Psychosocial Assessment of Candidates for Transplantation (PACT) Score Identifies High Risk Patients in Pediatric Renal Transplantation

Background: Currently, there is no standardized approach for determining psychosocial readiness in pediatric transplantation. We examined the utility of the Psychosocial Assessment of Candidates for Transplantation (PACT) to identify pediatric kidney transplant recipients at risk for adverse clinical outcomes.Methods: Kidney transplant patients <21-years-old transplanted at Duke University Medical Center between 2005 and 2015 underwent psychosocial assessment by a social worker with either PACT or unstructured interview, which were used to determine transplant candidacy. PACT assessed candidates on a scale of 0 (poor candidate) to 4 (excellent candidate) in areas of social support, psychological health, lifestyle factors, and understanding. Demographics and clinical outcomes were analyzed by presence or absence of PACT and further characterized by high (≥3) and low (≤2) scores.Results: Of 54 pediatric patients, 25 (46.3%) patients underwent pre-transplant evaluation utilizing PACT, while 29 (53.7%) were not evaluated with PACT. Patients assessed with PACT had a significantly lower percentage of acute rejection (16.0 vs. 55.2%, p = 0.007). After adjusting for HLA mismatch, a pre-transplant PACT score was persistently associated with lower odds of acute rejection (Odds Ratio 0.119, 95% Confidence Interval 0.027–0.52, p = 0.005). In PACT subsection analysis, the lack of family availability (OR 0.08, 95% CI 0.01–0.97, p = 0.047) and risk for psychopathology (OR 0.34, 95% CI 0.13–0.87, p = 0.025) were associated with a low PACT score and post-transplant non-adherence.Conclusions: Our study highlights the importance of standardized psychosocial assessments and the potential use of PACT in risk stratifying pre-transplant candidates

CHInese medicine NeuroAiD efficacy on stroke recovery - Extension study (CHIMES-E): A multicenter study of long-term efficacy

© 2015 S. Karger AG, Basel. Background: The CHInese Medicine NeuroAiD Efficacy on Stroke recovery (CHIMES) study was an international randomized double-blind placebo-controlled trial of MLC601 (NeuroAiD) in subjects with cerebral infarction of intermediate severity within 72 h. CHIMES-E (Extension) aimed at evaluating the effects of the initial 3-month treatment with MLC601 on long-term outcome for up to 2 years. Methods: All subjects randomized in CHIMES were eligible for CHIMES-E. Inclusion criteria for CHIMES were age ≥18, baseline National Institute of Health Stroke Scale of 6-14, and pre-stroke modified Rankin Scale (mRS) ≤1. Initial CHIMES treatment allocation blinding was maintained, although no further study treatment was provided in CHIMES-E. Subjects received standard care and rehabilitation as prescribed by the treating physician. mRS, Barthel Index (BI), and occurrence of medical events were ascertained at months 6, 12, 18, and 24. The primary outcome was mRS at 24 months. Secondary outcomes were mRS and BI at other time points. Results: CHIMES-E included 880 subjects (mean age 61.8 ± 11.3; 36% women). Adjusted OR for mRS ordinal analysis was 1.08 (95% CI 0.85-1.37, p = 0.543) and mRS dichotomy ≤1 was 1.29 (95% CI 0.96-1.74, p = 0.093) at 24 months. However, the treatment effect was significantly in favor of MLC601 for mRS dichotomy ≤1 at 6 months (OR 1.49, 95% CI 1.11-2.01, p = 0.008), 12 months (OR 1.41, 95% CI 1.05-1.90, p = 0.023), and 18 months (OR 1.36, 95% CI 1.01-1.83, p = 0.045), and for BI dichotomy ≥95 at 6 months (OR 1.55, 95% CI 1.14-2.10, p = 0.005) but not at other time points. Subgroup analyses showed no treatment heterogeneity. Rates of death and occurrence of vascular and other medical events were similar between groups. Conclusions: While the benefits of a 3-month treatment with MLC601 did not reach statistical significance for the primary endpoint at 2 years, the odds of functional independence defined as mRS ≤1 was significantly increased at 6 months and persisted up to 18 months after a stroke.Link_to_subscribed_fulltex

The effects of language proficiency on the executive functions of older Tamil-English bilinguals

Evidence of the effects of bilingualism on age-related cognitive decline remains inconclusive as the bilingual experience tends to be vastly different from one individual to another. This could be in part, due to the large variabilities in different dimensions of language (e.g. dominance, proficiency) that might interfere with how bilingualism influences cognitive functions. Language proficiency has been proposed as one source of variability. While there are studies that investigate how young bilinguals of different proficiency levels perform on various cognitive aspects, this same line of research is all but at its infancy concerning older adults and therefore warrants further examination. This study thus examines if higher proficiencies in older bilinguals would manifest in better performance in tasks assessing response inhibition, interference suppression and working memory (WM) performance. 28 older Tamil-English bilinguals whose native language is Tamil and only differed in English proficiency were dichotomized into Low and High proficiency groups based on their PPVT-IV English scores. They were then assessed on a range of tasks tapping upon various cognitive constructs such as response inhibition, interference suppression and WM. Results indicate that better English proficiency might modulate the maintenance and updating of information in WM, while interference suppression, response inhibition and conflict resolution in WM might be less sensitive to proficiency effects. These results suggest that effects of proficiency have a smaller effect on cognitive functions such as executive control or are restricted to only certain aspects of cognitive control than previously hypothesized.Bachelor of Arts in Linguistics and Multilingual Studie

ON THE CONDITION OF WAITING: EVERYDAY LIFE OF BANGLADESH FOREIGN WORKERS

Bachelor'sBachelor of Social Sciences (Honours

On quasinormal subgroups

This paper presents to the undergraduate students a new concept on Group Theory called quasinormal subgroup. This generalization of normal subgroups was introduced by Oystein Ore in his article Structures and Group Theory I. Every normal subgroup is a quasinormal subgroup. The converse however is not true. This was shown in the article written by Dean Hickerson, Sherwin Stein and Kenya Yamaoka entitled When Quasinormal Implies Normal, which was the basic reference of this paper.This paper discusses some of the differences between normal and quasinormal subgroups. Some sufficient conditions so that quasinormal subgroups are normal are given in some theorems proved in this paper. Examples of quasinormal subgroups which are not normal and which are normal are also provided in this paper

Modeling exchange rate volatility and volatility transmission between the Philippine peso and Indonesian rupiah for the period January 1996 to June 2000

The thrust of this paper is to investigate the linkage of the volatility of exchange rates of currencies which were adversely affected during the recent Asian currency crisis. Specifically, the study attempts to confirm the presence of volatility transmission and compares the temporal behavior of the transmission between the Philippine peso and Indonesian rupiah for the pre-crisis, crisis, and post-crisis subperiods. The plan for the rest of this paper is as follows. Models for the volatility of the peso and the rupiah will first be estimated using univariate GARCH (1,1) specifications. These models will then be used to prove our hypotheses on the behavior of exchange rate volatility. Next, vector auto regression (VAR) will be employed to simultaneously model returns (volatility) transmission between the currencies under study. Said models will prove the existence or non-existence of volatility transmission between the currencies. Finally, the VAR model for both currencies will be estimated on the overall, pre-crisis, and post-crisis periods to discover the effects, if any, of the Asian currency crisis on the volatility transmission between the two currencies. The study confirms the presence of own-market volatility transmission for both currencies. We also find evidence of volatility transmission for all subperiods except the pre-crisis period. Effects of the Asian currency crisis are still evident during the post-crisis subperiod specification. Furthermore, results of the study support the conjecture that volatility transmission is greater during periods of turbulence than during periods of relative calm. Finally, the paper discusses market contagion as the driving force behind volatility spillovers among currencies

Profile identification and characterization of risk perceptions and preventive behaviors during the COVID-19 pandemic: a latent profile analysis

In a public health crisis, communication plays a vital role in making sure policies and recommendations from the government level get disseminated accurately to its people and is only considered as effective when the public accepts, supports, complies to, and engages in policies or behaves as per governments' recommendations. Adopting the multivariate audience segmentation strategy for health communication, this study uses a data-driven analytical method to (1) identify audience segments of public health crisis communication in Singapore based on knowledge, risk perception, emotional responses, and preventive behaviors; and (2) characterize each audience segment according to demographic factors, personality traits, information processing styles, and health information preferences. Results (N = 2033) from a web-based questionnaire executed in August 2021 have identified three audience segments: the less-concerned (n = 650), the risk-anxious (n = 142), and the risk-majority (n = 1,241). This study offers insights to how audiences of public health crisis communication perceive, process, and respond to information directed to them during the pandemic, thereby informing policy makers to tailor more targeted public health communication interventions in promoting positive attitude and behavior change.Published versionThis research was supported by the DSO National Laboratories (DSOCL21088)