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56 results about "Liver failure" patented technology

Liver (hepatic) failure is a loss of liver function because of the death of many hepatocytes. The damage can occur suddenly, as with a viral infection, or slowly over time, as with cirrhosis. Acute liver failure refers to both fulminant hepatic failure (FHF) and subfulminant hepatic failure.

Multiple biomarker detection system for diagnosis and classification of hepatic failure acute kidney injury

The invention belongs to the technical field of biomedical engineering, and discloses a multiple biomarker detection system for diagnosis and classification of hepatic failure acute kidney injury, comprising a biomarker library construction module for obtaining historical hepatic failure acute kidney injury data to construct a biomarker library; the historical hepatic failure acute kidney injury data comprises biomarker data, pathological image data and patient clinical data; the data processing module is used for preprocessing the acquired biomarker data, pathological image data and patient clinical data to obtain a biomarker feature data set, a pathological image feature data set and a clinical feature data set; the acute kidney injury diagnosis module is used for fusing the biomarker feature data set, the pathological image feature data set and the clinical feature data set to obtain a comprehensive feature data set; inputting the comprehensive feature data set into a trained acute kidney injury diagnosis model, and predicting to obtain acute kidney injury type data; and the diagnosis accuracy is improved.
Owner:BEIJING YOUAN HOSPITAL CAPITAL MEDICAL UNIV

Preparation method and application of bioactive lipid and lipid nanoparticles thereof

PendingCN121378305APeptide/protein ingredientsAntipyreticEfficacyBioactive lipid
The invention discloses a preparation method and application of bioactive lipid and lipid nanoparticles thereof. The bioactive lipid molecule is formed by bonding long-chain fatty acid (LCFA) with different chain lengths with two functional small molecules, namely phenylboronic acid pinacol ester (PBAP) and Tempol (Tpl) respectively, so that two types of lipid molecules, namely PBAP-LCFA and Tpl-LCFA, with anti-inflammatory activity are constructed. The lipids are used as functional components, and the anti-inflammatory lipid nanoparticles with good biocompatibility, including PLP, TLP and TPLP, can be prepared through a film dispersion method. The lipidoid and the lipid nanoparticles are simple and convenient in preparation process, controllable in structure and function and easy for large-scale production, and have treatment potential in various acute and chronic inflammatory diseases. In an animal model, the lipid nanoparticles have remarkable curative effects on acute peritonitis, acute lung injury, acute hepatic failure, asthma and other diseases. Besides, the lipid bilayer structure of the TPLP can efficiently entrap hydrophilic / hydrophobic drugs, can synergistically deliver treatment drugs while exerting the anti-inflammatory effect of the TPLP, and realizes a synergistic combined treatment strategy for chronic lung inflammation and other diseases.
Owner:YU-YUE PATHOLOGICAL SCIENCES RESEARCH CENTER

Polyethylene glycol modified magnesium boride nanosheet and application thereof in treatment of acute liver failure and concurrent hepatic encephalopathy caused by acetaminophen

This invention discloses a polyethylene glycol-modified magnesium boride nanosheet and its application in treating acute liver failure and hepatic encephalopathy caused by acetaminophen. The nanosheet uses magnesium boride nanosheets as a core, with polyethylene glycol modified on the surface to improve biocompatibility. The nanosheet of this invention exhibits good antioxidant properties and can be used to prepare nanomedicines for treating acute liver failure and / or hepatic encephalopathy caused by acetaminophen. It generates reducing hydrogen gas through a hydrolysis reaction, effectively scavenging reactive oxygen species at the site of liver failure, thereby inhibiting inflammatory responses and effectively alleviating symptoms caused by acute liver failure.
Owner:HEFEI UNIV OF TECH

Application of serum mucoid or Tax1 binding protein 1 in preparation of medicine for treating medicine-induced liver injury or organ ischemia-reperfusion injury

PendingCN121606694AOrganic active ingredientsDigestive systemAdenoassociated virusOrgan damage
The invention relates to application of serum mucoid or Tax1 binding protein 1 in preparation of a medicine for treating medicine-induced liver injury or organ ischemia-reperfusion injury. Experiments prove that by using an adeno-associated virus (AAV) carrying an Orm2 gene, ORM2 recombinant protein or knocking down a TAX1BP1 gene, liver injury and liver failure, ischemia reperfusion injury of the liver, ischemia reperfusion injury of the kidney and ischemia reperfusion induction of intestines induced by APAP treatment can be effectively relieved, and the application has the advantages that the liver injury and liver failure, the ischemia reperfusion injury of the kidney and the ischemia reperfusion induction of the intestine can be effectively relieved; and a new target spot and a new treatment method are provided for treating the ferroptosis-related organ injury.
Owner:SHANGHAI JIAOTONG UNIV SCHOOL OF MEDICINE

Biomarkers for progression of chronic plus acute liver failure (ACLF)

The present invention relates to the field of liver disease, and more particularly to a method for determining the presence of chronic plus acute liver failure or for determining the risk of developing ACLF in a patient suffering from cirrhosis or a delayed early stage of ACLF. The invention also relates to a method for distinguishing patients suffering from decompensated liver cirrhosis, acute decompensated liver cirrhosis (ADC) or delayed ACLF from patients suffering from early ACLF or ACLF 1, 2, 3, a method for determining the degree of systemic inflammation and a method for determining the presence of a bacterial infection with sepsis.
Owner:GRIFOLS WORLDWIDE OPERATIONS +1

Lipid-containing compositions and their application in clearing protein-bound toxins in liver failure

A lipid-containing composition, by weight, includes phospholipids, and one or more of vegetable oil, medium-chain triglycerides, antioxidants, and sodium oleate. It has been verified that the various compositions provided by this invention competitively capture protein-bound toxoids in the blood, thereby achieving the purpose of clearing protein-bound toxoids from the blood, especially for patients with liver failure, and also alleviating oxidative stress in patients during dialysis treatment.
Owner:SHANGHAI NINTH PEOPLES HOSPITAL SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE

Use of apolipoprotein a-i in the preparation of a diagnostic reagent or system for predicting the risk of severe acute hepatitis e

The application belongs to the technical field of biological detection, and particularly relates to the use of apolipoprotein A-I in the preparation of a diagnostic reagent or system for predicting the risk of severe acute hepatitis E. The application first discloses and verifies the significant correlation between the serum apolipoprotein A-I (apoA-I) level and the adverse clinical outcomes (including severe jaundice, liver failure and death) of patients with acute hepatitis E, and establishes the risk interpretation threshold (0.675 g / L and 0.435 g / L) with clinical practical value. The application can objectively and early identify high-risk patients, and provides a powerful auxiliary tool for clinical stratified management and resource optimization.
Owner:RUIJIN HOSPITAL AFFILIATED TO SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE

Method and system for evaluating state of liver postoperative care process

The invention relates to the technical field of liver care, in particular to a liver postoperative care process state evaluation method and system. According to the method, the multiple groups of indexes and the image group feature data are combined, so that the liver nursing, especially the hepatic failure degree after the hepatic resection can be effectively evaluated, the score data reflecting the current hepatic failure development state after the hepatic resection can be obtained, and the wind direction degree can be more intuitively determined through the score data; therefore, the overall automatic prediction of the hepatic failure degree after the hepatic resection is realized.
Owner:FIRST AFFILIATED HOSPITAL OF XINJIANG MEDICAL UNIVERSITY

Therapy guidance and / or therapy monitoring for a treatment with angiotensin-receptor-agonist and / or a precursor thereof

Subject matter of the present invention is an angiotensin-receptor-agonist and / or a precursor thereof for use in the treatment of a disease in a subject, • wherein said disease is selected from the group comprising heart failure, chronic heart failure, acute heart failure (AHF), myocardial infarction (MI), stroke, liver failure, burn injuries, traumatic injuries, severe infection (microbial, viral (e.g. AIDS), parasitic diseases (e.g. Malaria)), SIRS or sepsis, cancer, acute kidney injury (AKI), CNS disorders (e.g. seizures, neurodegenerative diseases), autoimmune diseases, vascular diseases, hypotension and shock, and • wherein said subject has an amount of DPP3 protein and / or DPP3 activity in a sample of bodily fluid that is above a predetermined threshold.
Owner:4TEEN4 PHARMA GMBH

Preparation method and application of parenchymal hepatic cell targeting gene delivery system

The invention discloses a preparation method and application of a hepatic parenchymal cell targeting gene delivery system, and relates to construction and preparation of a hepatic parenchymal cell targeting lipid material GalNAc-PEG2000-DSPE modified MKK4-siRNA (siMKK4) loaded lipid nanoparticle gene delivery system GalNAc-LNP-siMKK4, and the hepatic parenchymal cell targeting gene delivery system can be used for active targeting gene therapy of hepatic failure. The parenchymal hepatic cell targeted gene delivery system selects siMKK4 as a liver regeneration promoting gene therapy drug, has the advantages of clear target spot and capability of accurately silencing a target gene, and can protect siMKK4 from being degraded by extracellular nuclease as a gene delivery carrier, so that the targeted gene delivery system has a good application prospect. N-acetylgalactosamine (GalNAc) is selected as a target head, so that therapeutic genes can be precisely targeted and delivered to parenchymal hepatic cells, the risk of tumorigenesis of other parts of an organism can be reduced while liver regeneration is promoted, and a new thought and a new method are provided for liver regeneration treatment of hepatic failure patients.
Owner:FOURTH MILITARY MEDICAL UNIVERSITY

Rnai agents for inhibiting expression of yellow fever virus (YFV) viral genome expression

The present disclosure relates to RNAi agents, e.g., double stranded RNAi agents, able to inhibit Yellow Fever Virus (YFV) viral genome expression. Also disclosed are pharmaceutical compositions that include YFV RNAi agents and methods of use thereof. The YFV RNAi agents disclosed herein may be conjugated to targeting ligands, including ligands that comprise N-acetyl-galactosamine, to facilitate the delivery to hepatocyte cells. Delivery of the YFV RNAi agents in vivo provides for inhibition of YFV viral genome expression. The RNAi agents can be used in methods of treatment of diseases, disorders, or symptoms caused by YFV infection, such as liver failure.
Owner:ARROWHEAD PHARMACEUTICALS INC

Treatment of liver failure by hepatogenic monocytes

PCT designated stageWO2025235744A1Peptide/protein ingredientsDigestive systemPluripotential stem cellM2 phenotype
Compositions of matter and therapeutic methods for preventing, reducing, or reversing liver pathologies. Autologous pluripotent stem cells for generating monocytes or macrophages that are capable of suppressing liver failure. Methods of administering monocytes that are engineered or induced to facilitate hepatic regeneration. Hepatogenic cells such as monocytes are generated from induced pluripotent stem cells. Hepatogenic cells can be generated by overexpression of one or a plurality of factors associated with an M2 phenotype in pluripotent stem cell-derived monocytes such as signal transducer and activator of transcription 6 (STAT6) and transforming growth factor-beta. Hepatogenic monocytes can be generated in an environment that simulates liver injury.
Owner:IMMORTA BIO INC

Transcriptional therapy based-lipid nanoparticles and mRNA for the treatment of end-stage liver disease

PendingUS20260250351A1NanoparticleLiver failure
Methods are disclosed for treating end-stage liver failure in a subject that include administering to the subject a therapeutically effective amount of a recombinant mRNA encoding HNF4α isoform 2. The methods can include administering a lipid nanoparticle including the recombinant mRNA to the subject. Also disclosed are recombinant mRNA encoding an HNF4α isoform 1 or HNF4α isoform 2, and lipid nanoparticles include the recombinant mRNA. Methods are also for treating liver disease or end-stage liver failure in a subject that include administering to the subject a therapeutically effective amount of a recombinant mRNA encoding HNF4α isoform 1.
Owner:UNIV OF PITTSBURGH OF THE COMMONWEALTH SYST OF HIGHER EDUCATION +1

A proteomic panel, kit and system for predicting secondary infection in patients with hepatitis b-related liver failure

The present application relates to a kind of protein combination, kit and system for predicting secondary infection of hepatitis B related liver failure patient, including the use of protein combination in the preparation for predicting secondary infection of hepatitis B related liver failure patient, the combination includes lysozyme LYZ, calmodulin 1 CALM1, heparin cofactor II SERPIND1 and cutin DPT.It is directly reflected that the combination is biomarker "inflammation-coagulation imbalance" this core mechanism of liver disease secondary infection, with high specificity, and the combination is not interfered by liver disease background, more can truly reflect the potential reaction state of body to infection under liver disease background, to overcome the problem of "failure" and "false negative" of traditional index ";The combination can significantly change concentration when patient is admitted to hospital early, without clinical infection signs, to provide key time window for early preventive treatment.
Owner:BEIJING DITAN HOSPITAL CAPITAL MEDICAL UNIVERSTY

Application of SETDB1 as drug target for preventing and / or treating acute liver injury and liver failure

The invention provides an application of SETDB1 as a drug target for preventing and / or treating acute liver injury and hepatic failure. The acute liver injury and hepatic failure are relieved by knocking out an SETDB1 gene or inhibiting SETDB1 enzyme activity. Experiments prove that the SETDB1 gene is specifically knocked out of the liver or a small-molecule inhibitor SETDB1-TTD-IN-1 is used, acute liver injury and hepatic failure induced by acetaminophen can be remarkably relieved, and the acute liver injury and hepatic failure are shown as reduction of hepatic cell necrosis and remarkable improvement of liver function indexes. The discovery provides new targets and candidate compounds for developing specific drugs for treating acute liver injury and hepatic failure, and has important clinical transformation value.
Owner:FOURTH MILITARY MEDICAL UNIVERSITY

ANTI-ADRENOMEDULLIN (ADM) ANTIBODY OR ANTI-ADM ANTIBODY FRAGMENT OR ANTI-ADM SCAFFIN MH-IG FOR PREVENTING OR REDUCING ORGAN DYSFUNCTION OR ORGAN FAILURE IN A PATIENT WITH A CHRONIC OR ACUTE DISEASE OR ACUTE CONDITION

UndeterminedCY1125947T1DiseaseHepatic dysfunction
The present invention provides an anti-adrenomedullin (ADM) antibody or an anti-adrenomedullin antibody fragment or an anti-ADM non-Ig scaffold for use in the treatment of a chronic or acute disease or acute condition in a patient to prevent or reduce organ dysfunction or organ failure. In a preferred embodiment, the invention provides an anti-ADM antibody or an anti-adrenomedullin antibody fragment or an anti-ADM non-Ig scaffold for use in the treatment of a chronic or acute disease or acute condition in a patient to prevent or reduce renal dysfunction or renal failure or hepatic dysfunction or hepatic failure.
Owner:ADRENOMED

Application of β-hydroxybutyric acid in the preparation of products that promote hepatocyte proliferation and liver regeneration

ActiveCN116869986BDigestive systemAnhydride/acid/halide active ingredientsHydroxybutyric acidLiving donor liver transplantation
This invention discloses the application of β-hydroxybutyric acid (BHB) in the preparation of products that promote hepatocyte proliferation and liver regeneration. This invention discovers that β-hydroxybutyric acid can promote liver regeneration and recovery by promoting the proliferation of hepatocytes in the residual liver after partial hepatectomy. Therefore, β-hydroxybutyric acid can be used to prepare products that promote liver regeneration. This invention not only discloses the application of β-hydroxybutyric acid in promoting liver regeneration, providing a drug source for the development of products that promote liver regeneration, but also provides a theoretical basis for subsequent clinical intervention strategies to promote liver regeneration. This helps to improve liver regeneration capacity and avoid poor prognosis and liver failure caused by insufficient liver regeneration capacity after partial hepatectomy or living donor liver transplantation.
Owner:SOUTHERN MEDICAL UNIVERSITY

Lipid-containing composition and application of lipid-containing composition in removing liver failure protein binding toxin

The lipid-containing composition comprises phospholipid, and one or more of vegetable oil, medium-chain triglyceride, an antioxidant and sodium oleate according to a weight ratio. Through verification, various compositions provided by the invention have the effect of competitively capturing the protein-binding toxoid in the blood, so that the purpose of removing the protein-binding toxoid in the blood is achieved, and particularly, the effect of removing the protein-binding toxoid in the blood of a liver failure patient is more obvious; the oxidative stress state of a patient in the dialysis treatment process is also relieved.
Owner:SHANGHAI NINTH PEOPLES HOSPITAL SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE

Application of β-1,4-galactosyltransferase 1 and its inhibitors in the preparation of drugs for treating acute and chronic liver diseases

ActiveCN116794308Bacute liver failure remissionEffective reliefDigestive systemMicrobiological testing/measurementHepatic inflammationChronic hepatitis
This invention discloses the application of β-1,4-galactosyltransferase 1 and its inhibitors in liver diseases, particularly acute liver injury and liver failure. The application of β-1,4-galactosyltransferase 1 and its inhibitors in acute liver injury and liver failure provides the correlation between β-1,4-galactosyltransferase 1 and acute liver injury and liver failure, confirming that inhibiting the activity of β-1,4-galactosyltransferase 1 can alleviate acute liver injury and liver failure. β-1,4-galactosyltransferase 1 can serve as a drug target for screening acute and chronic hepatitis, liver injury, fatty liver, liver fibrosis, and acute and chronic liver failure. This invention also confirms the alleviating effect of β-1,4-galactosyltransferase 1 inhibitors on acute liver failure. β-1,4-galactosyltransferase 1 inhibitors improve acute liver failure by reducing the enzyme activity or protein expression of β-1,4-galactosyltransferase 1.
Owner:CHINA PHARM UNIV

Application of uridine as serum marker in prognosis of hepatitis B related chronic-acute liver failure

The invention discloses application of uridine as a serum marker in prognosis of hepatitis B related chronic-acute hepatic failure, the uridine content is an independent predictive factor of 28-day mortality of patients with hepatitis B related chronic-acute hepatic failure, and when the mortality of the patients is increased, the uridine expression quantity is reduced, so that the content of the uridine in the prognosis of hepatitis B related chronic-acute hepatic failure is reduced. Uridine can be used for constructing a hepatitis B related chronic-acute liver failure prognosis prediction model. The serum marker uridine provided by the invention can be used for identifying high-death-risk patients in the early stage of hepatitis B-related chronic-acute hepatic failure, provides important reference for clinical doctors to accurately judge the severity of illness, and can identify the high-death-risk patients in the early stage and take corresponding positive treatment measures.
Owner:THE FIRST AFFILIATED HOSPITAL ZHEJIANG UNIV COLLEGE OF MEDICINE

A macromolecular JAK inhibitor, its preparation method and application

This invention discloses a macromolecular JAK inhibitor, its preparation method, and its applications. This macromolecular JAK inhibitor is an anti-inflammatory amphiphilic polymer of hexachlorocyclotriphosphazene or cyanuric chloride coupled with different functional groups. The anti-inflammatory amphiphilic polymer is synthesized with hexachlorocyclotriphosphazene or cyanuric chloride as the backbone structure, linked by a stepwise nucleophilic substitution reaction with different proportions of hydrophilic modules polyethylene glycol and 3-aminobenzoyl hydrazide (i.e., luminol). The preparation method of this type of anti-inflammatory macromolecular drug is simple, its structure and function are controllable, and it is easy to synthesize on a large scale. Furthermore, this type of amphiphilic anti-inflammatory macromolecular drug can self-assemble into nanomicelles in aqueous solution through intermolecular interactions. It can be applied to the treatment of various acute and chronic inflammations or diseases related to the JAK signaling pathway, and can be administered via intravenous injection, subcutaneous injection, nebulized inhalation, intramuscular injection, and any combination of the above methods. This anti-inflammatory macromolecular drug has significant therapeutic effects in acute lung injury, acute kidney injury, acute liver failure, sepsis, and asthma.
Owner:ARMY MEDICAL UNIV

Protein combination, kit and system for predicting secondary infection of hepatitis B related hepatic failure patient

The invention relates to a protein combination, a kit and a system for predicting secondary infection of a patient with hepatitis B related hepatic failure, and comprises application of the protein combination in preparation of a product for predicting secondary infection of the patient with hepatitis B related hepatic failure, and the combination comprises lysozyme LYZ, calmodulin 1 CALM1, heparin cofactor II SERPIND1 and dermatin DPT. The combination is used as a biomarker to directly reflect a core mechanism of inflammation-blood coagulation imbalance of secondary infection of the liver disease, has high specificity, is not interfered by the liver disease background, and can more truly reflect a potential reaction state of an organism to infection under the liver disease background, so that the problems of failure and false negative of a traditional index are solved; the composition can generate obvious concentration change at the early hospital admission stage of a patient when no clinical infection sign exists, and a key time window is provided for early preventive treatment.
Owner:BEIJING DITAN HOSPITAL CAPITAL MEDICAL UNIVERSTY

Lipid-containing compositions and use in clearing protein-bound toxins in liver failure

A lipid-containing composition, by weight, includes phospholipids, and one or more of vegetable oil, medium-chain triglycerides, antioxidants, and sodium oleate. It has been verified that the various compositions provided by this invention competitively capture protein-bound toxoids in the blood, thereby achieving the purpose of clearing protein-bound toxoids from the blood, especially for patients with liver failure, and also alleviating oxidative stress in patients during dialysis treatment.
Owner:SHANGHAI NINTH PEOPLES HOSPITAL SHANGHAI JIAO TONG UNIV SCHOOL OF MEDICINE

Composition containing exosome and application of composition in preparation of products for treating hepatic failure

The invention relates to an exosome-containing composition, which is prepared by blending a modified silicon dioxide agent and an exosome matrix according to a weight ratio of (2-5): 15, the exosome matrix is composed of a mesenchymal stem cell source exosome and a liver stem cell source exosome, and the mass ratio of the mesenchymal stem cell source exosome to the liver stem cell source exosome is 1: (0.5-2). The exosome is a core functional component which plays a role in treating hepatic failure, the biological activity of the exosome is greatly improved through double-source selection and hypoxia pretreatment, the double-stem-cell exosome has a synergistic effect, proliferation and repair of damaged hepatic cells can be directly promoted, and liver functional cells can be supplemented; through compounding of the two exosomes, triple synergy of inhibiting necrosis, promoting regeneration and regulating immunity can be realized, and the problems of single function and limited repair efficiency of a single exosome are solved.
Owner:GUANGZHOU ZHENGYUAN BIOTECHNOLOGY CO LTD

Application of serum tRFs as HBV (Hepatitis B Virus) related liver injury diagnostic marker

The invention relates to the technical field of biological molecular diagnosis of hepatitis B related diseases, and particularly discloses a group of HBV related liver injury diagnostic markers and application thereof. According to the serum exosomes tRF-Val-TAC, tRF-Lys-CTT and tRF-Lys-TTT provided by the invention, the tRFs marker is tRFs combined detection of any one or combination of the sequences, and has the index advantages of high AUC value, high sensitivity and strong specificity; the method can solve the problem of difficulty in early and accurate diagnosis of hepatitis B-related chronic plus acute liver failure (HBV-ACLF) caused by pure dependence on traditional biochemical and blood coagulation indexes, and can meet various diagnosis requirements of ACLF, chronic hepatitis B and cirrhosis.
Owner:SUN YAT SEN UNIV +1

Injectable decellularized matrix-liver organ three-dimensional compound as well as preparation method and application thereof

The invention discloses an injectable decellularized matrix-liver organ three-dimensional compound as well as a preparation method and application thereof. The three-dimensional compound comprises decellularized matrix fibers and liver organs which form a pasty compound, the length of the decellularized matrix fiber is 0.2-2mm, and the decellularized matrix fiber is obtained by selecting mammalian dermis, performing epidermis removal and degreasing, performing soaking treatment with alkali and a nonionic surfactant in sequence, then performing decellularization, and performing freeze-drying and ball milling. The liver organ is obtained by placing bile in matrigel for culture, amplification and induction. According to the invention, a Mini-liver complex with injectability, self-adhesion, biological activity and metabolic function is formed, unified integration of a material scaffold, signal delivery and cell function is realized, and an innovative solution with remarkable clinical potential is provided for local repair after hepatic resection and hepatic failure.
Owner:THE FIRST AFFILIATED HOSPITAL ZHEJIANG UNIV COLLEGE OF MEDICINE

Water-soluble fullerene material and its application in preventing and treating liver injury / liver failure

ActiveCN116812917BFullerenesDigestive systemLiver necrosisLiver function
The present disclosure relates to a new water-soluble fullerene derivative and a preparation method thereof, and application of the water-soluble fullerene material in preventing and treating liver damage / liver failure. The fullerene material of the present disclosure can efficiently scavenge active free radicals, reduce liver oxidative stress, restore normal liver function indicators, reduce liver necrosis, and prevent and treat drug-induced liver damage / liver failure.
Owner:INST OF CHEM CHINESE ACAD OF SCI +1