RESUMO
The effect of using donation after circulatory death (DCD) hearts on waitlist outcomes has not been substantiated. We retrospectively analyzed 184 heart transplant (HT) candidates at our institution from 2019 to 2021. Patients were stratified into 2 observation periods centered on September 12, 2020, when the adult DCD HT program officially began. The primary outcome was a comparison of transplant rate between period 1 (pre-DCD) and period 2 (post-DCD). Secondary outcomes included waitlist time-to-transplant, waitlist mortality rate, independent predictors of incidence of HT, and posttransplant outcomes. A total of 165 HTs (n = 92 in period 1 and n = 73 in period 2) were performed. The median waitlist time-to-transplant decreased from 47.5 to 19 days in periods 1 and 2, respectively (P = .004). The transplant rate increased from 181 per 100 patient-years in period 1 to 579 per 100 patient-years in period 2 (incidence rate ratio, 1.87; 95% CI, 1.04-3.38; P = .038). There were no statistical differences in waitlist mortality rate (P = .566) and 1-year survival (P = .699) between the 2 periods. DCD HTs (n = 36) contributed to 49.3% of overall HT activity in period 2. We concluded that utilization of DCD hearts significantly reduced waitlist time and increased transplant rate. Short-term posttransplant outcomes were comparable between the pre-DCD and post-DCD periods.
Assuntos
Transplante de Coração , Transplante de Fígado , Obtenção de Tecidos e Órgãos , Adulto , Humanos , Doadores de Tecidos , Estudos Retrospectivos , Morte , Sobrevivência de EnxertoRESUMO
Children in everyday environments experience verbs separated by minutes or hours and linked to events that vary in their similarity. Prior studies have shown that seeing similar events can be beneficial for verb learning (e.g., complex events), but there is also evidence that varied events or seeing both similar and varied events is useful; more studies are needed. In addition, few prior verb studies have tested verb learning from spaced practice. In Study 1, 3½- and 4½-year-olds (N = 72) saw either three similar events, three varied events, or a single live event (control) while hearing a new verb; events were separated by 1-min delays. Results showed better performance in multiple-event conditions than in the single-event condition and showed more extensions with age. Specifically, children benefitted more from seeing varied events with age. In Study 2, 2½-, 3½-, and 4½-year-olds (N = 163) either saw similar and then varied events or saw all varied video events separated by 1-min delays or no delays. The youngest children performed significantly better in the similar first condition than in the all varied condition, showing the first evidence of this benefit following spaced practice. In addition, as in Study 1, performance after seeing varied events increased with age. Together, these studies show that children can compare events separated in time and that their ability to learn verbs from varied examples develops with age.
Assuntos
Desenvolvimento da Linguagem , Aprendizagem Verbal , Humanos , Criança , Pré-EscolarRESUMO
A total of 221 Costa Rican Mestizos from the Central Valley were genotyped at high-resolution for the human leukocyte antigen loci HLA-A, -B, -C, -DRB1, and -DQB1 using sequence-based typing methods. The respective allele and extended haplotype frequencies, as well as Hardy-Weinberg proportions were calculated. The most frequent extended haplotype identified was A*24:02:01-B*40:02:01-C*03:05-DRB1*08:02:01-DQB1*04:02:01, with an estimated frequency of 2.04%. No deviation from Hardy-Weinberg Equilibrium was detected at any of the loci studied. The HLA genotypic data of the population sample reported here are available publicly in the Allele Frequencies Net Database under the population name "Costa Rica Central Valley Mestizo" and the identifier AFN3606.
RESUMO
Door openings in the operating room (OR) have been hypothesized to increase OR environmental contamination. This study measured average colony-forming units (CFU) in the OR as a function of door openings and other potentially important variables. Bacterial settle plates were placed inside and outside of laminar airflow (LAF) by both exit doors, on the instrument table, and on the back instrument table (if applicable) for 48 orthopedic and general surgery procedures. CFU data were paired to Staphylococcus aureus colonization status, door openings, surgery duration, time of day, OR location, number of staff, use of warming devices, temperature, and humidity. The number of door openings in the OR and surgery duration were significantly associated with increased CFU in the OR overall and outside of LAF. However, under LAF conditions, only the number of OR personnel was significantly associated with increased CFU.
Assuntos
Ambiente Controlado , Microbiologia Ambiental , Salas Cirúrgicas/métodos , Contagem de Colônia Microbiana , HumanosRESUMO
This study was conducted to evaluate the effect of commercially available engineered iron oxide nanoparticles coated with a surfactant (ENP(Fe-surf)) on effluent water quality from a lab-scale sequencing batch reactor as a model secondary biological wastewater treatment. Results showed that ~8.7% of ENP(Fe-surf) applied were present in the effluent stream. The stable presence of ENP(Fe-surf) was confirmed by analyzing the mean particle diameter and iron concentration in the effluent. Consequently, aqueous ENP(Fe-surf) deteriorated the effluent water quality at a statistically significant level (p < 0.05) with respect to soluble chemical oxygen demand, turbidity, and apparent color. This implied that ENP(Fe-surf) would be introduced into environmental receptors through the treated effluent and could potentially impact them.
Assuntos
Compostos Férricos/química , Tensoativos/química , Purificação da Água/métodos , Adsorção , Reatores Biológicos , Nanopartículas/química , Tamanho da Partícula , Purificação da Água/instrumentação , Qualidade da ÁguaRESUMO
The human leukocyte antigen (HLA) system is the most polymorphic in humans. Its allele, genotype, and haplotype frequencies vary significantly among different populations. Molecular typing data on HLA are necessary for the development of stem cell donor registries, cord blood banks, HLA-disease association studies, and anthropology studies. The Costa Rica Central Valley Population (CCVP) is the major population in this country. No previous study has characterized HLA frequencies in this population. Allele group and haplotype frequencies of HLA genes in the CCVP were determined by means of molecular typing in a sample of 130 unrelated blood donors from one of the country's major hospitals. A comparison between these frequencies and those of 126 populations worldwide was also carried out. A minimum variance dendrogram based on squared Euclidean distances was constructed to assess the relationship between the CCVP sample and populations from all over the world. Allele group and haplotype frequencies observed in this study are consistent with a profile of a dynamic and diverse population, with a hybrid ethnic origin, predominantly Caucasian-Amerindian. Results showed that populations genetically closest to the CCVP are a Mestizo urban population from Venezuela, and another one from Guadalajara, Mexico.