323 research outputs found
Effects of donor cause of death, ischemia time, inotrope exposure, troponin values, cardiopulmonary resuscitation, electrocardiographic and echocardiographic data on recipient outcomes: A review of the literature
BackgroundHeart transplantation has become standard of care for pediatric patients with either end‐stage heart failure or inoperable congenital heart defects. Despite increasing surgical complexity and overall volume, however, annual transplant rates remain largely unchanged. Data demonstrating pediatric donor heart refusal rates of 50% suggest optimizing donor utilization is critical. This review evaluated the impact of donor characteristics surrounding the time of death on pediatric heart transplant recipient outcomes.MethodsAn extensive literature review was performed to identify articles focused on donor characteristics surrounding the time of death and their impact on pediatric heart transplant recipient outcomes.ResultsPotential pediatric heart transplant recipient institutions commonly receive data from seven different donor death‐related categories with which to determine organ acceptance: cause of death, need for CPR, serum troponin, inotrope exposure, projected donor ischemia time, electrocardiographic, and echocardiographic results. Although DITs up to 8 hours have been reported with comparable recipient outcomes, most data support minimizing this period to <4 hours. CVA as a cause of death may be associated with decreased recipient survival but is rare in the pediatric population. Otherwise, however, in the setting of an acceptable donor heart with a normal echocardiogram, none of the other data categories surrounding donor death negatively impact pediatric heart transplant recipient survival.ConclusionsEchocardiographic evaluation is the most important donor clinical information following declaration of brain death provided to potential recipient institutions. Considering its relative importance, every effort should be made to allow direct image visualization.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154939/1/petr13676.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154939/2/petr13676_am.pd
Major flaws in conflict prevention policies towards Africa : the conceptual deficits of international actors’ approaches and how to overcome them
Current thinking on African conflicts suffers from misinterpretations oversimplification, lack of focus, lack of conceptual clarity, state-centrism and lack of vision). The paper analyses a variety of the dominant explanations of major international actors and donors, showing how these frequently do not distinguish with sufficient clarity between the ‘root causes’ of a conflict, its aggravating factors and its triggers. Specifically, a correct assessment of conflict prolonging (or sustaining) factors is of vital importance in Africa’s lingering confrontations. Broader approaches (e.g. “structural stability”) offer a better analytical framework than familiar one-dimensional explanations. Moreover, for explaining and dealing with violent conflicts a shift of attention from the nation-state towards the local and sub-regional level is needed.Aktuelle Analysen afrikanischer Gewaltkonflikte sind häufig voller Fehlinterpretationen (Mangel an Differenzierung, Genauigkeit und konzeptioneller Klarheit, Staatszentriertheit, fehlende mittelfristige Zielvorstellungen). Breitere Ansätze (z. B. das Modell der Strukturellen Stabilität) könnten die Grundlage für bessere Analyseraster und Politiken sein als eindimensionale Erklärungen. häufig differenzieren Erklärungsansätze nicht mit ausreichender Klarheit zwischen Ursachen, verschärfenden und auslösenden Faktoren. Insbesondere die richtige Einordnung konfliktverlängernder Faktoren ist in den jahrzehntelangen gewaltsamen Auseinandersetzungen in Afrika von zentraler Bedeutung. Das Diskussionspapier stellt die große Variationsbreite dominanter Erklärungsmuster der wichtigsten internationalen Geber und Akteure gegenüber und fordert einen Perspektivenwechsel zum Einbezug der lokalen und der subregionalen Ebene für die Erklärung und Bearbeitung gewaltsamer Konflikte
A novel type of intermittency in a nonlinear dynamo in a compressible flow
The transition to intermittent mean--field dynamos is studied using numerical
simulations of isotropic magnetohydrodynamic turbulence driven by a helical
flow. The low-Prandtl number regime is investigated by keeping the kinematic
viscosity fixed while the magnetic diffusivity is varied. Just below the
critical parameter value for the onset of dynamo action, a transient
mean--field with low magnetic energy is observed. After the transition to a
sustained dynamo, the system is shown to evolve through different types of
intermittency until a large--scale coherent field with small--scale turbulent
fluctuations is formed. Prior to this coherent field stage, a new type of
intermittency is detected, where the magnetic field randomly alternates between
phases of coherent and incoherent large--scale spatial structures. The
relevance of these findings to the understanding of the physics of mean--field
dynamo and the physical mechanisms behind intermittent behavior observed in
stellar magnetic field variability are discussed.Comment: 19 pages, 13 figure
Who Bears the Burden of Social Security Contributions in Germany? Evidence from 35 Years of Administrative Data
Flexible Work Time in Germany: Do Workers Like it and How Have Employers Exploited it Over the Cycle?
The Resource Curse and Rentier States in the Caspian Region : A Need for Context Analysis
Although much attention is paid to the Caspian region with regard to energy issues, the domestic
consequences of the region’s resource production have so far constituted a neglected field of research.
A systematic survey of the latest research trends in the economic and political causalities of
the resource curse and of rentier states reveals that there is a need for context analysis. In reference
to this, the paper traces any shortcomings and promising approaches in the existent body of literature
on the Caspian region. Following on from this, the paper then proposes a new approach; specifically,
one in which any differences and similarities in the context conditions are captured. This
enables a more precise exploration of the exact ways in which they form contemporary post-Soviet
Caspian rentier states.Obwohl der Region am Kaspischen Meer im Zuge von Energiediskursen große Aufmerksamkeit zuteil
wird, stellen die innerstaatlichen Folgen der Ressourcenproduktion in der Region ein bislang
vernachlässigtes Forschungsfeld dar. Ein systematischer Überblick über die jüngsten Forschungstrends
zu wirtschaftlichen und politischen Kausalzusammenhängen des Ressourcenfluchs und zu
Rentierstaaten offenbart die Notwendigkeit von Kontextanalysen. Hierauf Bezug nehmend, analysiert
der Aufsatz sowohl die Mängel als auch viel versprechende Ansätze in der betreffenden Literatur
zur Region am Kaspischen Meer. Der Aufsatz stellt letztendlich einen neuen Ansatz vor, der
Unterschiede und Gemeinsamkeiten in den Kontextbedingungen erfasst, um zu erforschen, wie diese
die gegenwärtigen post-sowjetischen Rentierstaaten in der Region am Kaspischen Meer tatsächlich
prägen
Leptin Therapy Reverses Hyperglycemia in Mice With Streptozotocin-Induced Diabetes, Independent of Hepatic Leptin Signaling
From Negative to Positive Integration: European State Aid Control Through Soft and Hard Law
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