483 research outputs found

    UK Renal Registry 18th Annual Report: Chapter 3 Demographic and Biochemistry Profile of Kidney Transplant Recipients in the UK in 2014: National and Centre-specific Analyses.

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    There was a 2% fall in overall renal transplant numbers in 2014, with a significant fall in kidney donation from donors after circulatory death (10%). In 2014, death-censored renal transplant failure rates in prevalent patients were similar to previous years at 2.4% per annum. Transplant patient death rates remained stable at 2.3 per 100 patient years. The median age of incident and prevalent renal transplant patients in the UK was 50.6 and 53.3 years respectively. The median eGFR of prevalent renal transplant recipients was 52.5 ml/min/1.73 m2. The median eGFR of patients one year after transplantation was 57.4 ml/min/1.73 m2 post live transplant, 53.6 ml/min/1.73 m2 post brainstem death transplant and 50.1 ml/min/1.73 m2 post circulatory death transplant. In 2014, 13% of prevalent transplant patients had eGFR ,30 ml/min/1.73 m2. The median decline in eGFR slope beyond the first year after transplantation was −0.48 ml/min/1.73 m2/year.In 2014, malignancy (26%) and infection (24%) remained the commonest causes of death in patients with a functioning renal transplant

    International Trade, Foreign Direct Investment, and Domestic Market Performance

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    We develop a model to estimate simultaneously import shares, export shares, outward foreign direct investment and domestic profits for a large sample of U.S. manufacturing industries. In our model, trade barriers alter the ability of domestic market structure to influence domestic performance. The results indicate that trade flows behave as expected in response to factor intensity. Profits are disciplined by imports and enhanced by exports. Concentration reduces both import and export shares but economies of scale increase them. Exports are complements rather than substitutes for foreign direct investment.Concentration; Exports; Foreign Direct Investment; Import; International Trade; Market Performance; Market Structure; Trade

    Evolutionary history of the Nesophontidae, the last unplaced Recent mammal family

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    The mammalian evolutionary tree has lost several major clades through recent human-caused extinctions. This process of historical biodiversity loss has particularly affected tropical island regions such as the Caribbean, an area of great evolutionary diversification but poor molecular preservation. The most enigmatic of the recently extinct endemic Caribbean mammals are the Nesophontidae, a family of morphologically plesiomorphic lipotyphlan insectivores with no consensus on their evolutionary affinities, and which constitute the only major recent mammal clade to lack any molecular information on their phylogenetic placement. Here, we use a palaeogenomic approach to place Nesophontidae within the phylogeny of recent Lipotyphla. We recovered the near-complete mitochondrial genome and sequences for 17 nuclear genes from a ∼750-year-old Hispaniolan Nesophontes specimen, and identify a divergence from their closest living relatives, the Solenodontidae, more than 40 million years ago. Nesophontidae is thus an older distinct lineage than many extant mammalian orders, highlighting not only the role of island systems as “museums” of diversity that preserve ancient lineages, but also the major human-caused loss of evolutionary history

    Limited sampling strategies for estimation of tacrolimus exposure in kidney transplant recipients receiving extended-release tacrolimus preparation.

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    Tacrolimus is the key component of most contemporary immunosuppressive drug regimens for the prevention of transplant rejection. Area under the concentration time curve over 24 h (AUC0-24 ) predicts efficacy, but predose (trough) tacrolimus blood concentration (C0 ) is currently used to guide dosing. In clinical or research situations where an estimate of AUC is required, collection of a full 24 h pharmacokinetic (PK) profile is cumbersome. Limited sampling strategies (LSSs) have been developed for some tacrolimus preparations but not for the new, extended-release, once-daily formulation of tacrolimus, ENVARSUS XR. Twenty-four kidney transplant recipients were enrolled in this study. Twenty-four tacrolimus PK profiles were obtained over 24 h. Multiple linear regression was used to generate LSSs with the best subset selection for accurate estimation of tacrolimus AUC0-24 . The predictive performance of each model was assessed in the evaluation group. The correlation between actual and predicted AUC0-24 was evaluated and mean percentage prediction error (MPE%), mean absolute percentage prediction error (MAE%), and root mean squared error (RMSE) were calculated for each prediction model to assess bias and precision. The selected LSSs were highly correlated to AUC0-24 compared with the correlation between C0 and AUC0-24 . Two and three sampling points limited sampling strategies: C0 , C2 , and C10 provide the most reliable and effective LSS for estimation of tacrolimus AUC0-24 in routine clinic use. These limited sampling models can be applied in therapeutic drug monitoring schemes to personalize tacrolimus dosing for kidney transplant recipients on treatment with extended-release tacrolimus
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