A change in allocation algorithm in July 2006 allowed broader regional sharing of donor hearts in the United States (US). We assessed if the allocation change has been associated with a decline in ...wait list mortality in the US.
We compared baseline characteristics and outcomes in patients ≥18 years old listed for a primary heart transplant in the US before (July 1, 2004-July 11, 2006, Era1) and after (July 12, 2006-June 30, 2009, Era 2) the change in allocation algorithm. Of 11 864 patients in the study, 4503 were listed during Era 1 and 7361 during Era 2. Patients listed during Era 2 were more likely to be listed status 1A, have an implantable cardioverter-defibrillator, and supported on a continuous flow assist device (P<0.001 for distribution. Patients listed in Era 2 were at a 17% lower risk of dying on the wait list or becoming too sick to transplant (adjusted hazard ratio, 0.83, 95% CI 0.75, 0.93). Transplant recipients in Era 2 were more likely to be transplanted as status 1A (37% versus 48%, respectively, P<0.001). Post-transplant in-hospital mortality (6.3% versus 5.4%; adjusted odds ratio, 0.86 for Era 2, 95% CI 0.79, 1.06) and 1-year survival were similar.
The risk of death on the wait list or becoming too sick to transplant has decreased by 17% in the US since the allocation algorithm allowing broader regional sharing was implemented in 2006. The shift in hearts to sicker candidates has not resulted in higher in-hospital or first year post-transplant mortality.
Racial differences in long-term survival after heart transplant (HT) are well known. We sought to assess racial/ethnic differences in wait-list outcomes among patients listed for HT in the United ...States in the current era.
We compared wait-list and posttransplant in-hospital mortality among white, black, and Hispanic patients ≥ 18 years of age listed for their primary HT in the United States between July 2006 and September 2010. Of 10 377 patients analyzed, 71% were white, 21% were black, and 8% were Hispanic. Black and Hispanic patients were more likely to be listed with higher urgency (listing status 1A/1B) in comparison with white patients (P<0.001). Overall, 10.5% of white, 11.6% of black, and 13.4% of Hispanic candidates died on the wait-list or became too sick for a transplant within 1 year of listing. After adjusting for baseline risk factors, Hispanic patients were at higher risk of wait-list mortality (hazard ratio 1.51, 95% CI 1.23, 1.85) in comparison with white patients, but not black patients (hazard ratio 1.13, 95% CI 0.97, 1.31). In comparison with white HT recipients, posttransplant in-hospital mortality was higher in black recipients (odds ratio 1.53, 95% CI 1.15, 2.03) but was not different in Hispanic recipients (odds ratio 0.78, 95% CI 0.48, 1.29).
Hispanic patients listed for HT in the United States appear to be at higher risk of dying on the wait-list or becoming too sick for a transplant in comparison with white patients. Black patients are not at higher risk of wait-list mortality, but they have higher early posttransplant mortality.
Evaluating conflicting theories about the influence of mountains on carbon dioxide cycling and climate requires understanding weathering fluxes from tectonically uplifting landscapes. The lack of ...soil production and weathering rate measurements in Earth's most rapidly uplifting mountains has made it difficult to determine whether weathering rates increase or decline in response to rapid erosion. Beryllium-10 concentrations in soils from the western Southern Alps, New Zealand, demonstrate that soil is produced from bedrock more rapidly than previously recognized, at rates up to 2.5 millimeters per year. Weathering intensity data further indicate that soil chemical denudation rates increase proportionally with erosion rates. These high weathering rates support the view that mountains play a key role in global-scale chemical weathering and thus have potentially important implications for the global carbon cycle.
This report is an extension of the 1983 AAPM protocol, popularly known as the TG‐21 Protocol. It deals with the calibration of plane‐parallel ionization chambers and their use in calibrating therapy ...electron beams. A hierarchy of methods is presented. The first is to calibrate the plane‐parallel chamber in a high energy electron beam against a cylindrical chamber which has an Ngascyl value that has been obtained from a NIST traceable60Co beam calibration. The second method, which is recommended for implementation by the ADCLs is an in‐air calibration against a NIST‐traceable calibrated cylindrical chamber in a Cobalt‐60 beam to obtain a plane‐parallel‐chamber calibration factor in terms of exposure or air kerma. The third method places the two chambers in a phantom in a Cobalt‐60 beam, and leads to an Ngaspp value for the plane‐parallel chamber. This report also gives Ngaspp/(NxAion)pp and Ngaspp/(NkAion)pp values for five commonly used commercially available plane‐parallel chambers: the Capintec PS‐033, the Exradin P‐11, the Holt, the NACP and the PTW‐Markus. The calculation of these Ngas ratios introduces aKcomp factor which is also calculated for the five parallel plate chambers. The use of the plane‐parallel chambers follows the 1983 AAPM protocol for absorbed dose calibrations of electrons, except that new energy‐dependent Prepl values are given for the Capintec PS‐033 and PTW‐Markus chambers consistent with the consensus of reports in the literature. For all the chambers, however,Prepl is unity for 20 MeV electrons. This report does not address the issue of the use of plane‐parallel chambers in calibrating photon beams.
Many serotypes of echovirus (EV) and Coxsackie B virus (CBV) bind human decay-accelerating factor (DAF) and use it as a receptor for infection. Analogues for DAF have been isolated from mice and rats ...and characterized; these analogues have amino acid identities to human DAF of ∼60%. EV serotypes 3, 6′, 7, 11–13, and 29 and CBV serotypes 1, 3, and 5 caused hemagglutination of human erythrocytes but not rat or mouse erythrocytes, suggesting failure to bind rodent DAF. To confirm this evidence, radiolabeled viruses were incubated with transfected Chinese hamster ovary (CHO) cells that were abundantly expressing each type of DAF. Only cells that expressed human DAF bound virus. Although binding of EV and CBV was specific for human DAF, complement inhibition by DAF expressed in CHO cells was similar for each analogue.
A number of echoviruses use decay accelerating factor (DAF) as a cellular receptor or attachment protein for cell infection. Binding of echovirus 7 to DAF at the cell surface, but not to soluble DAF ...in solution, triggers the formation of virus particles exhibiting an altered sedimentation coefficient ('A' particles) which are considered indicative of the particle uncoating process. We have previously demonstrated that antibodies to beta(2)-microglobulin block cell infection at a stage prior to 'A' particle formation and suggested that this reflects the involvement of beta(2)-microglobulin (or the associated MHC-I) in a virus-receptor complex that forms at the cell surface. We demonstrate here that antiserum to CD59 specifically blocks infection of rhabdomyosarcoma cells by a range of echoviruses, including viruses that bind DAF (e. g. echovirus 7) and those that use currently unidentified receptors other than DAF. The block occurs prior to 'A' particle formation and is cell-type specific. The potential role of CD59 as an active member, or passive participant, in the virus-receptor complex is discussed.
Effect of almond consumption on the serum fatty acid profile: a doseâresponse study Nishi, Stephanie; Cyril W. C. KendallauthorDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada, M5S 3E2Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, ON, CanadaDivision of Nutrition and Dietetics, College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada; Ana-Maria GascoyneauthorDepartment of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada, M5S 3E2Clinical Nutrition and Risk Factor Modification Center, St Michael's Hospital, Toronto, ON, Canada ...
2015
Journal Article
Enterovirus type 70 (EV70) is the causative agent of acute haemorrhagic conjunctivitis and may also give rise to a rare neurological complication closely resembling poliomyelitis. The complete ...nucleotide sequence of the genome of EV70 has been determined from cDNA cloned in Escherichia coli. The genome consists of a 5' non-coding region of 726 nucleotides (nt), a long open reading frame of 6582 nt and a 3' non-coding region of 82 nt prior to the poly(A) tract. Comparison of the nucleotide sequence and the predicted amino acid sequence of the polyprotein with those published for other enteroviruses reveals sufficiently high similarity to predict antigenic regions and polyprotein cleavage sites. The P1 region of EV70 is as similar to those of the entero- as to those of the rhinoviruses, whereas the P2 and P3 regions are more closely related to the coxsackie B and swine vesicular disease viruses than other entero- or rhinoviruses.
The consultation was jointly organized by the WHO-UNAIDS HIV Vaccine Initiative and the Quality Assurance and Safety of Biologicals Team of the World Health Organization (WHO). Thirty-four experts ...from 16 developed and developing countries attended the meeting, bringing together expertise from academic institutions, clinical trial centres, national and international regulatory authorities. Representatives of major pharmaceutical companies were also invited. The primary objective of the meeting was to identify gaps that need to be addressed from regulatory perspective to ensure appropriate progress of HIV vaccine development from basic research to human trials, licensing and future application, with a special focus on needs of developing countries. As a result of discussions, the following priority needs were identified and recommendations were made in order to establish an appropriate regulatory framework for the development and evaluation of preventive HIV/AIDS vaccines, which were divided in two main areas: (a) standardization and control of candidate HIV/AIDS vaccines, and (b) approaches to the conduct of clinical trials of candidate HIV/AIDS vaccines.
PDF
