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Older candidates for kidney transplantation:Who to refer and what to expect?

World Journal of Transplantation 2016年第4期6卷 650-657页

作者： Beatrice P Concepcion Rachel C Forbes heidi m schaefer Department of medicine Division of Nephrology and Hypertension Vanderbilt University Medical Center Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center

The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known. Transplant physicians are therefore faced with the challenge of determining who among older patients are appropriate candidates for kidney transplantation. This is usually achieved by means of an organ systemsbased medical evaluation with particular focus given to cardiovascular health. more recently, global measures of health such as functional status and frailty are increasingly being recognized as potential tools in risk stratifying kidney transplant candidates. For those candidates who are deemed eligible, living donor transplantation should be pursued. This may mean accepting a kidney from an older living donor. In the absence of any living donor, the choice to accept lesser quality kidneys should be made while taking into account the organ shortage and expected waiting times on the deceased donor list. Appropriate counseling of patients should be a cornerstone in the evaluation process and includes a discussion regarding expected outcomes, expected waiting times in the setting of the new Kidney Allocation System, benefits of living donor transplantation and the acceptance of lesser quality kidneys.

关键词： Kidney transplant outcomes Frailty Elderly Expanded criteria donor Quality of life

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High-fat diet and oral infection induced type 2 diabetes and obesity development under different genetic backgrounds

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Animal models and Experimental medicine 2023年第2期6卷 131-145页

作者： Iqbal m.Lone Nadav Ben Nun Aya Ghnaim Arne S.schaefer Yael Houri-Haddad Fuad A.Iraqi Department of Clinical microbiology and Immunology Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael Department of Periodontology and Synoptic Dentistry Institute for Dental Craniofacial SciencesCharite-University of MedicineBerlinGermany Department of Prosthodontics Dental SchoolThe Hebrew UniversityJerusalemIsrael

Background:Type 2 diabetes(T2D)is an adult-onset and obese form of diabetes caused by an interplay between genetic,epigenetic,and environmental ***,we have assessed a cohort of 11 genetically different collaborative cross(CC)mouse lines comprised of both sexes for T2D and obesity developments in response to oral infection and high-fat diet(HFD)***:mice were fed with either the HFD or the standard chow diet(control group)for 12 weeks starting at the age of 8 *** week 5 of the experiment,half of the mice of each diet group were infected with Porphyromonas gingivalis and Fusobacterium nucleatum bacteria *** the 12-week experimental period,body weight(BW)was recorded biweekly,and intraperitoneal glucose tolerance tests were performed at weeks 6 and 12 of the experiment to evaluate the glucose tolerance status of ***:Statistical analysis has shown the significance of phenotypic variations between the CC lines,which have different genetic backgrounds and sex effects in different experimental *** heritability of the studied phenotypes was estimated and ranged between 0.45 and *** applied machine learning methods to make an early call for T2D and its *** results showed that classification with random forest could reach the highest accuracy classification(ACC=0.91)when all the attributes were ***:Using sex,diet,infection status,initial BW,and area under the curve(AUC)at week 6,we could classify the final phenotypes/outcomes at the end stage of the experiment(at 12 weeks).

关键词： collaborative cross genetic covariance heritability high-fat diet machine learning mouse model obesity type 2 diabetes

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Exercise Catheterization for Hemodynamic Evaluation of Adults with Coarctation of the Aorta

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Congenital Heart Disease 2022年第6期17卷 605-615页

作者： Irene martin de miguel C.Charles Jain Alexander C.Egbe Jason H.Anderson heidi m.Connolly William R.miranda Department of Cardiovascular medicine Mayo ClinicRochesterMinnesotaUSA Department of Pediatric and Adolescent medicine Division of Pediatric CardiologyMayo ClinicRochesterMinnesotaUSA

Background: Coarctation of the aorta (CoA) is associated with a generalized arteriopathy and long-term complicationsdespite repair. Data on invasive exercise hemodynamics in this population are lacking. Accordingly, wereviewed adults with CoA undergoing exercise catheterization to assess 1. hemodynamic profile;2. feasibilityfor assessment of CoA severity. methods: Twenty patients undergoing exercise cardiac catheterization (12 armadduction and 8 supine cycle ergometry) at a quaternary care center between 2004 and 2021 were identified. Restingand exercise hemodynamic data were abstracted from the procedure logs. Results: mean age was 43.6 ±12.0 years. Eleven patients (55%) had resting pulmonary arterial wedge pressure (PAWP) >15 mmHg;amongthose undergoing arterial catheterization, left ventricular end-diastolic pressure was >15 mmHg in 63%. Elevenpatients (55%) had pulmonary hypertension: 7 (35%) combined and 4 (20%) isolated post-capillary. At peak exercise,ΔPAWP/Δcardiac output (CO) ≥2 and Δmean pulmonary artery pressure/ΔCO ≥3 mmHg/l/min were foundin 7 (78%) and 6 (67%) patients, respectively;the composite of exercise PAWP ≥25 mmHg or ΔPAWP/ΔCO>2 was seen in 12 (86%). CoA peak-to-peak gradients at baseline (n = 14) and during exercise (n = 9) were 12(3–16) and 16 mmHg (9–28), respectively. Only 2 patients had an increase in CoA gradient to >20 mmHg withexercise. Conclusions: Diastolic dysfunction and pulmonary hypertension were highly prevalent, with exerciseunmasking abnormal diastolic and pulmonary vascular reserve in some individuals. most patients failed to showsignificant increases in CoA peak-to-peak gradients with exercise. Further studies are warranted to establish thebest diagnostic method for CoA severity assessment.

关键词： Coarctation of the aorta exercise heart catheterization diastolic dysfunction hypertension

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Effects of temperature and hydric environment on survival of the Panamanian Golden Frog infected with a pathogenic chytrid fungus

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Integrative Zoology 2010年第2期5卷 143-153页

作者： heidi m.BUSTAmANTE Lauren J.LIVO Cynthia CAREY Department of Integrative Physiology University of ColoradoBoulderColoradoUSA

Considerable controversy exists concerning whether or not climate changes(particularly global warming)are causing outbreaks of a lethal amphibian pathogen,the chytrid fungus Batrachochytrium dendrobatidis(Longcore,Pessier&*** 1999).In the present study,groups of Panamanian golden frogs(Atelopus zeteki Dunn,1993),a critically endangered amphibian thought to be nearly extinct in Panama,were exposed to varying dosages of zoospores of Batrachochytrium dendrobatidis,temperatures and hydric environments in order to learn whether this species is susceptible to this pathogen and,if so,how environmental factors affect *** pathogen proved to be highly lethal for *** exposed to a dosage of 100 Bd zoospores survived significantly(Pmate change and the decline of these frogs in the field,but they inform the discussion about how environmental conditions can have an impact on the interaction between a susceptible amphibian and this *** data do not support the contention that rising global temperatures are necessary to cause the death of amphibians infected with this pathogen because the pathogen was equally lethal at 17 as at 23℃,and frogs at the warmer temperature lived significantly longer than those at the cooler one.

关键词： amphibian declines Atelopus zeteki Batrachochytrium dendrobatidis chytridiomycosis climatelinked-epidemic hypothesis

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Applied and Environmental Chemistry of Animal manure:A Review

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Pedosphere 2016年第6期26卷 779-816页

作者： Zhongqi HE Paulo H.PAGLIARI heidi m.WALDRIP USDA-ARS Southern Regional Research Center Department of Soil Waterand ClimateUniversity of MinnesotaSouthwest Research and Outreach Center USDA-ARS Conservation and Production Research Laboratory

Animal manure consists of predominantly urine and feces,but also may contain bedding materials,dropped feed,scurf,and other farming *** is typically applied to soils as fertilizer for agricultural *** estimated amount of manure produced in 12 major livestock-producing countries is 9 × 109 mg of manure *** is rich in plant ***,manure is also considered as an environmental pollutant when it is over-applied to cropland or following runoff into surface *** can also in?uence global climate change via emissions of methane（CH4） and nitrous oxide（N2O）.Thus,increased and updated knowledge of applied and environmental chemistry of animal manure is needed to shed light on the research and development of animal manure utilization and minimization of its adverse environmental *** advances in basic and applied studies of manure major components,organic matter,phosphorus,and nitrogen,primarily related to US livestock production are summarized in this *** focus was placed on three notable challenges for future manure research:1) soil application of animal manure,2)manure phytate phosphorus,and 3) manure nitrogen *** review may contribute to the global effort in sustainable and environmentally sound agriculture by stimulating new ideas and directions in animal manure research,and promoting application of knowledge and insight derived from manure research into improved manure management strategies.

关键词：畜禽粪便应用程序环境化学综述植物营养成分全球气候变化动物粪便农业废物

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Population differentiation at a regional scale in spadefoot toads： contributions of distance and divergent selective environments

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Current Zoology 2016年第2期62卷 193-206页

作者： Amber m. RICE michael A. mCQUILLAN heidi A. SEEARS Joanna A. WARREN Department of Biological Sciences Lehigh University BethLehem PA 18015 USA

The causes of population differentiation can provide insight into the origins of early barriers to gene flow. Two key drivers of population differentiation are geographic distance and local adaptation to divergent selective environments. When reproductive isolation arises because some populations of a species are under selection to avoid hybridization while others are not, population differentiation and even speciation can result. Spadefoot toad populations that are sympatric with a congener have undergone reinforcement. This reinforcement has resulted not only in increased reproductive isolation from the congener, but also in the evolution of reproductive isolation from nearby and distant conspecific allopatric populations. We used multiple approaches to evaluate the contributions of geographic distance and divergent selective environments to population structure across this regional scale in , based on genotypes from six nuclear microsatellite markers. We compared groups of populations varying in both geographic location and in the presence of a congener. Hierarchical F-statistics and results from cluster analyses and discriminant analyses of principal components all indicate that geographic distance is the stronger contributor to genetic differentiation among populations at a regional scale. However, we found evidence that adaptation to divergent selective environments also contributes to population structure. Our findings highlight how variation in the balance of evolutionary forces acting across a species' range can lead to variation in the relative contributions of geographic distance and local adaptation to population differentiation across different spatial scales.

关键词：种群分化距离和环境蟾蜍人口结构地理位置生殖隔离标记基因型

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Tuberculosis in kidney transplant recipients:A case series

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World Journal of Transplantation 2017年第3期7卷 213-221页

作者： manish Anand Ekta Nayyar Beatrice Concepcion megha Salani heidi schaefer Department of medicine Division of NephrologyUniversity of Cincinnati Trihealth Infectious Disease Good Samaritan Hospital De-partment of medicine Division of NephrologyVanderbilt University

Solid organ transplant recipients have an elevated risk of tuberculosis(TB) with high mortality. Data about TB in this population in the United States is sparse. We present four cases of active tuberculosis in kidney transplant recipients at our center. All patients had possible TB exposure prior to transplant and all were diagnosed with active TB within the first year of transplant. Disseminated TB was seen in half of the patients with extra-pulmonary TB being more common affecting lymph nodes, pericardium, and the kidney allograft. Delay in diagnosis from onset of symptoms ranged from fifteen days to two months. Two patients died from TB. TB is a largely preventable and curable disease. However, challenges remain in the diagnosis due to most recipients presenting with atypical symptoms. Physicians should maintain a high degree of suspicion for TB to promptly diagnose and treat posttransplant thereby minimizing complications. A review of the literature including the epidemiology, pathogenesis, clinical presentation, diagnosis and treatment options are discussed.

关键词： mycobacterium tuberculosis Kidney transplant Disseminated disease Tuberculosis

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Factors and expectations influencing concussion disclosure within NCAA DivisionⅠathletes:A mixed methodological approach

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Journal of Sport and Health Science 2023年第3期12卷 388-397页

作者： melissa C.Kay heidi Hennink-Kaminski Zachary Y.Kerr Paula Gildner Brittany m.Ingram Kenneth L.Cameron megan N.Houston Laura A.Linnan Stephen W.marshall Karen Y.Peck Johna K.Register-mihalik School of Health Professions College of Nursing and Health ProfessionsUniversity of Southern MississippiHattiesburgMS 39406USA School of media and Journalism University of North Carolina at Chapel HillChapel HillNC 27599USA Injury Prevention Research Center University of North Carolina at Chapel HillChapel HillNC 27599USA Department of Exercise and Sport Science College of Arts and SciencesUniversity of North Carolina at Chapel HillChapel HillNC 27599USA matthew Gfeller Sport-Related Traumatic Brain Injury Research Center University of North Carolina at Chapel HillChapel HillNC 27599USA Center for the Study of Retired Athletes University of North Carolina at Chapel HillChapel HillNC 27599USA Keller Army Hospital United States Military AcademyWest PointNY 10996USA Departments of Physical medicine and Rehabilitation and Surgery Uniformed Services University of the Health SciencesBethesdaMD 20814USA Department of Health Behavior School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599USA Department of Epidemiology School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599USA

Background:Participation in sports is associated with many benefits to all aspects of health;however,it also comes with the risk of injury,particularly ***-disclosure and care seeking following a concussion are especially important because of the lack of outwardly visible signs and/or *** recent research has explored factors affecting concussion disclosure,use of isolated methodologies limits the ability to contextualize how disclosure or nondisclosure ***,the purpose of this study was to describe the factors and expectations of National Collegiate Athletic Association(NCAA)athletes that may influence concussion ***:This mixed-methods convergent parallel research study included 25 NCAA Division I athletes representing 13 sports,all of whom completed a concussion-education session with pre-/post-test surveys and a semistructured *** athletes were at least 18 years old and on an NCAA *** surveys focused on previous concussion-related disclosure behaviors,knowledge,attitudes,beliefs,norms,and intentions about disclosing *** focused on the athletes’experiences related to concussion *** data were analyzed using descriptive statistics and mann-Whitney U *** were analyzed using a Consensual Qualitative Research ***:Participants had good concussion knowledge(median=46.0),positive attitudes(median=38.0),strong beliefs(median=13.0),and strong intentions to disclose concussion symptoms(median=7.0).None of the constructs differed by participants’*** quantitative findings were mostly positive,interview data highlighted factors that may explain why some participants are successful in disclosing concussions and why others may find disclosure *** efforts,sport culture,and medical professional presence were the primary facilitators discussed by ***,pressure,and a lack of team support were perceived as di

关键词： Education medical professional presence mixed methodological research Reporting Sport culture

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Improved source assessment of Si,Al and related mineral components to Pm_(10) based on a daily sampling procedure

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Journal of Environmental Sciences 2010年第4期22卷 582-588页

作者： Ge Peng Hans Puxbaum heidi Bauer Nicole Jankowski Yao Shi Chemical Engineering College Ningbo University of Technology Ningbo 315016 China. Institute for Chemical Technologies and Analytics Vienna University of Technology Vienna 1060 Austria College of Environmental and Resource Sciences Zhejiang University Hangzhou 310027 China

Samples obtained from an industrialized valley in the East Alpine region were collected daily for a half year and analyzed using X-ray fluorescence to examine the elements Si, Al, Fe, Ca, mg, Na, K, Zn, P, S and Cl. Some factors affecting the changes of these elements were considered, including time, elemental correlations, weekday, weekend and seasonal changes. Diagnostic analysis provided an insight into a decoupling behavior that occursin siliceous and carbonates minerals. A decrease in Si and Al and an increase in carbonates, Na, K, Zn and P were observed during the cold season. However, a consistently high correlation of Si and Al was observed in all seasons. It was established that such high levels originated from street surface abrasion. The increase in variability and absolute levels of carbonates during the cold season was demonstrated by adding carbonates to the street surface as gritting material to increase the grip on snowy surfaces. A marked increase in Na and Cl was observed in winter which may have been caused by thaw salt that is widely used in winter in Austria. This was associated with a significant increase in K, Zn, and P in the cold season that was the result of domestic space heating with wood. Pm10 levels in December were 12 μ/m^3 and were higher than levels detected in July. It was established that such high levels originated from mineral oxides, wood smoke, and inorganic ionic material（s）.

关键词： particulate matter Pm10 mineral aerosol silicates carbonates street dust wood combustion thaw salt

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Can non-typeable Haemophilus influenzae carriage surveillance data infer antimicrobial resistance associated with otitis media?

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Pediatric Investigation 2023年第1期7卷 13-22页

作者： Sophia Bowman-Derrick Tegan m.Harris Jemima Beissbarth mariana Kleinecke Katrina Lawrence Teresa m.Wozniak Amy Bleakley Angela Rumaseb michael J.Binks Robyn L.marsh Peter S.morris Amanda J.Leach heidi Smith-Vaughan menzies School of Health Research Charles Darwin UniversityDarwinAustralia Australian e-Health Research Centre CSIRO BrisbaneAustralia Royal Darwin Hospital DarwinAustralia

Importance:In remote communities of the Northern Territory,Australia,children experience high rates of otitis media(Om),commonly caused by non-typeable Haemophilus influenzae(NTHi).Few data exist on antibiotic susceptibility of NTHi from ***:To determine whether population-level nasopharyngeal NTHi antibiotic susceptibility data could inform antibiotic treatment for ***:NTHi isolates(n=92)collected from ear discharge between 2003 and 2013 were selected to time-and age-match NTHi isolates from the nasopharyngeal carriage(n=95).Antimicrobial susceptibility were *** trees and a genome-wide association study(GWAS)were performed to determine the similarity of nasopharyngeal and ear isolates at a population ***:Among 174 NTHi isolates available for antimicrobial susceptibility testing,10.3%(18/174)were resistant to ampicillin and 9.2%(16/174)were resistant to *** numbers of isolates(≤3)were resistant to tetracycline,chloramphenicol,or amoxicillin-clavulanic *** was no statistical difference in the proportion of ampicillin-resistant(P=0.11)or trimethoprim-sulfamethoxazole-resistant isolates(P=0.70)between ear discharge and nasopharynx-derived NTHi *** multi-drug resistant NTHi isolates were *** trees showed no clustering of 187 Haemophilus influenzae isolates based on anatomical niche(nasopharynx or ear discharge),and no genetic variations that distinguished NTHi derived from ear discharge and nasopharyngeal carriage were evident in the ***:In this population-level study,nasopharyngeal and ear discharge isolates did not represent distinct microbial *** results support tracking of population-level nasopharyngeal NTHi antibiotic resistance patterns to inform clinical management of Om in this population.

关键词： Haemophilus influenzae Otitis media Antimicrobial resistance

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