Abstract 16930: Despite Prior Results, Heart Transplant Recipients Over 70 Have Worse Survival Outcomes Based on the 2019 United Network for Organ Sharing Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jay Kanaparthi ◽  
Mohammed Kashem ◽  
Manish Suryapalam ◽  
Yoshiya Toyoda
Keyword(s):  
Demographic Data ◽  
Age Groups ◽  
Survival Outcomes ◽  
Ischemic Time ◽  
Kaplan Meier ◽  
Before And After ◽  
Chi Squared ◽  
Time Frames ◽  
United Network

Introduction: As the prevalence of heart failure increases by age, it is critical we understand the role of heart transplantation (HTx) in older patients. Recent long term studies have indicated no difference in HTx outcomes between recipients 70 years or older and those ages 60-69. But these studies included data from the 1980-90s, introducing significant variance due poorer outcomes across age groups in that era. We analyzed the most recent United Network for Organ Sharing (UNOS) database, stratified by time frames before and after 2000, to demonstrate this statistical discrepancy and derive a more representative comparison of modern survival by age group. Hypothesis: HTx recipients 70+ years old may not actually have comparable survival to those 60-69 years of age, when assessing more recent HTx data. Methods: All UNOS HTx recipients over 60 years of age (n=20,446) were divided into 2 cohorts: those 60-69 and those ≥70 years old, which were analyzed over two time frames: transplant date 1987-1999 and 2000-2019. Demographic data (gender, ethnicity, BMI) as well as peri-operative factors (ICU stay, ischemic time, and length of stay) were evaluated for significance using Chi-Squared and H-Tests as appropriate. Kaplan-Meier Curve with log-rank tests were used to assess 10 year survival outcomes. Results: 19,129 patients were 60-69 years old, and 1,317 were ≥70 years old, with mean ages of 64.0±2.7 and 71.3±1.6 years respectively. The distribution of demographic and peri-operative factors was significantly different between the cohorts, with p<0.05 for values. Survival analysis indicated no significance in the earlier timeframe (1987-1999) with p=0.341, but indicated significance in the later timeframe (2000-2019), with p=0.004. Conclusion: The results indicate that since 2000, recipients 60-69 years of age have better 10- year post transplant survival than older recipients, a relationship previously obscured by worse outcomes in early data.

scholarly journals Modern UNOS Data Reveals Septuagenarians have Inferior Heart Transplant Survival

2021 ◽  
Author(s):  
Manish Suryapalam ◽  
Jay Kanaparthi ◽  
Mohammed Abul Kashem ◽  
Huaqing Zhao ◽  
Yoshiya Toyoda
Keyword(s):  
Demographic Data ◽  
The United States ◽  
Survival Outcomes ◽  
Transplant Survival ◽  
Post Transplant ◽  
Kaplan Meier ◽  
Chi Squared ◽  
Older Recipients ◽  
Long Term Studies

Background: While heart transplantation is increasingly performed in the United States for elderly patients, survival outcomes have primarily been analyzed in single-center studies. The few existing long-term studies have indicated no difference in HTx outcomes between patients ≥70 years and 60-69 years age, but these studies only assessed to 5-years post-transplant and included data from the 1980-90s, introducing significant variance due to poorer outcomes in that era. We analyzed the UNOS database from 1987-2020, stratified by timeframe at 2000, to derive a more representative comparison of modern HTx survival outcomes. Methods: All UNOS HTx recipients over 18 years of age (n=66,186) were divided into 3 cohorts: 18-59, 60-69 and ≥70 years old. Demographic data as well as perioperative factors were evaluated for significance using Chi-Squared and H-Tests as appropriate. Kaplan-Meier Curve and cox regressions with log-rank tests were used to assess 5 through 10 year survival outcomes. Results: 45,748 were 18-59 years old, 19,129 were 60-69 years old and 1,309 were ≥70 year old. The distribution of most demographic and perioperative factors significantly differed between cohorts. Pairwise survival analysis involving the 18-59 cohort always indicated significance. While there was no significance between the two older cohorts in the earlier timeframe, there was significance in the later timeframe from 6-10 years post-HTx (p<0.05). Cox regressions confirmed results. Conclusions: The results indicate that since 2000, recipients 60-69 years of age have better 6 through 10-year post-transplant survival than older recipients, a relationship previously obscured by worse outcomes in early data.

Abstract 529: A Modern Large-scale Analysis of Heart Transplantation in Elderly Patients

2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Manish Suryapalam ◽  
Mohammed Kashem ◽  
Val Rakita ◽  
Yoshiya Toyoda
Keyword(s):  
Heart Transplantation ◽  
Large Scale ◽  
Age Groups ◽  
The Elderly ◽  
Survival Outcome ◽  
Outcome Analysis ◽  
Survival Outcomes ◽  
Ischemic Time ◽  
Significant Difference ◽  
Chi Squared

Introduction: As the prevalence of heart failure increases among older patients, the potential role of heart transplant (HTx) in this demographic demands further investigation. Survival outcome analysis of the elderly has primarily been analyzed in single-center studies, and the few long term studies performed have included a timeframe to the 1980s, introducing substantial variance from much poorer survival outcomes. We investigated the 5 to 10 year survival outcomes of more modern heart transplantation patients by analyzing the UNOS database. Methods: Heart transplantation data for 32,337 patients (2000-2014) was divided into three different age groups- <60, 60-69, and ≥70 years old. Gender, ethnicity, height, weight, BMI, ICU stay, ischemic time, length of stay (LOS), and creatinine level were evaluated for significance using Chi-Squared and H-Tests as appropriate (p<0.05). Survival outcome was assessed using a Kaplan-Meier Curve and log-rank tests. Results: 23,267 were <60, 8,459 were 60-69, and 611 were ≥70, with mean ages of 38±0.1, 64±0.0, and 72±0.1 respectively. The distribution of gender, ethnicity, ischemic time, BMI, height, and weight was significantly different between the cohorts, with p=0.000 for all. Survival analysis indicated complete pairwise significance at 10 years post-HTx, with overall significance of p=0.000. At 5 years post-HTx, only 60-69 vs ≥70 did not have pairwise significance in survival. Conclusion: Contrary to prior studies, results indicate a statistically significant difference in survival the older and younger cohorts. This difference is especially prominent at the 10 th year post-transplant, but can be seen even at the 5 th year.

scholarly journals EFFECT OF FREEZING ON THE MILK QUALITY OF COWS

2020 ◽  
pp. 54-57
Author(s):  
Lyubov Valentinovna Efimova ◽  
Tatyana Vyacheslavovna Zaznobina ◽  
Elena Vladimirovna Gatilova ◽  
Olga Valeryevna Ivanova
Keyword(s):  
Quality Indicators ◽  
Age Groups ◽  
Milk Quality ◽  
Long Term Storage ◽  
Before And After ◽  
Frozen State ◽  
Term Storage ◽  
Two Age Groups

Due to the fact that milk has a short shelf life, the issue of its freezing and long-term storage in the frozen state is relevant. A study was conducted on the effect of freezing on the milk quality after its defrosting of cows-mothers and cows-daughters of Red-Motley breed. As a result, it was established how milk quality indicators to change after five months of storage in a frozen state in cows of two age groups. A high correlation was established between quality indicators before and after freezing. The influence of the “freezing” factor on milk quality indicators was recognized statistically significant, the “generation” factor – not significant.

scholarly journals Intoxicated Donors and Heart Transplant Outcomes: Long-Term Safety

2021 ◽  
Author(s):  
David A. Baran ◽  
Justin Lansinger ◽  
Ashleigh Long ◽  
John M. Herre ◽  
Amin Yehya ◽  
...  
Keyword(s):  
Drug Use ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Heart Transplants ◽  
Term Survival ◽  
Ischemic Time ◽  
Cox Proportional Hazards Models ◽  
Donor Shortage ◽  
United Network

Background: The opioid crisis has led to an increase in available donor hearts, although questions remain about the long-term outcomes associated with the use of these organs. Prior studies have relied on historical information without examining the toxicology results at the time of organ offer. The objectives of this study were to examine the long-term survival of heart transplants in the recent era, stratified by results of toxicological testing at the time of organ offer as well as comparing the toxicology at the time of donation with variables based on reported history. Methods: The United Network for Organ Sharing database was requested as well as the donor toxicology field. Between 2007 and 2017, 23 748 adult heart transplants were performed. United Network for Organ Sharing historical variables formed a United Network for Organ Sharing Toxicology Score and the measured toxicology results formed a Measured Toxicology Score. Survival was examined by the United Network for Organ Sharing Toxicology Score and Measured Toxicology Score, as well as Cox proportional hazards models incorporating a variety of risk factors. Results: The number and percent of donors with drug use has significantly increased over the study period ( P <0.0001). Cox proportional hazards modeling of survival including toxicological and historical data did not demonstrate differences in post-transplant mortality. Combinations of drugs identified by toxicology were not associated with differences in survival. Lower donor age and ischemic time were significantly positively associated with survival ( P <0.0001). Conclusions: Among donors accepted for transplantation, neither history nor toxicological evidence of drug use was associated with significant differences in survival. Increasing use of such donors may help alleviate the chronic donor shortage.

scholarly journals Comparison of Survival Rates of Stainless-Steel Crowns Placed with and without Pulpotomy: A Two-Year Retrospective Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Fatmah N. AlMotawah ◽  
Sharat Chandra Pani ◽  
Tala AlKharashi ◽  
Saleh AlKhalaf ◽  
Mohammed AlKhathlan ◽  
...  
Keyword(s):  
Stainless Steel ◽  
General Anesthesia ◽  
Survival Rates ◽  
Survival Outcome ◽  
Survival Outcomes ◽  
Proximal Caries ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Chi Squared

Aim. This study aimed to retrospectively compare the survival outcomes over two years between teeth with proximal dental caries that were restored with stainless-steel crowns to those that were pulpotomized and then restored with a stainless-steel crown in patients who were rehabilitated under general anesthesia. Participants and Methods. The records of 131 patients aged between two to six years who had stainless-steel crowns placed under general anesthesia and had two-year follow-up were screened. 340 teeth with moderate proximal caries on the radiograph (D2) were included in the study. Of these, 164 teeth were treated with a pulpotomy and stainless-steel crown, while 176 teeth were crowned without a pulpotomy. The type of each tooth was compared using the Chi-squared test and Kaplan–Meier survival analysis, and curves were plotted based on the two-year outcomes. Results. Treatment: the sample comprised 59 males (mean age 4.73 years, SD ± 1.4 years) and 72 females (mean age 5.2 years, SD ± 2.0 years). The Kaplan–Meier regression model showed no significant difference in survival outcomes between teeth that had been pulpotomized and those that had not ( p  = 0.283). Conclusion. Within the limitations of the current study, we can conclude that performing a pulpotomy does not influence the survival outcome of mild/moderate proximal caries restored with stainless-steel crowns under general anesthesia.

Underlying factors of ups and downs in financial leverage overtime

2016 ◽  
Vol 23 (6) ◽  
pp. 1321-1342 ◽  
Author(s):  
Murat Kizildag ◽  
Ozgur Ozdemir
Keyword(s):  
Lower Cost ◽  
Macro Level ◽  
Financial Leverage ◽  
Short Term ◽  
Accounting Data ◽  
Before And After ◽  
Macroeconomic Indicators ◽  
Hospitality And Tourism ◽  
Time Frames

We present new stylized facts on the underlying reasons of US hospitality and tourism firms’ fluctuating levels of financial leverage during the period 1990–2015 using comprehensive micro- and macro-level accounting data overtime. To characterize this puzzling phenomenon, we quantified firm-specific and macroeconomic parameters and a diverse set of leverage proxies at various time frames with various structures. We further took account of the recent economic upheaval in our analyses so that we can compare firms’ leverage behavior as “before” and “after” the major economic turmoil in 2007–2009 periods. The primary themes of our arguments were that firm-specific leverage factors significantly influenced short-term leverage, while long-term leverage was mostly determined by macroeconomic indicators. Beyond that, book leverage was more favorable across firms than market leverage. Last, hospitality and tourism firms substantially extended their borrowing capacities, aggressively grew their leverage ratios, and dramatically increased collateral values leading to lower cost of borrowing due to relaxed lending standards in the aftermath of the recent upheaval. Our article complements previous work by examining whether leverage factors demonstrate discrepancies from the prior findings and by proposing rigorous industry-specific outlook and solution for the financial leverage literature.

scholarly journals Does retraction after misconduct have an impact on citations? A pre–post study

2020 ◽  
Vol 5 (11) ◽  
pp. e003719
Author(s):  
Cristina Candal-Pedreira ◽  
Alberto Ruano-Ravina ◽  
Esteve Fernández ◽  
Jorge Ramos ◽  
Isabel Campos-Varela ◽  
...  
Keyword(s):  
General Population ◽  
Scientific Community ◽  
Evaluation Study ◽  
Inclusion Criteria ◽  
Post Evaluation ◽  
Literature Reviews ◽  
Before And After ◽  
Time Frames ◽  
Number Of Citations

BackgroundRetracted articles continue to be cited after retraction, and this could have consequences for the scientific community and general population alike. This study was conducted to analyse the association of retraction on citations received by retracted papers due to misconduct using two-time frames: during a postretraction period equivalent to the time the article had been in print before retraction; and during the total postretraction period.MethodsQuasiexperimental, pre–post evaluation study. A total of 304 retracted original articles and literature reviews indexed in MEDLINE fulfilled the inclusion criteria. Articles were required to have been published in a journal indexed in MEDLINE from January 2013 through December 2015 and been retracted between January 2014 and December 2016. The main outcome was the number of citations received before and after retraction. Results were broken down by journal quartile according to impact factor and the most cited papers during the preretraction period were specifically analysed.ResultsThere was an increase in postretraction citations when compared with citations received preretraction. There were some exceptions however: first, citations received by articles published in first-quartile journals decreased immediately after retraction (p<0.05), only to increase again after some time had elapsed; and second, postretraction citations decreased significantly in the case of articles that had received many citations before their retraction (p<0.05).ConclusionsThe results indicate that retraction of articles has no association on citations in the long term, since the retracted articles continue to be cited, thus circumventing their retraction.

Grandchildren’s food workshop: Impact of an intergenerational cooking program on dietary habits, food courage, cooking skills and two-way interaction in Danish children and their grandparents

2021 ◽  
pp. 026010602199163
Author(s):  
Anne Marie Beck ◽  
Stine B. Nielsen ◽  
Kirsten S. Bjørnsbo
Keyword(s):  
Pilot Study ◽  
Dietary Habits ◽  
Age Groups ◽  
Cooking Skills ◽  
Before And After ◽  
Chi Squared ◽  
Good Nutrition ◽  
The Impact ◽  
Dietary Data

Background: Good nutrition is a key aspect of health. Cooking activities can improve dietary habits, cooking skills and food courage in terms of courage to cook and taste new foods, in individuals of all ages. However, targeting both grandchildren and grandparents at the same time through intergenerational cooking activities, is new. Aim: This paper aims to present the impact of intergenerational cooking activities on dietary habits, food courage, cooking skills and two-way interaction between young and old participants in The Grandchildren’s Food Workshop. Methods: In this observational pilot study, the Danish Heart Foundation’s experimental cooking program for grandchildren and grandparents was developed and tested. The influence of the food workshop on the participants’ dietary habits, food courage, cooking skills and two-way interaction was assessed by a before and after questionnaire. McNemar’s and chi-squared tests were used to evaluate the effects. Results: A total of 180 grandchildren (10 to 12 years) and 183 grandparents participated in The Grandchildren’s Food Workshop. A total of 82 (46%) grandchildren (71% of which were girls) and 125 (68%) grandparents (83% of which were women) responded to the baseline and follow-up questionnaires. The impact on dietary habits and food courage was limited, while there was an impact on cooking skills in the grandchildren. The already good two-way interaction was unaltered. Conclusions: The findings indicate an impact on cooking skills among grandchildren participating in The Grandchildren’s Food Workshop, while the impact on dietary habits, food courage and two-way interaction between age groups was limited. Further research, including more detailed dietary data, should explore the significance of an intergenerational approach.

scholarly journals Incorporating habitat suitability and demographic data for developing a reintroduction plan for the critically endangered yellow spotted mountain newt, Neurergus derjugini

2019 ◽  
pp. 282-294
Author(s):  
Somaye Vaissi
Keyword(s):  
Age Structure ◽  
Captive Breeding ◽  
Demographic Data ◽  
Life Stage ◽  
Survival Rates ◽  
Age Groups ◽  
Old Adults ◽  
Before And After ◽  
Maximum Entropy Modelling ◽  
Age At Maturation

In reintroduction programmes for amphibians, data on age structure in hosting populations and choices of life stage or age groups in releasing captive bred individuals are often missing. Similarly, employing site selection procedures for selecting appropriate reintroduction locations are often neglected. Here, we obtained data on longevity, age at maturation, and age structure from skeletochronological data in a free living population of the yellow spotted mountain newt, Neurergus derjugini. A maximum longevity of 13 years for males and 12 years for females showed that N. derjugini is a long living newt with a stable age structure. We also employed maximum entropy modelling, geographic information system, and multicriteria decision analysis to obtain ranked suitability scores for reintroduction sites. Finally, we determined post-release survival rates for different life stage and age groups of N. derjugini including 30 eggs and 60 individuals of six-months old larvae, one and three-year old juveniles, and six-year old adults (15 each) born and raised in a captive-breeding facility and released into mesh enclosures in a selected stream. Over 10 visits to the site before and after overwintering, the survival rates for eggs, larvae, one and three-year juveniles and six-year old adults were 25, 80, 86.66, 93.33 and 53.33 % respectively. Applying survival rates obtained from current experimental reintroductions through a static life table suggest that an optimal release strategy to arrive at a numerical target of 100 adults aged three can be achieved by reintroduction of 650 fertilised eggs and fostering them in meshed enclosures in the selected stream.

Older and young adults experience similar long-term olfactory habituation

2020 ◽  
Author(s):  
Coralie Mignot ◽  
Philipp Nahrath ◽  
Charlotte Sinding ◽  
Thomas Hummel
Keyword(s):  
Older Adults ◽  
Prolonged Exposure ◽  
Detection Threshold ◽  
Age Groups ◽  
Temporary Increase ◽  
Lower Sensitivity ◽  
Before And After ◽  
Olfactory Detection ◽  
Olfactory Detection Thresholds

Abstract Olfactory habituation corresponds to a decreased behavioral or perceptual response to an odor after a prolonged exposure to this odor. Our aim was to investigate whether long-term olfactory habituation and its recovery is similar in young (&lt;35 years old) and older adults (&gt;50). Fifty seven participants were recruited for a five week longitudinal study. They were exposed to one of two odors (manzanate, irone alpha) for two weeks at home. Olfactory detection thresholds for both odors were measured before and after exposure. Results showed that the two age groups behaved similarly. The long-term exposure to an odor led to a temporary increase of its detection threshold (lower sensitivity to the odor). Irone alpha thresholds were more sensitive to the duration of exposure with the odor than manzanate thresholds. One week after termination of exposure, participants fully recovered and even became more sensitive to both odors. No cross-habituation was found between the two odors. Our findings highlight that long-term habituation is specific to the odor exposed, behaves the same in young and older adults and is fully reversible in both age groups after one week.

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