The utility of preoperative six-minute-walk distance in lung transplantation

RATIONALE The use of 6-minute-walk distance (6MWD) as an indicator of exercise capacity to predict postoperative survival in lung transplantation has not previously been well studied. OBJECTIVES To evaluate the association between 6MWD and postoperative survival following lung transplantation. METHODS Adult, first time, lung-only transplantations per the United Network for Organ Sharing database from May 2005 to December 2011 were analyzed. Kaplan-Meier methods and Cox proportional hazards modeling were used to determine the association between preoperative 6MWD and post-transplant survival after adjusting for potential confounders. A receiver operating characteristic curve was used to determine the 6MWD value that provided maximal separation in 1-year mortality. A subanalysis was performed to assess the association between 6MWD and post-transplant survival by disease category. MEASUREMENTS AND MAIN RESULTS A total of 9,526 patients were included for analysis. The median 6MWD was 787 ft (25th-75th percentiles = 450-1,082 ft). Increasing 6MWD was associated with significantly lower overall hazard of death (P < 0.001). Continuous increase in walk distance through 1,200-1,400 ft conferred an incremental survival advantage. Although 6MWD strongly correlated with survival, the impact of a single dichotomous value to predict outcomes was limited. All disease categories demonstrated significantly longer survival with increasing 6MWD (P ≤ 0.009) except pulmonary vascular disease (P = 0.74); however, the low volume in this category (n = 312; 3.3%) may limit the ability to detect an association. CONCLUSIONS 6MWD is significantly associated with post-transplant survival and is best incorporated into transplant evaluations on a continuous basis given limited ability of a single, dichotomous value to predict outcomes.

Valeur, fonctionnement et fonction. La filiation Saussure-Jakobson: un malentendu?

Si Jakobson, par ailleurs si critique relativement à l’apport saussurien, s’inscrit, quant à la notion de valeur, dans la filiation de Saussure, il nous semble que cette filiation revendiquée par Jakobson repose sur un malentendu. La redéfinition jakobsonienne de la notion de valeur est en effet inséparable d’une disjonction des différentes dimensions constitutives du concept saussurien de valeur. Par ailleurs et corrélativement, la valeur jakobsonienne se caractérise d’emblée par sa positivité, qui se déploie sur deux plans : celui de la consistance objectale, qui répond à une problématique des rapports forme/substance et celui de la sémioticité, qui répond à une problématique des rapports son/sens, deux problématiques aussi étrangères l’une que l’autre à la linguistique saussurienne. A la définition saussurienne de la langue comme un fonctionnement dont son et sens apparaissent comme des effets, fonctionnement qu’est la division-combinaison des deux masses amorphes de la pensée et du son, se substitue la construction jakobsonienne d’une langue structure d’appariement du son et du sens, construction fondée sur l’évidence d’une définition de la langue comme instrument de communication. On peut cependant penser que cette substitution, ce malentendu, sont tout à fait révélateurs de la spécificité de l’objet de la linguistique, particulièrement résistant à la théorisation.

Distance from Sub-Saharan Africa Predicts Mutational Load in Diverse Human Genomes

The Out-of-Africa (OOA) dispersal ∼50,000 y ago is characterized by a series of founder events as modern humans expanded into multiple continents. Population genetics theory predicts an increase of mutational load in populations undergoing serial founder effects during range expansions. To test this hypothesis, we have sequenced full genomes and high-coverage exomes from seven geographically divergent human populations from Namibia, Congo, Algeria, Pakistan, Cambodia, Siberia, and Mexico. We find that individual genomes vary modestly in the overall number of predicted deleterious alleles. We show via spatially explicit simulations that the observed distribution of deleterious allele frequencies is consistent with the OOA dispersal, particularly under a model where deleterious mutations are recessive. We conclude that there is a strong signal of purifying selection at conserved genomic positions within Africa, but that many predicted deleterious mutations have evolved as if they were neutral during the expansion out of Africa. Under a model where selection is inversely related to dominance, we show that OOA populations are likely to have a higher mutation load due to increased allele frequencies of nearly neutral variants that are recessive or partially recessive.

Long-distance spore dispersal in wood-inhabiting Basidiomycetes

Eight species of wood-inhabiting basidiomycetes (Laurilia sulcata, Peniophora aurantiaca, Resinicium bicolor, Scytinostroma galactinum, Terana caerulea, Trichaptum abietinum, T. biforme and T. fuscoviolaceum) were used in a spore-trapping test to evaluate their individual ability for long-distance spore dispersal. Petri dishes with single spore mycelia were used as baits. In the experiment, carried out at the Botanical Institute in Göteborg, spores from the air were regularly captured. Surprisingly, spores were captured from species whose nearest known natural occurrence was located quite far from Göteborg. The closest population of Peniophora aurantiaca is about 1000 km south of Göteborg. The results from this experiment support the hypothesis that fungal spores are widely and efficiently dispersed. Such a broad and extensive dispersal ability is of vital importance, especially for wood-inhabiting species which are highly dependent on a substrate which is onlv temporarily available.

Long-distance transport of alkali metals in maturing wheat

The alkali metals cesium, rubidium, lithium and sodium were introduced together with strontium via flaps into leaf laminas or into the stem of maturing, intact winter wheat (Triticum aestivum L. cv. Arina) grown in a field. Long-distance transport of these elements and the influence of the application date and of different application positions were investigated. The phloem-immobile Sr served as a marker for the distribution of the xylem sap in the plants. Dry matter accumulation in the grains and the transpiration per shoot were not markedly affected by the treatments as compared to control plants. The phloem mobility was rather high for Cs and Rb. Li was almost immobile in the phloem (similarly to Sr). An application into the cut stem xylem below the second leaf node contributed more to the contents in the grains than an application into the flag leaf. An earlier feeding date led to a higher accumulation in the grains. The marked losses of the elements applied during maturation (most pronounced for Li) can be explained by leakage in the rain.

Long-distance transport of cobalt and nickel in maturing wheat

Cobalt, nickel and strontium were introduced via flaps into leaf laminas or into the stem of maturing, intact winter wheat (Triticum aestivum L., cv. `Arina') grown under natural conditions in a field. Long-distance transport of these elements and the influence of the application date and of different application positions were investigated. The dry-matter accumulation in the grains was not markedly affected by the treatments as compared to untreated control plants. The phloem-immobile strontium served as a marker for the distribution of the xylem sap in the plants. After foliar application, nickel accumulated more rapidly and in higher quantities in the grains than cobalt. Therefore, nickel has a slightly better phloem mobility than cobalt. Regardless of the application date, a higher percentage of the two elements was transported from the flag leaf lamina than from the second or third lamina from the top to the grains. These results indicate that the leaf position is highly relevant for the transfer of the heavy metals investigated to the ear. Introduction into the stem led to a higher accumulation of nickel and cobalt in the grains than introduction into one of the leaves. An earlier feeding date caused a higher accumulation of nickel and cobalt in the grains when introduced into the stem. In contrast, no major differences between earlier and later feeding dates were detected when the elements were introduced into the leaves. Losses of the applied elements were detected during maturation and can be explained by leakage in the rain.