Kidney transplant patients’ preferences and priorities for outcomes after transplantation

Kidney transplantation is associated with improved survival and quality of life compared to dialysis, and is the preferred treatment for many patients with end-stage kidney disease being. Nonetheless, long-term treatment after transplantation requires a balance between maintaining optimal graft function and serious harms associated with immunosuppression including cancer, cardiovascular disease, diabetes and infection. Furthermore, drug related side effects impact on patient well-being and quality of life. Understanding the net benefits associated with a treatment regimen requires knowledge of adverse outcomes as well as benefits. It is increasingly recognised that patient values, preferences and priorities should play a role in all clinical decisions. To date, as with many chronic diseases, treatment decisions have been predominantly driven by clinicians with little systematic, explicit and formal patient involvement.The aims of the studies contained in this thesis are: • To elicit patient preferences and priorities for outcomes following transplantation, and • To evaluate the extent to which clinical trials of maintenance immunosuppression after kidney transplantation, report outcomes relevant to patient preferences and thereby, support an evaluation of both benefits and harms.Qualitative and quantitative techniques have been used to elicit patient preferences and evaluate reporting of patient relevant outcomes in clinical trials

Optimizing Commercial Vehicle Enforcement Investments and Activities to Improve Safety and Increase Revenue Collections

The Kentucky Transportation Cabinet (KYTC) owns and maintains 14 fixed weigh stations for commercial vehicle enforcement. The Kentucky State Police (KSP) is responsible for staffing these facilities to conduct enforcement, while KYTC is responsible for constructing and maintaining these facilities. Like many states, Kentucky has experienced a decline of enforcement personnel to operate weigh stations limiting its ability to conduct inspections for safety enforcement and revenue collection. This study analyzes three CMV facilities for their impact on safety enforcement and revenue collection and determines their viability for potential replacement. All three existing weigh stations in Hardin, Fulton, and Henderson counties will be bypassed or removed due to future interstate and interchange construction plans. These weigh stations were assessed for the amount of revenue collected against operating expenses, the ratio of citations issued per violations, and the impact each weigh station had on overall safety. Researchers developed guidelines decision makers and stakeholders can use to determine the outcome for each of the three weigh stations: permanently close, replace with a new facility, or convert to remote monitoring. This guidance can be applied beyond the three facilities in the study, to help make future decisions on weigh stations across Kentucky

The Ursinus Weekly, April 28, 1905

Spring • Chemical-Biological outing • Alumni notes • Baseball • Schaff prize debate • College world • College notes • Seminary commencementhttps://digitalcommons.ursinus.edu/weekly/3013/thumbnail.jp

Molecular cytogenetic differentiation of paralogs of Hox paralogs in duplicated and re-diploidized genome of the North American paddlefish (Polyodon spathula).

BackgroundAcipenseriformes is a basal lineage of ray-finned fishes and comprise 27 extant species of sturgeons and paddlefishes. They are characterized by several specific genomic features as broad ploidy variation, high chromosome numbers, presence of numerous microchromosomes and propensity to interspecific hybridization. The presumed palaeotetraploidy of the American paddlefish was recently validated by molecular phylogeny and Hox genes analyses. A whole genome duplication in the paddlefish lineage was estimated at approximately 42 Mya and was found to be independent from several genome duplications evidenced in its sister lineage, i.e. sturgeons. We tested the ploidy status of available chromosomal markers after the expected rediploidization. Further we tested, whether paralogs of Hox gene clusters originated from this paddlefish specific genome duplication are cytogenetically distinguishable.ResultsWe found that both paralogs HoxA alpha and beta were distinguishable without any overlapping of the hybridization signal - each on one pair of large metacentric chromosomes. Of the HoxD, only the beta paralog was unequivocally identified, whereas the alpha paralog did not work and yielded only an inconclusive diffuse signal. Chromosomal markers on three diverse ploidy levels reflecting different stages of rediploidization were identified: quadruplets retaining their ancestral tetraploid condition, semi-quadruplets still reflecting the ancestral tetraploidy with clear signs of advanced rediploidization, doublets were diploidized with ancestral tetraploidy already blurred. Also some of the available microsatellite data exhibited diploid allelic band patterns at their loci whereas another locus showed more than two alleles.ConclusionsOur exhaustive staining of paddlefish chromosomes combined with cytogenetic mapping of ribosomal genes and Hox paralogs and with microsatellite data, brings a closer look at results of the process of rediploidization in the course of paddlefish genome evolution. We show a partial rediploidization represented by a complex mosaic structure comparable with segmental paleotetraploidy revealed in sturgeons (Acipenseridae). Sturgeons and paddlefishes with their high propensity for whole genome duplication thus offer suitable animal model systems to further explore evolutionary processes that were shaping the early evolution of all vertebrates

Generalized Geologic Map for Land-Use Planning: Jessamine County, Kentucky

This map is not intended to be used for selecting individual sites. Its purpose is to inform land-use planners, government officials, and the public in a general way about geologic bedrock conditions that affect the selection of sites for various purposes. The properties of thick soils may supercede those of the underlying bedrock and should be considered on a site to site basis. At any site, it is important to understand both the soils, and the underlying rock

Online Instructional Tools for Motor Carriers

Commercial motor carrier customers on Kentucky highways must register and pay taxes for licensing and credentialing requirements. The Kentucky Transportation Cabinet (KYTC) provides an online Motor Carrier Portal that offers information and instructions on meeting these requirements, but customers have increasingly resorted to calling into KYTC’s motor carrier help desk, thereby straining limited personnel resources. The Kentucky Transportation Center (KTC) coordinated with KYTC to develop a series of online instructional videos that can better assist customers with applying for and meeting credentialing requirements. KTC researchers used a three-phase approach to determine the feasibility and requirements for instructional videos. First, they investigated the use of online videos provided by other state departments of transportation for motor carrier customers. Second, KTC collected and analyzed over 305,000 customer service records to better understand the tax categories and key words commonly associated with high call volumes and durations. Finally, researchers interviewed KYTC customer service representatives who interacted with motor carrier customers to learn about common interaction themes. Using this approach, KTC successfully developed three priority instructional videos for KYTC including (1) IRP Requirements and Account Creation, (2) KYU Account Creation, and (3) KYU Account Reactivation

Generalized Geologic Map for Land-Use Planning: Lexington and Fayette County, Kentucky

This map is not intended to be used for selecting individual sites. Its purpose is to inform land-use planners, government officials, and the public in a general way about geologic bedrock conditions that affect the selection of sites for various purposes