64 research outputs found

    International Liver Transplantation Society Global Census:First Look at Pediatric Liver Transplantation Activity Around the World

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    Background. Over 16 000 children under the age of 15 died worldwide in 2017 because of liver disease. Pediatric liver transplantation (PLT) is currently the standard of care for these patients. The aim of this study is to describe global PLT activity and identify variations between regions. Methods. A survey was conducted from May 2018 to August 2019 to determine the current state of PLT. Transplant centers were categorized into quintile categories according to the year they performed their first PLT. Countries were classified according to gross national income per capita. Results. One hundred eight programs from 38 countries were included (68% response rate). 10 619 PLTs were performed within the last 5 y. High-income countries performed 4992 (46.4%) PLT, followed by upper-middle- (4704 [44·3%]) and lower-middle (993 [9·4%])-income countries. The most frequently used type of grafts worldwide are living donor grafts. A higher proportion of lower-middle-income countries (68·7%) performed ≄25 living donor liver transplants over the last 5 y compared to high-income countries (36%; P = 0.019). A greater proportion of programs from high-income countries have performed ≄25 whole liver transplants (52.4% versus 6.2%; P = 0.001) and ≄25 split/reduced liver transplants (53.2% versus 6.2%; P &lt; 0.001) compared to lower-middle-income countries. Conclusions. This study represents, to our knowledge, the most geographically comprehensive report on PLT activity and a first step toward global collaboration and data sharing for the greater good of children with liver disease; it is imperative that these centers share the lead in PLT.</p

    Dissecting the Transcriptional Regulatory Properties of Human Chromosome 16 Highly Conserved Non-Coding Regions

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    Non-coding DNA conservation across species has been often used as a predictor for transcriptional enhancer activity. However, only a few systematic analyses of the function of these highly conserved non-coding regions (HCNRs) have been performed. Here we use zebrafish transgenic assays to perform a systematic study of 113 HCNRs from human chromosome 16. By comparing transient and stable transgenesis, we show that the first method is highly inefficient, leading to 40% of false positives and 20% of false negatives. When analyzed in stable transgenic lines, a great majority of HCNRs were active in the central nervous system, although some of them drove expression in other organs such as the eye and the excretory system. Finally, by testing a fraction of the HCNRs lacking enhancer activity for in vivo insulator activity, we find that 20% of them may contain enhancer-blocking function. Altogether our data indicate that HCNRs may contain different types of cis-regulatory activity, including enhancer, insulators as well as other not yet discovered functions

    Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

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    OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

    Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

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    The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

    ICAR: endoscopic skull‐base surgery

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    Control of networked Lagrangian systems with delays

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    In sync with the accelerated integration of communication and control systems, this dissertation presents theoretical and experimental results on the robust control of networked Lagrangian systems with discrete-delayed inputs and uncertain information. Within this context, we present novel solutions to the control of nonlinear systems, coordination of multiple agents, bilateral teleoperation, and collision avoidance over unreliable communication channels. We start with the introduction of a passivity-based Model Reference Robust Control framework that guarantees delay-independent asymptotic stability and state convergence of dissipative, nonlinear Lagrangian systems with input and state measurement delays. Then, the proposed control methodology is extended to networks of multiple heterogeneous systems. We demonstrate that stability, formation, and cooperative motion coordination can be attained independently of arbitrarily large constant input delays. We next treat the control problem of single-master-single-slave bilateral teleoperation. Using concepts of passivity theory and input-to-state stability, we design a control strategy that passively compensates for position errors that arise during contact tasks and achieves delay-independent stability and transparency when alternating between unobstructed and obstructed environments. Likewise, we address the case of single-master-multi-slave teleoperation and propose a distributed control law that synthesizes the use of a proportional-derivative controller and the avoidance functions to enforce closed-loop stability, slaves-to-master motion coordination, formation control, static force reflection, and collision avoidance of a group of slave robots with bounded communication delays. We further investigate the topic of collision avoidance and formulate cooperative and noncooperative control strategies that guarantee the safe navigation of multiple Lagrangian systems with limited, unreliable sensing range. Along with the theoretical formulation of the control solutions, this dissertation presents simulation and experimental results with robotic manipulators and unmanned coaxial helicopters utilizing the proposed control strategies

    George Bernard Shaw in the Hispanic World: His Reception and Influence

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    320 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1973.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

    Methodology for Delay-Based Passenger Car Equivalencies for Urban Transit Buses

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    A delay-based passenger car equivalent (D-PCE) methodology for stopping transit buses is presented in this paper. It is based on a D-PCE approach developed in 2000. Field data collected at a near-side bus stop in Chicago, Illinois, were used to determine the total additional delay experienced by bus queues and to illustrate the D-PCE methodology. The relationships between total additional delay, D-PCE, and the factors contributing to delay such as bus dwell time, the number of vehicles queued behind the bus, the bus position within the queue, and the bus arrival–departure time within the cycle were evaluated. The approach is illustrated for cases when the stopping bus was in the first position in the queue. It was found that a bus in first position replaces 5.9 passenger cars. It was also observed that the total additional delay and D-PCE values increased with the factors contributing to additional delay
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