Techniques for combined procurement of hearts and kidneys with satisfactory early function of renal allografts.

Methods for combination of donor nephrectomy with donor cardiectomy are outlined. The satisfactory early function of 29 of 34 transplanted kidneys harvested with these techniques supports their wider application and should encourage their wider acceptance

Lectures on Linear Stability of Rotating Black Holes

These lecture notes are concerned with linear stability of the non-extreme Kerr geometry under perturbations of general spin. After a brief review of the Kerr black hole and its symmetries, we describe these symmetries by Killing fields and work out the connection to conservation laws. The Penrose process and superradiance effects are discussed. Decay results on the long-time behavior of Dirac waves are outlined. It is explained schematically how the Maxwell equations and the equations for linearized gravitational waves can be decoupled to obtain the Teukolsky equation. It is shown how the Teukolsky equation can be fully separated to a system of coupled ordinary differential equations. Linear stability of the non-extreme Kerr black hole is stated as a pointwise decay result for solutions of the Cauchy problem for the Teukolsky equation. The stability proof is outlined, with an emphasis on the underlying ideas and methods.Comment: 25 pages, LaTeX, 3 figures, lectures given at first DOMOSCHOOL in July 2018, minor improvements (published version

西沙珊瑚鍶溫度計: 便捷高精度海洋古水溫代用指標

Strontium concentrations in modem Porites coral from XishaIslands were determined by precise thermal ionization mass spectrometry. The coral skeleton grew in the period from 1976 to 1994. The results indicate that the variability of coral Sr is periodically at annual cycles, and is in agreement with in situ measured sea surface temperature (SST). The calibration of Sr and SST with correlation coefficient r = -0. 94 has been developed at monthly sampling resolution. In addition, maximum and minimum seasonal monthly Sr and SST values were also regressed for the 18-year interval, and the correlation coefficient is -0. 98. The error of this Sr thermometer is better than 0. 5 ℃.西沙群島現代濱珊瑚1976～1994年生長期間Sr含量的高精度熱電離質譜測定結果表明，Sr含量隨季節發生周期性的變化，并與當地同期實測海水月平均溫度變化相吻合，其Sr含量與實測海水溫度相關系數為-0.94。這18年冬夏季極端Sr含量與同期月溫的相關系數可高達-0.98。Sr溫度計誤差小于0.5℃。published_or_final_versio

An E-mail Service in a Military Adolescent Medicine Clinic: will teens use it and what for?

The goal of this study was to determine utilization patterns of an Adolescent Medicine Clinic e-mail service. An e-mail service was offered to 6134 patients presenting for care to a military Adolescent Medicine Clinic in San Antonio, Texas over a 6-month period. Families had to complete an authorization form acknowledging that the e-mail service was not encrypted and was not to be used for emergent issues prior to use. 482 families signed up for the service. A total of 42 e-mails were received from 28 of these families. 75% of all e-mails were initiated by parents. The majority of e-mails were administrative issues including: medication refills, lab follow up, and referrals requests. In conclusion, the e-mail service was a low cost method to increase communication options for our patients that was not associated with a large increase in clinic workload because of low utilization rates, especially among younger adolescents.Keywords: Adolescents; E-mail; Internet; Electronic communication; Physicianpatient communicatio

Dilaton Quantum Cosmology with a Schrodinger-like equation

A quantum cosmological model with radiation and a dilaton scalar field is analysed. The Wheeler-deWitt equation in the mini-superspace induces a Schr\"odinger equation, which can be solved. An explicit wavepacket is constructed for a particular choice of the ordering factor. A consistent solution is possible only when the scalar field is a phantom field. Moreover, although the wavepacket is time dependent, a Bohmian analysis allows to extract a bouncing behaviour for the scale factor.Comment: 14 pages, 3 figures in eps format. Minors corrections, new figure

A review of standard pharmacological therapy for adult asthma - Steps 1 to 5

The aim of pharmacological therapy for asthma is to improve symptoms and lung function and minimise the risk of asthma attacks. The intensity of treatment is based on the level of asthma control and the potential risk of future deterioration. In the British asthma guidelines, treatments are divided into Step One to Five, with each Step signifying a need for an increase in therapy in response to symptoms or to prevent exacerbations. Treatments comprise of inhaled or systemic medications. Inhaled therapy includes short-acting and long-acting medication to improve symptoms and inhaled corticosteroids which reduce airway inflammation. Systemic treatments include medications which act on specific biological pathways, such as the leukotriene or IgE pathways, or systemic corticosteroids. In choosing a particular therapy, treatment benefits are balanced by the potential risks of medication-related adverse effects. This review will provide a practical guide to the key pharmacological therapies for adult asthma at Steps One to Five based on British guidelines and consider future options for new treatments

Direct and indirect effects of rotavirus vaccination: Comparing predictions from transmission dynamic models

Early observations from countries that have introduced rotavirus vaccination suggest that there may be indirect protection for unvaccinated individuals, but it is unclear whether these benefits will extend to the long term. Transmission dynamic models have attempted to quantify the indirect protection that might be expected from rotavirus vaccination in developed countries, but results have varied. To better understand the magnitude and sources of variability in model projections, we undertook a comparative analysis of transmission dynamic models for rotavirus. We fit five models to reported rotavirus gastroenteritis (RVGE) data from England and Wales, and evaluated outcomes for short- and long-term vaccination effects. All of our models reproduced the important features of rotavirus epidemics in England and Wales. Models predicted that during the initial year after vaccine introduction, incidence of severe RVGE would be reduced 1.8-2.9 times more than expected from the direct effects of the vaccine alone (28-50% at 90% coverage), but over a 5-year period following vaccine introduction severe RVGE would be reduced only by 1.1-1.7 times more than expected from the direct effects (54-90% at 90% coverage). Projections for the long-term reduction of severe RVGE ranged from a 55% reduction at full coverage to elimination with at least 80% coverage. Our models predicted short-term reductions in the incidence of RVGE that exceeded estimates of the direct effects, consistent with observations from the United States and other countries. Some of the models predicted that the short-term indirect benefits may be offset by a partial shifting of the burden of RVGE to older unvaccinated individuals. Nonetheless, even when such a shift occurs, the overall reduction in severe RVGE is considerable. Discrepancies among model predictions reflect uncertainties about age variation in the risk and reporting of RVGE, and the duration of natural and vaccine-induced immunity, highlighting important questions for future research

RNA search engines empower the bacterial intranet

RNA acts not only as an information bearer in the biogenesis of proteins from genes, but also as a regulator that participates in the control of gene expression. In bacteria, small RNA molecules (sRNAs) play controlling roles in numerous processes and help to orchestrate complex regulatory networks. Such processes include cell growth and development, response to stress and metabolic change, transcription termination, cell-to-cell communication, and the launching of programmes for host invasion. All these processes require recognition of target messenger RNAs by the sRNAs. This review summarizes recent results that have provided insights into how bacterial sRNAs are recruited into effector ribonucleoprotein complexes that can seek out and act upon target transcripts. The results hint at how sRNAs and their protein partners act as pattern-matching search engines that efficaciously regulate gene expression, by performing with specificity and speed while avoiding off-target effects. The requirements for efficient searches of RNA patterns appear to be common to all domains of life

Personhood, consciousness, and god : how to be a proper pantheist

© Springer Nature B.V. 2018In this paper I develop a theory of personhood which leaves open the possibility of construing the universe as a person. If successful, it removes one bar to endorsing pantheism. I do this by examining a rising school of thought on personhood, on which persons, or selves, are understood as identical to episodes of consciousness. Through a critique of this experiential approach to personhood, I develop a theory of self as constituted of qualitative mental contents, but where these contents are also capable of unconscious existence. On this theory, though we can be conscious of our selves, consciousness turns out to be inessential to personhood. This move, I then argue, provides resources for responding to the pantheist’s problem of God’s person.Peer reviewedFinal Accepted Versio

An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

<p>Abstract</p> <p>Background</p> <p>Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases.</p> <p>Methods</p> <p>We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia.</p> <p>Results</p> <p>Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and adapted for use in other chronic diseases; (v) mental health disorders are extremely prevalent in Liberia and should remain a top chronic disease priority; and (vi) better information systems and data management are needed at all levels of the health system.</p> <p>Conclusions</p> <p>The way forward for chronic diseases in Liberia will require an increased emphasis on quality over quantity, better data management to inform rational health sector planning, corrective mechanisms to more efficiently align health infrastructure and personnel with existing needs, and innovative methods to improve long-term retention in care and bridge the rural health delivery gap.</p