Liver Transplantation in Older Patients

To the Editor: The impact of liver transplantation on public health policy has not been delineated, partly because of uncertainty about the upper age limit for candidacy. We have compared the outlook in 363 adult recipients of livers who were less than 50 years old (mean +SD, 35.8+8.5) and 92 recipients who were 50 to 77 years old (mean +SD, 55.7+4.8). Cyclosporine and steroids1,2 were used for immunosuppression, and monoclonal antilymphocyte globulin3 and azathioprine were added as needed. The techniques of liver transplantation4 were not influenced by the age of the patient. The indications for transplantation are shown in Figure 1…., No extract is available for articles shorter than 400 words. © 1987, Massachusetts Medical Society. All rights reserved

Orthotopic liver transplantation for alcoholic cirrhosis.

Fifteen patients with Laennec's cirrhosis underwent orthotopic liver transplantation between 1963 and the end of 1979. The first eight patients died perioperatively or within two months, but four of the next seven patients had long survival; three are still alive after 11 to 14 years. After the introduction of cyclosporine therapy, 41 more patients with alcoholic cirrhosis were treated with liver transplantation from 1980 to June 1987. The one-year survival is 73.2%, and, after one to three years, 28 (68%) of the recipients are living. Of the 35 patients in the combined old and new series who lived for six months or longer, only two returned to alcohol abuse. Social and vocational rehabilitation has been the rule in these recipients who were selected primarily because of urgency of need, because they or their families insisted on treatment, and because they and their families thereby committed themselves to long-standing programs of alcoholism care

Is Category Expansion a Realistic Long-Term Objective for Established Brands?

How often do established CPG categories expand following a period of stationarity? To what extent can the levers under manufacturer control bring about persistent growth in total category value? The authors explore these questions in order to test the commonly held assertion that brand leaders in established markets can grow sales by expanding total category demand. Findings from a study of US household panel data describing the purchasing of nearly 500 small and large categories by 60,000 households over a nine-year period are presented. The observations focus on the growth impact of three sales levers, category penetration, purchase volume per buyer, and price per volume paid, in various strategic windows ranging from one to nine years. The results demonstrate that category penetration increase is the most likely lever for category growth. The association between over-time revenue increase and growth in buying household numbers is far stronger than that between unit price increases or category usage. While this clearly indicates a promising strategic direction for brand management, results also carry a health warning: categories are relatively volatile in the short term, but highly stable over time, therefore while the direction is clear the path is very narrow indeed

Marketing research faces two challenges and a world of opportunity with long-term panel data

There have been frequent calls in the literature for a more comprehensive understanding of marketing impact on long-term firm performance (Dawes, Meyer-Waarden, & Driesener, 2015; Hanssens & Pauwels, 2016; Lodish & Mela, 2007; Webster & Lusch, 2013). Retail scanner data has been the principal source of empirical evidence in this strategic domain, but it cannot explain the behavioural shifts that underpin sales dynamics. Now that far larger extended household panels are available, there is, for the first time, a valuable behavioural lens with which to observe long-term brand and category buying. In this paper we outline theoretical and methodological challenges to this new type of panel research. The first concerns an approach to extending established marketing theory to long-run repeat buying; the second relates to the inherent constraints of long-term panels. We present a new research agenda to progress explanatory theories of long-run brand building and category growth in this new but largely untapped resource

Enhanced sensitivity to a possible variation of the proton-to-electron mass ratio in ammonia

Numerous accidental near degeneracies exist between the 2ν2 and ν4 rotation-vibration energy levels of ammonia. Transitions between these two states possess significantly enhanced sensitivity to a possible variation of the proton-to-electron mass ratio μ. Using a robust variational approach to determine the mass sensitivity of the energy levels along with accurate experimental values for the energies, sensitivity coefficients have been calculated for over 350 microwave, submillimeter, and far-infrared transitions up to J=15 for 14NH3. The sensitivities are the largest found in ammonia to date. One particular transition, although extremely weak, has a sensitivity of T=−16738 and illustrates the huge enhancement that can occur between close-lying energy levels. More promising however are a set of previously measured transitions with T=−32 to 28. Given the astrophysical importance of ammonia, the sensitivities presented here confirm that 14NH3 can be used exclusively to constrain a spatial or temporal variation of μ. Thus certain systematic errors which affect the ammonia method can be eliminated. For all transitions analyzed we provide frequency data and Einstein A coefficients to guide future laboratory and astronomical observations