Recipient pre-existing chronic hypotension is associated with delayed graft function and inferior graft survival in kidney transplantation from elderly donors

BackgroundPre-existing chronic hypotension affects a percentage of kidney transplanted patients (KTs). Although a relationship with delayed graft function (DGF) has been hypothesized, available data are still scarce and inconclusive.MethodsA monocentric retrospective observational study was performed on 1127 consecutive KTs from brain death donors over 11 years (2003-2013), classified according to their pre-transplant Mean Blood Pressure (MBP) as hypotensive (MBP ResultsUnivariate analysis showed that a pre-existing hypotension is associated to DGF occurrence (p50 years old donor.ConclusionsOur findings suggest that pre-existing recipient hypotension, and the subsequent hypotension-related DGF, could be considered a significant detrimental factor, especially when elderly donors are involved in the transplant procedure

The dimensionality of ecological networks

Anna Eklöf et al.How many dimensions (trait-axes) are required to predict whether two species interact? This unanswered question originated with the idea of ecological niches, and yet bears relevance today for understanding what determines network structure. Here, we analyse a set of 200 ecological networks, including food webs, antagonistic and mutualistic networks, and find that the number of dimensions needed to completely explain all interactions is small (< 10), with model selection favouring less than five. Using 18 high-quality webs including several species traits, we identify which traits contribute the most to explaining network structure. We show that accounting for a few traits dramatically improves our understanding of the structure of ecological networks. Matching traits for resources and consumers, for example, fruit size and bill gape, are the most successful combinations. These results link ecologically important species attributes to large-scale community structure. © 2013 Blackwell Publishing Ltd/CNRS.AE and JCK supported by NSF EF # 0827493. AE also by SOEB. SA supported by DEB #1148867. BD supported by Carlsberg foundation and the Danish Council for Independent research. AMMG supported by Spanish Ministry of Education, BVA-2010-0845. PRG supported by FAPESP. MAP supported by CNPq. JMT supported by a Rutherford Discovery Fellowship, RSNZ. RCU, NPC, SBL and DPV supported by CONICET (PIP 2781 and 6564), FONCyT (PICT 1471 and 20805) and BBVA Foundation (BIOCON03-162). JB and AR supported by Spanish MICNN (CICYT CGL2005-00491) and CONSOLIDER (csd2008-0040)Peer Reviewe

PERFORMANCE MEASUREMENT IN SUPPLY CHAIN: NEW NETWORK ANALYSIS AND ENTROPIC INDEXES

Industrial organisations must supply a variety of products and services, meet the needs of fragmented customer expectations, and cope with the consequences of the globalisation of world markets, all of which are producing significant levels of complexity. This study develops a new quantitative measurement of complexity for a supply network based on network analysis, which is often used to study natural ecosystems, focusing in particular on the concept of entropy of information. The research reports advances in both theory on the supply network analysis problem and on its application to industrial contexts. Eight indexes based on entropy are presented. These measures provide a meaningful analysis of the level of complexity in the whole supply network mapping the exchanges of goods between the different actors in the network. The impact of possible modifications of the structure can simply be evaluated using these tools, providing a simple evaluation of the different scenarios. The proposed method takes a holistic point of view to tackle the problem of supply network optimisation. A real world application of the developed new methodology is presented

Early onset of graft glomerulopathy in a patient with post-transplant diabetes mellitus after renal transplantation: a case report

Abstract Background Post-transplant diabetes mellitus (PTDM) is an emerging problem in kidney transplantation, representing an important risk factor for kidney function loss. Diabetic nephropathy (DN) occurrence in transplanted kidneys is poorly investigated. Current knowledge describes DN recurrence in graft 5.9 years from kidney transplantation however there is little data about PTDM and DN. Here, we report a clinical case peculiar for an early appearance of advanced glomerular diabetic lesions, after kidney transplantation. Case presentation A 45-year-old Caucasian male affected by autosomal polycystic kidney disease was transplanted with a cadaveric-kidney-donor from 58-year-old male. Induction immunosuppressive therapy included basiliximab and steroids while the maintenance treatment included, tacrolimus, mofetil micophenolate and methylprednisolone. One month after transplantation the patient developed diabetes requiring treatment with repaglinide quickly replaced with insulin to obtain an acceptable glycemic control (HbA1c 52 mmol/mol). Glycosuria was detected persistently during the first six months after transplantation. To achieve further improvement in glycemic control, a shift from tacrolimus to cyclosporine (CyA) was made and steroids were rapidly tapered and stopped. To minimize calcineurin inhibitors toxicity, which was revealed in the 1-year-protocol-biopsy, everolimus was introduced thereby lowering CyA through levels. Moderate hypertension was well controlled with doxazosin. Thirty months after transplantation a second graft biopsy was performed owing to renal function decline and microalbuminuria appearance. Histological analysis surprisingly showed mesangiolysis and microaneurysms; glomerular sclero-hyalinosis and basal membrane thickness and typical nodular glomerulosclerosis. C4d staining was negative and no evidence of immune deposits were detected. Donor Specific Antibodies, serum C3 and C4 levels and autoimmunity tests were negative. Retrospective analysis on donor history didn’t show diabetes or insulin resistance and no diabetic lesions were found in kidney pre-implant biopsy. Conclusions In our knowledge, this is the first report describing a very early onset of advanced diabetic glomerular lesions in a graft biopsy after PTDM. We hypothesize that additional factors such as everolimus and hypertension, may have contribute to kidney damage

Operationalizing Network Theory for Ecosystem Service Assessments

Managing ecosystems to provide ecosystem services in the face of global change is a pressing challenge for policy and science. Predicting how alternative management actions and changing future conditions will alter services is complicated by interactions among components in ecological and socioeconomic systems. Failure to understand those interactions can lead to detrimental outcomes from management decisions. Network theory that integrates ecological and socioeconomic systems may provide a path to meeting this challenge. While network theory offers promising approaches to examine ecosystem services, few studies have identified how to operationalize networks for managing and assessing diverse ecosystem services. We propose a framework for how to use networks to assess how drivers and management actions will directly and indirectly alter ecosystem services

A Randomized, Double-Blind, Placebo-Controlled Trial: Efficacy of <i>Opuntia ficus</i>-<i>indica</i> Prebiotic Supplementation in Subjects with Gut Dysbiosis

Gut dysbiosis refers to an imbalance in gut microbiota composition and function. Opuntia ficus-indica extract has been shown to modulate gut microbiota by improving SCFA production in vivo and gastrointestinal discomfort (GD) in humans. The aim of this study was to demonstrate the efficacy of OdiliaTM on gastrointestinal health by changing the microbial diversity of species involved in inflammation, immunity, oxidation, and the brain–gut–muscle axis. A randomized, double-blind clinical trial was conducted in 80 adults with gut dysbiosis. The intervention consisted of a 300 mg daily intake of OdiliaTM (n = 40) or maltodextrin as a placebo (n = 40), administered for 8 weeks. Intervention effect was evaluated using 16S metagenomics and GIQLI/GSAS scores at baseline, at 4 and 8 weeks. Eight weeks of OdiliaTM supplementation positively modulates gut microbiota composition with a significant reduction in the Firmicutes to Bacteroidetes ratio (p = 0.0012). Relative abundances of beneficial bacteria (Bacteroides and Clostridium_XIVa) were significantly increased (p p TM may represent an effective and well-tolerated treatment in subjects with gut dysbiosis