Factors associated with mortality in transplant patients with invasive aspergillosis.

BACKGROUND: Invasive aspergillosis (IA) is an important cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. The purpose of this study was to evaluate factors associated with mortality in transplant patients with IA. METHODS: Transplant patients from 23 US centers were enrolled from March 2001 to October 2005 as part of the Transplant Associated Infection Surveillance Network. IA cases were identified prospectively in this cohort through March 2006, and data were collected. Factors associated with 12-week all-cause mortality were determined by logistic regression analysis and Cox proportional hazards regression. RESULTS: Six-hundred forty-two cases of proven or probable IA were evaluated, of which 317 (49.4%) died by the study endpoint. All-cause mortality was greater in HSCT patients (239 [57.5%] of 415) than in SOT patients (78 [34.4%] of 227; P<.001). Independent poor prognostic factors in HSCT patients were neutropenia, renal insufficiency, hepatic insufficiency, early-onset IA, proven IA, and methylprednisolone use. In contrast, white race was associated with decreased risk of death. Among SOT patients, hepatic insufficiency, malnutrition, and central nervous system disease were poor prognostic indicators, whereas prednisone use was associated with decreased risk of death. Among HSCT or SOT patients who received antifungal therapy, use of an amphotericin B preparation as part of initial therapy was associated with increased risk of death. CONCLUSIONS: There are multiple variables associated with survival in transplant patients with IA. Understanding these prognostic factors may assist in the development of treatment algorithms and clinical trials.

Crafting analytical tools to study institutional change

Most powerful analytical tools used in the social sciences are well suited for studying static situations. Static and mechanistic analysis, however, is not adequate to understand the changing world in which we live. In order to adequately address the most pressing social and environmental challenges looming ahead, we need to develop analytical tools for analyzing dynamic situations -particularly institutional change. In this paper, we develop an analytical tool to study institutional change, more specifically, the evolution of rules and norms. We believe that in order for such an analytical tool to be useful to develop a general theory of institutional change, it needs to enable the analyst to concisely record the processes of change in multiple specific settings so that lessons from such settings can eventually be integrated into a more general predictive theory of change. Copyright © The JOIE Foundation 2010.

Policy-induced technology adoption: Evidence from the U.S. lead phasedown

Theory suggests that economic instruments, such as pollution taxes or tradable permits, can provide more efficient technology adoption incentives than conventional regulatory standards. We explore this issue for an important industry undergoing dramatic decreases in allowed pollution - the U.S. petroleum industry's phasedown of lead in gasoline. Using a duration model applied to a panel of refineries from 1971-1995, we find that the pattern of technology adoption is consistent with an economic response to market incentives, plant characteristics, and alternative policies. Importantly, evidence suggests that the tradable permit system used during the phasedown provided incentives for more efficient technology adoption decisions.

Biomarkers of PTA

© Springer Science+Business Media New York 2015.Prognostic biomarkers may indicate the likelihood of disease development and speed of progression or may serve as predictive indicators of responsiveness to treatment. Joint injuries, particularly severe injuries, may result in post-traumatic osteoarthritis (PTOA), and pre- and post-injury prognostic biomarkers are needed to enhance primary and secondary prevention approaches for PTOA. Several macromolecules from joint structures found in serum, urine, and synovial fluid are promising biochemical markers for monitoring joint metabolism and health before and after joint injury. The use of metabolic profiling (analysis of small molecules) as a predictive tool for osteoarthritis (OA) has increased in the past decade. Although there is some question as to whether PTOA and idiopathic OA are comparable conditions, there is some evidence to suggest that components of their pathogenesis are similar. Potentially, biomarkers important to the high-risk PTOA profile translate to idiopathic OA. Further work is needed to confirm the utility of macromolecules and metabolites as biomarkers for PTOA, particularly focusing on those strongly correlated to clinical efficacy measures important to the patient (e.g., symptoms, physical function, and quality of life) and the causal pathway of PTOA.

Human E2F6 is alternatively spliced to generate multiple protein isoforms

E2F6 protein belongs to the family of the E2F transcription factors. Here, we showed that the human E2F6 gene contains nine exons distributed along 20.4kbp of genomic DNA on chromosome 2 leading to the transcription of six alternatively spliced E2F6 mRNAs that encode four different E2F6 proteins. Moreover, we identified an E2F6 pseudogene localized on chromosome 22 completely spliced and devoid of exons 2, 3, and 4, and part of exons 1 and 5. Definition of the transcriptional initiation site and sequence analysis show that the gene contains a TATA less, CAAT less, GC-rich promoter with multiple transcription start sites. Regulatory elements necessary for basal transcription reside within a 134bp fragment as determined by transient transfection experiments. © 2004 Elsevier Inc. All rights reserved.

Analysis of the utility of QuantiFERON-TB gold in tube and measurement of IFNgamma release by peripheral mononuclear cells in response to different mycobacterium antigen in the work-up of patients with uveitis.

Evaluation Studies

Variaciones temporales en las determinaciones de Ca, Mg y K intercambiables

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Matemática con literatura

Tomando como inicio el contexto de la Matemática para su enseñanza, encontramos que existen múltiples relaciones entre ella y diferentes ramas del Arte. El tema que presentamos en este taller es ilimitado. Presentaremos algunos “matemáticos-escritores”, algunos autores del género “Matemática Recreativa” y otros ejemplos de famosos científicos que incursionaron en la Literatura o famosos literatos que incursionaron en la Matemática. En definitiva, se trata de mostrar, brevemente, algunos vínculos entre la Matemática y la Literatura, ya que estos textos pueden utilizarse como disparador para la introducción de nuevos contenidos.

Aspects of midwifery care 3: organisation of midwifery care

This is the third in a series of six papers presenting key findings from a national study that was undertaken to investigate the role and responsibilities of midwives and to identify continuing educational need. The background to the study and the titles of the other papers in the series have been outlined in the first paper. Issues related to the way midwifery care is organized nationally are discussed in this paper. Midwives and supervisors indicated a strong commitment to providing woman-centred care in a caring and sensitive manner, often in the face of enormous structural and organizational change. This paper addresses key issues that arose for midwives and supervisors when planning and providing an optimum quality service.

Towards the sustainable use of Europe’s forests: a centre for European forest science! – Some missing catalytic elements?

The Symposium, “Towards the sustainable use of Europe’s forests”, with sub-title “Forest ecosystem and landscape research: scientific challenges and opportunities” lists three fundamental substantive areas of research that are involved: Forest management and practices, Ecosystem processes and functional ecology, and Environmental economics and sociology. This paper argues that there are essential catalytic elements missing! Without these elements there is great danger that the aimed-for world leadership in the forest sciences will not materialize. What are the missing elements? All the sciences, and in particular biology, environmental sciences, sociology, economics, and forestry have evolved so that they include good scientific methodology. Good methodology is imperative in both the design and analysis of research studies, the management of research data, and in the interpretation of research finding. The methodological disciplines of Statistics, Modelling and Informatics (“SMI”) are crucial elements in a proposed Centre of European Forest Science, and the full involvement of professionals in these methodological disciplines is needed if the research of the Centre is to be world-class. Distributed Virtual Institute (DVI) for Statistics, Modelling and Informatics in Forestry and the Environment (SMIFE) is a consortium with the aim of providing world-class methodological support and collaboration to European research in the areas of Forestry and the Environment. It is suggested that DVI: SMIFE should be a formal partner in the proposed Centre for European Forest Science.

Thermal-mechanical modelling of power electronic module packaging

In this paper the reliability of the isolation substrate and chip mountdown solder interconnect of power modules under thermal-mechanical loading has been analysed using a numerical modelling approach. The damage indicators such as the peel stress and the accumulated plastic work density in solder interconnect are calculated for a range of geometrical design parameters, and the effects of these parameters on the reliability are studied by using a combination of the finite element analysis (FEA) method and optimisation techniques. The sensitivities of the reliability of the isolation substrate and solder interconnect to the changes of the design parameters are obtained and optimal designs are studied using response surface approximation and gradient optimization method