Donor-Reactive T-cell Responses after HLA-Identical Living-Related Kidney Transplantation

Kidney transplantation is the preferred treatment of choice for almost all categories of patients with end-stage-renal disease (ESRD) including those with hypertension, glomerulonephritis, diabetes mellitus and genetic causes as polycystic renal disease. Transplanted patients will live approximately 10-15 years longer than patients that remain on dialysis. In light of the increased donor shortage and the increasing waiting time, the number of kidney transplants from living donors enormously increased during the last decade. Complete matching for major Human Leucocyte Antigen (HLA) molecules between donor and recipients is preferable, but due to the high degree of polymorphism of HLA, only some recipients with a suitable living-related sibling donor receive a fully HLA-identical donor kidney

Damping mechanism for the strongly renormalized cc-axis charge transport in high-TcT_c cuprate superconductors

We analyze the $c$-axis infrared reflectivity of La$_{1.85}$Sr$_{0.15}$CuO$_4$ single crystals. The plasma edge near 6 meV, observed below $T_c$, is due to Cooper-pair tunneling. This low value of the plasma edge is consistent with the $c$-axis plasma frequency ($\nu_p$) obtained from LDA calculations ($>0.1$ eV) if we take into account that the single-particle charge transport along the $c$ axis is strongly incoherent both above and below $T_c$. We find no evidence for a reduction of the $c$-axis scattering rate ($\gamma$) below $T_c$. Our investigation suggests $h\gamma>h\nu_{p}\gg 3.5k_BT_c$, which is exactly opposite to the clean limit. VSGD.94.6.1Comment: 4 pages, figures on request. Revtex, version 2, Materials Science Center Internal Report Number VSGD.94.6.

mHealth technologies for pregnancy prevention:A challenge for patient-centred contraceptive counselling in Dutch general practice

BACKGROUND: A general practitioner (GP) standardly provides contraceptive counselling and care in the Netherlands. Recent years have seen the rise of mobile health technologies that aim to prevent pregnancy based on fertility awareness-based methods (FABMs). We lack high-quality evidence of these methods' effectiveness and clarity on how healthcare professionals include them in contraceptive counselling.OBJECTIVES: To analyse how Dutch healthcare professionals include pregnancy-prevention mobile health technologies (mHealth contraception) in contraceptive counselling and to propose practice recommendations based on our findings.METHODS: We used ethnographic methods, including semi-structured interviews with nine professionals who were recruited using purposive sampling, 10 observations of contraceptive counselling by four professionals, six observations of teaching sessions in medical training on contraception and reproductive health, one national clinical guideline, and seven Dutch patient decision aids. Data were collected between 2018 and 2021 and analysed inductively using praxiographic and thematic analysis.RESULTS: In contraceptive counselling and care, professionals tended to blend two approaches: 1) individual patient-tailored treatment and 2) risk minimisation. When interviewed about mHealth contraception, most professionals prioritised risk minimisation and forewent tailored treatment. Some did not consider mHealth contraception or FABMs as contraceptives or deemed them inferior methods.CONCLUSION: To minimise risk of unintended pregnancy, professionals hesitated to include mHealth contraception or other FABMs in contraceptive consultations. This may hamper adequate patient-centred counselling for patients with preference for mHealth contraception.Based on these results, we proposed recommendations that foster a patient-tailored approach to mHealth contraceptives.</p

Robot-assisted walking vs overground walking in stroke patients: an evaluation of muscle activity

Objective: There is increasing evidence that robot-assisted treadmill training might be useful for gait rehabilitation after stroke. The aim of this study was to evaluate the muscle activity of stroke patients during robot-assisted walking and overground walking, and of a group of able-bodied subjects during overground walking. Design: Case-control observational study. Subjects: Ten stroke subjects and 10 able-bodied control subjects. Methods: Electromyography measurements of 7 lower-limb muscles were made in 3 trials: robotic walking, in which stroke subjects walked in a robot-assisted gait orthosis; overground walking for the same group of stroke subjects; and overground walking for control subjects. Trials were compared with respect to electromyography amplitude of selected leg muscles. Results: Higher muscle activity during overground walking compared with robotic walking was found in several muscles during several phases of the gait cycle. A significant trial × leg interaction revealed smaller differences in muscle activity between the paretic and non-paretic leg during robotic walking compared with overground walking. Furthermore, the muscle activity pattern was not significantly different between control walking and robotic walking, while it was different between control walking and overground walking. Conclusion: Despite lower muscle activity, robot-assisted treadmill training may elicit a more symmetrical pattern of leg muscle activity, which approaches that of able-bodied individuals. © 2012 Foundation of Rehabilitation Information