Intermittent antegrade cardioplegia: isolated heart preservation with the Asporto heart preservation device

Background—A major problem in procurement of donor hearts is the limited time a donor heart remains viable. After cardiectomy, ischemic hypoxia is the main cause of donor heart degradation. The global myocardial ischemia causes a cascade of oxygen radical formation that cumulates in an elevation in hydrogen ions (decrease in pH), irreversible cellular injury, and potential microvascular changes in perfusion. Objective—To determine the changes of prolonged storage times on donor heart microvasculature and the effects of intermittent antegrade perfusion. Materials and Methods—Using porcine hearts flushed with a Ribosol-based cardioplegic solution, we examined how storage time affects microvascular myocardial perfusion by using contrast-enhanced magnetic resonance imaging at a mean (SD) of 6.1 (0.6) hours (n=13) or 15.6 (0.6) hours (n=11) after cardiectomy. Finally, to determine if administration of cardioplegic solution affects pH and microvascular perfusion, isolated hearts (group 1, n=9) given a single antegrade dose, were compared with hearts (group 2, n=8) given intermittent antegrade cardioplegia (150 mL, every 30 min, 150 mL/min) by a heart preservation device. Khuri pH probes in left and right ventricular tissue continuously measured hydrogen ion levels, and perfusion intensity on magnetic resonance images was plotted against time. Results—Myocardial perfusion measured via magnetic resonance imaging at 6.1 hours was significantly greater than at 15.6 hours (67% vs 30%, P= .00008). In group 1 hearts, the mean (SD) for pH at the end of 6 hours decreased to 6.2 (0.2). In group 2, hearts that received intermittent antegrade cardioplegia, pH at the end of 6 hours was higher at 6.7 (0.3) (P=.0005). Magnetic resonance imaging showed no significant differences between the 2 groups in contrast enhancement (group 1, 62%; group 2, 40%) or in the wet/dry weight ratio. Conclusion—Intermittent perfusion maintains a significantly higher myocardial pH than does a conventional single antegrade dose. This difference may translate into an improved quality of donor hearts procured for transplantation, allowing longer distance procurement, tissue matching, improved outcomes for transplant recipients, and ideally a decrease in transplant-related costs.

Local adaptation in moss life histories: population-level variation and a reciprocal transplant experiment

We examine the extent of population-level differentiation in life history traits of Pogonatum aloides, Polytrichum commune and Polytrichum juniperinum (Polytrichaceae) between upland and lowland localities within Britain. Reciprocal transplant studies are used to estimate the relative importance of genetic versus environmental effects on observed differences. We demonstrate significant life history differentiation between moss populations, and show that at least some of these are genetically determined, although environment and phenotypic plasticity are also significant components of the observed variation. The transplant experiments indicate divergence among populations in plasticity of male reproductive effort and of investment in vegetative shoots by females. Two tradeoffs are identified; one between the number and the size of spores, and the second between reproduction by spores versus vegetative reproduction. The patterns of life history variation observed between populations of Polytrichum juniperinum are consistent with selection along these implied tradeoff curves, and we propose that they reflect selective pressures arising from the spatial and demographic distribution of mortality at upland versus lowland sites. The results underscore the need for more studies of intra-specific life history variation in mosses.

Parametric accelerated failure time models with random effects and an application to kidney transplant survival

Accelerated failure time models with a shared random component are described, and are used to evaluate the effect of explanatory factors and different transplant centres on survival times following kidney transplantation. Different combinations of the distribution of the random effects and baseline hazard function are considered and the fit of such models to the transplant data is critically assessed. A mixture model that combines short- and long-term components of a hazard function is then developed, which provides a more flexible model for the hazard function. The model can incorporate different explanatory variables and random effects in each component. The model is straightforward to fit using standard statistical software, and is shown to be a good fit to the transplant data. Copyright (C) 2004 John Wiley Sons, Ltd.

An exploration of the role duality experienced by HR professionals as both implementers and recipients of HR practices: evidence from the Indian railways

This study provides an innovative perspective on empirically assessing HR by focusing on the duality of HR professionals’ experiences as both implementers and recipients or internal customers of HR practices given that they are also employees of the organization. We hypothesize that HR professionals experience HR practices more favorably from an implementer perspective as compared to an internal customer perspective. These differences in experiences are likely to be influenced by HR professionals’ hierarchical position in the HR department. Our analyses of 1,271 HR professionals employed by Indian Railways revealed a number of differences between the two types of experience. Some practices (recruitment and selection, training, and employee welfare) were viewed more negatively from the implementer perspective, whereas others (compensation, benefits, and employment relations) were rated more negatively from the internal customer perspective. Those holding more senior HR positions reported more positive experiences of training and employment relations from an internal customer perspective. Overall our contributions draw on the attribution theory and concepts of intraorganizational power and voice, and have implications concerning the effectiveness of HR practices. © 2015 Wiley Periodicals, Inc.