Normothermic ex vivo perfusion provides superior organ preservation and enables viability assessment of hearts from DCD donors

The shortage of donors in cardiac transplantation may be alleviated by the use of allografts from donation after circulatory death (DCD) donors. We have previously shown that hearts exposed to 30 min warm ischemic time and then flushed with Celsior supplemented with agents that activate ischemic postconditioning pathways, show complete recovery on a blood-perfused ex vivo working heart apparatus. In this study, these findings were assessed in a porcine orthotopic heart transplant model. DCD hearts were preserved with either normothermic ex vivo perfusion (NEVP) using a clinically approved device, or with standard cold storage (CS) for 4 h. Orthotopic transplantation into recipient animals was subsequently undertaken. Five of six hearts preserved with NEVP demonstrated favorable lactate profiles during NEVP and all five could be weaned off cardiopulmonary bypass posttransplant, compared with 0 of 3 hearts preserved with CS (p < 0.05, Fisher's exact test). In conclusion, DCD hearts flushed with supplemented Celsior solution and preserved with NEVP display viability before and after transplantation. Viability studies of human DCD hearts using NEVP are warranted.

Increasing the tolerance of DCD hearts to warm ischemia by pharmacological postconditioning

Donation after circulatory death (DCD) offers a potential additional source of cardiac allografts. We used a porcine asphyxia model to evaluate viability of DCD hearts subjected to warm ischemic times (WIT) of 20–40 min prior to flushing with Celsior (C) solution. We then assessed potential benefits of supplementing C with erythropoietin, glyceryl trinitrate and zoniporide (Cs), a combination that we have shown previously to activate ischemic postconditioning pathways. Hearts flushed with C/Cs were assessed for functional, biochemical and metabolic recovery on an ex vivo working heart apparatus. Hearts exposed to 20-min WIT showed full recovery of functional and metabolic profiles compared with control hearts (no WIT). Hearts subjected to 30- or 40-min WIT prior to C solution showed partial and no recovery, respectively. Hearts exposed to 30-min WIT and Cs solution displayed complete recovery, while hearts exposed to 40-min WIT and Cs solution demonstrated partial recovery. We conclude that DCD hearts flushed with C solution demonstrate complete recovery up to 20-min WIT after which there is rapid loss of viability. Cs extends the limit of WIT tolerability to 30 min. DCD hearts with ≤30-min WIT may be suitable for transplantation and warrant assessment in a transplant model.

Matrix effects for calcium and potassium K-X-rays, in fenugreek plants grown in iron rich soils

The present work comprises the matrix effects study of the plant system (plant and soil) for macronutrients Ca and K with elevated levels of iron in the soil. The earlier derived matrix effect terms from fundamental relations of intensities of analyte and substrate elements with basic atomic and experimental setup parameters had led to iterative determination of enhanced elements rather than avoiding their enhancement. The relations also facilitated the evaluations of absorption for close Z interfering constituents (like Ca and K) in samples of a lot of particular category with interpolation of matrix terms with elemental amounts. The process has already been employed successfully for potato, radish, rice and maize plants. On similar lines, the observed prominent change in interpolation parameters for the plants in the present experiment serves as a tool to check the toxicity/contamination of the growing medium.

Knowledge-Based Features for Place Classification of Unvoiced Stops

The classification of unvoiced stops in consonant–vowel (CV) syllables, segmented from continuous speech, is investigated by features related to speech production. As burst and vocalic transitions contribute to identification of stops in the CV context, features are computed from both regions. Although formants are the truly discriminating articulatory features, their estimation from the speech signal is a challenge especially in unvoiced regions like the release burst of stops. This may be compensated partially by sub-band energy-based features. In this work, formant features from the vocalic region are combined with features from the burst region comprising sub-band energies, as well as features from a formant tracking method developed for unvoiced regions. The overall combination of features at the classifier level obtains an accuracy of 84.4%, which is significantly better than that obtained with solely sub-band features on unvoiced stops in CV syllables of TIMIT.

Catatonia in systemic lupus erythematosus: a case report and review of literature

Although, neuropsychiatric morbidity is quite high in patients with systemic lupus erythematosus (SLE), catatonia has been rarely reported. We report a case of a 22-year-old female who presented with catatonic symptoms at the time of relapse of SLE and have discussed the presentation in the context of existing literature with regard to phenomenology of catatonia, psychiatric co-morbidity and treatment of catatonia in patients with SLE.

Inconsistent definitions of "urban" result in different conclusions about the size of urban carbon and nitrogen stocks

There is conflicting evidence about the importance of urban soils and vegetation in regional C budgets that is caused, in part, by inconsistent definitions of "urban" land use. We quantified urban ecosystem contributions to C stocks in the Boston (Massachusetts, USA) Metropolitan Statistical Area (MSA) using several alternative urban definitions. Development altered aboveground and belowground C and N stocks, and the sign and magnitude of these changes varied by land use and development intensity. Aboveground biomass (live trees, dbh > or = 5 cm) for the MSA was 7.2 +/- 0.4 kg C/m2 (mean +/- SE), reflecting a high proportion of forest cover. Vegetation C was highest in forest (11.6 +/- 0.5 kg C/m2), followed by residential (4.6 +/- 0.5 kg C/m2), and then other developed (2.0 +/- 0.4 kg C/m2) land uses. Soil C (0-10 cm depth) followed the same pattern of decreasing C concentration from forest, to residential, to other developed land uses (4.1 +/- 0.1, 4.0 +/- 0.2, and 3.3 +/- 0.2 kg C/m2, respectively). Within a land use type, urban areas (which we defined as > 25% impervious surface area [ISA] within a 1-km(2) moving window) generally contained less vegetation C, but slightly more soil C, than nonurban areas. Soil N concentrations were higher in urban areas than nonurban areas of the same land use type, except for residential areas, which had similarly high soil N concentrations. When we compared our definition of urban to other commonly used urban extents (U.S. Census Bureau, Global Rural-Urban Mapping Project [GRUMP], and the MSA itself), we found that urban soil (1 m depth) and vegetation C stocks spanned a wide range, from 14.4 +/- 0.8 to 54.5 +/- 3.4 Tg C and from 4.2 +/- 0.4 to 27.3 +/- 3.2 Tg C, respectively. Conclusions about the importance of urban soils and vegetation to regional C and N stocks are very sensitive to the definition of urban used by the investigators. Urban areas, regardless of definition, are rapidly expanding in their extent; a systematic understanding of how our development patterns influence ecosystems is necessary to inform future development choices.

Human papillomavirus vaccination and the primary prevention of cancer: implications for survivors of childhood cancer

Effective vaccination is now available to prevent human papillomavirus (HPV), the most common sexually transmitted infection and the cause of cervical cancer, the second most common cancer among women worldwide. HPV vaccine uptake is particularly important for females surviving cancer, who are at high risk for HPV-related complication due to the direct and indirect effects of cancer therapy. Thus, Version 3.0 of the Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancer recommends HPV vaccination for all eligible females surviving childhood cancer. Because this vaccine was only FDA approved in 2006, little is known about the complexity of vaccination uptake among those surviving childhood cancer. This chapter describes HPV vaccination and its usefulness in survivors of childhood cancer, provides a rationale for describing survivors as being at increased risk for HPV-related complication, identifies factors that are predictive of HPV vaccination, and discusses the utilization of these predictors in designing strategies to promote adherence to the HPV vaccination recommendations among survivors.

Profile of blood donors and reasons for deferral in coastal South India

BACKGROUND

A blood transfusion is a life-saving procedure in many instances. An adequate supply of safe blood is ensured by exercising donor deferral criteria and screening for Transfusion Transmitted Infections (TTI). The aim of this paper is to study the profile of blood donors and reasons for donor deferral in coastal South India.

METHOD

The study was conducted at a tertiary care hospital in Mangalore. All those who donated between 1 January 2008 and 31 December 2008 were included in the study. Data was collected using a pre-tested semi-structured proforma and analysed using SPSS version 11.5.

RESULTS

Most of the donors were under the age of 25 (42.92%). Donors were predominantly male (95.20%). In terms of occupation, most subjects were students (28.01%) followed by businessmen (18.61%). Slightly more than three-quarters of the donors (77.20%) were replacement donors. The main reasons for deferral were consumption of medication in the past 72 hours (15.15%), hypertension (13.18%), a low haemoglobin level (12.34%) and alcohol intake in the past 72 hours (12.20%). Among the TTIs identified, most samples were positive for Hepatitis B surface Antigen - HBsAg (0.87%) or tested positive for Anti-Hepatitis C (HCV antibodies (0.36%).

CONCLUSION

From the study it was concluded that the majority of the donor population was young and educated. The reason for donation was mainly replacement rather than voluntary. This issue needs to be addressed by exercising proactive measures to increase the number of voluntary, nonremunerated, low-risk donors.

Toxicity of alpha-ketoglutarate following 14-days repeated oral administration in Wistar rats

Oral treatment of alpha-ketoglutarate (A-KG) is known to antagonise experimental cyanide poisoning in rodents. Maximum protective efficacy of A-KG has been observed at a dose of 2.0 g kg-1 body weight but no acute toxicity has been observed at this dose level. As a pre-clinical regulatory requirement, sub-acute toxicity of A-KG has to be determined in two different animal species, following repeated exposure by the intended route of use. The present study reports the toxicity and No Observed Adverse Effect Level (NOAEL) of A-KG following 14 days repeated oral administration at low (1.0 g kg-1), middle (2.0 g kg-1) and high (4.0 g kg-1) doses of A-KG in Wistar rats. After termination of the exposure, animals were further observed for 7 days to assess the recovery pattern and residual effects. Clinical signs included diarrhoea at 4.0 g kg-1 in both the sexes and decrease in mean body weight in males. This dose also caused anaemia in females which resolved after withdrawal of treatment. In males, significant increase in absolute and relative weights of organs (adrenal, liver and kidneys) and haematological changes were observed at the end of recovery period, suggesting delayed toxic manifestations at 2.0 and 4.0 g kg-1 dose. However, these observations were not accompanied by any histological changes to suggest any toxicity of A-KG of clinical significance. The NOAEL of A-KG was determined as 1.0 g kg-1 body weight. Although A-KG is intended to treat acute cyanide poisoning, caution on dosage should be observed during its repeated administration.