Outcomes After Deceased Donor Kidney Transplantation Using Kidney Allografts With Marginal Perfusion Parameters

BACKGROUND

This study examines outcomes of deceased donor kidney transplantation (DDKT) in recipients of kidney allografts with marginal perfusion parameters.

METHODS

Allografts with marginal perfusion parameters (resistance index [RI] >0.4 and pump flow rate [F] <70 mL/min; MP group) were compared with those with good parameters (RI <0.4 and F >70 mL/min; GP group) for DDKT recipients between January 1996 and November 2017 after hypothermic pulsatile perfusion. Demographics, creatinine, cold ischemia times (CIT), delayed graft function (DGF), and recipient glomerular filtration rate at pre- and post-transplant were noted. The primary outcome was graft survival post-transplant.

RESULTS

In the MP (n = 31) versus GP (n = 1281) group, the median recipient was aged 57 years versus 51 years; the median donor was aged 47 versus 37 years; terminal creatinine was 0.9 versus 0.9 mg/dL; CIT was 10.2 versus 13 hours, and the RI and flow were 0.46 and 60 mL/min versus 0.21 and 120 mL/min. The DGF rate was 19% (MP) versus 8% (GP). The graft survival in the MP versus GP group was 81% versus 90% (1 year), 65% versus 79% (3 years), 65% versus 73% (4 years), and 45% versus 68% (5 years).

CONCLUSION

Carefully selected kidney allografts after comprehensive donor and recipient evaluation may allow for the use of these routinely discarded kidneys with marginal perfusion parameters.

An interesting case of chronic myeloid leukemia with twists and turns

Additional cytogenetic abnormalities (ACA) are known to crop up in Ph⁺ cells of chronic myeloid leukemia (CML) patients due to cytogenetic evolution. But the frequency of molecular evolution and ACA is much less in Ph^- cells of CML patients and is poorly understood. We report an interesting and rare case of Ph⁺ CML, who progressed to B lymphoblastic crisis, achieved remission, and later developed Ph^- acute myeloid leukemia (AML) with KMT2A gene rearrangement and no detectable BCR- ABL transcripts.

NMR Studies on the Interaction of Anticancer Drug Doxorubicin with Membrane Mimetic SDS

In the formulation of efficient drug delivery systems, it is essential to unravel the structural and dynamical aspects of the drug's interaction with biological membranes. This has been done for the anticancer drug-membrane system comprising doxorubicin hydrochloride (DOX), a water-soluble anticancer drug, and the micellar sodium dodecyl sulfate (SDS), the latter serving as a useful mimic for membrane proteins. Using a multimodal NMR approach involving ¹H, ²H, and ¹³C as probe nuclei and through the determination of chemical shifts, spin-relaxation, nuclear Overhauser enhancements (NOE), and translational self-diffusion (SD), the binding characteristics of the DOX with SDS have been determined. The perturbation to ¹³C chemical shifts of SDS indicate the penetration of DOX into the SDS micelle, which is further revealed by ¹H-¹H NOESY and SD measurements. ²H spin-relaxation measurements and their analysis using a two-step model show DOX induced SDS micellar volume changes, which determine the correlation times involved in the DOX-SDS mobility.

Interaction between sodium dodecylsulfate (SDS) and pluronic L61 in aqueous medium: assessment of the nature and morphology of the formed mixed aggregates by NMR, EPR, SANS and FF-TEM measurements

The interaction of copolymer L61 i.e., (EO)2(PO)32(EO)2 (where EO and PO are ethylene and propylene oxides, respectively) with surfactant SDS (sodium dodecylsulfate) in relation to their self-aggregation, dynamics and microstructures has been physicochemically studied in detail employing the Nuclear Magnetic Resonance (NMR), Electron Paramagnetic Resonance (EPR), Small-Angle Neutron Scattering (SANS), and Freeze-Fracture Transmission Electron Microscopy (FF-TEM) methods. The NMR self-diffusion study indicated a synergistic interaction between SDS and L61 forming L61-SDS mixed complex aggregates, and deuterium (2H) NMR pointed out the nonspherical nature of these aggregates with increasing [L61]. EPR spectral analysis of the motional parameters of 5-doxyl steraric acid (5-DSA) as a spin probe provided information on the microviscosity of the local environment of the L61-SDS complex aggregates. SANS probed the geometrical aspects of the SDS-L61 assemblies as a function of both [L61] and [SDS]. Progressive evolution of the mixed-aggregate geometries from globular to prolate ellipsoids with axial ratios ranging from 2 to 10 with increasing [L61] was found. Such morphological changes were further corroborated with the results of 2H NMR and FF-TEM measurements. The strategy of the measurements, and data analysis for a concerted conclusion have been presented.

Differential Modulation in Metabolites Revealed with the Improvement in the Shelf-Life of Alphonso Fruits

Globally farmers have difficulty in extending the shelf-life of the tropical fruits due to their perishable nature. The present study aimed to assess the effect of hexanal nano-formulation treatment (NFT) on the shelf-life of Alphonso mango. Further, volatilomics was performed to explore the molecular basis of such effect. Untreated and treated fruits were sampled starting from 5th to 21st day after NFT at an interval of 4 days. Moderate changes in visual and digital colour parameters were evident from the intact and dissected fruits of NFT set compared to untreated fruits. Biochemical assays affirmed the phenotypic differences with significant changes in the colour imparting compounds like carotenoids and anthocyanins among them. Further, gas chromatography-mass spectrometry analysis revealed significant qualitative and quantitative variations in the different classes of compounds like lactones, furanones, esters, aldehydes and alcohols. Some of the key metabolites showed differential modulations among the NFT and untreated fruit sets indicating their potential role in various processes, which ultimately might have resulted in delayed ripening of the mango. Overall, this study has demonstrated the beneficial effect of hexanal and identified important metabolites with the enhanced shelf-life in Alphonso that could be useful for farmers and mango-based food/flavour industries.

The learning environment in professional doctorate and postgraduate dental education: a qualitative study

INTRODUCTION

Currently, there is a lack of studies focusing on professional doctoral students' and graduates' perceptions of their learning environment, in particular, using a qualitative approach to elicit in-depth information. This article aims to contribute to the existing body of knowledge by systematically exploring, critically analysing and getting a deeper understanding of professional doctorate dental students' and graduates' insights into effective and ineffective clinical and physical learning environment characteristics.

METHODS

The study included a total of 20 participants. Participants included 16 final-year Doctor of Clinical Dentistry (DClinDent) students and four dental specialists (graduates of the DClinDent programme). Semi-structured, individual interviews were used. Participants were asked to reflect upon and describe in detail their effective and ineffective learning environment experiences. The critical incident technique was used to guide the data collection. Data were analysed using a general inductive qualitative approach.

RESULTS

Learning environment characteristics which participants associated with effective learning included the following: sufficient opportunities for comprehensive treatment planning; introduction to a number of patient treatment philosophies; a sufficient number of complex cases; clinically oriented research and assignment topics; a focus on clinical training in the programme generally; a research topic of a realistic depth and breadth, suitable for their 'specialist training' degree; and a well-resourced and updated physical infrastructure. On the other hand, most participants indicated that the absence of an adequate number of clinical cases, an overemphasis on research (as opposed to clinical practice) in the DClinDent programme and an 'outdated' physical infrastructure in the dental school clinics could hamper effective clinical learning.

CONCLUSION

These findings contribute to the meaningful advancement of the literature on learning environment strategies through the exploration of (and in-depth qualitative insights into) what facilitated effective learning by New Zealand professional doctorate candidates and graduates. These findings provide a starting point for reflection by international academic directors, educational developers, curriculum planners, programme managers and clinical teachers in respect of the further development of the learning environment. Although the findings from this study may not be directly transferable to all international contexts, they have the potential to contribute to the further development of theory in this area.

Vesicle to micelle transition in the ternary mixture of L121/SDS/D2O: NMR, EPR and SANS studies

Proposed model depicting vesicle to mixed micelle transformation in a ternary mixture of L121/SDS/D₂O.

Population pharmacokinetic analysis to identify the possibility of interaction between anti-cancer agents

BACKGROUND

A number of molecularly targeted agents in oncology are tested in clinical studies in combination with conventional chemotherapy and/or radiotherapy. There is the possibility that the pharmacokinetics and dynamics of these targeted agents may be different when administered alone as against when administered in combination with other agents.

AIM

The aim of this study is to understand the effects of addition of combination agents on the pharmacokinetics of a new, investigational, cyclin dependent kinase inhibitor anti-cancer drug (Compound A) using population pharmacokinetic (pop-PK) analysis.

MATERIALS AND METHODS

Integrated pop-PK analysis of data obtained from multiple phase I/II studies of Compound A, given alone or in combination with other agents.

RESULTS

A two compartmental model was found suitable to explain the pharmacokinetics of Compound A. No statistically significant influence of patient covariates or combination agents on the pharmacokinetic parameters of the central compartment was detected up to a significance level of 0.01. Model evaluation showed that the parameter estimates are stable and that the variability in the data was well reproduced by the model.

CONCLUSIONS

This study represents the first time that a pop-PK analysis was performed in India for a targeted anti-cancer agent being developed in India. Such an analysis is useful to not only understand the influence of patient covariates and combination agents on the pharmacokinetics of a new investigational agent, but would also be valuable in the simulation of later phase clinical trials for the agent under development.

Proximate Composition of Bio Potential Seaweeds from Mandapam South East Coast of India

Proximate composition of the three green seaweeds viz., Chaetomorpha aerea, Enteromorpha intestinalis, Enteromorpha compressa one brown seaweed Dictyota dichotoma and one red seaweed Gracilaria corticata was investigated by determination of protein, carbohydrates, lipid, moisture and ash content. In the present study, the total protein was recarded upper most in E.intestinalis and bare minimum in E.compressa. The maximum carbohydrates recorded in C. aerea and minimum in G. corticata. The lipid content was acquired upper limit in E. compressa and least in C. aerea. The ash and moisture content in following of 5 different seaweeds are as follows: 7.45mg/g, 3.91mg/g were recorded in the C.aerea, 8.52mg/g, 3.42mg/g in the E.intestinalis, 8.58mg/g, 3.75mg/g in the E.compressa, 9.47mg/g, 4.23mg/g in the D.dichotoma and 6.95mg/g, 3.98mg/g in G.corticata. The proximate composition of 5 different seaweed species exhibited high nutritional value for human consumption.

Proximate Composition of Bio Potential Seaweeds from Mandapam South East Coast of India

Proximate composition of the three green seaweeds viz., Chaetomorpha aerea, Enteromorpha intestinalis, Enteromorpha compressa one brown seaweed Dictyota dichotoma and one red seaweed Gracilaria corticata was investigated by determination of protein, carbohydrates, lipid, moisture and ash content. In the present study, the total protein was recarded upper most in E.intestinalis and bare minimum in E.compressa. The maximum carbohydrates recorded in C. aerea and minimum in G. corticata. The lipid content was acquired upper limit in E. compressa and least in C. aerea. The ash and moisture content in following of 5 different seaweeds are as follows: 7.45mg/g, 3.91mg/g were recorded in the C.aerea, 8.52mg/g, 3.42mg/g in the E.intestinalis, 8.58mg/g, 3.75mg/g in the E.compressa, 9.47mg/g, 4.23mg/g in the D.dichotoma and 6.95mg/g, 3.98mg/g in G.corticata. The proximate composition of 5 different seaweed species exhibited high nutritional value for human consumption.

Physicochemical perspectives (aggregation, structure and dynamics) of interaction between pluronic (L31) and surfactant (SDS)

The influence of the water soluble non-ionic tri-block copolymer L31 on the microstructure and self-aggregation dynamics of the anionic surfactant sodium dodecylsulfate (SDS) in aqueous solution was investigated.

Screening and Characterization of Fibrinolytic Protease Producing <i>Bacillus circulans</i> from Mangrove Sediments Pitchavaram, South East Coast of India

Regulation and production of Fibrinolytic enzymes from bacterial sources especially from Bacillus strains has taken a leading role in the medical sciences for the treatment of cardiovascular disorders as it removes thrombus or clots adding to its significant role in curing human health issues saving millions. Significant progress has been made during the last few years on the studies of fibrinolytic enzymes in identifying, cloning, purification, characterization and overproduction of these for commercialization in medical sciences and in fields like detergents development. Production of fibrinolytic enzyme from Bacillus circulans was done using Nutrient broth medium. In addition, a strong fibrinolytic enzyme was purified from the cultivation media. The purified enzyme was almost homogeneous with other species of same genus, as examined by SDS−PAGE and sephadex G-75 column chromatography. The enzyme had an optimal pH of 7-12, an optimal temperature of 50 °C, for fibrin hydrolysis. The molecular mass estimated by gel filtration was 24 to36 KDa. Further studies for characterization and structural elucidation are necessary for their medicinal applications and molecular biological characteristics.

Screening and Characterization of Fibrinolytic Protease Producing <i>Bacillus circulans</i> from Mangrove Sediments Pitchavaram, South East Coast of India

Regulation and production of Fibrinolytic enzymes from bacterial sources especially from Bacillus strains has taken a leading role in the medical sciences for the treatment of cardiovascular disorders as it removes thrombus or clots adding to its significant role in curing human health issues saving millions. Significant progress has been made during the last few years on the studies of fibrinolytic enzymes in identifying, cloning, purification, characterization and overproduction of these for commercialization in medical sciences and in fields like detergents development. Production of fibrinolytic enzyme from Bacillus circulans was done using Nutrient broth medium. In addition, a strong fibrinolytic enzyme was purified from the cultivation media. The purified enzyme was almost homogeneous with other species of same genus, as examined by SDS−PAGE and sephadex G-75 column chromatography. The enzyme had an optimal pH of 7-12, an optimal temperature of 50 °C, for fibrin hydrolysis. The molecular mass estimated by gel filtration was 24 to36 KDa. Further studies for characterization and structural elucidation are necessary for their medicinal applications and molecular biological characteristics.

ESR Studies on 205Tl Hyperfine Couplings in the Radical Cations of Tl(III)Porphyrins

The isotropic 205Tl hyperfine couplings obtained from the ESR spectra of the radical cations of Tl (III) meso tetraphenyl porphyrin (TPP), octaethyl porphyrin (OEP) and octaethyl chlorin (OEC) are reported. The radical cations were generated by electrooxidation in dichloromethane as solvent. A Karplus-Fraenkel type bilinear relation is used to interpret the 205Tl couplings, taking into account the sigma-pi spin polarization of Tl -N bonds by the spin density at the nitrogen atoms in the ligand as well as the direct pi interaction of the orbitals of Tl with the pi orbitals of the ligand. It is shown that for the cation radicals of Tl porphyrins, both these mechanisms contribute to the Tl couplings whereas for the cation radicals of Co- and Zn-porphyrins the sigma-pi polarization alone is sufficient to account for the metal hyperfine couplings. It is suggested that Tl-hyperfine couplings can be used to estimate the nitrogen spin densities of porphyrin radical systems when the nitrogen splittings are not resolved in the ESR spectra.

The importance of 'student voice' in dental education

Although much published school and higher education research have established a strong conceptual foundation for eliciting student feedback, this element is relatively poorly developed in dental education research. This paper examines 'student voice' as a conceptual/theoretical framework and justification for attending to students' perspectives in dental education. The aims of this review paper were: to explore the concept of student voice, including some pragmatic considerations and key critiques of listening to student feedback; to critically analyse key debates about the importance of a research focus on student perceptions using themes from the seminal and contemporary educational literature on student voice from the school, higher and dental educational sectors; to identify gaps in the dental education literature in relation to students' perceptions of their learning, and highlight some practical implications drawn from the 'student voice' literature for dental education; and to assist dental educational researchers in developing a strong rationale for listening to student voice in dental educational institutions. This paper is intended to assist dental educational researchers in justifying future research projects which require eliciting dental student feedback/perceptions.

The importance of 'student voice' in dental education

Although much published school and higher education research have established a strong conceptual foundation for eliciting student feedback, this element is relatively poorly developed in dental education research. This paper examines 'student voice' as a conceptual/theoretical framework and justification for attending to students' perspectives in dental education. The aims of this review paper were: to explore the concept of student voice, including some pragmatic considerations and key critiques of listening to student feedback; to critically analyse key debates about the importance of a research focus on student perceptions using themes from the seminal and contemporary educational literature on student voice from the school, higher and dental educational sectors; to identify gaps in the dental education literature in relation to students' perceptions of their learning, and highlight some practical implications drawn from the 'student voice' literature for dental education; and to assist dental educational researchers in developing a strong rationale for listening to student voice in dental educational institutions. This paper is intended to assist dental educational researchers in justifying future research projects which require eliciting dental student feedback/perceptions.

Effective and ineffective supervision in postgraduate dental education: a qualitative study

INTRODUCTION

Research suggests that students' perceptions should be considered in any discussion of their education, but there has been no systematic examination of New Zealand postgraduate dental students' learning experiences. This study aimed to obtain in-depth qualitative insights into student and graduate perceptions of effective and ineffective learning in postgraduate dental education.

METHODS

Data were collected in 2010 using semi-structured individual interviews. Participants included final-year students and graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe atleast one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach.

RESULTS

Broad themes which emerged included supervisory approaches, characteristics of the learning process, and the physical learning environment. This paper considers students' and graduates' perceptions of postgraduate supervision in dentistry as it promotes or precludes effective learning. Effective learning was associated by participants with approachable and supportive supervisory practices, and technique demonstrations accompanied by explicit explanations. Ineffective learning was associated with minimal supervisor demonstrations and guidance (particularly when beginning postgraduate study), and aggressive, discriminatory and/or culturally insensitive supervisory approaches.

CONCLUSION

Participants' responses provided rich, in-depth insights into their reflections and understandings of effective and ineffective approaches to supervision as it influenced their learning in the clinical and research settings. These findings provide a starting point for the development of curriculum and supervisory practices, enhancement of supervisory and mentoring approaches, and the design of continuing education programmes for supervisors at an institutional level. Additionally, these findings might also stimulate topics for reflection and discussion amongst dental educators and administrators more broadly.

Improving the quality of educational strategies in postgraduate dental education using student and graduate feedback: findings from a qualitative study in New Zealand

INTRODUCTION

Research suggests that students' perceptions should be considered in any discussion of their education. However, to date, there has been no systematic examination of New Zealand postgraduate dental students' learning processes in both the research and clinical settings. This study aimed to obtain in-depth qualitative insights into student and graduate perspectives of effective and ineffective learning experiences during their postgraduate dental education.

METHODS

Data were collected in 2010 using semi-structured individual interviews. Participants included 2010 final-year students and 2009 graduates of the University of Otago Doctor of Clinical Dentistry programme. Using the Critical Incident Technique, participants were asked to describe at least one effective and one ineffective learning experience in detail. Interview transcripts were analysed using a general inductive approach.

RESULTS

Broad themes which emerged included supervisory approaches, characteristics of the learning process and characteristics of the physical learning environment. The focus of this article is to report and discuss the learning processes that participants identified as promoting and precluding effective learning experiences in the clinical and research settings. Students and graduates in the study had largely similar perspectives of learning processes likely to result in effective clinical and research learning. These included self-directed and collaborative learning; timely, constructive and detailed feedback with directions for further improvement; and discreet clinical feedback. Learning processes that precluded effective learning included unsupported and isolated learning, delayed and overly critical/destructive feedback and open criticism in the clinical context.

CONCLUSION

The in-depth findings of this study contribute to the scientific literature that identifies learning process characteristics which facilitate effective learning from New Zealand postgraduate students' and graduates' perspectives. Additional cross-sectional and longitudinal studies (both qualitative and quantitative) would lead to a better understanding of what constitutes effective teaching in postgraduate dental education.

Lung cancer in never-smokers: A single institutional experience

17044

Background: Approximately 10% of patients (pts) with lung cancer do not have a history of tobacco smoking. The clinical presentation and outcomes of pts with LCINS have not been well characterized in the Western population. Methods: We reviewed our institutional tumor registry to identify patients with lung cancer from 1992 to 2002. Data regarding tobacco smoking, stage, histology and survival were collected. Results: Of the 5417 consecutive pts diagnosed with lung cancer, 254 were determined to be never-smokers with confirmed pathologic diagnosis of non-small cell lung cancer (NSCLC). The table below describes the patient demographics. The five-year survival for the entire population with LCINS was 22.56%, with 37 pts surviving beyond five years. The median overall survival for women was 21.08 months (95% CI 14.03–23.37) and for men 13.5 months (95% CI 8.5–32.492); p = 0.73. Among the different histologic subtypes, broncho-alveolar carcinoma was associated with better median overall survival of 61.67 months (p < 0.0001). The median overall survival by TNM stage: I (71 months), II (32 months), III (15 months), and IV (6 months). Conclusions: 1. LCINS affects predominantly women. 2. Adenocarcinoma is the most common histological type. 3. Brain and bone are the most common sites of metastases.

[Table: see text]

No significant financial relationships to disclose.

A new dinuclear biphenylene bridged copper(II) complex: DNA cleavage under hydrolytic conditions

The dinucleating ligand, tpbpd (tetrapyridyl biphenylenediamine) forms a dicopper complex with practically no electronic coupling between the two copper (II) centres. The EPR spectrum of the complex is consistent with coordination of each copper ion to two nitrogens of the binuclear ligand. Cyclic voltammogram of the complex also reveals that the two copper (II) centres have identical ligating environment. This dimeric copper (II) complex is found to be a very efficient catalyst for the cleavage of plasmid DNA in the absence of any added cofactor. The amount of conversion of supercoiled form (Form I) of plasmid to the open circular form (Form II) depends on the concentration of the complex as well as the duration of incubation of the complex with DNA. The maximum rate of conversion of the supercoiled form to the nicked circular form at pH 7.5 in the presence of 150 microM of the complex is found to be 1.8 x 10(-3) s(-1).

DNA damage induced by a chromium(III) Schiff base complex is reversible under physiological condition

[Cr(naphen)(H2O)(2)]+, where naphen is 1,2-bis(naphthylideneamino)ethane having the basic salen moiety, has been characterized structurally. [Cr(naphen)(H2O)(2)]+, which has an extended aromatic system and binds with calf thymus DNA (CT DNA) intercalatively, has been found to promote DNA cleavage in the presence of biological reductant such as ascorbate and oxidant like hydrogen peroxide. Results of electron paramagnetic resonance (EPR) experiments suggest involvement of hydroxyl radicals in the oxidative cleavage of DNA in the presence of the Cr(III) complex and hydrogen peroxide. The cell viability study on nicked DNA by [Cr(naphen)(H2O)(2)]+ has shown that the damage brought about to DNA could be repaired by Escherichia coli DNA repair enzymes.