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Aging, higher prevalence of diabetes, worsening obesity, and hyperglycemia among potential donors increase the likelihood that pancreata will be declined by transplant centers. Hemoglobin A1c testing, also known as glycated hemoglobin testing, identifies a donor's average blood glucose concentration for the preceding 2 to 3 months and is the standard test for identifying prolonged periods of hyperglycemia. To compare pancreas utilization rates before and after implementation of hemoglobin A1c testing. A retrospective study of data from the New York Organ Donor Network was conducted. Potential donors were defined as standard criteria donors who had no history of diabetes and were not seropositive for hepatitis B or C. Criteria for \"ideal\" potential pancreas donors were based on age, body mass index, lipase level, and terminal creatinine level. Potential donors who did not meet the criteria for ideal donors were considered \"expanded\" potential pancreas donors. Pancreas utilization rate was defined as the number of pancreata transplanted divided by the number of potential pancreas donors. Of 779 standard criteria donors, 691 (89%) were potential pancreas donors: 251 ideal (36%) and 440 expanded (64%) donors. In 2005 and 2006, before hemoglobin A1c testing, pancreas utilization rates were 21% and 18%, respectively. In 2008, 2009, and 2010, after hemoglobin A1c testing was incorporated, utilization rates were 27%, 28%, and 32%, respectively. Utilization of ideal donors increased from 33% to 51% (P= .003), and utilization of expanded donors increased from 11% to 17% (P= .05). Pancreas utilization increased 51.0%, and pancreas discards decreased 50.8% with the implementation of hemoglobin A1c testing. Hemoglobin A1c testing may increase utilization of ideal and expanded criteria pancreata.

Context Aging, higher prevalence of diabetes, worsening obesity, and hyperglycemia among potential donors increase the likelihood that pancreata will be declined by transplant centers. Hemoglobin Alc testing, also known as glycated hemoglobin testing, identifies a donor's average blood glucose concentration for the preceding 2 to 3 months and is the standard test for identifying prolonged periods of hyperglycemia. Objective To compare pancreas utilization rates before and after implementation of hemoglobin Alc testing. Design A retrospective study of data from the New York Organ Donor Network was conducted. Potential donors were defined as standard criteria donors who had no history of diabetes and were not seropositive for hepatitis B or C. Criteria for “ideal” potential pancreas donors were based on age, body mass index, lipase level, and terminal creatinine level. Potential donors who did not meet the criteria for ideal donors were considered “expanded” potential pancreas donors. Pancreas utilization rate was defined as the number of pancreata transplanted divided by the number of potential pancreas donors. Results Of 779 standard criteria donors, 691 (89%) were potential pancreas donors: 251 ideal (36%) and 440 expanded (64%) donors. In 2005 and 2006, before hemoglobin Alc testing, pancreas utilization rates were 21% and 18%, respectively. In 2008, 2009, and 2010, after hemoglobin Alc testing was incorporated, utilization rates were 27%, 28%, and 32%, respectively. Utilization of ideal donors increased from 33% to 51% (P = .003), and utilization of expanded donors increased from 11% to 17% (P = .05). Pancreas utilization increased 51.0%, and pancreas discards decreased 50.8% with the implementation of hemoglobin Alc testing. Conclusion Hemoglobin Alc testing may increase utilization of ideal and expanded criteria pancreata.

Aging, higher prevalence of diabetes, worsening obesity, and hyperglycemia among potential donors increase the likelihood that pancreata will be declined by transplant centers. Hemoglobin A1c testing, also known as glycated hemoglobin testing, identifies a donor's average blood glucose concentration for the preceding 2 to 3 months and is the standard test for identifying prolonged periods of hyperglycemia. To compare pancreas utilization rates before and after implementation of hemoglobin A1c testing. A retrospective study of data from the New York Organ Donor Network was conducted. Potential donors were defined as standard criteria donors who had no history of diabetes and were not seropositive for hepatitis B or C. Criteria for \"ideal\" potential pancreas donors were based on age, body mass index, lipase level, and terminal creatinine level. Potential donors who did not meet the criteria for ideal donors were considered \"expanded\" potential pancreas donors. Pancreas utilization rate was defined as the number of pancreata transplanted divided by the number of potential pancreas donors. Of 779 standard criteria donors, 691 (89%) were potential pancreas donors: 251 ideal (36%) and 440 expanded (64%) donors. In 2005 and 2006, before hemoglobin A1c testing, pancreas utilization rates were 21% and 18%, respectively. In 2008, 2009, and 2010, after hemoglobin A1c testing was incorporated, utilization rates were 27%, 28%, and 32%, respectively. Utilization of ideal donors increased from 33% to 51% (P= .003), and utilization of expanded donors increased from 11% to 17% (P= .05). Pancreas utilization increased 51.0%, and pancreas discards decreased 50.8% with the implementation of hemoglobin A1c testing. Hemoglobin A1c testing may increase utilization of ideal and expanded criteria pancreata.

I was distressed to read that the Justice Department has omitted emergency contraception from the standards of care for rape victims [\"U.S. shift on rape victims,\" News, Jan. 11]. The omission of emergency contraception promotes substandard care for survivors. To withhold any available federally approved treatment, whether it is HIV prophylaxis or pregnancy prophylaxis, would be unethical. Excluding information regarding emergency contraception compromises the rights of rape and sexual assault survivors, and contradicts standards of best practice put forth by New York State Department of Health to hospitals, physicians, sexual assault nurse examiners and rape crisis advocates. Regarding the furor surrounding Dan Rather and CBS, as reported in \"Black eye for media\" [Editorial, Jan. 12]: I was deeply distressed at the thought that Dan Rather stepped down and that four CBS employees were dismissed with respect to a report by an independent panel investigating the \"journalistic breakdowns\" that led CBS News to broadcast and then vigorously defend its National Guard segment. The [George W. Bush] administration is given a virtual free pass with respect to every lie, exaggeration, disaster and crime it commits.

I can only conclude from all the pictures I have seen of the U.S. soldiers \"torturing\" Iraqi prisoners that their actions were no more serious than many fraternity hazing pranks. Iraq had nothing to do with 9/11 and the torture inflicted on Iraqi prisoners occured months before the Fallujah incident. Oh, yeah, I remember: to neutralize Saddam Husseins's weapons of mass destruction; to replace his sadistic regime with American values of decency and democracy; to control U.S. gasoline prices by restoring Iraq's petroleum industry; to make life better for Iraqis; to reduce terrorist attacks.

Cellular senescence and the senescence‐associated secretory phenotype (SASP) contribute to age‐related arterial dysfunction, in part, by promoting oxidative stress and inflammation, which reduce the bioavailability of the vasodilatory molecule nitric oxide (NO). In the present study, we assessed the efficacy of fisetin, a natural compound, as a senolytic to reduce vascular cell senescence and SASP factors and improve arterial function in old mice. We found that fisetin decreased cellular senescence in human endothelial cell culture. In old mice, vascular cell senescence and SASP‐related inflammation were lower 1 week after the final dose of oral intermittent (1 week on—2 weeks off—1 weeks on dosing) fisetin supplementation. Old fisetin‐supplemented mice had higher endothelial function. Leveraging old p16‐3MR mice, a transgenic model allowing genetic clearance of p16INK4A‐positive senescent cells, we found that ex vivo removal of senescent cells from arteries isolated from vehicle‐ but not fisetin‐treated mice increased endothelium‐dependent dilation, demonstrating that fisetin improved endothelial function through senolysis. Enhanced endothelial function with fisetin was mediated by increased NO bioavailability and reduced cellular‐ and mitochondrial‐related oxidative stress. Arterial stiffness was lower in fisetin‐treated mice. Ex vivo genetic senolysis in aorta rings from p16‐3MR mice did not further reduce mechanical wall stiffness in fisetin‐treated mice, demonstrating lower arterial stiffness after fisetin was due to senolysis. Lower arterial stiffness with fisetin was accompanied by favorable arterial wall remodeling. The findings from this study identify fisetin as promising therapy for clinical translation to target excess cell senescence to treat age‐related arterial dysfunction. Oral intermittent fisetin supplementation reduces vascular cell senescence to improve vascular endothelial function and reduce aortic stiffness in old mice.

Excess cellular senescence contributes to age‐related increases in frailty and reductions in skeletal muscle strength. In the present study, we determined the efficacy of oral intermittent treatment (1 week on—2 weeks off—1 week on) with the natural flavonoid senolytic fisetin to improve frailty and grip strength in old mice. Further, the effects of fisetin on physical function were evaluated in young mice. We performed bulk RNA sequencing of quadricep skeletal muscle to determine the cell senescence‐related signaling pathways modulated by fisetin. We also assessed the relative effects of fisetin on frailty and grip strength with aging in comparison with two other well‐established approaches for the removal of senescent cells: (1) genetic‐based clearance of excess senescent cells in old p16‐3MR mice, a model that allows for clearance of p16‐positive (p16+) senescent cells, and (2) oral intermittent treatment with the synthetic pharmacological senolytic ABT‐263 in old mice. We found that fisetin mitigated the adverse changes in frailty and grip strength with aging. Fisetin had no effects in young mice. The improvements in frailty and grip strength in old mice were accompanied by favorable modulation of the skeletal muscle transcriptome, including lower abundance of cellular senescence‐related genes (e.g., Cdkn1a and Ddit4). Improvements in frailty and grip strength with fisetin were comparable to those observed with genetic‐based clearance of excess p16+ senescent cells and treatment with ABT‐263. Taken together, our findings provide proof‐of‐concept support for fisetin as a senolytic strategy to improve physical function with aging. Supplementation with the natural senolytic agent fisetin attenuated age‐related declines in physical function in mice. Better physical function with fisetin was accompanied by lower expression of cell senescence‐related genes. Fisetin treatment had comparable effects on physical function as genetic clearance of senescent cells and synthetic senolytic therapy.

The authors use data from a résumé audit to estimate the impact of unemployment and underemployment on the employment prospects of recent college graduates. They find no statistical evidence linking unemployment spells of different durations to employment opportunities. By contrast, college graduates who are underemployed have callback rates that are 30% lower than those of applicants who are adequately employed. The null effects associated with unemployment and the adverse effects associated with underemployment are robust across cities with relatively tight and loose labor-market conditions. Internship experience obtained while completing one’s degree substantially reduces the negative effects of underemployment. The data support the proposition that employers view underemployment as a strong signal of lower expected productivity.

Objectives To identify daily activity limitations, including but not limited to impairments in physical function, experienced by persons with rheumatoid arthritis (RA) and identify Patient-Reported Outcomes Measurement Information System (PROMIS) short form (SF) scales that can measure these limitations. Methodology A cross-sectional, web-based survey was conducted among a diverse group of adults with RA across the spectrum of disease activity. PROMIS Upper Extremity (UE) SF7a, Physical Function (PF) SF8b, and a Task Difficulty Scale were used to assess daily activity limitations experienced by persons with RA in the United States. An open-ended question asking what other daily activity limitations respondents experienced was also included. The daily activity limitation in the text response and the three scale items were deductively coded using the International Classification of Functioning, Disability, and Health (ICF) based on an established linking rule. Potential PROMIS SF scales were identified and linked to ICF to measure some activity limitations reported by persons with RA. PROMIS PF SF10a was linked to ICF and compared with UE SF7a and PF SF8b. Results Eighty-three out of 99 RA patient respondents answered the open-ended question, the majority (> 70%) of whom had severe or moderate physical function limitations. All 9 second-level sub-categories of the Activities and Participation (A&P) in ICF were linked to the text response to the open-ended question. UE SF7a and PF SF8b were linked to four of these second-level sub-categories (e.g., Mobility), while additional four second-level sub-categories (e.g., General tasks and demands, Interpersonal interactions and relationships) linked to PROMIS Fatigue SF7a and Ability to Participate in Social Roles and Activities (APS) SF4a. Moreover, PF SF10a was linked to four of these second-level sub-categories too, but with fewer items than UE SF7a plus the PF SF8b. Some activity limitations, such as driving and using telecommunication devices, were not linked to any items of the five PROMIS SF scales. Conclusions Persons with RA reported a variety of activity limitations across multiple domains, including physical function, telecommunication, social interactions, and other aspects of daily living, which could be a focus for goal-setting communication in the clinical setting. PROMIS PF SF10a may be a more effective and efficient scale to measure 4 sub-categories of daily activity limitations. To more comprehensively assess the spectrum of the impact of RA, it appears advisable to also use PROMIS Fatigue SF7a and APS SF4a to examine General tasks and demands, and Interpersonal interactions and relationships limitations.