The Effect of Donor Transportation on the Function of Donor’s Organs

Abstract Background: The impact of donor transportation on the outcome of deceased organ donation remains largely unknown. This study aimed to investigate the effect of donor transportation on the function of the donor’s organs. Methods: From 2016 to 2018, 139 donors of successful deceased organ donation from the local (primary) hospitals transferred to our hospital were included for analysis. Blood samples were drawn immediately after the donor admitted to our hospital (pre-transport data) and before donation (post-transport data) to assess the donor’s organ functions by determining the levels of blood biochemical indexes. Results: The donor with a transport distance >200 km had higher post-transportation AST and a bigger change of TB level as compared with those with a transport distance < 200 km. Pearson’s correlation analysis showed a positive correlation between transport distance and post-transport AST. The donors with cardiac arrest history had significantly higher pre-transport AST, pre-transport ALT, post-transport ALT, post-transport BUN, and the change level of BUN after transport as compared with those without cardiac arrest history. The donors with a history of cranial decompression surgery had significantly lower pre-transport AST, pre-transport ALT, and post-transport Cr as compared with those without a history of cranial decompression surgery. Conclusion: These results suggested that long-distance donor transportation may result in organ function deterioration, especially for donors with a cardiac arrest history. Donors with a history of intracranial decompression surgery can alleviate this problem.

Download Full-text

Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

BMJ Open ◽

10.1136/bmjopen-2019-031655 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031655 ◽

Cited By ~ 4

Author(s):

David Majewski ◽

Stephen Ball ◽

Judith Finn

Keyword(s):

Systematic Review ◽

Cardiac Arrest ◽

Current Evidence ◽

Cochrane Library ◽

Neurological Outcomes ◽

Statistical Heterogeneity ◽

Comorbidity Burden ◽

History Of ◽

The Impact ◽

Hospital Cardiac Arrest

ObjectivesTo assess the current evidence on the effect pre-arrest comorbidity has on survival and neurological outcomes following out-of-hospital cardiac arrest (OHCA).DesignSystematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesMEDLINE, Ovid Embase, Scopus, CINAHL, Cochrane Library and MedNar were searched from inception to 31 December 2018.Eligibility criteriaStudies included if they examined the association between prearrest comorbidity and OHCA survival and neurological outcomes in adult or paediatric populations.Data extraction and synthesisData were extracted from individual studies but not pooled due to heterogeneity. Quality of included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.ResultsThis review included 29 observational studies. There were high levels of clinical heterogeneity between studies with regards to patient recruitment, inclusion criteria, outcome measures and statistical methods used which ultimately resulted in a high risk of bias. Comorbidities reported across the studies were diverse, with some studies reporting individual comorbidities while others reported comorbidity burden using tools like the Charlson Comorbidity Index. Generally, prearrest comorbidity was associated with both reduced survival and poorer neurological outcomes following OHCA with 79% (74/94) of all reported adjusted results across 23 studies showing effect estimates suggesting lower survival with 42% (40/94) of these being statistically significant. OHCA survival was particularly reduced in patients with a prior history of diabetes (four out of six studies). However, a prearrest history of myocardial infarction appeared to be associated with increased survival in one of four studies.ConclusionsPrearrest comorbidity is generally associated with unfavourable OHCA outcomes, however differences between individual studies makes comparisons difficult. Due to the clinical and statistical heterogeneity across the studies, no meta-analysis was conducted. Future studies should follow a more standardised approach to investigating the impact of comorbidity on OHCA outcomes.PROSPERO registration numberCRD42018087578

Download Full-text

Evaluating the Impact of Anthropogenic Factors on the Dissemination of Contemporary Cosmopolitan, Arctic, and Arctic-like Rabies Viruses

Viruses ◽

10.3390/v14010066 ◽

2021 ◽

Vol 14 (1) ◽

pp. 66

Author(s):

Andrei A. Deviatkin ◽

Yulia A. Vakulenko ◽

Mariia A. Dashian ◽

Alexander N. Lukashev

Keyword(s):

Rabies Virus ◽

Economic Consequences ◽

The Arctic ◽

Anthropogenic Factors ◽

Long Distance ◽

Systematic Analysis ◽

Phylogeographic History ◽

History Of ◽

Group A ◽

The Impact

Rabies is a globally prevalent viral zoonosis that causes 59,000 deaths per year and has important economic consequences. Most virus spread is associated with the migration of its primary hosts. Anthropogenic dissemination, mainly via the transportation of rabid dogs, shaped virus ecology a few hundred years ago and is responsible for several current outbreaks. A systematic analysis of aberrant long-distance events in the steppe and Arctic-like groups of rabies virus was performed using statistical (Bayesian) phylogeography and plots of genetic vs. geographic distances. The two approaches produced similar results but had some significant differences and complemented each other. No phylogeographic analysis could be performed for the Arctic group because polar foxes transfer the virus across the whole circumpolar region at high velocity, and there was no correlation between genetic and geographic distances in this virus group. In the Arctic-like group and the steppe subgroup of the cosmopolitan group, a significant number of known sequences (15%–20%) was associated with rapid long-distance transfers, which mainly occurred within Eurasia. Some of these events have been described previously, while others have not been documented. Most of the recent long-distance transfers apparently did not result in establishing the introduced virus, but a few had important implications for the phylogeographic history of rabies. Thus, human-mediated long-distance transmission of the rabies virus remains a significant threat that needs to be addressed.

Download Full-text

Personifying Prehistory

10.1093/oso/9780198768012.001.0001 ◽

2019 ◽

Cited By ~ 2

Author(s):

Joanna Brück

Keyword(s):

Bronze Age ◽

Cultural Context ◽

Social Power ◽

Modern World ◽

Long Distance ◽

History Of Research ◽

History Of ◽

Human World ◽

The Impact ◽

The Bronze Age

The Bronze Age is frequently framed in social evolutionary terms. Viewed as the period which saw the emergence of social differentiation, the development of long-distance trade, and the intensification of agricultural production, it is seen as the precursor and origin-point for significant aspects of the modern world. This book presents a very different image of Bronze Age Britain and Ireland. Drawing on the wealth of material from recent excavations, as well as a long history of research, it explores the impact of the post-Enlightenment 'othering' of the non-human on our understanding of Bronze Age society. There is much to suggest that the conceptual boundary between the active human subject and the passive world of objects, so familiar from our own cultural context, was not drawn in this categorical way in the Bronze Age; the self was constructed in relational rather than individualistic terms, and aspects of the non-human world such as pots, houses, and mountains were considered animate entities with their own spirit or soul. In a series of thematic chapters on the human body, artefacts, settlements, and landscapes, this book considers the character of Bronze Age personhood, the relationship between individual and society, and ideas around agency and social power. The treatment and deposition of things such as querns, axes, and human remains provides insights into the meanings and values ascribed to objects and places, and the ways in which such items acted as social agents in the Bronze Age world.

Download Full-text

Abstract 337: Prognostic Impact of Cardiac Arrest Among Patients With ST-Elevation Myocardial Infarction

Circulation ◽

10.1161/circ.138.suppl_2.337 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Anirudh Kumar ◽

Chetan P Huded ◽

Michael J Johnson ◽

Venu Menon ◽

Stephen G Ellis ◽

...

Keyword(s):

Myocardial Infarction ◽

Heart Failure ◽

Cardiac Arrest ◽

Troponin T ◽

Coronary Intervention ◽

St Elevation Myocardial Infarction ◽

Prognostic Impact ◽

History Of ◽

St Elevation ◽

The Impact

Background: ST-elevation myocardial infarction (STEMI) is a potentially fatal condition that may be complicated by cardiac arrest (CA). However, the impact of CA complicating STEMI on prognosis in the contemporary era of rapid primary PCI is uncertain. Methods: We reviewed consecutive cases of STEMI treated with percutaneous coronary intervention (PCI) at our center between January 1, 2011 and December 31, 2016. Baseline clinical characteristics and in-hospital long-term outcomes were compared between patients with and without CA. Results: Among 1,272 patients with STEMI, 148 (11.6%) had CA (30.4% out-of-hospital, 69.6% after ED arrival). Compared to patients without CA, patients with STEMI+CA were more likely to have a history of heart failure, valve surgery, peripheral and cerebrovascular disease, and chronic kidney disease with a trend towards increased prevalence of left main or left anterior descending culprit vessel. Patients with STEMI+CA had greater creatinine (1.28±0.92 vs. 1.07±0.67, p=0.013, infarct size (CK-MB 171.6±131.6 vs. 139.2±117.0 ng/mL, p=0.010; troponin T 6.2±6.2 vs. 5.0±4.8 ng/mL, p=0.024), door-to-balloon-time (118.1±63.6 vs. 106.8±64.0, p=0.045), and incidence of cardiogenic shock (48.0% vs. 5.9%, p<0.0001) and intra-aortic balloon pump need (36.5% vs. 8.3%, p<0.0001). Patients with STEMI+ CA had higher rates of major bleeding (25.0% vs. 9.4%, p<0.0001) and post-PCI heart failure (13.5% vs. 8.1%, p=0.042). Patients with STEMI+CA had significantly greater mortality in-hospital (14.9% vs. 3.6%, p<0.0001) and at 1-year (22.9% vs. 9.3%, p<0.0001) (Figure). Conclusions: CA is a complication in >1 in 10 patients with STEMI and is associated with significantly higher morbidity and mortality compared with STEMI without CA. Strategies to improve the care and outcomes of STEMI patients with CA are needed.

Download Full-text

Can financial rewards complement altruism to raise deceased organ donation rates?

Nursing Ethics ◽

10.1177/0969733020918927 ◽

2020 ◽

Vol 27 (6) ◽

pp. 1436-1449

Author(s):

Rajah Rasiah ◽

Navaz Naghavi ◽

Muhammad Shujaat Mubarik ◽

Hamid Sharif Nia

Keyword(s):

Socioeconomic Status ◽

Organ Donation ◽

Financial Incentives ◽

Structural Equation ◽

Public Awareness ◽

Equation Modeling ◽

Willingness To Donate ◽

Deceased Organ Donation ◽

The University ◽

The Impact

Background: Organ supply–demand in developing countries worldwide has continued to widen. Hence, using a large survey (n ¼ 10,412), this study seeks to investigate whether human psychology could be used to inculcate philanthropy to raise deceased organ donation rates. Methods: Three models were constructed to examine multidimensional relationships among the variables. Structural equation modeling was applied to estimate the direct and indirect influence of altruism, financial incentives, donation perception, and socioeconomic status simultaneously on willingness to donate deceased organs. Ethical considerations: The study was approved by the University of Malaya ethics committee. Results: The results show that altruism amplifies the impact of socioeconomic status and donation perception on willingness to donate. Also, the results show that financial incentives cannot complement altruism to raise organ donation rates. Hence, investing in education and public awareness enhances altruism in people, which then increases the propensity to donate. Conclusion: Evidence suggests that governments should allocate resources to increase public awareness about organ donation. Awareness programs about the importance of philanthropic donations and the participation of medical consultants at hospitals in the processes form the foundation of such a presumptive approach.

Download Full-text

Nomads in the Middle East

10.1017/9781139028813 ◽

2021 ◽

Author(s):

Beatrice Forbes Manz

Keyword(s):

Middle East ◽

Cultural Production ◽

Political Ideology ◽

Long Distance ◽

Animal Products ◽

Ibn Khaldun ◽

Pastoral Nomads ◽

Eurasian Steppe ◽

History Of ◽

The Impact

A history of pastoral nomads in the Islamic Middle East from the rise of Islam, through the middle periods when Mongols and Turks ruled most of the region, to the decline of nomadism in the twentieth century. Offering a vivid insight into the impact of nomads on the politics, culture, and ideology of the region, Beatrice Forbes Manz examines and challenges existing perceptions of these nomads, including the popular cyclical model of nomad-settled interaction developed by Ibn Khaldun. Looking at both the Arab Bedouin and the nomads from the Eurasian steppe, Manz demonstrates the significance of Bedouin and Turco-Mongolian contributions to cultural production and political ideology in the Middle East, and shows the central role played by pastoral nomads in war, trade, and state-building throughout history. Nomads provided horses and soldiers for war, the livestock and guidance which made long-distance trade possible, and animal products to provision the region's growing cities.

Download Full-text

A Program of Research to Evaluate the Impact of Deceased Organ Donation Legislative Reform in Nova Scotia: The LEADDR Program

Transplantation Direct ◽

10.1097/txd.0000000000001093 ◽

2020 ◽

Vol 7 (1) ◽

pp. e641

Author(s):

Matthew J. Weiss ◽

Kristina Krmpotic ◽

Tim Cyr ◽

Sonny Dhanani ◽

Mélanie Dieudé ◽

...

Keyword(s):

Nova Scotia ◽

Organ Donation ◽

Legislative Reform ◽

Deceased Organ Donation ◽

The Impact

Download Full-text

History and Geography of Neotropical Tree Diversity

Annual Review of Ecology Evolution and Systematics ◽

10.1146/annurev-ecolsys-110617-062314 ◽

2019 ◽

Vol 50 (1) ◽

pp. 279-301 ◽

Cited By ~ 6

Author(s):

Christopher W. Dick ◽

R. Toby Pennington

Keyword(s):

Community Assembly ◽

Tree Diversity ◽

Long Distance ◽

Neotropical Forests ◽

The Past ◽

Biogeographic History ◽

Neotropical Tree ◽

History Of ◽

The Impact

Early botanical explorers invoked biogeographic history to explain the remarkable tree diversity of Neotropical forests. In this context, we review the history of Neotropical tree diversity over the past 100 million years, focusing on biomes with significant tree diversity. We evaluate hypotheses for rain forest origins, intercontinental disjunctions, and models of Neotropical tree diversification. To assess the impact of biotic interchange on the Amazon tree flora, we examined biogeographic histories of trees in Ecuador's Yasuní Forest, which suggest that nearly 50% of its species descend from immigrant lineages that colonized South America during the Cenozoic. Long-distance and intercontinental dispersal, combined with trait filtering and niche evolution, are important factors in the community assembly of Neotropical forests. We evaluate the role of pre-Columbian people on Neotropical tree diversity and discuss the future of Neotropical forests in the Anthropocene.

Download Full-text