Immunosuppressant Regimen over Time and Their Association with Rejection, Graft Failure, and Mortality

The acute phase protein group IIA secretory phospholipase A2 (sPLA2-IIA) has proatherosclerotic properties. The present study prospectively investigated whether plasma sPLA2-IIA levels are associated with graft failure, cardiovascular and all-cause mortality in renal transplant recipients (RTRs), patients known to be susceptible to accelerated atherosclerosis, both in the graft and in the systemic vasculature. In 495 RTRs (median follow-up 7.0 years) sPLA2-IIA was determined at baseline and was significantly higher in RTRs than in healthy controls (median 384 ng/dL [range 86-6951] vs. 185 ng/dL [range 104-271], P<0.001), but lower than in end-stage renal disease patients (median 1053 ng/mL [range 458-2599], P<0.001). Kaplan-Meier analysis demonstrated an increased risk for graft failure (P=0.002), cardiovascular (P<0.001) and all-cause mortality (P<0.001) with increasing gender-stratified quartiles of sPLA2-IIA. Cox regression analyses showed a strong association of sPLA2-IIA with increased risks of graft failure (hazard ratio=1.42[1.11-1.83], P=0.006), cardiovascular (hazard ratio=1.48[1.18-1.85], P=0.001) and all-cause mortality (hazard ratio=1.39[1.17-1.64], P<0.001). However, this association was largely explained by parameters of kidney function. Further analyses in RTRs demonstrated that patients with higher baseline sPLA2-IIA levels showed faster decline in renal function during follow-up. In addition, kidney function in human sPLA2-IIA transgenic mice deteriorated more rapid over time as compared with wild-type controls (urinary albumin:creatinine ratio at 48 weeks of age 774±156 vs. 193±60, P<0.01). In summary, this prospective study demonstrates that sPLA2-IIA is a significant predictive biomarker for the occurrence of chronic graft failure, overall and CVD mortality in RTRs dependent on kidney function. This dependency is explained by sPLA2-IIA impacting negatively on kidney function over time in humans and transgenic mice.

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Social transmission bias and the cultural evolution of folk-economic beliefs

Behavioral and Brain Sciences ◽

10.1017/s0140525x18000365 ◽

2018 ◽

Vol 41 ◽

Cited By ~ 3

Author(s):

David Hirshleifer ◽

Siew Hong Teoh

Keyword(s):

Cultural Evolution ◽

Social Transmission ◽

Cognitive Approach ◽

Economic Problems ◽

Economic Attitudes ◽

The Social ◽

Economic Beliefs ◽

Over Time

AbstractEvolved dispositions influence, but do not determine, how people think about economic problems. The evolutionary cognitive approach offers important insights but underweights the social transmission of ideas as a level of explanation. The need for asocialexplanation for the evolution of economic attitudes is evidenced, for example, by immense variations in folk-economic beliefs over time and across individuals.

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Do student perceptions of their dental curriculum change over time?

Journal of Dental Education ◽

10.1002/j.0022-0337.1998.62.11.tb03260.x ◽

1998 ◽

Vol 62 (11) ◽

pp. 934-937 ◽

Cited By ~ 3

Author(s):

NW Berk ◽

JM Close ◽

RJ Weyant

Keyword(s):

Student Perceptions ◽

Curriculum Change ◽

Change Over Time ◽

Dental Curriculum ◽

Over Time

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Articulatory Generalization in Two Word-Medial, Ambisyllabic Contexts

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1903.251 ◽

1988 ◽

Vol 19 (3) ◽

pp. 251-258 ◽

Cited By ~ 5

Author(s):

Virginia I. Wolfe ◽

Suzanne D. Blocker ◽

Norma J. Prater

Keyword(s):

Common View ◽

Perceptual Salience ◽

The Common ◽

Unitary Concept ◽

Over Time

Articulatory generalization of velar cognates /k/, /g/ in two phonologically disordered children was studied over time as a function of sequential word-morpheme position training. Although patterns of contextual acquisition differed, correct responses to the word-medial, inflected context (e.g., "picking," "hugging") occurred earlier and exceeded those to the word-medial, noninflected context (e.g., "bacon," "wagon"). This finding indicates that the common view of the word-medial position as a unitary concept is an oversimplification. Possible explanations for superior generalization to the word-medial, inflected position are discussed in terms of coarticulation, perceptual salience, and the representational integrity of the word.

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Treatment Fidelity Procedures for an Aphasia Intervention Within a Randomized Controlled Trial: Design, Feasibility, and Results

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-cac48-18-0227 ◽

2020 ◽

Vol 29 (1S) ◽

pp. 412-424

Author(s):

Elissa L. Conlon ◽

Emily J. Braun ◽

Edna M. Babbitt ◽

Leora R. Cherney

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Treatment Protocol ◽

Treatment Fidelity ◽

Protocol Adherence ◽

Study Condition ◽

Randomized Controlled ◽

Aphasia Therapy ◽

Percent Accuracy ◽

Over Time

Purpose This study reports on the treatment fidelity procedures implemented during a 5-year randomized controlled trial comparing intensive and distributed comprehensive aphasia therapy. Specifically, the results of 1 treatment, verb network strengthening treatment (VNeST), are examined. Method Eight participants were recruited for each of 7 consecutive cohorts for a total of 56 participants. Participants completed 60 hr of aphasia therapy, including 15 hr of VNeST. Two experienced speech-language pathologists delivered the treatment. To promote treatment fidelity, the study team developed a detailed manual of procedures and fidelity checklists, completed role plays to standardize treatment administration, and video-recorded all treatment sessions for review. To assess protocol adherence during treatment delivery, trained research assistants not involved in the treatment reviewed video recordings of a subset of randomly selected VNeST treatment sessions and completed the fidelity checklists. This process was completed for 32 participants representing 2 early cohorts and 2 later cohorts, which allowed for measurement of protocol adherence over time. Percent accuracy of protocol adherence was calculated across clinicians, cohorts, and study condition (intensive vs. distributed therapy). Results The fidelity procedures were sufficient to promote and verify a high level of adherence to the treatment protocol across clinicians, cohorts, and study condition. Conclusion Treatment fidelity strategies and monitoring are feasible when incorporated into the study design. Treatment fidelity monitoring should be completed at regular intervals during the course of a study to ensure that high levels of protocol adherence are maintained over time and across conditions.

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Percutaneous Tracheostomy: A Multidisciplinary Approach

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd18.2.87 ◽

2008 ◽

Vol 18 (2) ◽

pp. 87-98 ◽

Cited By ~ 3

Author(s):

Vinciya Pandian ◽

Thai Tran Nguyen ◽

Marek Mirski ◽

Nasir Islam Bhatti

Keyword(s):

Health Care ◽

Quality Assurance ◽

Data Collection ◽

Health Care Professionals ◽

Multidisciplinary Approach ◽

Percutaneous Tracheostomy ◽

Johns Hopkins Hospital ◽

Prospective Data ◽

Comprehensive Service ◽

Over Time

Abstract The techniques of performing a tracheostomy has transformed over time. Percutaneous tracheostomy is gaining popularity over open tracheostomy given its advantages and as a result the number of bedside tracheostomies has increased necessitating the need for a Percutaneous Tracheostomy Program. The Percutaneous Tracheostomy Program at the Johns Hopkins Hospital is a comprehensive service that provides care to patients before, during, and after a tracheostomy with a multidisciplinary approach aimed at decreasing complications. Education is provided to patients, families, and health-care professionals who are involved in the management of a tracheostomy. Ongoing prospective data collection serves as a tool for Quality Assurance.

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