1,314 research outputs found

    A prospective randomized trial of tacrolimus and prednisone versus tacrolimus, prednisone and mycophenolate mofetil in primary adult liver transplantation: A single center report

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    Background. Tacrolimus (TAC) and mycophenolate mofetil (MMF) are currently approved immunosuppressants for prevention of rejection in liver transplantation (LTx). They have different modes of action and toxicity profiles, but the efficacy and safety of MMF in primary liver transplantation with TAC has not been determined. Methods. An Institutional Review Board-approved, open-label, single-center, prospective randomized trial was initiated to study the efficacy and toxicity of TAC and steroids (double-drug therapy (D)) versus TAC, steroids, and MMF (triple-drug therapy (T)) in primary adult LTx recipients. Both groups of patients were started on the same doses of TAC and steroids. Patients randomized to T also received 1 gm MMF twice a day. Results. Between August 1995 and May 1998, 350 patients were enrolled at a single center-175 in the D and 175 in the T groups. All patients were followed until May 1998, with a mean follow-up of 33.8±9.1 months. Using an intention-to-treat analysis, the 1-, 2-, 3-, and 4-year patient survival was 85.1%, 81.6%, 78.6%, and 75.8%, respectively, for D and 87.4%, 85.4%, 81.3%, and 79.9%, respectively, for T. The 4-year graft survival was 70% for D and 72.1% for T. Although the rate of acute rejection in the first 3 months was significantly lower for T than for D (28% for triple vs. 38.9% for double, P=0.03), the overall rate of rejection for T at the end of 1 year was not significantly lower than for the D (38.9% triple vs. 45.2% double). The median time to the first episode of rejection was 14 days for D versus 24 days for T (P=0.008). During the study period, 38 of 175 patients in D received MMF to control ongoing acute rejection, nephrotoxicity, and/or neurotoxicity. On the other hand, 103 patients in the T discontinued MMF for infection, myelosuppression, and/or gastrointestinal disturbances. The need for corticosteroids was less after 6 months for T and the perioperative need for dialysis was lower with use of MMF. Conclusion. This final report confirms similar patient survival and graft survival up to 4 years with a trend towards fewer episodes of rejection, lower need for steroids, and better perioperative renal function. However, the complex nature of LTx patients and their posttransplantation course prevents the routine application of MMF

    Measuring Atmospheric Neutrino Oscillations with Neutrino Telescopes

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    Neutrino telescopes with large detection volumes can demonstrate that the current indications of neutrino oscillation are correct or if a better description can be achieved with non-standard alternatives. Observations of contained muons produced by atmospheric neutrinos can better constrain the allowed region for oscillations or determine the relevant parameters of non-standard models. We analyze the possibility of neutrino telescopes measuring atmospheric neutrino oscillations. We suggest adjustments to improve this potential. An addition of four densely-instrumented strings to the AMANDA II detector makes observations feasible. Such a configuration is competitive with current and proposed experiments.Comment: 36 pages, 21 figures, revte

    IR-correlated 31 GHz radio emission from Orion East

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    Lynds dark cloud LDN1622 represents one of the best examples of anomalous dust emission, possibly originating from small spinning dust grains. We present Cosmic Background Imager (CBI) 31 GHz data of LDN1621, a diffuse dark cloud to the north of LDN1622 in a region known as Orion East. A broken ring with diameter g\approx 20 arcmin of diffuse emission is detected at 31 GHz, at \approx 20-30 mJy beam−1^{-1} with an angular resolution of \approx 5 arcmin. The ring-like structure is highly correlated with Far Infra-Red emission at 12−100ÎŒ12-100 \mum with correlation coefficients of r \approx 0.7-0.8, significant at ∌10σ\sim10\sigma. Multi-frequency data are used to place constraints on other components of emission that could be contributing to the 31 GHz flux. An analysis of the GB6 survey maps at 4.85 GHz yields a 3σ3\sigma upper limit on free-free emission of 7.2 mJy beam−1^{-1} (\la 30 per cent of the observed flux) at the CBI resolution. The bulk of the 31 GHz flux therefore appears to be mostly due to dust radiation. Aperture photometry, at an angular resolution of 13 arcmin and with an aperture of diameter 30 arcmin, allowed the use of IRAS maps and the {\it WMAP} 5-year W-band map at 93.5 GHz. A single modified blackbody model was fitted to the data to estimate the contribution from thermal dust, which amounts to \sim10percentat31GHz.Inthismodel,anexcessof1.52±0.66Jy(2.3σ)isseenat31GHz.Futurehighfrequency 10 per cent at 31 GHz. In this model, an excess of 1.52\pm 0.66 Jy (2.3\sigma) is seen at 31 GHz. Future high frequency \sim100−1000GHzdata,suchasthosefromthePlancksatellite,arerequiredtoaccuratelydeterminethethermaldustcontributionat31GHz.CorrelationswiththeIRAS 100-1000 GHz data, such as those from the {\it Planck} satellite, are required to accurately determine the thermal dust contribution at 31 GHz. Correlations with the IRAS 100 \mumgaveacouplingcoefficientofm gave a coupling coefficient of 18.1\pm4.4 \muK(MJy/sr)K (MJy/sr)^{-1}$, consistent with the values found for LDN1622.Comment: 8 pages, 3 figures, 3 tables, submitted to MNRA

    The arctic curve of the domain-wall six-vertex model

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    The problem of the form of the `arctic' curve of the six-vertex model with domain wall boundary conditions in its disordered regime is addressed. It is well-known that in the scaling limit the model exhibits phase-separation, with regions of order and disorder sharply separated by a smooth curve, called the arctic curve. To find this curve, we study a multiple integral representation for the emptiness formation probability, a correlation function devised to detect spatial transition from order to disorder. We conjecture that the arctic curve, for arbitrary choice of the vertex weights, can be characterized by the condition of condensation of almost all roots of the corresponding saddle-point equations at the same, known, value. In explicit calculations we restrict to the disordered regime for which we have been able to compute the scaling limit of certain generating function entering the saddle-point equations. The arctic curve is obtained in parametric form and appears to be a non-algebraic curve in general; it turns into an algebraic one in the so-called root-of-unity cases. The arctic curve is also discussed in application to the limit shape of qq-enumerated (with 0<q≀40<q\leq 4) large alternating sign matrices. In particular, as q→0q\to 0 the limit shape tends to a nontrivial limiting curve, given by a relatively simple equation.Comment: 39 pages, 2 figures; minor correction

    A joint scoring model for peer-to-peer and traditional lending:A bivariate model with copula dependence

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    We analyse the dependence between defaults in peer-to-peer lending and credit bureaus. To achieve this, we propose a new flexible bivariate regression model that is suitable for binary imbalanced samples. We use different copula functions to model the dependence structure between defaults in the two credit markets. We implement the model in the R package BivGEV and we explore the empirical properties of the proposed fitting procedure by a Monte Carlo study. The application of this proposal to a comprehensive data set provided by Lending Club shows a significant level of dependence between the defaults in peer-to-peer and credit bureaus. Finally, we find that our model outperforms the bivariate probit and univariate logit models in predicting peer-to-peer default, in estimating the value at risk and the expected shortfall

    Methamphetamine and Viagra Use: Relationship to Sexual Risk Behaviors

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    Recent studies show that Viagra and methamphetamine use are associated with unprotected anal intercourse among men who have sex with men (MSM). In Long Beach, California, we have reported on an association between Viagra use and the use of amphetamines during sex. The current research investigated the use of both Viagra and amphetamine in men in Long Beach, California. Data on 1,839 men recruited into HIV prevention and testing programs were collected using the Risk Behavior Assessment. A generalized logit model was constructed comparing ever having used both amphetamine and Viagra together and separately, as compared to never having used either (referent). Men who used both methamphetamine and Viagra showed a significantly higher prevalence of hepatitis B, syphilis, and HIV compared to those who used only one or neither drug. Of the 1,794 complete cases, 11.1% (199/1794) had used both amphetamine and Viagra. Of 20 potential risk and protective factors for use of amphetamine and Viagra, 12 were significant predictors: ever used gamma-hydroxybutyrate (GHB), ever used cocaine, ever used ecstasy, being infected with HIV, race = White compared to other, ever having hepatitis B, ever using crack, ever given money to have sex, living in a hotel, ever been in drug treatment, and ever using heroin. The protective factor was being heterosexual. Viagra use was associated with insertive, and methamphetamine was associated with receptive, anal intercourse. GHB use appears to play a more important role than previously thought

    Tau Neutrinos Underground: Signals of ΜΌ→Μτ\nu_\mu \to \nu_\tau Oscillations with Extragalactic Neutrinos

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    The appearance of high energy tau neutrinos due to ΜΌ→Μτ\nu_\mu \to \nu_\tau oscillations of extragalactic neutrinos can be observed by measuring the neutrino induced upward hadronic and electromagnetic showers and upward muons. We evaluate quantitatively the tau neutrino regeneration in the Earth for a variety of extragalactic neutrino fluxes. Charged-current interactions of the upward tau neutrinos below and in the detector, and the subsequent tau decay create muons or hadronic and electromagnetic showers. The background for these events are muon neutrino and electron neutrino charged-current and neutral-current interactions, where in addition to extragalactic neutrinos, we consider atmospheric neutrinos. We find significant signal to background ratios for the hadronic/electromagnetic showers with energies above 10 TeV to 100 TeV initiated by the extragalactic neutrinos. We show that the tau neutrinos from point sources also have the potential for discovery above a 1 TeV threshold. A kilometer-size neutrino telescope has a very good chance of detecting the appearance of tau neutrinos when both muon and hadronic/electromagnetic showers are detected.Comment: section added and two new figs; accepted for publication in Physical Review
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