population.AIM To assess the efficacy and safety of an opioid-sparing protocol utilizing a multimodal pain management approach in living kidney donors post-nephrectomy.METHODS Single-center,retrospective chart review study examining 52 living kidney donors(26 pre-protocol implementation,26 post-protocol implementation)from May 24th,2019 to September 27th,2023.Patients in the post-protocol group received intraoperative liposomal bupivacaine,hydromorphone PCA(until able to tolerate oral medications),15 mg of intravenous ketorolac every 6 hours for 3 doses,and scheduled oral acetaminophen,in addition to oxycodone as needed for moderate to severe pain.The primary endpoint was oral morphine equivalent(OME)use within 48 hours post-surgery.Secondary endpoints include average daily pain scale within 48 hours post-surgery,length of stay(LOS)(days),and incidence of new acute kidney injury(AKI)or gastrointestinal(GI)bleed during admission per provider.Differences between the pre-and post-protocol implementation groups were compared utilizing the exact Wilcoxon test for continuous variables and either the Fisher’s Exact orχ^(2) test for categorical variables.RESULTS Patients in the pre-protocol implementation group received more OME(mg)within 48 hours post-surgery when compared to the post-protocol group(median:84.5 vs 69.0).The median of total OME over the course of admission was numerically greater the pre-protocol group(105.0 vs 69.0),and was significantly more per LOS(41.3 vs 25.7,P=0.02).Average daily pain score was not statistically significantly different between the two groups on postoperative day 1(median:5.3 vs 4.4;P=0.43)and post-operative day 2(median:4.7 vs 5.2;P=0.96).No significant differences were found in provider-identified incidences of AKI or GI bleeding during admission.There was no difference in serum creatinine at the time of discharge between the two groups.CONCLUSION A multimodal,opioid-sparing pain management protocol was as effective for pain control and resulted in significantly less opioid daily exposure over LOS.No adverse events were found related to use of ketorolac in patients undergoing donor nephrectomy.Our findings suggest that an opioid-sparing protocol is both safe and effective at minimizing opioid exposure and managing post-operative pain within the first 48 hours post-surgery.
文摘好题精选阅读下面短文,从每题所给的A、B、C、D四个选项中选出最佳选项。Two years ago,I came across a collection of loose and dusty photos.I thought that if these were mine,or my family's,I'd want someone to 1 them to me.
文摘BACKGROUND Organ donation and transplantation are vital for saving lives,yet awareness remains limited.Health literacy,the ability to understand and use health information,and self-control,which influences decision-making,are crucial factors in promoting awareness.Understanding their relationship can guide efforts to increase participation in organ donation.AIM To investigate the effect of health literacy on organ donation and transplantation awareness,with self-control acting as a mediator,and to emphasize its importance.METHODS The study comprised 345 adults recruited from five different cities in Türkiye.The sample included 208 women(60.29%)and 137 men(39.71%).The age range of the sample group varies between 18 and 49(median age=24.13;SD=8.81).Selfreport data were collected including psychometric measures assessing organ donation and transplantation awareness,health literacy,and self-control.Reliability analysis,descriptive statistics,correlational analysis,and mediational analysis of the data were carried.RESULTS The analysis showed that health literacy was positively correlated with organ donation and transplantation awareness(r=0.340)and self-control(r=0.376).Self-control was positively related to organ donation and transplantation awareness(r=0.531).Mediating analysis supported a mediation model where health literacy was found to influence organ donation and transplantation awareness via self-control(bootstrap=0.158,95%confidence interval=0.105-0.215).CONCLUSION The results indicate that self-control mediates the positive relationship between health literacy and organ donation and transplantation awareness.Enhancing individuals’health literacy may therefore increase awareness of organ donation and transplantation through improvements in self-control.
文摘In a crumbling tech hub near the marginal coastline,young Angolan developers,despite the challenges of unreliable Internet and dependence on foreign APIs(application programming interfaces),are tapping on donated laptops,debugging health apps that alert rural clinics of disease outbreaks.Their resilience and determination in the face of such obstacles are not just a source of innovation,but also of inspiration and hope.
文摘BACKGROUND Marginal donation after circulatory death(DCD)liver grafts are carefully used to combat the constant shortage of donors.Clinically,the worst outcomes are mainly related to severe ischemia-reperfusion-injury and the dangerous effect of various inflammatory cytokines(CK).The machine perfusion(MP)is a promising device to rescue these grafts.AIM To analyze the role of MP connected to a sorbent cartridge(PerSorb®)and used for very damaged DCD pig livers.METHODS Seven grafts were procured from pigs from a slaughterhouse.Grafts were made very marginal with at least 60 minutes of donor warm ischemia time and 24 hours of static-cold ischemia time:(1)3 grafts were perfused in hypothermic MP with PerSorb(Sorb);(2)2 other grafts in hypothermic MP(HMP)without the cartridge(NoSorb);and(3)The other 2 livers stored in the ice box(NoTreat).The CK were measured at HMP start(T0)and at the end(Tend).Biopsies were taken at T0 and Tend.RESULTS All 5 grafts treated with HMP had a negative lactate trend after 3 hours of treatment(8.83 at T0 vs 6.4 at Tend of Sorb;15 at T0 vs 5.45 at Tend for NoSorb,P value>0.05).At Tend,both Sorb and NoSorb groups had better hemodynamic parameters,comparable between the two groups.Enzyme-linked immunosorbent assay analysis showed a reduction of monocyte chemotactic protein-1,tumor necrosis factor-alpha and interleukin-1βfor NoSorb group at Tend and a complete downregulation to physiological levels of the same CK in Sorb livers after 3 hours of treatment.Biopsies showed a reduction of the perisinusoidal edema for the Sorb grafts compared with the NoSorb livers.CONCLUSION These data suggest a potential protective role of treatment of grafts with MP and sorbent cartridge in reducing the inflammatory response after a severe ischemic injury.
文摘Khan et al’single-centre,retrospective study on the use of right or left kidneys in living-donor renal transplantation,offers the opportunity to further discuss a complex and debated topic in clinical transplantation.In brief,the authors confirm that,despite the historical preference for left kidneys,attributed to their anatomical advantages during donor nephrectomy and recipient transplantation,right kidneys can provide excellent outcomes when donors and recipients are carefully selected,and a meticulous surgical technique is applied in every step of the process.Usefully,the article includes some practical tips to help less experienced surgeons address the technical challenges of right kidney transplantation,such as extended renal vein dissection or full mobilization of the iliac vein of the recipient to minimize tension during anastomosis.Although limited by the selective use of minimally invasive(MI)nephrectomy for left kidneys,this work underscores the importance of expanding the living-donor pool,challenging the traditional taboos,and facilitating access to transplantation for a wider population of patients around the globe.Properly designed studies with larger sample size,comparable MI surgical techniques,prospective data collection,and long-term donor and recipient outcomes are warranted.
