Cardiac transplantation with cyclosporin A and prednisone

Influenced by continuing improvement in results from Stanford, cardiac transplantation was resumed at the University Health Center of Pittsburgh in June 1980. Cyclosporin A (CyA) became available to the authors early in 1981. This report describes the preliminary experience with 21 patients who were treated between March 1981 and April 10, 1982 with cyclosporin A and low-dose steroids. Ages ranged from eight to 53 years, median 46 years. Median age of ten patients disabled because of idiopathic myocardiopathy was 33 years; it was 45 years in the 11 suffering from ischemic heart disease. Sixteen of the 21 patients survived. Eleven have survived for three months, of which six have survived for six months, giving a cumulative survival of 74 and 66%, respectively. Four died perioperatively; one died at six weeks and one at four months. Hyperacute rejection resulted in one death at 12 hours even though the warm and cold lymphocytotoxic crossmatch for T and B cells was negative as evaluated by trypan blue. The two late deaths were related to infection. No late death has occurred because of rejection, and a unique feature is that three recipients with a lymphocytotoxic mismatch did not develop hyperacute rejection. The number of infectious episodes and nonviral infections appears to be less than that associated with the use of azathiaprine and larger doses of steroids. Cyclosporin A (5-10 mg/kg/d) and low-dose prednisone (rapidly tapered in seven days from 200 mg to 15-20 mg/d) is effective in preventing early morbid rejection of the transplanted heart

Evidence for the Protective and Compensatory Functions of Resilience in Children with Intellectual and Developmental Disabilities

Children with intellectual and developmental disabilities (IDD) are more likely to engage in behavior problems than children without IDD. In the present study, we explored whether adverse life experiences and events were related to child behavioral and emotional problems. We also examined whether child resilience would act as a protective factor in this putative association between adverse experiences and child behavioral and emotional problems. Mothers of 310 children with IDD aged between 4 and 15 years old completed a cross-sectional online survey including measures of exposure to adverse life experiences, child resilience, and behavior and emotional problems. In moderated multiple regression models, we found that exposure to adverse life experiences had a positive association with child behavior problems and peer problems and that these associations were moderated by child resilience. Resilience served a protective function—lowering risk of problems for children exposed to adversity. Child resilience also served a compensatory function, being directly associated with fewer conduct and emotional problems and increased pro-social behavior. Child resilience may be an important factor in understanding the behavior and emotional problems of children with IDD. Further, especially longitudinal, research is needed. Interventions designed to increase children’s resilience may be beneficial for children with IDD

Fracture toughness in some hetero-modulus composite carbides: carbon inclusions and voids. Advances in Applied Ceramics

Fracture toughness of ceramics in some cases can be significantly improved by the inclusion of low-modulus phase and even voids. Structure and mechanical characteristics of dense ceramic composites synthesised by reactive hot pressing of TiC-B4C powder mixtures at 1800 - 1950°С under 30MPa during 16 minutes are investigated. X-Ray Diffraction, Scanning Electron Microscopy and Energy Dispersive X-Ray Spectroscopy (SEM and EDX) have shown that during hot pressing solid phase chemical interaction 2TiС + B4C = 2TiВ2 + 3С has occurred resulting in TiB2-TiC-C, TiB2-C or TiB2-B4C-C hetero-modulus composite formation with approximately 1μm carbon precipitates. The volume of such precipitated carbon can reach 35 vol. %. The fracture toughness depends on the precipitate size and amount of graphite precipitation and has a distinct maximum K1C = 10MPa∙m1/2 at nearly 7 vol. % . Such fracture toughness behaviour is explained by the proposed model of crack propagation and the model-based assessment of hetero-modulus ceramic fracture toughness. It is shown that voids and low modulus carbon inclusions blunt the cracks and can increase ceramic toughness. The later has been demonstrated in the another carbon containing ceramic Cr2AlC, so named MAX phase material, when thin film fracture resistance increases as the ceramic was deposited to be porous

Challenging behaviours in adults with an intellectual disability: A total population study and exploration of risk indices

Objectives Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with ID in a defined geographical area and used a behaviour assessment tool with good psychometric properties. Methods Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory – Short Form. The prevalence of self‐injurious, aggressive/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (CRI) to inform longitudinal research and clinical practice. Results The prevalence of overall CB was 18.1% (95% CI: 13.94–23.19%). The prevalence of self‐injurious behaviour was 7.5% (95% CI: 4.94–11.37%), aggressive–destructive behaviour 8.3% (95% CI: 5.54–12.25%), and stereotyped behaviour 10.9% (95% CI: 7.73–15.27%). Communication problems and severity of ID were consistently associated with higher risk of CBs. CRIs were significantly associated with CBs, and the five methods of CRI development produced similar results. Conclusions Findings suggest a multi‐element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of CRIs suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services

A heteroskedastic error covariance matrix estimator using a first-order conditional autoregressive Markov simulation for deriving asympotical efficient estimates from ecological sampled Anopheles arabiensis aquatic habitat covariates

<p>Abstract</p> <p>Background</p> <p>Autoregressive regression coefficients for <it>Anopheles arabiensis </it>aquatic habitat models are usually assessed using global error techniques and are reported as error covariance matrices. A global statistic, however, will summarize error estimates from multiple habitat locations. This makes it difficult to identify where there are clusters of <it>An. arabiensis </it>aquatic habitats of acceptable prediction. It is therefore useful to conduct some form of spatial error analysis to detect clusters of <it>An. arabiensis </it>aquatic habitats based on uncertainty residuals from individual sampled habitats. In this research, a method of error estimation for spatial simulation models was demonstrated using autocorrelation indices and eigenfunction spatial filters to distinguish among the effects of parameter uncertainty on a stochastic simulation of ecological sampled <it>Anopheles </it>aquatic habitat covariates. A test for diagnostic checking error residuals in an <it>An. arabiensis </it>aquatic habitat model may enable intervention efforts targeting productive habitats clusters, based on larval/pupal productivity, by using the asymptotic distribution of parameter estimates from a residual autocovariance matrix. The models considered in this research extends a normal regression analysis previously considered in the literature.</p> <p>Methods</p> <p>Field and remote-sampled data were collected during July 2006 to December 2007 in Karima rice-village complex in Mwea, Kenya. SAS 9.1.4^®was used to explore univariate statistics, correlations, distributions, and to generate global autocorrelation statistics from the ecological sampled datasets. A local autocorrelation index was also generated using spatial covariance parameters (i.e., Moran's Indices) in a SAS/GIS^®database. The Moran's statistic was decomposed into orthogonal and uncorrelated synthetic map pattern components using a Poisson model with a gamma-distributed mean (i.e. negative binomial regression). The eigenfunction values from the spatial configuration matrices were then used to define expectations for prior distributions using a Markov chain Monte Carlo (MCMC) algorithm. A set of posterior means were defined in WinBUGS 1.4.3^®. After the model had converged, samples from the conditional distributions were used to summarize the posterior distribution of the parameters. Thereafter, a spatial residual trend analyses was used to evaluate variance uncertainty propagation in the model using an autocovariance error matrix.</p> <p>Results</p> <p>By specifying coefficient estimates in a Bayesian framework, the covariate number of tillers was found to be a significant predictor, positively associated with <it>An. arabiensis </it>aquatic habitats. The spatial filter models accounted for approximately 19% redundant locational information in the ecological sampled <it>An. arabiensis </it>aquatic habitat data. In the residual error estimation model there was significant positive autocorrelation (i.e., clustering of habitats in geographic space) based on log-transformed larval/pupal data and the sampled covariate depth of habitat.</p> <p>Conclusion</p> <p>An autocorrelation error covariance matrix and a spatial filter analyses can prioritize mosquito control strategies by providing a computationally attractive and feasible description of variance uncertainty estimates for correctly identifying clusters of prolific <it>An. arabiensis </it>aquatic habitats based on larval/pupal productivity.</p

Electrochemical synthesis of peroxomonophosphate using boron-doped diamond anodes

A new method for the synthesis of peroxomonophosphate, based on the use of boron-doped diamond electrodes, is described. The amount of oxidant electrogenerated depends on the characteristics of the supporting media (pH and solute concentration) and on the operating conditions (temperature and current density). Results show that the pH, between values of 1 and 5, does not influence either the electrosynthesis of peroxomonophosphate or the chemical stability of the oxidant generated. Conversely, low temperatures are required during the electrosynthesis process to minimize the thermal decomposition of peroxomonophosphate and to guarantee significant oxidant concentration. In addition, a marked influence of both the current density and the initial substrate is observed. This observation can be explained in terms of the contribution of hydroxyl radicals in the oxidation mechanisms that occur on diamond surfaces. In the assays carried out below the water oxidation potential, the generation of hydroxyl radicals did not take place. In these cases, peroxomonophosphate generation occurs through a direct electron transfer and, therefore, at these low current densities lower concentrations are obtained. On the other hand, at higher potentials both direct and hydroxyl radical-mediated mechanisms contribute to the oxidant generation and the process is more efficient. In the same way, the contribution of hydroxyl radicals may also help to explain the significant influence of the substrate concentration. Thus, the coexistence of both phosphate and hydroxyl radicals is required to ensure the generation of significant amounts of peroxomonophosphoric acid

Metabolic synergies in the biotransformation of organic and metallic toxic compounds by a saprotrophic soil fungus

The saprotrophic fungus Penicillium griseofulvum was chosen as model organism to study responses to a mixture of hexachlorocyclohexane (HCH) isomers (α-HCH, β-HCH, γ-HCH, δ-HCH) and of potentially toxic metals (vanadium, lead) in solid and liquid media. The P. griseofulvum FBL 500 strain was isolated from polluted soil containing high concentrations of HCH isomers and potentially toxic elements (Pb, V). Experiments were performed in order to analyse the tolerance/resistance of this fungus to xenobiotics, and to shed further light on fungal potential in inorganic and organic biotransformations. The aim was to examine the ecological and bioremedial potential of this fungus verifying the presence of mechanisms that allow it to transform HCH isomers and metals under different, extreme, test conditions. To our knowledge, this work is the first to provide evidence on the biotransformation of HCH mixtures, in combination with toxic metals, by a saprotrophic non-white-rot fungus and on the metabolic synergies involved