The outcomes of simultaneous liver and kidney transplantation using donation after cardiac death organs.

PubMed

Alhamad, Tarek; Spatz, Christin; Uemura, Tadahiro; Lehman, Eric; Farooq, Umar

2014-12-15

There has been a remarkable increase in simultaneous liver and kidney transplantations (SLK). As organ demand has increased, so has the use of donation after cardiac death (DCD). However, little is known about the outcomes of DCD in SLK. We performed a retrospective analysis using the United Network for Organ Sharing database to compare the outcomes of DCD SLK to donation after brain death (DBD) and determine the impact of donor and recipient factors on allograft and patient survival. Between 2002 and 2011, a total of 3,026 subjects received SLK from DBD and 98 from DCD. Kidney, liver, and patient survival from DCD donors were inferior to DBD at 1, 3, and 5 years (P=0.0056, P=0.0035, and P=0.0205, respectively). With the use of the Cox model, DCD was a significant risk factor for kidney and liver allograft failure and patient mortality. Recipient factors that were associated with worse allograft and patient outcomes included black race, diabetes, being on a ventilator, hospitalization, delayed graft function, hepatocellular carcinoma, and intensive care unit stay. Older age of the donor was also associated with worse outcomes. Despite the decreased allograft and patient survival compared with DBD, DCD SLK provides an acceptable option for SLK, with a survival probability of more than 50% at 5 years.

Potent antitumor activities of recombinant human PDCD5 protein in combination with chemotherapy drugs in K562 cells

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shi, Lin; Song, Quansheng; Zhang, Yingmei

Conventional chemotherapy is still frequently used. Programmed cell death 5 (PDCD5) enhances apoptosis of various tumor cells triggered by certain stimuli and is lowly expressed in leukemic cells from chronic myelogenous leukemia patients. Here, we describe for the first time that recombinant human PDCD5 protein (rhPDCD5) in combination with chemotherapy drugs has potent antitumor effects on chronic myelogenous leukemia K562 cells in vitro and in vivo. The antitumor efficacy of rhPDCD5 protein with chemotherapy drugs, idarubicin (IDR) or cytarabine (Ara-C), was examined in K562 cells in vitro and K562 xenograft tumor models in vivo. rhPDCD5 protein markedly increased the apoptosismore » rates and decreased the colony-forming capability of K562 cells after the combined treatment with IDR or Ara-C. rhPDCD5 protein by intraperitoneal administration dramatically improved the antitumor effects of IDR treatment in the K562 xenograft model. The tumor sizes and cell proliferation were significantly decreased; and TUNEL positive cells were significantly increased in the combined group with rhPDCD5 protein and IDR treatment compared with single IDR treatment groups. rhPDCD5 protein, in combination with IDR, has potent antitumor effects on chronic myelogenous leukemia K562 cells and may be a novel and promising agent for the treatment of chronic myelogenous leukemia.« less

MicroRNA-16 suppresses the activation of inflammatory macrophages in atherosclerosis by targeting PDCD4

PubMed Central

LIANG, XUE; XU, ZHAO; YUAN, MENG; ZHANG, YUE; ZHAO, BO; WANG, JUNQIAN; ZHANG, AIXUE; LI, GUANGPING

2016-01-01

Programmed cell death 4 (PDCD4) is involved in a number of bioprocesses, such as apoptosis and inflammation. However, its regulatory mechanisms in atherosclerosis remain unclear. In this study, we investigated the role and mechanisms of action of PDCD4 in high-fat diet-induced atherosclerosis in mice and in foam cells (characteristic pathological cells in atherosclerotic lesions) derived from ox-LDL-stimulated macrophages. MicroRNA (miR)-16 was predicted to bind PDCD4 by bioinformatics analysis. In the mice with atherosclerosis and in the foam cells, PDCD4 protein expression (but not the mRNA expression) was enhanced, while that of miR-16 was reduced. Transfection with miR-16 mimic decreased the activity of a luciferase reporter containing the 3′ untranslated region (3′UTR) of PDCD4 in the macrophage-derived foam cells. Conversely, treatment with miR-16 inhibitor enhanced the luciferase activity. However, by introducing mutations in the predicted binding site located in the 3′UTR of PDCD4, the miR-16 mimic and inhibitor were unable to alter the level of PDCD4, suggesting that miR-16 is a direct negative regulator of PDCD4 in atherosclerosis. Furthermore, transfection wtih miR-16 mimic and siRNA targeting PDCD4 suppressed the secretion and mRNA expression of pro-inflammatory factors, such as interleukin (IL)-6 and tumor necrosis factor-α (TNF-α), whereas it enhanced the secretion and mRNA expression of the anti-inflammatory factor, IL-10. Treatment with miR-16 inhibitor exerted the opposite effects. In addition, the phosphorylation of p38 and extracellular signal-regulated kinase (ERK), and nuclear factor-κB (NF-κB) expression were altered by miR-16. In conclusion, our data demonstrate that the targeting of PDCD4 by miR-16 may suppress the activation of inflammatory macrophages though mitogen-activated protein kinase (MAPK) and NF-κB signaling in atherosclerosis; thus, PDCD4 may prove to be a potential therapeutic target in the treatment of atherosclerosis. PMID:26936421

AtPDCD5 Plays a Role in Programmed Cell Death after UV-B Exposure in Arabidopsis1[OPEN

PubMed Central

Falcone Ferreyra, María Lorena; D’Andrea, Lucio; AbdElgawad, Hamada

2016-01-01

DNA damage responses have evolved to sense and react to DNA damage; the induction of DNA repair mechanisms can lead to genomic restoration or, if the damaged DNA cannot be adequately repaired, to the execution of a cell death program. In this work, we investigated the role of an Arabidopsis (Arabidopsis thaliana) protein, AtPDCD5, which is highly similar to the human PDCD5 protein; it is induced by ultraviolet (UV)-B radiation and participates in programmed cell death in the UV-B DNA damage response. Transgenic plants expressing AtPDCD5 fused to GREEN FLUORESCENT PROTEIN indicate that AtPDCD5 is localized both in the nucleus and the cytosol. By use of pdcd5 mutants, we here demonstrate that these plants have an altered antioxidant metabolism and accumulate higher levels of DNA damage after UV-B exposure, similar to levels in ham1ham2 RNA interference transgenic lines with decreased expression of acetyltransferases from the MYST family. By coimmunoprecipitation and pull-down assays, we provide evidence that AtPDCD5 interacts with HAM proteins, suggesting that both proteins participate in the same pathway of DNA damage responses. Plants overexpressing AtPDCD5 show less DNA damage but more cell death in root tips upon UV-B exposure. Finally, we here show that AtPDCD5 also participates in age-induced programmed cell death. Together, the data presented here demonstrate that AtPDCD5 plays an important role during DNA damage responses induced by UV-B radiation in Arabidopsis and also participates in programmed cell death programs. PMID:26884483

PDCD1 (PD-1) promoter methylation predicts outcome in head and neck squamous cell carcinoma patients.

PubMed

Goltz, Diane; Gevensleben, Heidrun; Dietrich, Joern; Schroeck, Friederike; de Vos, Luka; Droege, Freya; Kristiansen, Glen; Schroeck, Andreas; Landsberg, Jennifer; Bootz, Friedrich; Dietrich, Dimo

2017-06-20

Biomarkers that facilitate the prediction of disease recurrence in head and neck squamous cell carcinoma (HNSCC) may enable physicians to personalize treatment. In the current study, DNA promoter methylation of programmed cell death 1 (PDCD1, PD-1) was evaluated as a prognostic biomarker in HNSCC patients. High PDCD1 methylation (mPDCD1) was associated with a significantly shorter overall survival after surgical resection in both the discovery (HR = 2.24 [95%CI: 1.08-4.64], p = 0.029) and the validation cohort (HR = 1.54 [95%CI: 1.08-2.21], p = 0.017). In multivariate Cox proportional hazards analysis, PDCD1 methylation remained a significant prognostic factor for HNSCC (HR = 2.14 [95%CI: 1.19-3.84], p = 0.011). Further, mPDCD1 was strongly associated with the human papilloma virus (HPV) status. mPDCD1 was assessed retrospectively in a discovery cohort of 120 HNSCC patients treated at the University Hospital of Bonn and a validation cohort of 527 HNSCC cases analyzed by The Cancer Genome Atlas Research Network. PDCD1 methylation might aid the identification of HNSCC patients potentially benefitting from a radical or alternative treatment, particularly in the context of immunotherapies targeting PD-1/PD-L1.

SRSF3 represses the expression of PDCD4 protein by coordinated regulation of alternative splicing, export and translation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Seung Kuk; Jeong, Sunjoo, E-mail: sjsj@dankook.ac.kr

2016-02-05

Gene expression is regulated at multiple steps, such as transcription, splicing, export, degradation and translation. Considering diverse roles of SR proteins, we determined whether the tumor-related splicing factor SRSF3 regulates the expression of the tumor-suppressor protein, PDCD4, at multiple steps. As we have reported previously, knockdown of SRSF3 increased the PDCD4 protein level in SW480 colon cancer cells. More interestingly, here we showed that the alternative splicing and the nuclear export of minor isoforms of pdcd4 mRNA were repressed by SRSF3, but the translation step was unaffected. In contrast, only the translation step of the major isoform of pdcd4 mRNAmore » was repressed by SRSF3. Therefore, overexpression of SRSF3 might be relevant to the repression of all isoforms of PDCD4 protein levels in most types of cancer cell. We propose that SRSF3 could act as a coordinator of the expression of PDCD4 protein via two mechanisms on two alternatively spliced mRNA isoforms.« less

Aerosol-delivered programmed cell death 4 enhanced apoptosis, controlled cell cycle and suppressed AP-1 activity in the lungs of AP-1 luciferase reporter mice.

PubMed

Hwang, S-K; Jin, H; Kwon, J T; Chang, S-H; Kim, T H; Cho, C-S; Lee, K H; Young, M R; Colburn, N H; Beck, G R; Yang, H-S; Cho, M-H

2007-09-01

The long-term survival of lung cancer patients treated with conventional therapies remains poor and therefore the need for novel approaches remains high. This has led to the re-emergence of aerosol delivery as a therapeutic intervention. In this study, glucosylated polyethylenimine (GPEI) was used as carrier to investigate programmed cell death 4 (PDCD4) and PDCD4 mutant (D418A), an eIF4A-binding mutant, on PDCD4-related signaling and activator protein-1 (AP-1) activity in the lungs of AP-1 luciferase reporter mice. After confirming the efficiency of GPEI as a carrier in lungs, the effects of aerosol-delivered PDCD4 were investigated in AP-1 luciferase reporter mice. Aerosol delivery of GPEI/PDCD4 through a nose-only inhalation facilitated the apoptosis of lungs whereas aerosol PDCD4 mutant did not. Also, such aerosol delivery regulated proteins relevant to cell-cycle control and suppressed AP-1 activity. Results obtained by western blot analysis, immunohistochemistry, luciferase assay and deoxynucleotidyl-transferase-mediated nick end labeling study suggest that combined actions such as facilitating apoptosis, controlling cell cycle and suppression of AP-1 activity by PDCD4 may provide useful tool for designing lung tumor prevention and treatment by which PDCD4 functions as a transformation suppressor in the future.

PDCD1 (PD-1) promoter methylation predicts outcome in head and neck squamous cell carcinoma patients

PubMed Central

Dietrich, Joern; Schroeck, Friederike; de Vos, Luka; Droege, Freya; Kristiansen, Glen; Schroeck, Andreas; Landsberg, Jennifer; Bootz, Friedrich; Dietrich, Dimo

2017-01-01

Background Biomarkers that facilitate the prediction of disease recurrence in head and neck squamous cell carcinoma (HNSCC) may enable physicians to personalize treatment. In the current study, DNA promoter methylation of programmed cell death 1 (PDCD1, PD-1) was evaluated as a prognostic biomarker in HNSCC patients. Results High PDCD1 methylation (mPDCD1) was associated with a significantly shorter overall survival after surgical resection in both the discovery (HR = 2.24 [95%CI: 1.08–4.64], p = 0.029) and the validation cohort (HR = 1.54 [95%CI: 1.08–2.21], p = 0.017). In multivariate Cox proportional hazards analysis, PDCD1 methylation remained a significant prognostic factor for HNSCC (HR = 2.14 [95%CI: 1.19–3.84], p = 0.011). Further, mPDCD1 was strongly associated with the human papilloma virus (HPV) status. Materials and Methods mPDCD1 was assessed retrospectively in a discovery cohort of 120 HNSCC patients treated at the University Hospital of Bonn and a validation cohort of 527 HNSCC cases analyzed by The Cancer Genome Atlas Research Network. Conclusions PDCD1 methylation might aid the identification of HNSCC patients potentially benefitting from a radical or alternative treatment, particularly in the context of immunotherapies targeting PD-1/PD-L1. PMID:28487502

Donation after cardiac death liver transplantation: Graft quality evaluation based on pretransplant liver biopsy.

PubMed

Xia, Weiliang; Ke, Qinghong; Wang, Ye; Feng, Xiaowen; Guo, Haijun; Wang, Weilin; Zhang, Min; Shen, Yan; Wu, Jian; Xu, Xiao; Yan, Sheng; Zheng, Shusen

2015-06-01

Donation after cardiac death (DCD) liver grafts are associated with inferior clinical outcomes and high discard rates because of poor graft quality. We investigated the predictive value of DCD liver biopsy for the pretransplant graft quality evaluation. DCD liver transplants that took place between October 2010 and April 2014 were included (n = 127). Histological features of graft biopsy samples were analyzed to assess risk factors for graft survival. Macrovesicular steatosis ≥ 20% [hazard ratio (HR) = 2.973; P = 0.045] and sinusoidal neutrophilic infiltrate (HR = 6.969; P = 0.005) were confirmed as independent risk factors for graft survival; hepatocellular swelling, vacuolation, and necrosis failed to show prognostic value. Additionally, a donor serum total bilirubin level ≥ 34.2 μmol/L was also associated with a lower probability of graft survival. Our analysis indicates that macrovesicular steatosis ≥ 20% and sinusoidal neutrophilic infiltrate are novel and useful histological markers for DCD liver grafts with unacceptable quality. This finding can be used by transplant surgeons to improve DCD liver acceptance protocols. © 2015 American Association for the Study of Liver Diseases.

Effects of tumor necrosis factor inhibitor on serum level of HLA-B27 and PDCD-1 in patients with ankylosing spondylitis.

PubMed

Chen, Xiaogang; Zhou, Xiaoqing; Li, Xia; Tang, Jinshan; Hu, Xiaowu; Wang, Junsheng; Xu, Cheng

2014-11-01

The aim of this study was to evaluate the effect of tumor necrosis factor-alpha (TNF-α) inhibitor-infliximab on ankylosing spondylitis (AS) patients and detect the serum level of HLA-B27 and PDCD-1 before and after TNF inhibitor treatment. 138 patients at active stage of AS were treated with infliximab; serum was collected before and after TNF-α inhibitor treatment for analysis. Reverse transcription-polymerase chain reaction (RT-PCR), flow cytometry, and enzyme-linked immuno sorbent assay were applied to detect the levels of HLA-B27 and PDCD-1 at different time points, which were used for statistical analysis with clinical data including two AS indicators (erythrocyte sedimentation rate--ESR and C-reactive protein--CRP). After the treatment for 6 weeks, RT-PCR showed that the gene expressions of HLA-B27 and PDCD-1 were significantly downregulated compared with baseline before infliximab treatment (P < 0.05); flow cytometry showed that the HLA-B27 and PDCD-1 double-labeled cells were significantly downregulated (P < 0.05). After 2, 6, or 10 weeks of infliximab treatment, the levels of ESR, CRP, serum HLA-B27, and PDCD-1 of the AS patients were all significantly lower than the baseline levels (P < 0.05), and the serum HLA-B27 and PDCD-1 levels were all significantly correlated with ESR (P < 0.05). Infliximab, an anti-TNF-α inhibitor, decreases significantly not only ESR and CRP, but also the serum levels of HLA-B27 and PDCD-1 in patients with AS. HLA-B27 and PDCD-1 are involved in the pathogenesis, and disease activities of AS. HLA-B27 and PDCD-1 are potentially the useful markers of AS activity and useful parameters to evaluate the effectiveness of anti-TNF-α inhibitor in treating AS.

Hexavalent chromium induces malignant transformation of human lung bronchial epithelial cells via ROS-dependent activation of miR-21-PDCD4 signaling

PubMed Central

Divya, Sasidharan Padmaja; Turcios, Lilia; Roy, Ram Vinod; Hitron, John Andrew; Wang, Lei; Kim, Donghern; Dai, Jin; Asha, Padmaja; Zhang, Zhuo; Shi, Xianglin

2016-01-01

Hexavalent chromium [Cr(VI)] is a well-known human carcinogen associated with an increased risk of lung cancer. However, the mechanisms underlying Cr(VI)-induced carcinogenesis remain unclear. MicroRNA-21 (miR-21) is a key regulator of oncogenic processes. Studies have shown that miR-21 exerts its oncogenic activity by targeting the tumor suppressor gene programmed cell death 4 (PDCD4). The present study examined the role of miR-21-PDCD4 signaling in Cr(VI)-induced cell transformation and tumorigenesis. Results showed that Cr(VI) induces ROS generation in human bronchial epithelial (BEAS-2B) cells. Chronic exposure to Cr(VI) is able to cause malignant transformation in BEAS-2B cells. Cr(VI) caused a significant increase of miR-21 expression associated with an inhibition of PDCD4 expression. Notably, STAT3 transcriptional activation by IL-6 is crucial for the Cr(VI)-induced miR-21 elevation. Stable knockdown of miR-21 or overexpression of PDCD4 in BEAS-2B cells significantly reduced the Cr(VI)-induced cell transformation. Furthermore, the Cr(VI) induced inhibition of PDCD4 suppressed downstream E-cadherin protein expression, but promoted β-catenin/TCF-dependent transcription of uPAR and c-Myc. We also found an increased miR-21 level and decreased PDCD4 expression in xenograft tumors generated with chronic Cr(VI)-exposed BEAS-2B cells. In addition, stable knockdown of miR-21 and overexpression of PDCD4 reduced the tumorogenicity of chronic Cr(VI)-exposed BEAS-2B cells in nude mice. Taken together, these results demonstrate that the miR-21-PDCD4 signaling axis plays an important role in Cr(VI)-induced carcinogenesis. PMID:27323401

Play or hard work: unpacking well-being at preschool.

PubMed

Kennedy-Behr, A; Rodger, S; Mickan, S

2015-03-01

Well-being or quality of life is thought to give a more accurate picture of the impact a condition has on day-to-day functioning than traditional outcome measures. This study sought to examine the relationship between engagement in play and well-being for preschool children with and without developmental coordination disorder (DCD). A quasi-experimental design was used with two independent groups of preschool children aged 4-6 years with (n=32) and without (n=31) probable DCD. Play skills were assessed using the Play Observation Scale based on 30min of videotape of free-play at preschool. Well-being was assessed using a parent-proxy version of the Revised Children Quality of Life Questionnaire (KINDL(R)). Spearman rho correlations were performed to examine the relationship between play and well-being. Well-being at preschool was significantly lower for the children in the DCD group however overall well-being was not significantly different. Engagement in type of social play (solitary, parallel or group) was found to predict well-being for the typically developing children. For the children with DCD, engagement in group play was not associated with well-being. An explanation for this difference may be that children with DCD may not experience free-play at preschool as "play" but rather as hard work. Further research is needed to determine why children with DCD experience lower well-being at preschool than their peers and to investigate children's perceptions of free-play. This may enable teachers and therapists to better support children with DCD in the preschool environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

microRNA-21-induced dissociation of PDCD4 from rictor contributes to Akt-IKKβ-mTORC1 axis to regulate renal cancer cell invasion.

PubMed

Bera, Amit; Das, Falguni; Ghosh-Choudhury, Nandini; Kasinath, Balakuntalam S; Abboud, Hanna E; Choudhury, Goutam Ghosh

2014-10-15

Renal cancer metastasis may result from oncogenic forces that contribute to the primary tumor. We have recently identified microRNA-21 as an oncogenic driver of renal cancer cells. The mechanism by which miR-21 controls renal cancer cell invasion is poorly understood. We show that miR-21 directly downregulates the proapoptotic protein PDCD4 to increase migration and invasion of ACHN and 786-O renal cancer cells as a result of phosphorylation/activation of Akt and IKKβ, which activate NFκB-dependent transcription. Constitutively active (CA) Akt or CA IKKβ blocks PDCD4-mediated inhibition and restores renal cancer cell migration and invasion. PDCD4 inhibits mTORC1 activity, which was reversed by CA IKKβ. Moreover, CA mTORC1 restores cell migration and invasion inhibited by PDCD4 and dominant negative IKKβ. Moreover, PDCD4 negatively regulates mTORC2-dependent Akt phosphorylation upstream of this cascade. We show that PDCD4 forms a complex with rictor, an exclusive component of mTORC2, and that this complex formation is reduced in renal cancer cells due to increased miR-21 expression resulting in enhanced phosphorylation of Akt. Thus our results identify a previously unrecognized signaling node where high miR-21 levels reduce rictor-PDCD4 interaction to increase phosphorylation of Akt and contribute to metastatic fitness of renal cancer cells. Copyright © 2014 Elsevier Inc. All rights reserved.

microRNA-21-induced Dissociation of PDCD4 from Rictor Contributes to Akt-IKKβ-mTORC1 axis to Regulate Select Renal Cancer Cell Invasion

PubMed Central

Bera, Amit; Das, Falguni; Ghosh-Choudhury, Nandini; Kasinath, Balakuntalam S.; Abboud, Hanna E.; Choudhury, Goutam Ghosh

2014-01-01

Renal cancer metastasis may result from oncogenic forces that contribute to the primary tumor. We have recently identified microRNA-21 as an oncogenic driver of renal cancer cells. The mechanism by which miR-21 controls renal cancer cell invasion is poorly understood. We show that miR-21 directly downregulates the proapoptotic protein PDCD4 to increase migration and invasion of ACHN and 786-O renal cancer cells as a result of phosphorylation/activation of Akt and IKKβ, which activate NFκB-dependent transcription. Constitutively active (CA) Akt or CA IKKβ blocks PDCD4-mediated inhibition and restores renal cancer cell migration and invasion. PDCD4 inhibits mTORC1 activity, which was reversed by CA IKKβ. Moreover, CA mTORC1 restores cell migration and invasion inhibited by PDCD4- and dominant negative IKKβ. Moreover, PDCD4 negatively regulates mTORC2-dependent Akt phosphorylation upstream of this cascade. We show that PDCD4 forms a complex with rictor, an exclusive component of mTORC2, and that this complex formation is reduced in renal cancer cells due to increased miR-21 expression resulting in enhanced phosphorylation of Akt. Thus our results identify a previously unrecognized signaling node where high miR-21 levels reduce rictor-PDCD4 interaction to increase phosphorylation of Akt and contribute to metastatic fitness of renal cancer cells. PMID:25016284

RNA-binding protein HuR sequesters microRNA-21 to prevent translation repression of proinflammatory tumor suppressor gene programmed cell death 4.

PubMed

Poria, D K; Guha, A; Nandi, I; Ray, P S

2016-03-31

Translation control of proinflammatory genes has a crucial role in regulating the inflammatory response and preventing chronic inflammation, including a transition to cancer. The proinflammatory tumor suppressor protein programmed cell death 4 (PDCD4) is important for maintaining the balance between inflammation and tumorigenesis. PDCD4 messenger RNA translation is inhibited by the oncogenic microRNA, miR-21. AU-rich element-binding protein HuR was found to interact with the PDCD4 3'-untranslated region (UTR) and prevent miR-21-mediated repression of PDCD4 translation. Cells stably expressing miR-21 showed higher proliferation and reduced apoptosis, which was reversed by HuR expression. Inflammatory stimulus caused nuclear-cytoplasmic relocalization of HuR, reversing the translation repression of PDCD4. Unprecedentedly, HuR was also found to bind to miR-21 directly, preventing its interaction with the PDCD4 3'-UTR, thereby preventing the translation repression of PDCD4. This suggests that HuR might act as a 'miRNA sponge' to regulate miRNA-mediated translation regulation under conditions of stress-induced nuclear-cytoplasmic translocation of HuR, which would allow fine-tuned gene expression in complex regulatory environments.

Roles of phosphatidylinositol 3-kinase regulatory subunit alpha, activator protein-1, and programmed cell death 4 in diagnosis of papillary thyroid carcinoma.

PubMed

Chen, Xiaojun; Wu, Wenjun; Chen, Xiong; Gong, Xiaohua

2016-05-01

This study evaluated the diagnostic values of phosphatidylinositol 3-kinase regulatory subunit alpha (P85α), activator protein-1 (AP-1), and programmed cell death 4 (PDCD4) in papillary thyroid carcinoma (PTC). P85α, AP-1, and PDCD4 expressions were detected in PTC tissues (n = 116) and thyroid papillary hyperplasia (PTH) tissues (n = 90) by immunohistochemistry, western blot, and enzyme-linked immunosorbent assay (ELISA). Associations of P85α, AP-1, and PDCD4 expressions with clinicopathological features in PTC were analyzed. Diagnostic values of P85α, AP-1, and PDCD4 in PTC were evaluated by receiver operating characteristic (ROC) curve. P85α, AP-1, and PDCD4 expression levels in PTC tissues were statistically different from those in PTH tissues (all P < 0.05). In PTC tissues, AP-1 expression was positively associated with P85α expression (r = 0.841, P < 0.01), while negatively associated with PDCD4 expression (r = -0.755, P < 0.01). P85α expression was associated with lymph node metastasis (LNM) and the degree of differentiation (both P < 0.05); AP-1 and PDCD4 expressions were associated with the degree of differentiation (both P < 0.05). The diagnostic sensitivity and specificity of P85α were 92.2 and 91.1 %, respectively, with a cutoff value of 2.100 and an area under curve (AUC) of 0.966. The diagnostic sensitivity and specificity of AP-1 reached 94.4 and 93.3 % with a cutoff value of 1.655 and an AUC of 0.987. The diagnostic sensitivity and specificity of PDCD4 were 54.4 and 85.6 % with a cutoff value of 2.025 and an AUC of 0.754. P85α, AP-1, and PDCD4 proteins may be related to the tumorigenesis and progression of PTC. Moreover, P85α, AP-1, and PDCD4 proteins may serve as potential diagnostic markers to the biological behavior of PTC.

Effects of microRNA-21 on Nerve Cell Regeneration and Neural Function Recovery in Diabetes Mellitus Combined with Cerebral Infarction Rats by Targeting PDCD4.

PubMed

Guo, Yun-Bao; Ji, Tie-Feng; Zhou, Hong-Wei; Yu, Jin-Lu

2018-03-01

We aimed to determine the effect and mechanism of microRNA-21 (miR-21) on nerve cell regeneration and nerve functional recovery in diabetes mellitus combined with cerebral infarction (DM + CI) rats by targeting PDCD4. A total of 125 male Wistar rats were selected for DM + CI rat model construction and assigned into the blank, miR-21 mimics, mimics control, miR-21 inhibitor, inhibitor control, miR-21 inhibitor + si-PDCD4 and si-PDCD4 groups. And, 20 healthy rats were selected for the normal group. Triphenylterazolium chloride (TTC) staining and HE staining were used for determination of the area of CI and pathological changes, respectively. Behaviors of rats in the eight groups were determined by forelimb placement test and balance beam walking test. Immunohistochemical staining, double immunofluorescence staining assay, Western blotting, and qRT-PCR were used to detect expressions of miR-21, PDCD4, HNA, Nestin, NeuN, β-III-Tub, PTEN, FasL, and GFAP. DNA laddering and TUNEL staining was used for cell apoptosis. TTC and HE staining confirmed that 87.5% rats were induced into CI + DM models successfully. Results of forelimb placement test and balance beam walking test showed that miR-21 mimics, and si-PCDC4 improved the nerve defect of model rats. Comparing with the blank group at the same time, rats in the miR-21 inhibitor group displayed significant decrease in the forelimb placement test score, significant increase in the balance beam walking test score, and exacerbation of nerve defect, while rats in the miR-21 mimics and si-PCDC4 groups displayed significant increase in forelimb placement test score and significant decrease in the balance beam walking test score and improvement of nerve defect situation. The HNA, Nestin, and PDCD4 expressions were decreased and the NeuN, β-III-Tub, and GFAP expressions were increased in the miR-21 mimics and si-PDCD4 groups comparing with the blank group. The results of miR-21 inhibitor group were on the contrary. In comparison to the blank group, the miR-21 mimics group and the si-PDCD4 had lower miR-21 expressions and higher expressions of PDCD4, PTEN, and FasL, while the miR-21 inhibitor group was in the opposite trend. The results of qRT-PCR were the same with Western blotting. The expressions of fluorescence in other groups were higher than the normal group; compared with the blank group, the miR-21 mimics group and the si-PDCD4 group had lower fluorescence expression and DNA ladder. However, the fluorescence expressions and DNA ladder of miR-21 inhibitor group increased markedly in contrast with the blank group. Comparing with the blank group, BrdU + /DEX + fluorescence intensity significantly enhanced in the miR-21 mimics and si-PDCD4 groups and significantly reduced in the miR-21 inhibitor group. And, comparing with the blank group, in the miR-21 mimics group, the signal strength of luciferase carrying the wild-type PDCD4 was reduced by 25%. The present studies demonstrated that miR-21 could promote the nerve cell regeneration, suppress apoptosis of nerve cells in DM + CI rats and improves the nerve defect situation of DM + CI rats by inhibiting PDCD4.

Expression and clinicopathological significance of microRNA-21 and programmed cell death 4 in malignant melanoma.

PubMed

Jiao, Jian; Fan, Yu; Zhang, Yan

2015-10-01

To measure levels of microRNA (miR)-21 and its target gene, programmed cell death 4 (PDCD4), in samples of human cutaneous malignant melanoma and normal non-malignant control skin. Relative levels of miR-21 and PDCD4 mRNA were measured using a quantitative real-time reverse transcription-polymerase chain reaction. Correlations between the levels of the two molecules and the clinicopathological characteristics of malignant melanoma were analysed. A total of 67 cases of human cutaneous malignant melanoma were analysed and compared with 67 samples of normal nonmalignant control skin. Compared with normal skin samples, the relative level of miR-21 was significantly higher and the relative level of PDCD4 mRNA was significantly lower in the melanoma specimens. A significant negative correlation between PDCD4 mRNA and miR-21 was demonstrated in malignant melanoma (r = -0.602). Elevated miR-21 and reduced PDCD4 mRNA levels were both significantly correlated with increased tumour size, a higher Clark classification level and the presence of lymph node metastases in malignant melanoma. These findings suggest that miR-21 and PDCD4 might be potential biomarkers for malignant melanoma and might provide treatment targets in the future. © The Author(s) 2015.

Diagnostic investigations of DKK-1 and PDCD5 expression levels as independent prognostic markers of human chondrosarcoma.

PubMed

Zarea, Mojtaba; Mohammadian Bajgiran, Amirhossein; Sedaghati, Farnoush; Hatami, Negin; Taheriazam, Afshin; Yahaghi, Emad; Shakeri, Mohammadreza

2016-07-01

In this study, we investigated the expression levels of Dickkopf-1 (DKK-1) and programmed cell death 5 (PDCD5) by using quantitative real-time PCR and immunohistochemistry in patients with chondrosarcoma. The DKK-1 mRNA levels were significantly higher in chondrosarcoma when compared with the corresponding nontumor tissues (mean ± SD: 4.23 ± 1.54; 1.54 ± 0.87; P = 0.001). PDCD5 mRNA levels were remarkably deceased in tumor tissues when compared with corresponding nontumor tissues (mean ± SD: 1.94 ± 0.73; 5.42 ± 1.73; P = 0.001). The high and moderate DKK-1 expressions were observed for 60% of chondrosarcoma samples in comparison with 27.5% of corresponding nontumor tissues (P  =  0.001). Moreover, low expression of PDCD5 was found in 67.5% of the tumor tissues when compared with the nontumor tissues (32.5%; P = 0.002). The results of this study showed that high DKK-1 expression levels were strongly related to MSTS stage (P = 0.011) and the advancement of histological grade (P < 0.001). Furthermore, the PDCD5 expression levels were correlated with histological grade (P < 0.001), MSTS stage (P = 0.016), and distant metastasis (P = 0.001). Kaplan-Meier survival and log-rank survival showed that patients with high DKK-1 levels and low PDCD5 levels were correlated with shorter overall survival (log-rank test P < 0.001). PDCD5 levels, histological grade, and tumor stage were independent predictors of overall survival. In conclusion, DKK-1 and PDCD5 can be independent predictors of overall survival in patients suffering from chondrosarcoma. © 2016 IUBMB Life, 68(7):597-601, 2016. © 2016 International Union of Biochemistry and Molecular Biology.

Sulforaphane suppresses LPS-induced or TPA-induced downregulation of PDCD4 in RAW 264.7 cells.

PubMed

Cho, Jong-Ho; Kim, Young-Woo; Keum, Young-Sam

2014-11-01

Sulforaphane is a natural chemopreventive isothiocyanate and abundantly found in various cruciferous vegetables. Although chemopreventive activity of sulforaphane is well documented, the detailed biochemical mechanism(s), underlying how it regulates the protein translation process to antagonize pro-inflammatory responses are largely unclear. In the present study, we show that lipopolysaccharide (LPS) or 12-O-tetradecanoylphorbol-13-acetate (TPA) treatment reduces cellular levels of PDCD4, and this event is mediated by affecting both transcription and proteolysis in RAW 264.7 cells. We show that LPS-mediated or TPA-mediated PDCD4 downregulation is catalyzed by the activation of intracellular Akt1 or S6K1 kinases and that sulforaphane suppresses LPS-induced or TPA-induced Akt1 or S6K1 activation, thereby resulting in the attenuation of PDCD4 downregulation in RAW 264.7 cells. We propose that sulforaphane suppression of PDCD4 downregulation serves as a novel molecular mechanism to control proliferation in response to pro-inflammatory signals. Copyright © 2014 John Wiley & Sons, Ltd.

SOX6 and PDCD4 enhance cardiomyocyte apoptosis through LPS-induced miR-499 inhibition.

PubMed

Jia, Zhuqing; Wang, Jiaji; Shi, Qiong; Liu, Siyu; Wang, Weiping; Tian, Yuyao; Lu, Qin; Chen, Ping; Ma, Kangtao; Zhou, Chunyan

2016-02-01

Sepsis-induced cardiac apoptosis is one of the major pathogenic factors in myocardial dysfunction. As it enhances numerous proinflammatory factors, lipopolysaccharide (LPS) is considered the principal mediator in this pathological process. However, the detailed mechanisms involved are unclear. In this study, we attempted to explore the mechanisms involved in LPS-induced cardiomyocyte apoptosis. We found that LPS stimulation inhibited microRNA (miR)-499 expression and thereby upregulated the expression of SOX6 and PDCD4 in neonatal rat cardiomyocytes. We demonstrate that SOX6 and PDCD4 are target genes of miR-499, and they enhance LPS-induced cardiomyocyte apoptosis by activating the BCL-2 family pathway. The apoptosis process enhanced by overexpression of SOX6 or PDCD4, was rescued by the cardiac-abundant miR-499. Overexpression of miR-499 protected the cardiomyocytes against LPS-induced apoptosis. In brief, our results demonstrate the existence of a miR-499-SOX6/PDCD4-BCL-2 family pathway in cardiomyocytes in response to LPS stimulation.

Identification of novel molecular markers for prognosis estimation of acute myeloid leukemia: over-expression of PDCD7, FIS1 and Ang2 may indicate poor prognosis in pretreatment patients with acute myeloid leukemia.

PubMed

Tian, Yiming; Huang, Zoufang; Wang, Zhixiang; Yin, Changxin; Zhou, Lanlan; Zhang, Lingxiu; Huang, Kaikai; Zhou, Hongsheng; Jiang, Xuejie; Li, Jinming; Liao, Libin; Yang, Mo; Meng, Fanyi

2014-01-01

Numerous factors impact on the prognosis of acute myeloid leukemia (AML), among which molecular genetic abnormalities are developed increasingly, however, accurate prediction for newly diagnosed AML patients remains unsatisfied. For further improving the prognosis evaluation system, we investigated the transcripts levels of PDCD7, FIS1, FAM3A, CA6, APP, KLRF1, ATCAY, GGT5 and Ang2 in 97 AML patients and 30 non-malignant controls, and validated using the published microarray data from 225 cytogenetically normal AML (CN-AML) patients treated according to the German AMLCG-1999 protocol. Real-time quantitative polymerase chain reaction and western blot were carried out, and clinical data were collected and analyzed. High Ang2 and FIS1 expression discriminated the CR rate of AML patients (62.5% versus 82.9% for Ang2, P = 0.011; 61.4% versus 82.2% for FIS1, P = 0.029). In CN-AML, patients with high FIS1 expression were more likely to be resistant to two courses of induction (P = 0.035). Overall survival (OS) and relapse-free survival (RFS) were shorter in CN-AML patients with high PDCD7 expression (P<0.001; P = 0.006), and PDCD7 was revealed to be an independent risk factor for OS in CN-AML (P = 0.004). In the analysis of published data from 225 CN-AML patients, PDCD7 remained independently predicting OS in CN-AML (P = 0.039). As a conclusion, Ang2 and FIS1 seem related to decreased CR rate of AML patients, and PDCD7 is associated with shorter OS and RFS in CN-AML. Hence, PDCD7, Ang2 and FIS1 may indicate a more aggressive form and poor prognosis of AML.

Identification of Novel Molecular Markers for Prognosis Estimation of Acute Myeloid Leukemia: Over-Expression of PDCD7, FIS1 and Ang2 May Indicate Poor Prognosis in Pretreatment Patients with Acute Myeloid Leukemia

PubMed Central

Tian, Yiming; Huang, Zoufang; Wang, Zhixiang; Yin, Changxin; Zhou, Lanlan; Zhang, Lingxiu; Huang, Kaikai; Zhou, Hongsheng; Jiang, Xuejie; Li, Jinming; Liao, Libin; Yang, Mo; Meng, Fanyi

2014-01-01

Numerous factors impact on the prognosis of acute myeloid leukemia (AML), among which molecular genetic abnormalities are developed increasingly, however, accurate prediction for newly diagnosed AML patients remains unsatisfied. For further improving the prognosis evaluation system, we investigated the transcripts levels of PDCD7, FIS1, FAM3A, CA6, APP, KLRF1, ATCAY, GGT5 and Ang2 in 97 AML patients and 30 non-malignant controls, and validated using the published microarray data from 225 cytogenetically normal AML (CN-AML) patients treated according to the German AMLCG-1999 protocol. Real-time quantitative polymerase chain reaction and western blot were carried out, and clinical data were collected and analyzed. High Ang2 and FIS1 expression discriminated the CR rate of AML patients (62.5% versus 82.9% for Ang2, P = 0.011; 61.4% versus 82.2% for FIS1, P = 0.029). In CN-AML, patients with high FIS1 expression were more likely to be resistant to two courses of induction (P = 0.035). Overall survival (OS) and relapse-free survival (RFS) were shorter in CN-AML patients with high PDCD7 expression (P<0.001; P = 0.006), and PDCD7 was revealed to be an independent risk factor for OS in CN-AML (P = 0.004). In the analysis of published data from 225 CN-AML patients, PDCD7 remained independently predicting OS in CN-AML (P = 0.039). As a conclusion, Ang2 and FIS1 seem related to decreased CR rate of AML patients, and PDCD7 is associated with shorter OS and RFS in CN-AML. Hence, PDCD7, Ang2 and FIS1 may indicate a more aggressive form and poor prognosis of AML. PMID:24416201

Use of cationic polymers to reduce pathogen levels during dairy manure separation.

PubMed

Liu, Zong; Carroll, Zachary S; Long, Sharon C; Gunasekaran, Sundaram; Runge, Troy

2016-01-15

Various separation technologies are used to deal with the enormous amounts of animal waste that large livestock operations generate. When the recycled waste stream is land applied, it is essential to lower the pathogen load to safeguard the health of livestock and humans. We investigated whether cationic polymers, used as a flocculent in the solid/liquid separation process, could reduce the pathogen indicator load in the animal waste stream. The effects of low charge density cationic polyacrylamide (CPAM) and high charge density cationic polydicyandiamide (PDCD) were investigated. Results demonstrated that CPAM was more effective than PDCD for manure coagulation and flocculation, while PDCD was more effective than CPAM in reducing the pathogen indicator loads. However, their combined use, CPAM followed by PDCD, resulted in both improved solids separation and pathogen indicator reduction. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Programmed cell death 4 protein (Pdcd4) and homeodomain-interacting protein kinase 2 (Hipk2) antagonistically control translation of Hipk2 mRNA.

PubMed

Ohnheiser, Johanna; Ferlemann, Eva; Haas, Astrid; Müller, Jan P; Werwein, Eugen; Fehler, Olesja; Biyanee, Abhiruchi; Klempnauer, Karl-Heinz

2015-07-01

The tumor suppressor protein programmed cell death 4 (Pdcd4) is a highly conserved RNA-binding protein that inhibits the translation of specific mRNAs. Here, we have identified the homeobox-interacting protein kinase-2 (Hipk2) mRNA as a novel translational target of Pdcd4. Unlike most other protein kinases Hipk2 is constitutively active after being synthesized by the ribosome and its expression and activity are thought to be mainly controlled by modulation of the half-life of the kinase. Our work provides the first evidence that Hipk2 expression is also controlled on the level of translation. We show that Hipk2 stimulates the translation of its own mRNA and that Pdcd4 suppresses the translation of Hipk2 mRNA by interfering with this auto-regulatory feedback mechanism. We also show that the translation of the related kinase Hipk1 is controlled by a similar feedback loop and that Hipk2 also stimulates the translation of Hipk1 mRNA. Taken together, our work describes a novel mechanism of translational suppression by Pdcd4 and shows for the first time that Hipk2 controls its own synthesis by an auto-regulatory feedback mechanism. Furthermore, the effect of Hipk2 on the translation of Hipk1 RNA suggests that Hipk2 and Pdcd4 can act in similar manner to control the translation of other mRNAs. Copyright © 2015 Elsevier B.V. All rights reserved.

Elevation of autoantibody level against PDCD11 in patients with transient ischemic attack

PubMed Central

Yoshida, Yoichi; Wang, Hao; Hiwasa, Takaki; Machida, Toshio; Kobayashi, Eiichi; Mine, Seiichiro; Tomiyoshi, Go; Nakamura, Rika; Shinmen, Natsuko; Kuroda, Hideyuki; Takizawa, Hirotaka; Kashiwado, Koichi; Kamitsukasa, Ikuo; Shin, Hideo; Wada, Takeshi; Aotsuka, Akiyo; Nishi, Eiichiro; Ohno, Mikiko; Takemoto, Minoru; Yokote, Koutaro; Takahashi, Sho; Matsushima, Jun; Zhang, Xiao-Meng; Takiguchi, Masaki; Iwadate, Yasuo

2018-01-01

Background Disease specific autoantibodies have been detected in the sera of patients with atherosclerosis-related diseases, such as cerebral infarction, cardiovascular disease. In the present study, we aimed to identify novel autoantibodies responsible for transient ischemic attack (TIA), a prodromal condition for cerebral infarction. Methods To identify candidate antigens, we screened a human aortic endothelial cell cDNA library using sera from 20 patients with TIA. Serum antibody levels were measured using amplified luminescent proximity homogeneous assay-linked immunosorbent assay (AlphaLISA) in 2 independent patient/healthy donor (HD) cohorts (n = 192 and n = 906 in the second screening and validation cohort, respectively). Results First screening identified 3 candidate antigens. Of these, programmed cell death 11 (PDCD11) was determined to be associated with stroke (p < 0.0001), as evidenced from the second screening using AlphaLISA. The validation cohort revealed significantly higher antibody levels against PDCD11 (PDCD11-Ab levels) in patients with TIA than in HDs. Multivariate logistic regression analysis indicated that the predictive value of PDCD11-Ab levels for TIA [Odds ratio (OR): 2.44, 95% confidence interval (CI): 1.33-4.57, p = 0.0039] was not inferior to other known risk factors for ischemic stroke, including age (OR: 4.97, 95% CI: 2.67–9.48, p < 0.0001); hypertension (OR: 3.21, 95% CI: 1.76–5.86, p = 0.0001); and diabetes (OR: 4.31, 95% CI: 1.74–11.2, p = 0.0015). Conclusion Serum PDCD11-Ab level may serve as a potential biomarker for TIA. PMID:29507658

Similar 5-Year Estimated Glomerular Filtration Rate Between Kidney Transplants From Uncontrolled and Controlled Donors After Circulatory Death—A Dutch Cohort Study

PubMed Central

Peters-Sengers, Hessel; Homan van der Heide, Jaap J.; Heemskerk, Martin B. A.; ten Berge, Ineke J. M.; Ultee, Fred C. W.; Idu, Mirza M.; Betjes, Michiel G. H.; van Zuilen, Arjan D.; Christiaans, Maarten H. L.; Hilbrands, Luuk H.; de Vries, Aiko P. J.; Nurmohamed, Azam S.; Berger, Stefan P.; Bemelman, Frederike J.

2017-01-01

Background Organ shortage persists despite a high rate of donation after circulatory death (DCD) in the Netherlands. The median waiting time for a deceased donor kidney in 2013 was 3.5 years. Most DCD kidneys are from controlled DCD (cDCD; Maastricht category III). Experience with uncontrolled donors after cardiac death (uDCD), that is, donors with an unexpected and irreversible cardiac arrest (Maastricht categories I and II), is increasing; and its effect on transplant outcomes needs evaluation. Methods We used the Dutch Organ Transplantation Registry to include recipients (≥18 years old) from all Dutch centers who received transplants from 2002 to 2012 with a first DCD kidney. We compared transplant outcome in uDCD (n = 97) and cDCD (n = 1441). Results Primary nonfunction in uDCD was higher than in the cDCD (19.6% vs 9.6%, P < 0.001, respectively). Delayed graft function was also higher in uDCD than in cDCD, but not significantly (73.7% vs 63.3%, P = .074, respectively). If censored for primary nonfunction, estimated glomerular filtration rates after 1 year and 5 years were comparable between uDCD and cDCD (1 year: uDCD, 44.3 (23.4) mL/min/m2 and cDCD, 45.8 (24.1) mL/min/m2; P = 0.621; 5 years: uDCD, 49.1 (25.6) mL/min/m2 and cDCD, 47.7 (21.7) mL/min/m2; P = 0.686). The differences in primary nonfunction between kidneys from uDCD and cDCD were explained by differences in the first warm ischemic period, cold ischemic time, and donor age. Conclusions We conclude that uDCD kidneys have potential for excellent function and can constitute a valuable extension of the donor pool. However, further efforts are necessary to address the high rate of primary nonfunction. PMID:27257998

Inhibition of p70S6K1 activation by Pdcd4 overcomes the resistance to an IGF-1R/IR inhibitor in colon carcinoma cells

PubMed Central

Zhang, Yan; Wang, Qing; Chen, Li; Yang, Hsin-Sheng

2015-01-01

Agents targeting insulin-like growth factor 1 receptor (IGF-1R) are being actively examined in clinical trials. Although there has been some initial success of single agent targeting IGF-1R, attempts in later studies failed due to resistance. This study aimed to understand the effects of programmed cell death 4 (Pdcd4) on the chemosensitivity of the IGF-1R inhibitor, OSI-906, in colorectal cancer (CRC) cells and the mechanism underlying this impact. Using OSI-906 resistant and sensitive CRC cells, we found that the Pdcd4 level directly correlates with cell chemosensitivity to OSI-906. In addition, tumors derived from Pdcd4 knockdown cells resist the growth inhibitory effect of OSI-906 in a CRC xenograft mouse model. Moreover, Pdcd4 enhances the antiproliferative effect of OSI-906 in resistant cells through suppression of p70S6K1 activation. Knockdown of p70S6K1, but not p70S6K2, significantly increases the chemosensitivity of OSI-906 in cultured CRC cells. Furthermore, the combination of OSI-906 and PF4708671, a p70S6K1 inhibitor, efficiently suppresses the growth of OSI-906 resistant colon tumor cells in vitro and in vivo. Taken together, activation of p70S6K1 that is inhibited by Pdcd4 is essential for resistance to IGF-1R inhibitor in colon tumor cells, and the combinational treatment of OSI-906 and PF-4708671 results in enhanced antiproliferation effects in CRC cells in vitro and in vivo, providing a novel venue to overcome the resistance to IGF-1R inhibitor in treating colorectal cancer. PMID:25573956

Linc00472 suppresses proliferation and promotes apoptosis through elevating PDCD4 expression by sponging miR-196a in colorectal cancer.

PubMed

Ye, Yafei; Yang, Shengnan; Han, Yanping; Sun, Jingjing; Xv, Lijuan; Wu, Lina; Wang, Yongfeng; Ming, Liang

2018-06-21

Long intergenic non-coding RNA Linc00472 has been considered as a tumor suppressor in some cancers. However, the function and mechanism of Linc00472 in colorectal cancer has not been well elucidated. In this study, we found that Linc00472 was down-regulated in colorectal cancer tissues and cells. Elevated Linc00472 expression suppressed proliferation and induced apoptosis in colorectal cancer cells. Moreover, Linc00472 acted as a competing endogenous RNA (ceRNA) of miR-196a to release programmed cell death 4 (PDCD4). Furthermore, miR-196a overexpression or PDCD4 knockdown reversed Linc00472-mediated proliferation inhibition and apoptosis induction in colorectal cancer cells. Ectopic Linc00472 expression hindered tumor growth in vivo . Our study demonstrated that Linc00472 suppressed proliferation and induced apoptosis through up-regulating PDCD4 by decoying miR-196a, which may be an effective therapeutic target for colorectal cancer.

Downregulated PITX1 Modulated by MiR-19a-3p Promotes Cell Malignancy and Predicts a Poor Prognosis of Gastric Cancer by Affecting Transcriptionally Activated PDCD5.

PubMed

Qiao, Fengchang; Gong, Pihai; Song, Yunwei; Shen, Xiaohui; Su, Xianwei; Li, Yiping; Wu, Huazhang; Zhao, Zhujiang; Fan, Hong

2018-01-01

PITX1 has been identified as a potential tumor-suppressor gene in several malignant tumors. The molecular mechanism underlying PITX1, particularly its function as a transcription factor regulating gene expression during tumorigenesis, is still poorly understood. The expression level and location of PITX1 were determined by quantitative reverse transcription PCR (qRT-PCR) and immunohistochemical staining in gastric cancer (GC). The effect of PITX1 on the GC cell proliferation and tumorigenesis was analyzed in vitro and in vivo. To explore how PITX1 suppresses cell proliferation, we used PITX1-ChIP-sequencing to measure genome-wide binding sites of PITX1 and assessed global function associations based on its putative target genes. ChIP-PCR, electrophoretic mobility shift assay, and promoter reporter assays examined whether PITX1 bound to PDCD5 and regulated its expression. The function of PDCD5 in GC cell apoptosis was further examined in vitro and in vivo. The relationship between the PITX1 protein level and GC patient prognosis was evaluated by the Kaplan-Meier estimator. Meanwhile, the expression level of miR-19a-3p, which is related to PITX1, was also detected by luciferase reporter assay, qRT-PCR, and western blotting. The expression level of PITX1 was decreased in GC tissues and cell lines. Elevated PITX1 expression significantly suppressed the cell proliferation of GC cells and tumorigenesis in vitro and in vivo. PITX1 knockdown blocked its inhibition of GC cell proliferation. PITX1 bound to whole genome-wide sites, with these targets enriched on genes with functions mainly related to cell growth and apoptosis. PITX1 bound to PDCD5, an apoptosis-related gene, during tumorigenesis, and cis-regulated PDCD5 expression. Increased PDCD5 expression in GC cells not only induced GC cell apoptosis, but also suppressed GC cell growth in vitro and in vivo. Moreover, PITX1 expression was regulated by miR-19a-3p. More importantly, a decreased level of PITX1 protein was correlated with poor GC patient prognosis. Decreased expression of PITX1 predicts shorter overall survival in GC patients. As a transcriptional activator, PITX1 regulates apoptosis-related genes, including PDCD5, during gastric carcinogenesis. These data indicate PDCD5 to be a novel and feasible therapeutic target for GC. © 2018 The Author(s). Published by S. Karger AG, Basel.

Effect of organ donation after circulatory determination of death on number of organ transplants from donors with neurologic determination of death

PubMed Central

Rao, Vivek; Dhanani, Sonny; MacLean, Janet; Payne, Clare; Paltser, Elizabeth; Humar, Atul; Zaltzman, Jeffrey

2017-01-01

BACKGROUND: To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. METHODS: We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14). We compared these donor groups by categorical characteristics. RESULTS: Donation increased by 57%, from 578 donors in the pre-DCD era to 905 donors in the recent DCD era, with a 21% proportion (190/905) of DCD donors in the recent DCD era. However, overall NDD donation also increased. The mean length of hospital stay before declaration for NDD was 2.7 days versus 6.0 days before withdrawal of life support and subsequent asystole in cases of DCD. The average organ yield was 3.73 with NDD donation versus 2.58 with DCD (p < 0.001). Apart from hearts, all organs from DCD donors were successfully transplanted. From the pre-DCD era to the recent DCD era, transplant activity in each era increased for all solid-organ recipients, including heart (from 158 to 216), kidney (from 821 to 1321), liver (from 477 to 657) and lung (from 160 to 305). INTERPRETATION: Implementation of DCD in Ontario led to increased transplant activity for all solid-organ recipients. There was no evidence that the use of DCD was pre-empting potential NDD donation. In contrast to groups receiving other organs, heart transplant candidates have not yet benefited from DCD. PMID:28947546

microRNA-21a-5p/PDCD4 axis regulates mesenchymal stem cell-induced neuroprotection in acute glaucoma.

PubMed

Su, Wenru; Li, Zuohong; Jia, Y; Zhu, Yingting; Cai, Wenjia; Wan, Peixing; Zhang, Yingying; Zheng, Song Guo; Zhuo, Yehong

2017-08-01

Mesenchymal stem cells (MSCs) have been demonstrated to have promising therapeutic benefits for a variety of neurological diseases; however, the underlying mechanisms are poorly understood. Here, we showed that intravitreal infusion of MSCs promoted retinal ganglion cell (RGC) survival in a mouse model of acute glaucoma, with significant inhibition of microglial activation, production of TNF-α, IL-1β, and reactive oxygen species, as well as caspase-8 and caspase-3 activation. In vitro, MSCs inhibited both caspase-8-mediated RGC apoptosis and microglial activation, partly via the action of stanniocalcin 1 (STC1). Furthermore, we found that microRNA-21a-5p (miR-21) and its target, PDCD4, were essential for STC1 production and the neuroprotective property of MSCs in vitro and in vivo. Importantly, miR-21 overexpression or PDCD4 knockdown augmented MSC-mediated neuroprotective effects on acute glaucoma. These data highlight a previously unrecognized neuroprotective mechanism by which the miR-21/PDCD4 axis induces MSCs to secrete STC1 and other factors that exert neuroprotective effects. Therefore, modulating the miR-21/PDCD4 axis might be a promising strategy for clinical treatment of acute glaucoma and other neurological diseases. © The Author (2017). Published by Oxford University Press on behalf of Journal of Molecular Cell Biology, IBCB, SIBS, CAS. All rights reserved.

Safety and Outcomes in 100 Consecutive Donation After Circulatory Death Liver Transplants Using a Protocol That Includes Thrombolytic Therapy.

PubMed

Bohorquez, H; Seal, J B; Cohen, A J; Kressel, A; Bugeaud, E; Bruce, D S; Carmody, I C; Reichman, T W; Battula, N; Alsaggaf, M; Therapondos, G; Bzowej, N; Tyson, G; Joshi, S; Nicolau-Raducu, R; Girgrah, N; Loss, G E

2017-08-01

Donation after circulatory death (DCD) liver transplantation (LT) reportedly yields inferior survival and increased complication rates compared with donation after brain death (DBD). We compare 100 consecutive DCD LT using a protocol that includes thrombolytic therapy (late DCD group) to an historical DCD group (early DCD group n = 38) and a cohort of DBD LT recipients (DBD group n = 435). Late DCD LT recipients had better 1- and 3-year graft survival rates than early DCD LT recipients (92% vs. 76.3%, p = 0.03 and 91.4% vs. 73.7%, p = 0.01). Late DCD graft survival rates were comparable to those of the DBD group (92% vs. 93.3%, p = 0.24 and 91.4% vs. 88.2%, p = 0.62). Re-transplantation occurred in 18.4% versus 1% for the early and late DCD groups, respectively (p = 0.001). Patient survival was similar in all three groups. Ischemic-type biliary lesions (ITBL) occurred in 5%, 3%, and 0.2% for early DCD, late DCD, and DBD groups, respectively, but unlike in the early DCD group, in the late DCD group ITBL was endoscopically managed and resolved in each case. Using a protocol that includes a thrombolytic therapy, DCD LT yielded patient and graft survival rates comparable to DBD LT. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study.

PubMed

Cavalcante Neto, Jorge L; Zamunér, Antonio R; Moreno, Bianca C; Silva, Ester; Tudella, Eloisa

2018-01-01

Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV ( p < 0.0001) and 2UV ( p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.

Association between PDCD1 Gene Polymorphisms and Risk of Systemic Lupus Erythematosus in Three Main Ethnic Groups of the Malaysian Population.

PubMed

Chua, Kek Heng; Lian, Lay Hoong; Sim, Xiu Jia; Cheah, Tien Eang; Lau, Tze Pheng

2015-04-29

The programmed cell death 1 (PDCD1) gene encodes for the PD-1 (programmed death 1) molecule, which negatively regulates self-reactive T- and B-cells in the maintenance of peripheral tolerance. A previous report had shown the development of lupus-like phenotypes in PD-1-deficient C57BL/6 mice, was suggestive to the role of PDCD1 in predisposing to systemic lupus erythematosus (SLE). Hence, we aimed to investigate the association between PDCD1 and SLE susceptibility in the Malaysian population. A TaqMan-based real-time PCR was employed to screen for PD1.1, PD1.3, PD1.5 and PD1.6 in both SLE and healthy control groups of 200 samples each. The observed frequency for PD1.5C/C genotype was significantly higher in Indian SLE patients and Malay controls (p < 0.01). On the other hand, the PD1.5C/T genotype might predispose the Malays to SLE, but confer a protective effect among the Indians (p < 0.01). The PD1.1, PD1.3 and PD1.6 were, however, not correlated to genetic predisposition of SLE in our Malaysian population. In conclusion, PD1.5 variant was significantly associated to SLE susceptibility in our Malaysian cohort. Our failure in replicating the association between other investigated PDCD1 variants and risk of getting SLE might due to ethnic and geographic variations in the distribution of these genetic variants.

Inhibition of p70S6K1 Activation by Pdcd4 Overcomes the Resistance to an IGF-1R/IR Inhibitor in Colon Carcinoma Cells.

PubMed

Zhang, Yan; Wang, Qing; Chen, Li; Yang, Hsin-Sheng

2015-03-01

Agents targeting insulin-like growth factor 1 receptor (IGF-1R) are being actively examined in clinical trials. Although there has been some initial success of single-agent targeting IGF-1R, attempts in later studies failed because of resistance. This study aimed to understand the effects of programmed cell death 4 (Pdcd4) on the chemosensitivity of the IGF-1R inhibitor OSI-906 in colorectal cancer cells and the mechanism underlying this impact. Using OSI-906-resistant and -sensitive colorectal cancer cells, we found that the Pdcd4 level directly correlates with cell chemosensitivity to OSI-906. In addition, tumors derived from Pdcd4 knockdown cells resist the growth inhibitory effect of OSI-906 in a colorectal cancer xenograft mouse model. Moreover, Pdcd4 enhances the antiproliferative effect of OSI-906 in resistant cells through suppression of p70S6K1 activation. Knockdown of p70S6K1, but not p70S6K2, significantly increases the chemosensitivity of OSI-906 in cultured colorectal cancer cells. Furthermore, the combination of OSI-906 and PF-4708671, a p70S6K1 inhibitor, efficiently suppresses the growth of OSI-906-resistant colon tumor cells in vitro and in vivo. Taken together, activation of p70S6K1 that is inhibited by Pdcd4 is essential for resistance to the IGF-1R inhibitor in colon tumor cells, and the combinational treatment of OSI-906 and PF-4708671 results in enhanced antiproliferation effects in colorectal cancer cells in vitro and in vivo, providing a novel venue to overcome the resistance to the IGF-1R inhibitor in treating colorectal cancer. ©2015 American Association for Cancer Research.

Cost Evaluation of a Donation after Cardiac Death Program: How Cost per Organ Compares to Other Donor Types.

PubMed

Lindemann, Jessica; Dageforde, Leigh Anne; Vachharajani, Neeta; Stahlschmidt, Emily; Brockmeier, Diane; Wellen, Jason R; Khan, Adeel; Chapman, William C; Doyle, Mb Majella

2018-05-01

Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. Donation after cardiac death program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected. Mean costs per donor and per organ were calculated. Cost of DCD donors that did not yield a transplantable organ were included in cost analyses resulting in total cost of the DCD program. Donation after cardiac death donor costs were compared with costs of in-hospital donation after brain death (DBD) donors. There were 289 organs transplanted from 264 DCD donors evaluated. Mean cost per DCD donor yielding transplantable organs was $9,306. However, 127 donors yielded no organs, at a mean cost of $8,794 per donor. The total cost of the DCD program was $32,020 per donor and $15,179 per organ. Mean cost for an in-hospital DBD donor was $33,546 and $9,478 per organ transplanted. Mean organ yield for DBD donors was 3.54 vs 2.21 for DCD donors (p < 0.0001), making the cost per DBD organ 63% of the cost of a DCD organ. Mean cost per DCD donor is comparable with DBD donors, however, individual cost of DCD organs increases by almost 40% when all costs of an entire DCD program are included. Published by Elsevier Inc.

Increased risk of severe recurrence of hepatitis C virus in liver transplant recipients of donation after cardiac death allografts.

PubMed

Hernandez-Alejandro, Roberto; Croome, Kris P; Quan, Douglas; Mawardi, Mohamed; Chandok, Natasha; Dale, Cheryl; McAlister, Vivian; Levstik, Mark A; Wall, William; Marotta, Paul

2011-09-27

In hepatitis C virus (HCV) recipients of donation after cardiac death (DCD) grafts, there is suggestion of lower rates of graft survival, indicating that DCD grafts themselves may represent a significant risk factor for severe recurrence of HCV. We evaluated all DCD liver transplant recipients from August 2006 to February 2011 at our center. Recipients with HCV who received a DCD graft (group 1, HCV+ DCD, n=17) were compared with non-HCV recipients transplanted with a DCD graft (group 2, HCV- DCD, n=15), and with a matched group of HCV recipients transplanted with a donation after brain death (DBD) graft (group 3, HCV+ DBD, n=42). A trend of poorer graft survival was seen in HCV+ patients who underwent a DCD transplant (group 1) compared with HCV- patients who underwent a DCD transplant (group 2) (P=0.14). Importantly, a statistically significant difference in graft survival was seen in HCV+ patients undergoing DCD transplant (group 1) (73%) as compared with DBD transplant (group 3) (93%)(P=0.01). There was a statistically significant increase in HCV recurrence at 3 months (76% vs. 16%) (P=0.005) and severe HCV recurrence within the first year (47% vs. 10%) in the DCD group (P=0.004). HCV recurrence is more severe and progresses more rapidly in HCV+ recipients who receive grafts from DCD compared with those who receive grafts from DBD. DCD liver transplantation in HCV+ recipients is associated with a higher rate of graft failure compared with those who receive grafts from DBD. Caution must be taken when using DCD grafts in HCV+ recipients.

Effect of timing of joint application of hydroquinone and dicyandiamide on nitrous oxide emission from irrigated lowland rice paddy field.

PubMed

Li, Xianglan; Zhang, Guangbin; Xu, Hua; Cai, Zucong; Yagi, Kazuyuki

2009-06-01

A field experiment was conducted to study the effect of timing of joint application of urease inhibitor hydroquinone (HQ) and nitrification inhibitor dicyandiamide (DCD) on N(2)O emission from irrigated lowland rice paddy field. Four treatments including Treatment CK (the control with urea alone), HQ/DCD-1 (application of HQ and DCD together with fertilizer before transplanting), HQ/DCD-2 (HQ and DCD with fertilizer at tillering stage) and HQ/DCD-3 (HQ and DCD with fertilizer at panicle initiation stage) were designed and implemented separately during rice growth period. Seasonal peaks of N(2)O flux occurred during midseason drainage and significant negative correlation between N(2)O flux and water layer depth was observed (r=-0.69 to -0.75, P<0.01). Mean N(2)O flux was the highest in the control with urea alone, while joint addition of HQ and DCD with urea lowered mean N(2)O flux considerably (P<0.05). Total N(2)O emission during rice growth season in Treatment CK, HQ/DCD-1, HQ/DCD-2 and HQ/DCD-3 was 3.90, 2.98, 1.73 and 3.23kgN(2)O-N ha(-1), respectively. Application of HQ and DCD together with basal fertilizer, tillering fertilizer and panicle initiation fertilizer decreased the total N(2)O emission by 24%, 56% and 17%, respectively, while increased grain yield by 10%, 18% and 6%, respectively. Effect of application of inhibitors on N(2)O emission during the continuous period from incorporation of HQ and DCD to rice harvest was also studied, where results indicating that the highest inhibiting efficiency of inhibitors on N(2)O emission was recorded when HQ and DCD applied with fertilizer at tillering stage.

Behavioral comparisons in Autism Spectrum Disorder and Developmental Coordination Disorder: A systematic literature review.

PubMed

Caçola, Priscila; Miller, Haylie L; Williamson, Peace Ossom

2017-06-01

Autism Spectrum Disorder (ASD) and Developmental Coordination Disorder (DCD) are developmental disorders that, since the DSM-5, can be diagnosed as co-occurring conditions. While some recent studies suggest that ASD and DCD have similar traits, others show clear behavioral distinctions between the two conditions. By gathering all studies that included (1) an ASD group and a DCD group, (2) an ASD+DCD group and a DCD group, or (3) ASD, ASD+DCD, and DCD groups, we aimed to identify similarities and differences in behaviors between the two disorders. We used a systematic search of PubMed (1946 -), Scopus (1970 -), PsycINFO (via EBSCO, 1600 -), CINAHL (via EBSCO, 1937 -), SportDiscus (via EBSCO, 1985 -), and WorldCat (via FirstSearch) in addition to reference list and author name searching PubMed, Scopus, PsycINFO, CINAHL, SportDiscus, and WorldCat to identify original studies that met the following criteria: (1) an ASD group and a DCD group, (2) an ASD+DCD group and a DCD group, or (3) ASD, ASD+DCD, and DCD groups. From the 1,598 articles screened, 11 were included in the qualitative analysis. The articles included reported more differences than similarities in individuals with ASD and DCD, with clear distinctions for working memory ability, gestural performance, grip selection, and cortical thickness. Only two studies reported similarities in face processing abilities and perceived competence, and the interventional studies showed group similarities in behavior improvement, such as intelligence and attention. Based on the articles reviewed, we conclude that while DCD and ASD share some behavioral symptoms, the symptom profiles of each disorder are unique and separable. We recommend that the evaluation of potential DCD in individuals with ASD be performed systematically and thoroughly, so as to distinguish this co-occurring condition from sensorimotor symptoms associated with ASD.

High risk for obesity in children with a subtype of developmental coordination disorder.

PubMed

Zhu, Yi-Ching; Cairney, John; Li, Yao-Chuen; Chen, Wei-Ying; Chen, Fu-Chen; Wu, Sheng K

2014-07-01

The purpose of this study was to compare the prevalence of overweight and obesity in typically developing (TD) children, children with developmental coordination disorder (DCD) and balance problems (DCD-BP), and children with DCD without balance problems (DCD-NBP). Two thousand and fifty-seven children (1095 boys, 962 girls) ages 9-12 years were recruited from 18 elementary schools in Taiwan. The Movement Assessment Battery for Children was used to assess motor coordination ability. International cut-off points for body mass index were used to classify participants into the following groups: normal-weight, overweight or obese. Compared with TD children, children in the DCD-BP group were more than twice as likely to be obese (OR=2.28; 95% CI=1.41-3.68). DCD-BP children were also more likely to be obese compared to DCD-NBP children (OR=1.79; 95% CI=1.02-3.16). Boys in the DCD-BP group were more likely to be obese when compared to DCD-BP girls (OR=3.12; 95% CI=1.28-7.57). Similarly, DCD-NBP boys were more likely to be obese when compared to DCD-NBP girls (OR=2.67; 95% CI=1.21-5.89). Children with both DCD and BP were significantly more likely to be obese when compared to TD and DCD-NBP children. From an intervention perspective, the inclusion of regular physical activity, including activities that encourage development of both balance and energy expenditure, may be required to prevent obesity in this population. Copyright © 2014 Elsevier Ltd. All rights reserved.

Neural signature of developmental coordination disorder in the structural connectome independent of comorbid autism.

PubMed

Caeyenberghs, Karen; Taymans, Tom; Wilson, Peter H; Vanderstraeten, Guy; Hosseini, Hadi; van Waelvelde, Hilde

2016-07-01

Children with autism spectrum disorders (ASD) often exhibit motor clumsiness (Developmental Coordination Disorder, DCD), i.e. they struggle with everyday tasks that require motor coordination like dressing, self-care, and participating in sport and leisure activities. Previous studies in these neurodevelopmental disorders have demonstrated functional abnormalities and alterations of white matter microstructural integrity in specific brain regions. These findings suggest that the global organization of brain networks is affected in DCD and ASD and support the hypothesis of a 'dys-connectivity syndrome' from a network perspective. No studies have compared the structural covariance networks between ASD and DCD in order to look for the signature of DCD independent of comorbid autism. Here, we aimed to address the question of whether abnormal connectivity in DCD overlaps that seen in autism or comorbid DCD-autism. Using graph theoretical analysis, we investigated differences in global and regional topological properties of structural brain networks in 53 children: 8 ASD children with DCD (DCD+ASD), 15 ASD children without DCD (ASD), 11 with DCD only, and 19 typically developing (TD) children. We constructed separate structural correlation networks based on cortical thickness derived from Freesurfer. The children were assessed on the Movement-ABC and the Beery Test of Visual Motor Integration. Behavioral results demonstrated that the DCD group and DCD+ASD group scored on average poorer than the TD and ASD groups on various motor measures. Furthermore, although the brain networks of all groups exhibited small-world properties, the topological architecture of the networks was significantly altered in children with ASD compared with DCD and TD. ASD children showed increased normalized path length and higher values of clustering coefficient. Also, paralimbic regions exhibited nodal clustering coefficient alterations in singular disorders. These changes were disorder-specific, and included alterations in clustering coefficient in the isthmus of the right cingulate gyrus and the pars orbitalis of the right inferior frontal gyrus in ASD children, and DCD-related increases in the lateral orbitofrontal cortex. Children meeting criteria for both DCD and ASD exhibited topological changes that were more widespread from those seen in children with only DCD, i.e. children with DCD+ASD showed alterations of clustering coefficient in (para)limbic regions, primary areas, and association areas. The DCD+ASD group showed changes in clustering coefficient in the left association cortex relative to the ASD group. Finally, the DCD+ASD group shared ASD-specific abnormalities in the pars orbitalis of right inferior frontal gyrus, which was hypothesized to reflect atypical emotional-cognitive processing. Our results provide evidence that DCD and ASD are neurodevelopmental disorders with a low degree of overlap in abnormalities in connectivity. The co-occurrence of DCD+ASD was also associated with a distinct topological pattern, highlighting the unique neural signature of comorbid neurodevelopmental disorders. © 2016 John Wiley & Sons Ltd.

Diabetic cognitive dysfunction is associated with increased bile acids in liver and activation of bile acid signaling in intestine.

PubMed

Wang, Xue; Wang, Fangyu; Zhang, Yidan; Xiong, Hui; Zhang, Yanjun; Zhuang, Pengwei; Zhang, Youcai

2018-05-01

Impaired regulation of bile acid (BA) homeostasis has been suggested to be associated with adverse metabolic consequences. However, whether BA homeostasis is altered in diabetes-induced cognitive dysfunction (DCD) remains unknown. In the present study, mice were divided into four groups, namely normal control (NC) group, high-fat diet (HFD) group, diabetes without cognitive dysfunction (unDCD) group, and DCD group. Compared to HFD mice, the concentration of total BAs in liver was higher in unDCD and DCD mice, due to increased intestinal BA absorption. DCD mice tended to have higher BA concentrations in both liver and ileum than unDCD mice. Consequently, DCD mice had increased basolateral BA efflux (Ostα, Ostβ, and Mrp4) and decreased BA synthesis (Cyp7a1, Cyp8b1, and Cyp7b1) in the liver as well as activated Fxr-Fgf15 signaling in the ileum. DCD mice also had increased BA hydroxylation (Cyp3a11) and BA sulfation (Sult2a1) in the liver compared to HFD mice. Furthermore, the bacterial community composition was altered in the cecum of DCD mice, characterized with a marked increase in Defferribacteres and Candidatus Saccharibacteria. In summary, the present study provides the first comprehensive analysis of BA homeostasis in DCD mice, and revealed a potential role of BAs in DCD development. Copyright © 2018 Elsevier B.V. All rights reserved.

Epigenetic modification of the PD-1 (Pdcd1) promoter in effector CD4+ T cells tolerized by peptide immunotherapy

PubMed Central

McPherson, Rhoanne C; Konkel, Joanne E; Prendergast, Catriona T; Thomson, John P; Ottaviano, Raffaele; Leech, Melanie D; Kay, Oliver; Zandee, Stephanie E J; Sweenie, Claire H; Wraith, David C; Meehan, Richard R; Drake, Amanda J; Anderton, Stephen M

2014-01-01

Clinically effective antigen-based immunotherapy must silence antigen-experienced effector T cells (Teff) driving ongoing immune pathology. Using CD4+ autoimmune Teff cells, we demonstrate that peptide immunotherapy (PIT) is strictly dependent upon sustained T cell expression of the co-inhibitory molecule PD-1. We found high levels of 5-hydroxymethylcytosine (5hmC) at the PD-1 (Pdcd1) promoter of non-tolerant T cells. 5hmC was lost in response to PIT, with DNA hypomethylation of the promoter. We identified dynamic changes in expression of the genes encoding the Ten-Eleven-Translocation (TET) proteins that are associated with the oxidative conversion 5-methylcytosine and 5hmC, during cytosine demethylation. We describe a model whereby promoter demethylation requires the co-incident expression of permissive histone modifications at the Pdcd1 promoter together with TET availability. This combination was only seen in tolerant Teff cells following PIT, but not in Teff that transiently express PD-1. Epigenetic changes at the Pdcd1 locus therefore determine the tolerizing potential of TCR-ligation. DOI: http://dx.doi.org/10.7554/eLife.03416.001 PMID:25546306

Mathematical problems in children with developmental coordination disorder.

PubMed

Pieters, Stefanie; Desoete, Annemie; Van Waelvelde, Hilde; Vanderswalmen, Ruth; Roeyers, Herbert

2012-01-01

Developmental coordination disorder (DCD) is a heterogeneous disorder, which is often co-morbid with learning disabilities. However, mathematical problems have rarely been studied in DCD. The aim of this study was to investigate the mathematical problems in children with various degrees of motor problems. Specifically, this study explored if the development of mathematical skills in children with DCD is delayed or deficient. Children with DCD performed significantly worse for number fact retrieval and procedural calculation in comparison with age-matched control children. Moreover, children with mild DCD differed significantly from children with severe DCD on both number fact retrieval and procedural calculation. In addition, we found a developmental delay of 1 year for number fact retrieval in children with mild DCD and a developmental delay of 2 years in children with severe DCD. No evidence for a mathematical deficit was found. Diagnostic implications are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Confirmed Transmission of Bacterial or Fungal Infection to Kidney Transplant Recipients from Donated After Cardiac Death (DCD) Donors in China: A Single-Center Analysis.

PubMed

Wan, Qiquan; Liu, Huanmiao; Ye, Shaojun; Ye, Qifa

2017-08-03

BACKGROUND We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. MATERIAL AND METHODS Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections. RESULTS Seven of 154 (4.5%) kidney recipients developed confirmed donor-derived bacterial or fungal infections. Inappropriate use of antibiotics in donor was a risk factor for donor-derived infection (p=0.048). The use of FK506 was more frequent in recipients without donor-derived infection than those with donor-derived infection (p=0.033). Recipients with donor-derived infection were associated with higher mortality and graft loss (42.9% and 28.6%, respectively), when compared with those without donor-derived infection (4.8% each). Three kidney recipients with donor-derived infection died; one death was due to multi-organ failure caused by Candida albicans, and two were related to rupture of the renal artery; two of them did not receive appropriate antimicrobial therapy after infection. CONCLUSIONS Our kidney recipients showed high occurrence rates of donor-derived infection. Recipients with donor-derived infection were associated with higher mortality and graft loss than those without donor-derived infection. The majority of recipients with donor-derived infection who died did not receive appropriate antimicrobial therapy after infection.

An International Comparison of the Effect of Policy Shifts to Organ Donation following Cardiocirculatory Death (DCD) on Donation Rates after Brain Death (DBD) and Transplantation Rates

PubMed Central

Bendorf, Aric; Kelly, Patrick J.; Kerridge, Ian H.; McCaughan, Geoffrey W.; Myerson, Brian; Stewart, Cameron; Pussell, Bruce A.

2013-01-01

During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD) in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD) donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD) and DBD rates, we analyzed deceased donation rates from 82 countries from 2000–2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01). Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp) increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; p<0.0001). We also found that the number of organs transplanted per donor was significantly lower in DCD when compared to DBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; p<0.001). Whilst the results do not infer a causal relationship between increased DCD and decreased DBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed. PMID:23667452

An international comparison of the effect of policy shifts to organ donation following cardiocirculatory death (DCD) on donation rates after brain death (DBD) and transplantation rates.

PubMed

Bendorf, Aric; Kelly, Patrick J; Kerridge, Ian H; McCaughan, Geoffrey W; Myerson, Brian; Stewart, Cameron; Pussell, Bruce A

2013-01-01

During the past decade an increasing number of countries have adopted policies that emphasize donation after cardiocirculatory death (DCD) in an attempt to address the widening gap between the demand for transplantable organs and the availability of organs from donation after brain death (DBD) donors. In order to examine how these policy shifts have affected overall deceased organ donor (DD) and DBD rates, we analyzed deceased donation rates from 82 countries from 2000-2010. On average, overall DD, DBD and DCD rates have increased over time, with the proportion of DCD increasing 0.3% per year (p = 0.01). Countries with higher DCD rates have, on average, lower DBD rates. For every one-per million population (pmp) increase in the DCD rate, the average DBD rate decreased by 1.02 pmp (95% CI: 0.73, 1.32; p<0.0001). We also found that the number of organs transplanted per donor was significantly lower in DCD when compared to DBD donors with 1.51 less transplants per DCD compared to DBD (95% CI: 1.23, 1.79; p<0.001). Whilst the results do not infer a causal relationship between increased DCD and decreased DBD rates, the significant correlation between higher DCD and lower DBD rates coupled with the reduced number of organs transplanted per DCD donor suggests that a national policy focus on DCD may lead to an overall reduction in the number of transplants performed.

Health-related quality of life and peer relationships in adolescents with developmental coordination disorder and attention-deficit-hyperactivity disorder.

PubMed

Dewey, Deborah; Volkovinskaia, Anna

2018-07-01

Health-related quality of life (HRQoL) and peer relationships were investigated in adolescents with developmental coordination disorder (DCD) and attention-deficit-hyperactivity disorder (ADHD). Adolescents with DCD (n=9), ADHD (n=9), DCD and ADHD (n=10), and typically developing adolescents (n=16) completed the following questionnaires: KIDSCREEN-52 Health-Related Quality of Life Questionnaire and Peer Relations Questionnaire for Children. Twenty-five participants took part in semi-structured interviews. Adolescents with DCD and ADHD had lower HRQoL on the mood and emotions, school environment, and financial resources scales of the KIDSCREEN-52 than adolescents in the DCD and typically developing groups (all p<0.05). On the Peer Relations Questionnaire for Children, the DCD and ADHD group reported significantly higher victimization compared with those in the typically developing (p=0.030) and DCD (p=0.010) groups. Qualitative interviews among young people with DCD and ADHD revealed feelings of marginalization and victimization. Descriptors such as 'misfits', 'oddballs', 'weird', and 'the rejects' were used to describe themselves. HRQoL and peer relationships are negatively affected in adolescents with DCD and ADHD. WHAT THIS PAPER ADDS?: Children with developmental coordination disorder (DCD) do not display poorer overall health-related quality of life (HRQoL) versus typically developing controls. Having DCD and attention-deficit-hyperactivity disorder (ADHD) was associated with poorer HRQoL. Adolescents with DCD and ADHD experience significantly higher levels of peer victimization than typically developing adolescents. HRQoL and peer relationships are significantly associated in adolescent respondents. © 2018 Mac Keith Press.

Graphomotor skills in children with developmental coordination disorder (DCD): Handwriting and learning a new letter.

PubMed

Huau, Andréa; Velay, Jean-Luc; Jover, Marianne

2015-08-01

The aim of the present study was to analyze handwriting difficulties in children with developmental coordination disorder (DCD) and investigate the hypothesis that a deficit in procedural learning could help to explain them. The experimental set-up was designed to compare the performances of children with DCD with those of a non-DCD group on tasks that rely on motor learning in different ways, namely handwriting and learning a new letter. Ten children with DCD and 10 non-DCD children, aged 8-10 years, were asked to perform handwriting tasks (letter/word/sentence; normal/fast), and a learning task (new letter) on a graphic tablet. The BHK concise assessment scale for children's handwriting was used to evaluate their handwriting quality. Results showed that both the handwriting and learning tasks differentiated between the groups. Furthermore, when speed or length constraints were added, handwriting was more impaired in children with DCD than in non-DCD children. Greater intra-individual variability was observed in the group of children with DCD, arguing in favor of a deficit in motor pattern stabilization. The results of this study could support both the hypothesis of a deficit in procedural learning and the hypothesis of neuromotor noise in DCD. Copyright © 2015 Elsevier B.V. All rights reserved.

Organ donation after cardiac death in the Middle East.

PubMed

Faraj, W; Fakih, H; Mukherji, D; Khalife, M

2010-04-01

The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool: living donors, split livers, domino livers, and organs from donations after cardiac death (DCD). The purpose of this article was to focus upon aspects of DCD application in the religious, traditional, ethical, and legal aspects of the Arab world. DCD can increase the donor pool by 15%-25%. Several ethical, legal, and social concerns need to be addressed to make DCD more widely accepted by the general population in Western countries as well as in the Middle East. Organs from DCD donors have been transplanted since the 1960s. As soon as brain death criteria were published in 1968, organ retrieval from cadaveric heart-beating donors predominated. Donation after brain death (DBD) almost completely replaced DCD. In the 1990s, the organ shortage led to DCD in many countries, but not in the Arab world. DCD is still not accepted by most in the Arab world due to religious, ethical, social, and legal issues. DCD in the Arab world is more complicated than in Western countries. It should be re-evaluated and thoroughly reviewed with the new criteria for DCD and its implementation in our region. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Clinical outcomes and quality of life in recipients of livers donated after cardiac death.

PubMed

Parikh, Neehar D; Skaro, Anton I; Ladner, Daniela P; Lyuksemburg, Vadim; Cahan, Joshua G; Daud, Amna; Butt, Zeeshan

2015-01-01

Donation after cardiac death (DCD) has expanded in the last decade in the US; however, DCD liver utilization has flattened in recent years due to poor outcomes. We examined clinical and quality of life (QOL) outcomes of DCD recipients by conducting a retrospective and cross-sectional review of patients from 2003 to 2010. We compared clinical outcomes of DCD recipients (n = 60) to those of donation after brain death (DBD) liver recipients (n = 669) during the same time period. DCD recipients had significantly lower rates of 5-year graft survival (P < 0.001) and a trend toward lower rates of 5-year patient survival (P = 0.064) when compared to the DBD cohort. In order to examine QOL outcomes in our cohorts, we administered the Short Form Liver Disease Quality of Life questionnaire to 30 DCD and 60 DBD recipients. The DCD recipients reported lower generic and liver-specific QOL. We further stratified the DCD cohort by the presence of ischemic cholangiopathy (IC). Patients with IC reported lower QOL when compared to DBD recipients and those DCD recipients without IC (P < 0.05). While the results are consistent with clinical experience, this is the first report of QOL in DCD recipients using standardized measures. These data can be used to guide future comparative effectiveness studies.

Development of hybrid fog detection algorithm (FDA) using satellite and ground observation data for nighttime

NASA Astrophysics Data System (ADS)

Kim, So-Hyeong; Han, Ji-Hae; Suh, Myoung-Seok

2017-04-01

In this study, we developed a hybrid fog detection algorithm (FDA) using AHI/Himawari-8 satellite and ground observation data for nighttime. In order to detect fog at nighttime, Dual Channel Difference (DCD) method based on the emissivity difference between SWIR and IR1 is most widely used. DCD is good at discriminating fog from other things (middle/high clouds, clear sea and land). However, it is difficult to distinguish fog from low clouds. In order to separate the low clouds from the pixels that satisfy the thresholds of fog in the DCD test, we conducted supplementary tests such as normalized local standard derivation (NLSD) of BT11 and the difference of fog top temperature (BT11) and air temperature (Ta) from NWP data (SST from OSTIA data). These tests are based on the larger homogeneity of fog top than low cloud tops and the similarity of fog top temperature and Ta (SST). Threshold values for the three tests were optimized through ROC analysis for the selected fog cases. In addition, considering the spatial continuity of fog, post-processing was performed to detect the missed pixels, in particular, at edge of fog or sub-pixel size fog. The final fog detection results are presented by fog probability (0 100 %). Validation was conducted by comparing fog detection probability with the ground observed visibility data from KMA. The validation results showed that POD and FAR are ranged from 0.70 0.94 and 0.45 0.72, respectively. The quantitative validation and visual inspection indicate that current FDA has a tendency to over-detect the fog. So, more works which reducing the FAR is needed. In the future, we will also validate sea fog using CALIPSO data.

Biliary complications after liver transplantation from donation after cardiac death donors: an analysis of risk factors and long-term outcomes from a single center.

PubMed

Foley, David P; Fernandez, Luis A; Leverson, Glen; Anderson, Michael; Mezrich, Joshua; Sollinger, Hans W; D'Alessandro, Anthony

2011-04-01

This study evaluates the long-term outcomes, biliary complication rates, and risk factors for biliary complications after liver transplantation from "donation after cardiac death" (DCD) donors. Recent enthusiasm toward increased use of DCD donors' livers is mitigated by high biliary complication rates. Predictive risk factors for the development of biliary complications after DCD liver transplantation remain incompletely defined. We performed a retrospective review of 1157 "donation after brain death" (DBD) and 87 DCD liver transplants performed between January 1, 1993, and December 31, 2008. Patient and graft survivals and complication rates within the first year of transplantation were compared between DBD and DCD groups. Cox proportional hazards models were used to assess the influence of potential risk factors. Patient survival was significantly lower in the DCD group compared with the DBD group at 1, 5, 10, and 15 years (DCD: 84%, 68%, 54%, and 54% vs DBD: 91%, 81%, 67%, and 58%; P < 0.01). Graft survival was also significantly lower in the DCD group compared with the DBD group at 1, 5, 10, and 15 years (DCD: 69%, 56%, 43%, 43% vs DBD: 86%, 76%, 60%, 51%; P < 0.001). Rates of overall biliary complications (OBC) (DCD: 47% vs DBD: 26%; P < 0.01) and ischemic cholangiopathy (IC) (DCD: 34% vs DBD: 1%; P < 0.01) were significantly higher in the DCD group. Donor age [hazard ratio (HR): 1.04; P < 0.01] and donor age greater than 40 years (HR: 3.13; P < 0.01) were significant risk factors for the development of OBC. Multivariate analysis revealed that cold ischemic time (CIT) greater than 8 hours (HR: 2.46; P = 0.05) and donor age greater than 40 years (HR: 2.90; P < 0.01) significantly increased the risk of IC. Long-term patient and graft survival after DCD liver transplantation remain significantly lower but acceptable when compared with DBD liver transplantations. Donor age and CIT greater than 8 hours are the strongest predictors for the development of IC. Careful selection of younger DCD donors and minimization of CIT may limit the incidence of severe biliary complications and improve the successful utilization of DCD donors' livers.

Biliary Complications after Liver Transplantation from Donation after Cardiac Death Donors: An Analysis of Risk Factors and Long Term Outcomes from a Single Center

PubMed Central

Foley, David P.; Fernandez, Luis A.; Leverson, Glen; Anderson, Michael; Mezrich, Joshua; Sollinger, Hans W.; D’Alessandro, Anthony

2011-01-01

Objective This study evaluates the long-term outcomes, biliary complication rates, and risk factors for biliary complications after liver transplantation from donation after cardiac death (DCD) donors. Summary Background Data Recent enthusiasm toward increased use of DCD donor livers is mitigated by high biliary complication rates. Predictive risk factors for the development of biliary complications after DCD liver transplantation remain incompletely defined. Methods We performed a retrospective review of 1157 donation after brain death (DBD) and 87 DCD liver transplants performed between January 1, 1993 and December 31, 2008. Patient and graft survivals, and complication rates within the first year of transplantation were compared between DBD and DCD groups. Cox proportional hazards models were used to assess the influence of potential risk factors. Results Patient survival was significantly lower in the DCD group compared to the DBD group at 1, 5, 10 and 15 years (DCD: 84%, 68%, 54%, 54% vs. DBD: 91%, 81%, 67%, 58%, p<0.01). Graft survival was also significantly lower in the DCD group compared to the DBD group at 1, 5, 10 and 15 years (DCD: 69%, 56%, 43%, 43% vs. DBD: 86%, 76%, 60%, 51%, p<0.001). Rates of overall biliary complications (OBC) (DCD: 47% vs. DBD: 26%, p<0.01) and ischemic cholangiopathy (IC) (DCD: 34% vs. DBD: 1%, p<0.01) were significantly higher in the DCD group. Donor age (HR: 1.04, p<0.01) and donor age >40 years (HR: 3.13, p < 0.01) were significant risk factors for the development of OBC. Multivariate analysis revealed cold ischemic time (CIT) >8 hours (HR: 2.46, p=0.05), donor age >40 (HR: 2.90, p< 0.01) significantly increased the risk of IC. Conclusions Long-term patient and graft survival after DCD liver transplantation remain significantly lower but acceptable when compared to DBD liver transplants. Donor age and CIT >8 hours are the strongest predictors for the development of ischemic cholangiopathy. Careful selection of younger DCD donors and minimizing CIT may limit the incidence of severe biliary complications and improve the successful utilization of DCD donor livers. PMID:21475025

Is auditory perceptual timing a core deficit of developmental coordination disorder?

PubMed

Trainor, Laurel J; Chang, Andrew; Cairney, John; Li, Yao-Chuen

2018-05-09

Time is an essential dimension for perceiving and processing auditory events, and for planning and producing motor behaviors. Developmental coordination disorder (DCD) is a neurodevelopmental disorder affecting 5-6% of children that is characterized by deficits in motor skills. Studies show that children with DCD have motor timing and sensorimotor timing deficits. We suggest that auditory perceptual timing deficits may also be core characteristics of DCD. This idea is consistent with evidence from several domains, (1) motor-related brain regions are often involved in auditory timing process; (2) DCD has high comorbidity with dyslexia and attention deficit hyperactivity, which are known to be associated with auditory timing deficits; (3) a few studies report deficits in auditory-motor timing among children with DCD; and (4) our preliminary behavioral and neuroimaging results show that children with DCD at age 6 and 7 have deficits in auditory time discrimination compared to typically developing children. We propose directions for investigating auditory perceptual timing processing in DCD that use various behavioral and neuroimaging approaches. From a clinical perspective, research findings can potentially benefit our understanding of the etiology of DCD, identify early biomarkers of DCD, and can be used to develop evidence-based interventions for DCD involving auditory-motor training. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

Organ Donation After Circulatory Death: Ethical Issues and International Practices.

PubMed

Jericho, Barbara G

2018-05-21

Donation after circulatory death (DCD) is an increasingly utilized practice that can contribute to reducing the difference between the supply of organs and the demand for organs for transplantation. As the number of transplanted organs from DCD donors continues to increase, there is an essential need to address the ethical aspects of DCD in institutional DCD protocols and clinical practice. Ethical issues of respecting the end-of-life wishes of a potential donor, respecting a recipient's wishes, and addressing potential conflicts of interest are important considerations in developing policies and procedures for DCD programs. Although there may be diversity among DCD programs in Europe, Australia, Israel, China, the United States, and Canada, addressing ethical considerations in these DCD programs is essential to respect donors and recipients during the altruistic and generous act of organ donation.

The Impact of Ischemia/Reperfusion Injury on Liver Allografts from Deceased after Cardiac Death versus Deceased after Brain Death Donors.

PubMed

Xu, Jin; Sayed, Blayne Amir; Casas-Ferreira, Ana Maria; Srinivasan, Parthi; Heaton, Nigel; Rela, Mohammed; Ma, Yun; Fuggle, Susan; Legido-Quigley, Cristina; Jassem, Wayel

2016-01-01

The shortage of organs for transplantation has led to increased use of organs procured from donors after cardiac death (DCD). The effects of cardiac death on the liver remain poorly understood, however. Using livers obtained from DCD versus donors after brain death (DBD), we aimed to understand how ischemia/reperfusion (I/R) injury alters expression of pro-inflammatory markers ceramides and influences graft leukocyte infiltration. Hepatocyte inflammation, as assessed by ceramide expression, was evaluated in DCD (n = 13) and DBD (n = 10) livers. Allograft expression of inflammatory and cell death markers, and allograft leukocyte infiltration were evaluated from a contemporaneous independent cohort of DCD (n = 22) and DBD (n = 13) livers. When examining the differences between transplant stages in each group, C18, C20, C24 ceramides showed significant difference in DBD (p<0.05) and C22 ceramide (p<0.05) were more pronounced for DCD. C18 ceramide is correlated to bilirubin, INR, and creatinine after transplant in DCD. Prior to transplantation, DCD livers have reduced leukocyte infiltration compared to DBD allografts. Following reperfusion, the neutrophil infiltration and platelet deposition was less prevalent in DCD grafts while cell death and recipients levels of serum aspartate aminotransferase (AST) of DCD allografts had significantly increased. These data suggest that I/R injury generate necrosis in the absence of a strong inflammatory response in DCD livers with an appreciable effect on early graft function. The long-term consequences of increased inflammation in DBD and increased cell death in DCD allografts are unknown and warrant further investigation.

A Prospective Cohort Study Comparing Workload in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Rivilis, Irina; Liu, Jian; Cairney, John; Hay, John A.; Klentrou, Panagiota; Faught, Brent E.

2012-01-01

The purpose of this prospective cohort study was to assess how cardiorespiratory fitness (CRF) of children with probable developmental coordination disorder (DCD) changes over a period of 4.7 years relative to a group of typically developing controls. A school-based sample of children in a large region of Ontario, Canada with 75 out of a possible…

10 CFR Appendix A to Part 52 - Design Certification Rule for the U.S. Advanced Boiling Water Reactor

Code of Federal Regulations, 2012 CFR

2012-01-01

...) of 10 CFR 50.34—Post-Accident Sampling for Boron, Chloride, and Dissolved Gases; and 3. Paragraph (f... affecting resolution of an ex-vessel severe accident design feature identified in the plant-specific DCD, requires a license amendment if: (1) There is a substantial increase in the probability of an ex-vessel...

Lack of association of programmed cell death 1 gene (PDCD1) polymorphisms with susceptibility to chronic urticaria in patients with positive autologous serum skin test.

PubMed

Brzoza, Z; Grzeszczak, W; Trautsolt, W; Moczulski, D

2012-01-01

Autoimmune mechanisms play an important role in the pathophysiology of chronic urticaria (CU), and the autologous serum skin test (ASST) helps to identify patients with autoreactive CU. One of the factors involved in autoreactive mechanisms is the cell surface receptor programmed death-1 which is encoded by the programmed cell death 1 gene (PDCD1). To investigate whether PDCD1 polymorphisms influence susceptibility to CU. We enrolled 93 ASST-positive patients with CU and a control group consisting of 105 healthy volunteers. In all individuals, PD1.3 (7146 A/G; rs 11568821) and PD1.5 (7785 C/T; rs 2227981) polymorphisms were analyzed. No statistically significant differences were found between CU patients and controls for allele or genotype distribution. We also did not observe any association between PDCD1 genotypes and severity of urticaria or age of disease onset. PD1.3 and PD1.5 polymorphisms were not proven to be implicated in susceptibility to ASST-positive CU in the Polish population. A more comprehensive analysis of the 2q33-2q37 genomic region might reveal whether variants of 1 or more of the genes in this region are involved in susceptibility to CU.

SATB1 Expression Governs Epigenetic Repression of PD-1 in Tumor-Reactive T Cells.

PubMed

Stephen, Tom L; Payne, Kyle K; Chaurio, Ricardo A; Allegrezza, Michael J; Zhu, Hengrui; Perez-Sanz, Jairo; Perales-Puchalt, Alfredo; Nguyen, Jenny M; Vara-Ailor, Ana E; Eruslanov, Evgeniy B; Borowsky, Mark E; Zhang, Rugang; Laufer, Terri M; Conejo-Garcia, Jose R

2017-01-17

Despite the importance of programmed cell death-1 (PD-1) in inhibiting T cell effector activity, the mechanisms regulating its expression remain poorly defined. We found that the chromatin organizer special AT-rich sequence-binding protein-1 (Satb1) restrains PD-1 expression induced upon T cell activation by recruiting a nucleosome remodeling deacetylase (NuRD) complex to Pdcd1 regulatory regions. Satb1 deficienct T cells exhibited a 40-fold increase in PD-1 expression. Tumor-derived transforming growth factor β (Tgf-β) decreased Satb1 expression through binding of Smad proteins to the Satb1 promoter. Smad proteins also competed with the Satb1-NuRD complex for binding to Pdcd1 enhancers, releasing Pdcd1 expression from Satb1-mediated repression, Satb1-deficient tumor-reactive T cells lost effector activity more rapidly than wild-type lymphocytes at tumor beds expressing PD-1 ligand (CD274), and these differences were abrogated by sustained CD274 blockade. Our findings suggest that Satb1 functions to prevent premature T cell exhaustion by regulating Pdcd1 expression upon T cell activation. Dysregulation of this pathway in tumor-infiltrating T cells results in diminished anti-tumor immunity. Copyright © 2017 Elsevier Inc. All rights reserved.

Confirmed Transmission of Bacterial or Fungal Infection to Kidney Transplant Recipients from Donated After Cardiac Death (DCD) Donors in China: A Single-Center Analysis

PubMed Central

Wan, Qiquan; Liu, Huanmiao; Ye, Shaojun; Ye, Qifa

2017-01-01

Background We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. Material/Methods Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections. Results Seven of 154 (4.5%) kidney recipients developed confirmed donor-derived bacterial or fungal infections. Inappropriate use of antibiotics in donor was a risk factor for donor-derived infection (p=0.048). The use of FK506 was more frequent in recipients without donor-derived infection than those with donor-derived infection (p=0.033). Recipients with donor-derived infection were associated with higher mortality and graft loss (42.9% and 28.6%, respectively), when compared with those without donor-derived infection (4.8% each). Three kidney recipients with donor-derived infection died; one death was due to multi-organ failure caused by Candida albicans, and two were related to rupture of the renal artery; two of them did not receive appropriate antimicrobial therapy after infection. Conclusions Our kidney recipients showed high occurrence rates of donor-derived infection. Recipients with donor-derived infection were associated with higher mortality and graft loss than those without donor-derived infection. The majority of recipients with donor-derived infection who died did not receive appropriate antimicrobial therapy after infection. PMID:28771455

Increasing organ donation after cardiac death in trauma patients.

PubMed

Joseph, Bellal; Khalil, Mazhar; Pandit, Viraj; Orouji Jokar, Tahereh; Cheaito, Ali; Kulvatunyou, Narong; Tang, Andrew; O'Keeffe, Terence; Vercruysse, Gary; Green, Donald J; Friese, Randall S; Rhee, Peter

2015-09-01

Organ donation after cardiac death (DCD) is not optimal but still remains a valuable source of organ donation in trauma donors. The aim of this study was to assess national trends in DCD from trauma patients. A 12-year (2002 to 2013) retrospective analysis of the United Network for Organ Sharing database was performed. Outcome measures were the following: proportion of DCD donors over the years and number and type of solid organs donated. DCD resulted in procurement of 16,248 solid organs from 8,724 donors. The number of organs donated per donor remained unchanged over the study period (P = .1). DCD increased significantly from 3.1% in 2002 to 14.6% in 2013 (P = .001). There was a significant increase in the proportion of kidney (2002: 3.4% vs 2013: 16.3%, P = .001) and liver (2002: 1.6% vs 2013: 5%, P = .041) donation among DCD donors over the study period. DCD from trauma donors provides a significant source of solid organs. The proportion of DCD donors increased significantly over the last 12 years. Copyright © 2015 Elsevier Inc. All rights reserved.

Controversy and consensus on pediatric donation after cardiac death: ethical issues and institutional process.

PubMed

Harrison, C H; Laussen, P C

2008-05-01

Donation after cardiac death (DCD) remains controversial in some pediatric institutions. An evidence-based, consensus-building approach to setting institutional policy about DCD can address the controversy openly and identify common ground. To resolve an extended internal debate regarding DCD policy at Children's Hospital Boston, a multidisciplinary task force was commissioned to engage in fact finding and deliberations about clinical and ethical issues in pediatric DCD, and attempt to reach consensus regarding the development of a protocol for pediatric DCD. Issues examined included values and attitudes of staff, families, and the public; number of possible candidates for DCD at the hospital; risks and benefits for child donors and their families; and research needs. Consensus was reached on a set of foundational ethical principles for pediatric DCD. With assistance from the local organ procurement organization (OPO), the task force developed a protocol for pediatric kidney DCD which most members believed could meet all the requirements of the foundational ethical principles. Complete consensus on the use of the protocol was not reached; however, almost all members supported initiation of kidney DCD for older pediatric patients who had wished to be organ donors. The hospital has implemented the protocol on this limited basis and established a process for considering proposals to expand the eligible donor population and include other organs.

Attention during functional tasks is associated with motor performance in children with developmental coordination disorder

PubMed Central

Fong, Shirley S.M.; Chung, Joanne W.Y.; Cheng, Yoyo T.Y.; Yam, Timothy T.T.; Chiu, Hsiu-Ching; Fong, Daniel Y.T.; Cheung, C.Y.; Yuen, Lily; Yu, Esther Y.T.; Hung, Yeung Sam; Macfarlane, Duncan J.; Ng, Shamay S.M.

2016-01-01

Abstract This cross-sectional and exploratory study aimed to compare motor performance and electroencephalographic (EEG) attention levels in children with developmental coordination disorder (DCD) and those with typical development, and determine the relationship between motor performance and the real-time EEG attention level in children with DCD. Eighty-six children with DCD [DCD: n = 57; DCD and attention deficit hyperactivity disorder (ADHD): n = 29] and 99 children with typical development were recruited. Their motor performance was assessed with the Movement Assessment Battery for Children (MABC) and attention during the tasks of the MABC was evaluated by EEG. All children with DCD had higher MABC impairment scores and lower EEG attention scores than their peers (P < 0.05). After accounting for age, sex, body mass index, and physical activity level, the attention index remained significantly associated with the MABC total impairment score and explained 14.1% of the variance in children who had DCD but not ADHD (P = 0.009) and 17.5% of the variance in children with both DCD and ADHD (P = 0.007). Children with DCD had poorer motor performance and were less attentive to movements than their peers. Their poor motor performance may be explained by inattention. PMID:27631272

Perceived athletic competence and physical activity in children with developmental coordination disorder who are clinically referred, and control children.

PubMed

Noordstar, Johannes J; Stuive, Ilse; Herweijer, Hester; Holty, Lian; Oudenampsen, Chantal; Schoemaker, Marina M; Reinders-Messelink, Heleen A

2014-12-01

The relationship between perceived athletic competence (PAC) and physical activity (PA) in children with developmental coordination disorder (DCD) is still unclear. This study investigated differences in PAC and PA between, and within, a group of children with DCD that were clinically referred (n = 31) and a group of control children (n = 38), aged 7-12 years. All children were categorized in four groups: (1) children with DCD/low PAC, (2) children with DCD/normal to high PAC, (3) control children/low PAC, and (4) control children/normal to high PAC. PAC was assessed with the Self-Perception Profile for Children, and PA was assessed with the Modifiable Activity Questionnaire. Children with DCD participated less in unorganized PA, but not in organized PA, compared with control children. Normal to high PAC was found in more than half of the children (64.5%) with DCD. Children with DCD/low PAC and children with DCD/normal to high PAC participated significantly less in unorganized physical activity compared with control children/normal to high PAC, but not compared with control children/low PAC. The results indicate that there are large individual differences in PAC in children with DCD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Donation after cardiac death: a 29-year experience.

PubMed

Bellingham, Janet M; Santhanakrishnan, Chandrasekar; Neidlinger, Nikole; Wai, Philip; Kim, Jim; Niederhaus, Silke; Leverson, Glen E; Fernandez, Luis A; Foley, David P; Mezrich, Joshua D; Odorico, Jon S; Love, Robert B; De Oliveira, Nilto; Sollinger, Hans W; D'Alessandro, Anthony M

2011-10-01

To report the long-term outcomes of 1218 organs transplanted from donation after cardiac death (DCD) donors from January 1980 through December 2008. One-thousand two-hundred-eighteen organs were transplanted into 1137 recipients from 577 DCD donors. This includes 1038 kidneys (RTX), 87 livers (LTX), 72 pancreas (PTX), and 21 DCD lungs. The outcomes were compared with 3470 RTX, 1157 LTX, 903 PTX, and 409 lung transplants from donors after brain death (DBD). Both patient and graft survival is comparable between DBD and DCD transplant recipients for kidney, pancreas, and lung after 1, 3, and 10 years. Our findings reveal a significant difference for patient and graft survival of DCD livers at each of these time points. In contrast to the overall kidney transplant experience, the most recent 16-year period (n = 396 DCD and 1,937 DBD) revealed no difference in patient and graft survival, rejection rates, or surgical complications but delayed graft function was higher (44.7% vs 22.0%; P < .001). In DCD LTX, biliary complications (51% vs 33.4%; P < .01) and retransplantation for ischemic cholangiopathy (13.9% vs 0.2%; P < .01) were increased. PTX recipients had no difference in surgical complications, rejection, and hemoglobin A1c levels. Surgical complications were equivalent between DCD and DBD lung recipients. This series represents the largest single center experience with more than 1000 DCD transplants and given the critical demand for organs, demonstrates successful kidney, pancreas, liver, and lung allografts from DCD donors. Copyright © 2011 Mosby, Inc. All rights reserved.

Endoscopic management of biliary complications following liver transplantation after donation from cardiac death donors.

PubMed

Croome, Kris P; McAlister, Vivian; Adams, Paul; Marotta, Paul; Wall, William; Hernandez-Alejandro, Roberto

2012-09-01

Previous studies have shown a higher incidence of biliary complications following donation after cardiac death (DCD) liver transplantation compared with donation after brain death (DBD) liver transplantation. The endoscopic management of ischemic type biliary strictures in patients who have undergone DCD liver transplants needs to be characterized further. A retrospective institutional review of all patients who underwent DCD liver transplant from January 2006 to September 2011 was performed. These patients were compared with all patients who underwent DBD liver transplantation in the same time period. A descriptive analysis of all DCD patients who developed biliary complications and their subsequent endoscopic management was also performed. Of the 36 patients who received DCD liver transplants, 25% developed biliary complications compared with 13% of patients who received DBD liver transplants (P=0.062). All DCD allograft recipients who developed biliary complications became symptomatic within three months of transplantation. Ischemic type biliary strictures in DCD allograft recipients included disseminated biliary strictures in two patients, biliary strictures of the hepatic duct bifurcation in three patients and biliary strictures of the donor common hepatic duct in three patients. There was a trend toward increasing incidence of total biliary complications in recipients of DCD liver allografts compared with those receiving DBD livers, and the rate of diffuse ischemic cholangiopathy was significantly higher. Focal ischemic type biliary strictures can be treated effectively in DCD liver transplant recipients with favourable results. Diffuse ischemic type biliary strictures in DCD liver transplant recipients ultimately requires retransplantation.

Use and Outcomes of Kidneys from Donation after Circulatory Death Donors in the United States.

PubMed

Gill, John; Rose, Caren; Lesage, Julie; Joffres, Yayuk; Gill, Jagbir; O'Connor, Kevin

2017-12-01

Donation after circulatory death (DCD) donors are an important source of kidneys for transplantation, but DCD donor transplantation is less common in the United States than in other countries. In this study of national data obtained between 2008 and 2015, recovery of DCD kidneys varied substantially among the country's 58 donor service areas, and 25% of DCD kidneys were recovered in only four donor service areas. Overall, 20% of recovered DCD kidneys were discarded, varying from 3% to 33% among donor service areas. Compared with kidneys from neurologically brain dead (NBD) donors, DCD kidneys had a higher adjusted odds ratio of discard that varied from 1.25 (95% confidence interval [95% CI], 1.16 to 1.34) in kidneys with total donor warm ischemic time (WIT) of 10-26 minutes to 2.67 (95% CI, 2.34 to 3.04) in kidneys with total donor WIT >48 minutes. Among the 12,831 DCD kidneys transplanted, kidneys with WIT≤48 minutes had survival similar to that of NBD kidneys. DCD kidneys with WIT>48 minutes had a higher risk of allograft failure (hazard ratio, 1.23; 95% CI, 1.07 to 1.41), but this risk was limited to kidneys with cold ischemia time (CIT) >12 hours. We conclude that donor service area-level variation in the recovery and discard of DCD kidneys is large. Additional national data collection is needed to understand the potential to increase DCD donor transplantation in the United States. Strategies to minimize cold ischemic injury may safely allow increased use of DCD kidneys with WIT>48 minutes. Copyright © 2017 by the American Society of Nephrology.

Effects of dicyandiamide and dolomite application on N2O emission from an acidic soil.

PubMed

Shaaban, Muhammad; Wu, Yupeng; Peng, Qi-an; Lin, Shan; Mo, Yongliang; Wu, Lei; Hu, Ronggui; Zhou, Wei

2016-04-01

Soil acidification is a major problem for sustainable agriculture since it limits productivity of several crops. Liming is usually adopted to ameliorate soil acidity that can trigger soil processes such as nitrification, denitrification, and loss of nitrogen (N) as nitrous oxide (N2O) emissions. The loss of N following liming of acidic soils can be controlled by nitrification inhibitors (such as dicyandiamide). However, effects of nitrification inhibitors following liming of acidic soils are not well understood so far. Here, we conducted a laboratory study using an acidic soil to examine the effects of dolomite and dicyandiamide (DCD) application on N2O emissions. Three levels of DCD (0, 10, and 20 mg kg(-1); DCD0, DCD10, and DCD20, respectively) were applied to the acidic soil under two levels of dolomite (0 and 1 g kg(-1)) which were further treated with two levels of N fertilizer (0 and 200 mg N kg(-1)). Results showed that N2O emissions were highest at low soil pH levels in fertilizer-treated soil without application of DCD and dolomite. Application of DCD and dolomite significantly (P ≤ 0.001) reduced N2O emissions through decreasing rates of NH4 (+)-N oxidation and increasing soil pH, respectively. Total N2O emissions were reduced by 44 and 13% in DCD20 and dolomite alone treatments, respectively, while DCD20 + dolomite reduced N2O emissions by 54% when compared with DCD0 treatment. The present study suggests that application of DCD and dolomite to acidic soils can mitigate N2O emissions.

The Impact of Ischemia/Reperfusion Injury on Liver Allografts from Deceased after Cardiac Death versus Deceased after Brain Death Donors

PubMed Central

Xu, Jin; Sayed, Blayne Amir; Casas-Ferreira, Ana Maria; Srinivasan, Parthi; Heaton, Nigel; Rela, Mohammed; Ma, Yun; Fuggle, Susan; Legido-Quigley, Cristina; Jassem, Wayel

2016-01-01

Background and aims The shortage of organs for transplantation has led to increased use of organs procured from donors after cardiac death (DCD). The effects of cardiac death on the liver remain poorly understood, however. Using livers obtained from DCD versus donors after brain death (DBD), we aimed to understand how ischemia/reperfusion (I/R) injury alters expression of pro-inflammatory markers ceramides and influences graft leukocyte infiltration. Methods Hepatocyte inflammation, as assessed by ceramide expression, was evaluated in DCD (n = 13) and DBD (n = 10) livers. Allograft expression of inflammatory and cell death markers, and allograft leukocyte infiltration were evaluated from a contemporaneous independent cohort of DCD (n = 22) and DBD (n = 13) livers. Results When examining the differences between transplant stages in each group, C18, C20, C24 ceramides showed significant difference in DBD (p<0.05) and C22 ceramide (p<0.05) were more pronounced for DCD. C18 ceramide is correlated to bilirubin, INR, and creatinine after transplant in DCD. Prior to transplantation, DCD livers have reduced leukocyte infiltration compared to DBD allografts. Following reperfusion, the neutrophil infiltration and platelet deposition was less prevalent in DCD grafts while cell death and recipients levels of serum aspartate aminotransferase (AST) of DCD allografts had significantly increased. Conclusion These data suggest that I/R injury generate necrosis in the absence of a strong inflammatory response in DCD livers with an appreciable effect on early graft function. The long-term consequences of increased inflammation in DBD and increased cell death in DCD allografts are unknown and warrant further investigation. PMID:26863224

Consent for donation after cardiac death: a survey of organ procurement organizations.

PubMed

Kalkbrenner, Kathy J; Hardart, George E

2012-01-01

Despite the increasing number of policies governing organ donation after cardiac death (DCD), nothing is presently known about the informed consent process for DCD. Without guidelines, organ procurement organizations (OPOs) are likely to structure the consent process similarly to that for organ donation after brain death (DBD), despite important ethical differences between the 2 modes of organ recovery. To describe informed consent practices used by OPOs for DCD. Cross-sectional, internet-based survey of the 58 OPOs in the United States. OPO policies and reported levels of physician participation in the consent process for DCD. Seventeen OPOs completed the survey (29%). Responders and nonresponders did not differ by DCD volume over the last year or last 5 years. None of the OPO's policies require physician involvement in obtaining written informed consent; 94% of policies require only the OPO representative to obtain written consent for DCD and 6% state that either the OPO representative or the treating physician may obtain consent; 71% of OPOs reported that discussions with family regarding DCD occur with the treating physician present less than 51% of the time and 82% indicated that the OPO representative is solely involved in obtaining consent for DCD in the majority of cases. A total of 24% of OPOs require physicians to participate in obtaining consent for procedures performed prior to death exclusively for organ preservation. No differences were found between the OPO consent practices for DCD and DBD. None of the OPOs responding to this survey have a policy requirement for physician involvement in obtaining consent for DCD. These findings raise questions about the role of physicians in DCD and how best to maintain a patient- and family-centered focus on care for patients at the end of life while supporting organ recovery efforts.

Midterm Results of Renal Transplantation From Controlled Cardiac Death Donors Are Similar to Those From Brain Death Donors.

PubMed

Lafuente, O; Sánchez-Sobrino, B; Pérez, M; López-Sánchez, P; Janeiro, D; Rubio, E; Huerta, A; Marques, M; Llópez-Carratala, M R; Rubio, J J; Portolés, J

2016-11-01

The systematic use of grafts from controlled donors after cardiac death (cDCD) started in our country in 2012 and expanded with the strategic support of National Transplant Organization. We present our experience in kidney transplantation with organs from cDCD donors with a mean follow-up of 3 years. Observational prospective study of all transplants performed in our center in 2012-2013 followed to 2016. The immunosuppression protocols were triple therapy for low-risk recipients from a standard brain death donor (DBD), adding basiliximab or thymoglobulin induction for extended-criteria donor or high-risk recipient, respectively, and thymoglobulin induction plus triple therapy for all cDCD recipients. A total of 42 donors were included (84 grafts in total, but 1 discarded due to multiple cysts); 25 DBD and 17 cDCD without differences in age or sex. The graft use rate was 98.9% for cDCD; 55 grafts were implanted in our hospital (26 DBD and 29 cDCD), and the remaining 28 grafts were transferred to other centers. There were no differences in primary failure (3.4% cDCD vs 7.4% DBD), but the cDCD organs had a higher incidence of delayed graft function (51.7% vs 25.9%). Despite that, graft and patient survivals, as well as glomerular filtration rate (66.3 vs 59.6 mL/min) were similar in both groups. Only 1 patient died at home with a functioning graft in the cDCD group. Despite a higher rate of delayed graft function with cDCD, the midterm outcomes are at least similar to those with DBD. The cDCD programs should be promoted to increase the chances of a transplant in our patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of donor age in liver transplantation from donation after circulatory death donors: A decade of experience at Cleveland Clinic.

PubMed

Firl, Daniel J; Hashimoto, Koji; O'Rourke, Colin; Diago-Uso, Teresa; Fujiki, Masato; Aucejo, Federico N; Quintini, Cristiano; Kelly, Dympna M; Miller, Charles M; Fung, John J; Eghtesad, Bijan

2015-12-01

The use of liver grafts from donation after circulatory death (DCD) donors remains controversial, particularly with donors of advanced age. This retrospective study investigated the impact of donor age in DCD liver transplantation. We examined 92 recipients who received DCD grafts and 92 matched recipients who received donation after brain death (DBD) grafts at Cleveland Clinic from January 2005 to June 2014. DCD grafts met stringent criteria to minimize risk factors in both donors and recipients. The 1-, 3-, and 5-year graft survival in DCD recipients was significantly inferior to that in DBD recipients (82%, 71%, 66% versus 92%, 87%, 85%, respectively; P = 0.03). Six DCD recipients (7%), but no DBD recipients, experienced ischemic-type biliary stricture (P = 0.01). However, the incidence of biliary stricture was not associated with donor age (P = 0.57). Interestingly, recipients receiving DCD grafts from donors who were <45 years of age (n = 55) showed similar graft survival rates compared to those receiving DCD grafts from donors who were ≥45 years of age (n = 37; 80%, 69%, 66% versus 83%, 72%, 66%, respectively; P = 0.67). Cox proportional hazards modeling in all study populations (n = 184) revealed advanced donor age (P = 0.05) and the use of a DCD graft (P = 0.03) as unfavorable factors for graft survival. Logistic regression analysis showed that the risk of DBD graft failure increased with increasing age, but the risk of DCD graft failure did not increase with increasing age (P = 0.13). In conclusion, these data suggest that stringent donor and recipient selection may ameliorate the negative impact of donor age in DCD liver transplantation. DCD grafts should not be discarded because of donor age, per se, and could help expand the donor pool for liver transplantation. © 2015 American Association for the Study of Liver Diseases.

Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent

PubMed Central

2011-01-01

Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: irreversibility of absent circulation has not occurred and the many attempts to claim it has have all failed; conflicts of interest at all steps in the DCD process, including the decision to withdraw life support before DCD, are simply unavoidable; potentially harmful premortem interventions to preserve organ utility are not justifiable, even with the help of the principle of double effect; claims that DCD conforms with the intent of the law and current accepted medical standards are misleading and inaccurate; and consensus statements by respected medical groups do not change these arguments due to their low quality including being plagued by conflict of interest. Moreover, some arguments in favor of DCD, while likely true, are "straw-man arguments," such as the great benefit of organ donation. The truth is that honesty and trustworthiness require that we face these problems instead of avoiding them. We believe that DCD is not ethically allowable because it abandons the dead donor rule, has unavoidable conflicts of interests, and implements premortem interventions which can hasten death. These important points have not been, but need to be fully disclosed to the public and incorporated into fully informed consent. These are tall orders, and require open public debate. Until this debate occurs, we call for a moratorium on the practice of DCD. PMID:22206616

Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors.

PubMed

van Rijn, Rianne; Hoogland, Pieter E R; Lehner, Frank; van Heurn, Ernest L W; Porte, Robert J

2017-01-01

Liver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors. All transplantations performed with a liver from a pediatric donor (≤16 years) in the Netherlands between 2002 and 2015 were included. Patient survival, graft survival, and complication rates were compared between DCD and DBD liver transplantation. In total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15-43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT ≥30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups. Transplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept ≤30 min. Patient and graft survival rates are not significantly different between recipients of a pediatric DCD or DBD liver. Moreover, the incidence of non-anastomotic biliary strictures after transplantation of pediatric DCD livers is remarkably low.

Normothermic machine perfusion reduces bile duct injury and improves biliary epithelial function in rat donor livers.

PubMed

Op den Dries, Sanna; Karimian, Negin; Westerkamp, Andrie C; Sutton, Michael E; Kuipers, Michiel; Wiersema-Buist, Janneke; Ottens, Petra J; Kuipers, Jeroen; Giepmans, Ben N; Leuvenink, Henri G D; Lisman, Ton; Porte, Robert J

2016-07-01

Bile duct injury may occur during liver procurement and transplantation, especially in livers from donation after circulatory death (DCD) donors. Normothermic machine perfusion (NMP) has been shown to reduce hepatic injury compared to static cold storage (SCS). However, it is unknown whether NMP provides better preservation of bile ducts. The aim of this study was to determine the impact of NMP on bile duct preservation in both DCD and non-DCD livers. DCD and non-DCD livers obtained from Lewis rats were preserved for 3 hours using either SCS or NMP, followed by 2 hours ex vivo reperfusion. Biomarkers of bile duct injury (gamma-glutamyltransferase and lactate dehydrogenase in bile) were lower in NMP-preserved livers compared to SCS-preserved livers. Biliary bicarbonate concentration, reflecting biliary epithelial function, was 2-fold higher in NMP-preserved livers (P < 0.01). In parallel with this, the pH of the bile was significantly higher in NMP-preserved livers (7.63 ± 0.02 and 7.74 ± 0.05 for non-DCD and DCD livers, respectively) compared with SCS-preserved livers (7.46 ± 0.02 and 7.49 ± 0.04 for non-DCD and DCD livers, respectively). Scanning and transmission electron microscopy of donor extrahepatic bile ducts demonstrated significantly decreased injury of the biliary epithelium of NMP-preserved donor livers (including the loss of lateral interdigitations and mitochondrial injury). Differences between NMP and SCS were most prominent in DCD livers. Compared to conventional SCS, NMP provides superior preservation of bile duct epithelial cell function and morphology, especially in DCD donor livers. By reducing biliary injury, NMP could have an important impact on the utilization of DCD livers and outcome after transplantation. Liver Transplantation 22 994-1005 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors

PubMed Central

Hoogland, Pieter E. R.; Lehner, Frank; van Heurn, Ernest L. W.; Porte, Robert J.

2017-01-01

Background Liver grafts from donation after circulatory death (DCD) donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD) donors. Method All transplantations performed with a liver from a pediatric donor (≤16 years) in the Netherlands between 2002 and 2015 were included. Patient survival, graft survival, and complication rates were compared between DCD and DBD liver transplantation. Results In total, 74 liver transplantations with pediatric grafts were performed; twenty (27%) DCD and 54 (73%) DBD. The median donor warm ischemia time (DWIT) was 24 min (range 15–43 min). Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32). Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20). If donor livers in this study would have been rejected for transplantation when the DWIT ≥30 min (n = 4), the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00). Other complication rates were also similar between both groups. Conclusions Transplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept ≤30 min. Patient and graft survival rates are not significantly different between recipients of a pediatric DCD or DBD liver. Moreover, the incidence of non-anastomotic biliary strictures after transplantation of pediatric DCD livers is remarkably low. PMID:28426684

Educational outreach and collaborative care enhances physician's perceived knowledge about Developmental Coordination Disorder.

PubMed

Gaines, Robin; Missiuna, Cheryl; Egan, Mary; McLean, Jennifer

2008-01-24

Developmental Coordination Disorder (DCD) is a chronic neurodevelopmental condition that affects 5-6% of children. When not recognized and properly managed during the child's development, DCD can lead to academic failure, mental health problems and poor physical fitness. Physicians, working in collaboration with rehabilitation professionals, are in an excellent position to recognize and manage DCD. This study was designed to determine the feasibility and impact of an educational outreach and collaborative care model to improve chronic disease management of children with DCD. The intervention included educational outreach and collaborative care for children with suspected DCD. Physicians were educated by and worked with rehabilitation professionals from February 2005 to April 2006. Mixed methods evaluation approach documented the process and impact of the intervention. Physicians: 750 primary care physicians from one major urban area and outlying regions were invited to participate; 147 physicians enrolled in the project. Children: 125 children were identified and referred with suspected DCD. The main outcome was improvement in knowledge and perceived skill of physicians concerning their ability to screen, diagnose and manage DCD. At baseline 91.1% of physicians were unaware of the diagnosis of DCD, and only 1.6% could diagnose condition. Post-intervention, 91% of participating physicians reported greater knowledge about DCD and 29.2% were able to diagnose DCD compared to 0.5% of non-participating physicians. 100% of physicians who participated in collaborative care indicated they would continue to use the project materials and resources and 59.4% reported they would recommend or share the materials with medical colleagues. In addition, 17.6% of physicians not formally enrolled in the project reported an increase in knowledge of DCD. Physicians receiving educational outreach visits significantly improved their knowledge about DCD and their ability to identify and diagnose children with this condition. Physicians who collaborated with occupational therapists in providing care reported more confidence in diagnosing children with DCD and were more likely to continue to use screening measures and to provide educational materials to families.

The UK DCD Risk Score: A new proposal to define futility in donation-after-circulatory-death liver transplantation.

PubMed

Schlegel, Andrea; Kalisvaart, Marit; Scalera, Irene; Laing, Richard W; Mergental, Hynek; Mirza, Darius F; Perera, Thamara; Isaac, John; Dutkowski, Philipp; Muiesan, Paolo

2018-03-01

Primary non-function and ischaemic cholangiopathy are the most feared complications following donation-after-circulatory-death (DCD) liver transplantation. The aim of this study was to design a new score on risk assessment in liver-transplantation DCD based on donor-and-recipient parameters. Using the UK national DCD database, a risk analysis was performed in adult recipients of DCD liver grafts in the UK between 2000 and 2015 (n = 1,153). A new risk score was calculated (UK DCD Risk Score) on the basis of a regression analysis. This is validated using the United Network for Organ Sharing database (n = 1,617) and our own DCD liver-transplant database (n = 315). Finally, the new score was compared with two other available prediction systems: the DCD risk scores from the University of California, Los Angeles and King's College Hospital, London. The following seven strongest predictors of DCD graft survival were identified: functional donor warm ischaemia, cold ischaemia, recipient model for end-stage liver disease, recipient age, donor age, previous orthotopic liver transplantation, and donor body mass index. A combination of these risk factors (UK DCD risk model) stratified the best recipients in terms of graft survival in the entire UK DCD database, as well as in the United Network for Organ Sharing and in our own DCD population. Importantly, the UK DCD Risk Score significantly predicted graft loss caused by primary non-function or ischaemic cholangiopathy in the futile group (>10 score points). The new prediction model demonstrated a better C statistic of 0.79 compared to the two other available systems (0.71 and 0.64, respectively). The UK DCD Risk Score is a reliable tool to detect high-risk and futile combinations of donor-and-recipient factors in DCD liver transplantation. It is simple to use and offers a great potential for making better decisions on which DCD graft should be rejected or may benefit from functional assessment and further optimization by machine perfusion. In this study, we provide a new prediction model for graft loss in donation-after-circulatory-death (DCD) liver transplantation. Based on UK national data, the new UK DCD Risk Score involves the following seven clinically relevant risk factors: donor age, donor body mass index, functional donor warm ischaemia, cold storage, recipient age, recipient laboratory model for end-stage liver disease, and retransplantation. Three risk classes were defined: low risk (0-5 points), high risk (6-10 points), and futile (>10 points). This new model stratified best in terms of graft survival compared to other available models. Futile combinations (>10 points) achieved an only very limited 1- and 5-year graft survival of 37% and less than 20%, respectively. In contrast, an excellent graft survival has been shown in low-risk combinations (≤5 points). The new model is easy to calculate at the time of liver acceptance. It may help to decide which risk combination will benefit from additional graft treatment, or which DCD liver should be declined for a certain recipient. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Is donation after cardiac death reducing the brain-dead donor pool in Australia?

PubMed

Sampson, Brett G; O'Callaghan, Gerry P; Russ, Graeme R

2013-03-01

Donation after cardiac death (DCD) has increased faster than donation after brain death (DBD) in Australia. However, DBD is the preferred pathway because it provides more organs per donor, the donation process is simpler and transplant outcomes are optimised. To determine if the increase in DCD has reduced the brain-dead donor pool in Australia. Retrospective analysis of records of organ donors (intended and actual) with brain injury as the cause of death from 2001 to 2011 in Australian intensive care units. Change in median ventilation period, over time, before brain-death determination in DBD donors (as DCD increased); a decreased median ventilation period in DBD donors being consistent with the conversion of DBD to DCD. As DCD (n = 311) increased, the median ventilation period in DBD donors (n = 2218) did not fall overall (P = 0.83), in all jurisdictions (P > 0.25) and for all causes of death (P > 0.3). The proportion of patients ventilated for less than 2 days was unchanged over time in both DBD (P = 1) and DCD (P = 0.99). The overall ventilation period in DCD donors (3.8 days; interquartile range [IQR], 2.1-6.3 days), exceeded the ventilation period in DBD donors (1.3 days; IQR, 1.0-2.4 days; P < 0.0001). DCD ventilation period was significantly longer in all jurisdictions, for all causes of death and annually (P < 0.05). In Australia, brain-injured donors appear to be ventilated long enough to allow progression to brain death before proceeding to DCD. Therefore, DCD is unlikely to have reduced the brain-dead donor pool.

Donation after cardiac death as a strategy to increase deceased donor liver availability.

PubMed

Merion, Robert M; Pelletier, Shawn J; Goodrich, Nathan; Englesbe, Michael J; Delmonico, Francis L

2006-10-01

This study examines donation after cardiac death (DCD) practices and outcomes in liver transplantation. Livers procured from DCD donors have recently been used to increase the number of deceased donors and bridge the gap between limited organ supply and the pool of waiting list candidates. Comprehensive evaluation of this practice and its outcomes has not been previously reported. A national cohort of all DCD and donation after brain-death (DBD) liver transplants between January 1, 2000 and December 31, 2004 was identified in the Scientific Registry of Transplant Recipients. Time to graft failure (including death) was modeled by Cox regression, adjusted for relevant donor and recipient characteristics. DCD livers were used for 472 (2%) of 24,070 transplants. Annual DCD liver activity increased from 39 in 2000 to 176 in 2004. The adjusted relative risk of DCD graft failure was 85% higher than for DBD grafts (relative risk, 1.85; 95% confidence interval, 1.51-2.26; P < 0.001), corresponding to 3-month, 1-year, and 3-year graft survival rates of 83.0%, 70.1%, and 60.5%, respectively (vs. 89.2%, 83.0%, and 75.0% for DBD recipients). There was no significant association between transplant program DCD liver transplant volume and graft outcome. The annual number of DCD livers used for transplant has increased rapidly. However, DCD livers are associated with a significantly increased risk of graft failure unrelated to modifiable donor or recipient factors. Appropriate recipients for DCD livers have not been fully characterized and recipient informed consent should be obtained before use of these organs.

Clinical islet isolation and transplantation outcomes with deceased cardiac death donors are similar to neurological determination of death donors.

PubMed

Andres, Axel; Kin, Tatsuya; O'Gorman, Doug; Livingstone, Scott; Bigam, David; Kneteman, Norman; Senior, Peter; Shapiro, A M James

2016-01-01

In islet transplantation, deceased cardiac death (DCD) donation has been identified as a potential extended source. There are currently no studies comparing outcomes between these categories, and our goal was to compare islet isolation success rates and transplantation outcomes between DCD and neurological determination of death (NDD) donors. Islet isolations from 15 DCD and 418 NDD were performed in our centre between September 2008 and September 2014. Donor variables, islet yields, metabolic function of isolated isled and insulin requirements at 1-month post-transplant were compared. Compared to NDD, pancreata from DCD were more often procured locally and donors required less vasopressive support (P < 0.001 and P = 0.023, respectively), but the other variables were similar between groups. Pre- and postpurification islet yields were similar between NDD and DCD (576 vs. 608 × 10(3) islet equivalent, P = 0.628 and 386 vs. 379, P = 0.881, respectively). The metabolic function was similar between NDD and DCD, as well as the mean decrease in insulin requirement at 1-month post-transplantation (NDD: 64.82%; DCD: 60.17% reduction, P = 0.517). These results support the broader use of DCD pancreata for islet isolation. A much larger DCD islet experience will be required to truly determine noninferiority of both short- and long-term outcomes. © 2015 Steunstichting ESOT.

The potential of cardiac allografts from donors after cardiac death at the University of Wisconsin Organ Procurement Organization.

PubMed

Osaki, Satoru; Anderson, James E; Johnson, Maryl R; Edwards, Niloo M; Kohmoto, Takushi

2010-01-01

The purpose of this study is to investigate the potential availability of hearts from adult donation after cardiac death (DCD) donors within an acceptable hypoxic period. We retrospectively reviewed a donor database from the University of Wisconsin Organ Procurement Organization Donor Tracking System between 2004 and 2006. The DCD population (n=78) was screened using our inclusion criteria for DCD cardiac donor suitability, including warm ischaemic time (WIT) limit of 30 min. In the same period, 70 hearts were donated from brain-dead donors. Of 78 DCD donors, 12 (15%) met our proposed DCD cardiac donor criteria. The mean WIT of these 12 DCD donors was 21 min (range 14-29 min). When inclusion criteria are further narrowed to (1) age <30 years, (2) WIT <20 min and (3) male gender, only two out of 12 met the criteria. Based on our proposed DCD cardiac donor criteria, the potential application of DCD cardiac donors would represent an increase in cardiac donation of 17% (12/70) during the 3-year period. When the criteria were narrowed to the initial 'ideal' case, only two donors met such criteria, suggesting that such 'ideal' DCD donors are rare but they do exist. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

A Comparison of Request Process and Outcomes in Donation after Cardiac Death (DCD) and Donation after Brain Death (DBD): Results from a National Study

PubMed Central

Siminoff, Laura A.; Alolod, Gerard P.; Wilson-Genderson, Maureen; Yuen, Eva Y. N.; Traino, Heather M.

2016-01-01

Available literature points to healthcare providers’ discomfort with donation after cardiac death (DCD) and their perception of the public’s reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers’ (FDMs’) experiences of both modalities. We recruited 1,601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semi-structured telephone interviews yielded FDMs’ sociodemographic data, predisposition toward donation, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with White FDMs more likely to authorize DCD or DBD than Black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and reasons for refusal. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar communication skills and strategies during approaches and the development of education campaigns about the public’s acceptance of DCD. PMID:27753206

Reduced expression of dermcidin, a peptide active against propionibacterium acnes, in sweat of patients with acne vulgaris.

PubMed

Nakano, Toshiaki; Yoshino, Takashi; Fujimura, Takao; Arai, Satoru; Mukuno, Akira; Sato, Naoya; Katsuoka, Kensei

2015-09-01

Dermcidin (DCD), an antimicrobial peptide with a broad spectrum of activity against bacteria such as Propionibacterum acnes, is expressed constitutively in sweat in the absence of stimulation due to injury or inflammation. The aim of this study was to determine the relationship between DCD expression and acne vulgaris associated with P. acnes. The antimicrobial activity of recombinant full-length DCD (50 μg/ml) was 97% against Escherichia coli and 100% against Staphylococcus aureus. Antimicrobial activity against P. acnes ranged from 68% at 50 μg/ml DCD to 83% at 270 μg/ml DCD. DCD concentration in sweat from patients with acne vulgaris (median 9.8 μg/ml, range 6.9-95.3 μg/ml) was significantly lower than in healthy subjects (median 136.7 μg/ml, range 45.4-201.6 μg/ml) (p = 0.001). DCD demonstrated concentration-dependent, but partial, microbicidal activity against P. acnes. These results suggest that reduced DCD concentration in sweat in patients with inflammatory acne may permit proliferation of P. acnes in pilosebaceous units, resulting in progression of inflammatory acne.

Aggressive interactions during free-play at preschool of children with and without developmental coordination disorder.

PubMed

Kennedy-Behr, A; Rodger, S; Mickan, S

2013-09-01

This aim of this study was to investigate an unexpected finding from a larger study examining the play of preschool children with and without developmental coordination disorder (DCD). We found that children with DCD were more frequently involved in aggressive incidents during free-play than their peers. Children with (n=32) and without DCD (n=31) were videotaped during free-play at preschool and their play was assessed using the Play Observation Scale. A post hoc analysis was conducted using a specifically developed rating instrument to examine the aggressive incidents captured on video. Videos from 18 children with DCD and 8 typically developing children without DCD were found to contain aggressive incidents. Children with DCD were significantly more often involved as both aggressor (p=.016) and victim (p=.008) than children without DCD (p=.031). This is the first study to identify victimization and aggression as being problematic for children with DCD as young as 4 years of age and needs replication. Given the negative consequences of involvement in aggression and victimization, play-based early intervention focusing on prevention needs to be developed and implemented. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of Fundamental Movement Skills Training on Children With Developmental Coordination Disorder.

PubMed

Yu, Jie; Sit, Cindy H; Burnett, Angus; Capio, Catherine M; Ha, Amy S; Huang, Wendy Y

2016-04-01

The purpose of this study was to examine the effects of fundamental movement skills (FMS) training on FMS proficiency, self-perceived physical competence (SPC), physical activity (PA), and sleep disturbance in children with developmental coordination disorder (DCD) compared with children with typical development (TD). A total of 84 children were allocated into either experimental group (DCD[exp], TD[exp]) who received 6 weeks of FMS training or control groups (DCD[con], TD[con]). FMS were assessed using the Test of Gross Motor Development-2, whereas PA was monitored using accelerometers. SPC and sleep disturbance were evaluated using questionnaires. Results showed that the DCD[exp] group had significantly higher scores in FMS and SPC compared with the DCD[con] group at posttest. The DCD[exp] group scored lower in sleep disturbance at follow-up when compared with posttest. It is suggested that short-term FMS training is effective in improving FMS and SPC and reducing sleep disturbances for children with DCD.

Clinical expression of developmental coordination disorder in a large Canadian family

PubMed Central

Gaines, Robin; Collins, David; Boycott, Kym; Missiuna, Cheryl; DeLaat, Denise; Soucie, Helen

2008-01-01

Previous studies of the phenotype of developmental coordination disorder (DCD) have largely concentrated on population-based samples. The present study reports on an in-depth examination of a large Canadian family with eight children, after three children who were suspected to have DCD were referred for evaluation. Subsequently, five of the six children whose motor impairments could be measured, and the mother, met the diagnostic criteria for DCD as per the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – fourth edition. The family members diagnosed with DCD showed remarkably similar profiles of motor difficulties. Additionally, the five children diagnosed with DCD had current speech articulation difficulties, with four of them having visited speech/language pathologists; the mother had a lateral lisp. More in-depth testing for three children revealed intact intellectual, academic and language comprehension skills. Three of the children diagnosed with DCD were obese. The present report highlights familial clustering of DCD and the presence of comorbid conditions in the affected children. PMID:19436536

Postreperfusion hyperkalemia in liver transplantation using donation after cardiac death grafts with pathological changes.

PubMed

Zhang, Wen-Jin; Xia, Wei-Liang; Pan, Hui-Yun; Zheng, Shu-Sen

2016-10-01

With the increasing use of donation after cardiac death (DCD), especially of the graft liver with steatosis or other pathological changes, the frequency of postreperfusion hyperkalemia in liver transplantation has increased significantly. The present study aimed to determine the factors associated with developing postreperfusion hyperkalemia in liver transplantation from DCD. One hundred thirty-one consecutive adult patients who underwent orthotopic liver transplantation from DCD were retrospectively studied. Based on serum potassium within 5 minutes after reperfusion, recipients were divided into two groups: hyperkalemia and normokalemia. According to preoperative biopsy results, the DCD graft livers were classified into five categories. Univariate analysis was performed using Chi-square test to identify variables that were significantly different between two groups. Multivariate logistic regression was used to confirm the risk factors of developing hyperkalemia and postreperfusion syndrome. Correlation analysis was used to identify the relationship between the serum concentration of potassium within 5 minutes after reperfusion and the difference in mean arterial pressure values before and within 5 minutes after reperfusion. Twenty-two of 131 liver recipients had hyperkalemia episodes within 5 minutes after reperfusion. The rate of hyperkalemia was significantly higher in recipients of macrosteatotic DCD graft liver (78.6%, P<0.001) than that in recipients of non-macrosteatotic DCD graft liver. The odds ratio of developing postreperfusion hyperkalemia in recipients of macrosteatotic DCD graft liver was 51.3 (P<0.001). Macrosteatosis in the DCD graft liver was an independent risk factor of developing hyperkalemia within 5 minutes after reperfusion. The highest rate of postreperfusion syndrome also occurred in the recipients with macrosteatotic DCD graft liver (71.4%, P<0.001). A strong relationship existed between the serum potassium within 5 minutes after reperfusion and the difference in mean arterial pressure values before and within 5 minutes after reperfusion in macrosteatotic DCD graft liver recipients. Macrosteatosis in the DCD graft liver was an independent risk factor of developing hyperkalemia and postreperfusion syndrome in the recipients.

Subtyping children with developmental coordination disorder based on physical fitness outcomes.

PubMed

Aertssen, Wendy; Bonney, Emmanuel; Ferguson, Gillian; Smits-Engelsman, Bouwien

2018-05-28

Children with Developmental Coordination Disorder (DCD) are known to have poor physical fitness. However, differentiating homogenous subgroups of DCD using fitness performance has not yet been established. Therefore the purpose of this study was to identify subtypes in children with and without DCD using measures of physical fitness. Children (aged 6-10 years, n = 217) constituted the sample for this study. They were assessed on 1) aerobic fitness (20m Shuttle Run test), 2) anaerobic fitness (Muscle Power Sprint Test), 3) isometric muscle strength (handheld dynamometry) 4) functional upper and lower body strength (Functional Strength Measurement) and 5) motor coordination [Movement Assessment Battery for Children-2nd edition (MABC-2) test]. The Ward method was used to identify the various clusters. Five subtypes emerged in the entire sample. In the typically developing (TD) children mainly 2 subtypes (number 5 and 2) were found containing 89% of the TD children (n = 55), with the largest group demonstrating above average performance on all measures (cluster 5). Children in subtype 2 had just above average motor coordination and good aerobic fitness but lower muscle strength. Subtypes 1, 3 and 4 were clearly "DCD" clusters, however they showed difference in fitness performance. Subtype 1 contained children with DCD who showed poor performance on all fitness outcomes (n = 45). Children with DCD in subtype 3 had poor aerobic but average strength and anaerobic fitness (n = 48). Subtype 4 contained children with DCD (n = 45) who had good muscle strength and anaerobic fitness. Of these, 36% were at risk of DCD while 24% had definite motor coordination problems. Our findings indicate that children with and without DCD demonstrate heterogeneous physical fitness profiles. The majority of the children (66%) with DCD belonged to subtypes with lower fitness performance. Further studies are needed to confirm these findings in other samples of DCD children. Copyright © 2018 Elsevier B.V. All rights reserved.

Effect of internal versus external focus of attention on implicit motor learning in children with developmental coordination disorder.

PubMed

Jarus, Tal; Ghanouni, Parisa; Abel, Rachel L; Fomenoff, Shelby L; Lundberg, Jocelyn; Davidson, Stephanie; Caswell, Sarah; Bickerton, Laura; Zwicker, Jill G

2015-02-01

Children with developmental coordination disorder (DCD) struggle to learn new motor skills. It is unknown whether children with DCD learn motor skills more effectively with an external focus of attention (focusing on impact of movement on the environment) or an internal focus of attention (focusing on one's body movements) during implicit (unconscious) and explicit (conscious) motor learning. This paper aims to determine the trends of implicit motor learning in children with DCD, and how focus of attention influences motor learning in children with DCD in comparison with typically developing children. 25 children, aged 8-12, with (n=12) and without (n=13) DCD were randomly assigned to receive instructions that focused attention externally or internally while completing a computer tracking task during acquisition, retention, and transfer phases. The motor task involved tracking both repeated and random patterns, with the repeated pattern indicative of implicit learning. Children with DCD scored lower on the motor task in all three phases of the study, demonstrating poorer implicit learning. Furthermore, graphical data showed that for the children with DCD, there was no apparent difference between internal and external focus of attention during retention and transfer, while there was an advantage to the external focus of attention group for typically developing children. Children with DCD demonstrate less accuracy than typically developing children in learning a motor task. Also, the effect of focus of attention on motor performance is different in children with DCD versus their typically developing counterparts during the three phases of motor learning. Results may inform clinicians how to facilitate motor learning in children with DCD by incorporating explicit learning with either internal or external focus of attention within interventions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Increase in dermcidin-derived peptides in sweat of patients with atopic eczema caused by a humorous video.

PubMed

Kimata, Hajime

2007-01-01

Dermcidin (DCD)-derived peptide is an antimicrobial peptide produced by the sweat glands. However, the levels of DCD-derived peptide in sweat were decreased in patients with atopic eczema (AE). The effect of viewing a humorous video on the levels of DCD-derived peptide was studied. Twenty patients with AE viewed an 87-min humorous video (Modern Times, featuring Charlie Chaplin). Just before and immediately after viewing, sweat was collected, and the levels of DCD-derived peptide and total protein in sweat were measured. Viewing a humorous video increased the levels of DCD-derived peptide without affecting the levels of total protein in sweat. Viewing a humorous video increased DCD-derived peptide in sweat of patients with AE, and thus, it may be helpful in the treatment of skin infection of AE.

Reading and writing performances of children 7-8 years of age with developmental coordination disorder in Taiwan.

PubMed

Cheng, Hsiang-Chun; Chen, Jenn-Yeu; Tsai, Chia-Liang; Shen, Miau-Lin; Cherng, Rong-Ju

2011-01-01

Developmental coordination disorder (DCD) refers to a delay in motor development that does not have any known medical cause. Studies conducted in English speaking societies have found that children with DCD display a higher co-occurrence rate of learning difficulties (e.g., problems in reading and writing) than typically developing (TD) children. The present study examined the reading and writing performance of school-aged children with DCD and TD children in Taiwan to determine whether reading and writing difficulties also co-occur with DCD in a non-English speaking society. The Chinese Reading Achievement Test and the Basic Reading and Writing Test were administered to 37 children with DCD (7.8 ± 0.6 years) and 93 TD children (8.0 ± 0.7 years). Children with DCD had significantly lower writing composite scores than TD children on the Basic Reading and Writing Test (105.9 ± 20.0 vs. 114.4 ± 19.9). However, there were no significant differences between children with DCD and TD children in their scores on the Chinese Reading Achievement Test and in their reading composite scores on the Basic Reading and Writing Test. These results contrasted interestingly with those obtained from English-speaking children: English-speaking DCD children showed poorer reading and poorer writing than English-speaking TD children. The possibility that the logographic nature of the Chinese script might have protected the DCD children against additional reading difficulty is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

Level walking in adults with and without Developmental Coordination Disorder: An analysis of movement variability.

PubMed

Du, Wenchong; Wilmut, Kate; Barnett, Anna L

2015-10-01

Several studies have shown that Developmental Coordination Disorder (DCD) is a condition that continues beyond childhood. Although adults with DCD report difficulties with dynamic balance, as well as frequent tripping and bumping into objects, there have been no specific studies on walking in this population. Some previous work has focused on walking in children with DCD but variation in the tasks and measures used has led to inconsistent findings. The aim of the current study therefore was to examine the characteristics of level walking in adults with and without DCD. Fifteen adults with DCD and 15 typically developing (TD) controls walked barefoot at a natural pace up and down an 11 m walkway for one minute. Foot placement measures and velocity and acceleration of the body were recorded, as well as measures of movement variability. The adults with DCD showed similar gait patterns to the TD group in terms of step length, step width, double support time and stride time. The DCD group also showed similar velocity and acceleration to the TD group in the medio-lateral, anterior-posterior and vertical direction. However, the DCD group exhibited greater variability in all foot placement and some body movement measures. The finding that adults with DCD have a reduced ability to produce consistent movement patterns is discussed in relation to postural control limitations and compared to variability of walking measures found in elderly populations. Copyright © 2015 Elsevier B.V. All rights reserved.

[Association between family environment and developmental coordination disorder in preschool children].

PubMed

Liu, Li-Fei; Lu, Lan; Yue, Hong-Ni; Huan, Bei; Gu, Gui-Xiong; Jin, Hua; Wang, Yu-Mei

2017-09-01

To investigate the influence of family environment on developmental coordination disorder (DCD) in preschool children. Stratified random cluster sampling was used to select 1 727 children (4-6 years old). The Movement Assessment Battery for Children was used to screen out the children with DCD. The Family Environment Scale on Motor Development for Preschool Urban Children and a self-designed questionnaire were used to assess family environment. A total of 117 children were confirmed with DCD. There were significant differences in mother's education level and family structure between the DCD and normal control groups. There were also significant differences in the scores of "Let children manage their daily items" and "Arrange all affairs" between the DCD and normal control groups. The multivariate logistic regression analysis indicated that when children's age and gender were controlled, mother's education level, family structure, "Let children manage their daily items", and "Arrange all affairs" were main factors influencing the development of DCD in children (P<0.05). Family environment may affect the development of DCD in preschool children. Therefore, parents should not arrange all affairs for children and should provide more opportunities for children to manage their daily life, in order to promote the development of early motor coordination and prevent the development of DCD.

Neural Signature of DCD: A Critical Review of MRI Neuroimaging Studies

PubMed Central

Biotteau, Maëlle; Chaix, Yves; Blais, Mélody; Tallet, Jessica; Péran, Patrice; Albaret, Jean-Michel

2016-01-01

The most common neurodevelopmental disorders (e.g., developmental dyslexia (DD), autism, attention-deficit hyperactivity disorder (ADHD)) have been the subject of numerous neuroimaging studies, leading to certain brain regions being identified as neural correlates of these conditions, referring to a neural signature of disorders. Developmental coordination disorder (DCD), however, remains one of the least understood and studied neurodevelopmental disorders. Given the acknowledged link between motor difficulties and brain features, it is surprising that so few research studies have systematically explored the brains of children with DCD. The aim of the present review was to ascertain whether it is currently possible to identify a neural signature for DCD, based on the 14 magnetic resonance imaging neuroimaging studies that have been conducted in DCD to date. Our results indicate that several brain areas are unquestionably linked to DCD: cerebellum, basal ganglia, parietal lobe, and parts of the frontal lobe (medial orbitofrontal cortex and dorsolateral prefrontal cortex). However, research has been too sparse and studies have suffered from several limitations that constitute a serious obstacle to address the question of a well-established neural signature for DCD. PMID:28018285

Motor and gestural performance in children with autism spectrum disorders, developmental coordination disorder, and/or attention deficit hyperactivity disorder.

PubMed

Dewey, Deborah; Cantell, Marja; Crawford, Susan G

2007-03-01

Motor and gestural skills of children with autism spectrum disorders (ASD), developmental coordination disorder (DCD), and/or attention deficit hyperactivity disorder (ADHD) were investigated. A total of 49 children with ASD, 46 children with DCD, 38 children with DCD+ADHD, 27 children with ADHD, and 78 typically developing control children participated. Motor skills were assessed with the Bruininks-Oseretsky Test of Motor Proficiency Short Form, and gestural skills were assessed using a test that required children to produce meaningful gestures to command and imitation. Children with ASD, DCD, and DCD+ADHD were significantly impaired on motor coordination skills; however, only children with ASD showed a generalized impairment in gestural performance. Examination of types of gestural errors revealed that children with ASD made significantly more incorrect action and orientation errors to command, and significantly more orientation and distortion errors to imitation than children with DCD, DCD+ADHD, ADHD, and typically developing control children. These findings suggest that gestural impairments displayed by the children with ASD were not solely attributable to deficits in motor coordination skills.

Mathematical difficulties in developmental coordination disorder: Symbolic and nonsymbolic number processing.

PubMed

Gomez, Alice; Piazza, Manuela; Jobert, Antoinette; Dehaene-Lambertz, Ghislaine; Dehaene, Stanislas; Huron, Caroline

2015-01-01

At school, children with Developmental Coordination Disorder (DCD) struggle with mathematics. However, little attention has been paid to their numerical cognition abilities. The goal of this study was to better understand the cognitive basis for mathematical difficulties in children with DCD. Twenty 7-to-10 years-old children with DCD were compared to twenty age-matched typically developing children using dot and digit comparison tasks to assess symbolic and nonsymbolic number processing and in a task of single digits additions. Results showed that children with DCD had lower performance in nonsymbolic and symbolic number comparison tasks than typically developing children. They were also slower to solve simple addition problems. Moreover, correlational analyses showed that children with DCD who experienced greater impairments in the nonsymbolic task also performed more poorly in the symbolic tasks. These findings suggest that DCD impairs both nonsymbolic and symbolic number processing. A systematic assessment of numerical cognition in children with DCD could provide a more comprehensive picture of their deficits and help in proposing specific remediation. Copyright © 2015 Elsevier Ltd. All rights reserved.

International Society for Heart and Lung Transplantation Donation After Circulatory Death Registry Report.

PubMed

Cypel, Marcelo; Levvey, Bronwyn; Van Raemdonck, Dirk; Erasmus, Michiel; Dark, John; Love, Robert; Mason, David; Glanville, Allan R; Chambers, Daniel; Edwards, Leah B; Stehlik, Josef; Hertz, Marshall; Whitson, Brian A; Yusen, Roger D; Puri, Varun; Hopkins, Peter; Snell, Greg; Keshavjee, Shaf

2015-10-01

The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia. The control group was a cohort of lung recipients transplanted using brain-dead donors (DBDs) during the same study period. The primary end-point was survival after lung transplantation. There were 306 transplants performed using DCD donors and 3,992 transplants using DBD donors during the study period. Of the DCD transplants, 94.8% were Maastricht Category III, whereas 4% were Category IV and 1.2% Category V (euthanasia). Heparin was given in 54% of the cases, donor extubation occurred in 90% of the cases, and normothermic ex vivo lung perfusion (EVLP) was used in 12%. The median time from withdrawal of life support therapy (WLST) to cardiac arrest was 15 minutes (5th to 95th percentiles of 5 to 55 minutes), and from WLST to cold flush was 33 minutes (5th to 95th percentiles of 19.5 to 79.5 minutes). Recipient age and medical diagnosis were similar in DCD and DBD groups (p = not significant [NS]). Median hospital length of stay was 18 days in DCD lung transplants and 16 days in DBD transplants (p = 0.016). Thirty-day survival was 96% in the DCD group and 97% in the DBD group. One-year survival was 89% in the DCD group and 88% in the DBD group (p = NS). Five-year survival was 61% in both groups (p = NS). The mechanism of donor death within the DCD group seemed to influence recipient early survival. The survival rates through 30 days were significantly different by donor mechanism of death (p = 0.0152). There was no significant correlation between the interval of WLST to pulmonary flush with survival (p = 0.11). This large study of international, multi-center experience demonstrates excellent survival after lung transplantation using DCD donors. It should be further evaluated whether the mechanism of donor death influences survival after DCD transplant. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Changing pattern of organ donation at a single center: are potential brain dead donors being lost to donation after cardiac death?

PubMed

Saidi, R F; Bradley, J; Greer, D; Luskin, R; O'Connor, K; Delmonico, F; Kennealey, P; Pathan, F; Schuetz, C; Elias, N; Ko, D S C; Kawai, T; Hertl, M; Cosimi, A B; Markmann, J F

2010-11-01

Donation after cardiac death (DCD) has proven effective at increasing the availability of organs for transplantation.We performed a retrospective examination of Massachusetts General Hospital (MGH) records of all 201 donors from 1/1/98 to the 11/2008, including 54 DCD, 115 DBD and 32 DCD candidates that did not progress to donation (DCD-dnp). Comparing three time periods, era 1 (01/98-12/02), era 2 (01/03-12/05) and era 3 (01/06-11/08), DCD’s comprised 14.8,48.4% and 60% of donors, respectively (p = 0.002). A significant increase in the incidence of cardiovascular/cerebrovascular as cause of death was evident in era 3 versus eras 1 and 2; 74% versus 57.1% (p<0.001),as was a corresponding decrease in the incidence of traumatic death. Interestingly, we noted an increase in utilization of aggressive neurological management over time, especially in the DCD group.We detected significant changes in the make-up of the donor pool over the past decade. That the changes in diagnosis over time did not differ between DCD and DBD groups suggests this difference is not responsible for the increase in DCD rates. Instead, we suggest that changes in clinical practice, especially in management of patients with severe brain injury may account for the increased proportion of DCD.

A Comparison of Request Process and Outcomes in Donation After Cardiac Death and Donation After Brain Death: Results From a National Study.

PubMed

Siminoff, L A; Alolod, G P; Wilson-Genderson, M; Yuen, E Y N; Traino, H M

2017-05-01

Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of public reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors. Semistructured telephone interviews yielded FDMs' sociodemographic data, donation attitudes, assessment of approach, final outcomes, and substantiating reasons. Initial analysis consisted of bivariate analyses. Multilevel mixture models compared groups representing authorization outcome and DCD/DBD status. No significant differences in family authorization were found between DCD and DBD cases. Statistically significant associations were found between sociodemographic characteristics and authorization, with white FDMs more likely to authorize DCD or DBD than black FDMs. FDMs of both modalities had similar evaluations of requester skills, topics discussed, satisfaction, and refusal reasons. The findings suggest that the DCD/DBD distinction may not be notable to families. We recommend the use of similar approach strategies and communication skills and the development of education campaigns about the public's acceptance of DCD. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

Efficiency of two nitrification inhibitors (dicyandiamide and 3, 4-dimethypyrazole phosphate) on soil nitrogen transformations and plant productivity: a meta-analysis

PubMed Central

Yang, Ming; Fang, Yunting; Sun, Di; Shi, Yuanliang

2016-01-01

Dicyandiamide (DCD) and 3, 4-dimethypyrazole phosphate (DMPP) are often claimed to be efficient in regulating soil N transformations and influencing plant productivity, but the difference of their performances across field sites is less clear. Here we applied a meta-analysis approach to compare effectiveness of DCD and DMPP across field trials. Our results showed that DCD and DMPP were equally effective in altering soil inorganic N content, dissolve inorganic N (DIN) leaching and nitrous oxide (N2O) emissions. DCD was more effective than DMPP on increasing plant productivity. An increase of crop yield by DMPP was generally only observed in alkaline soil. The cost and benefit analysis (CBA) showed that applying fertilizer N with DCD produced additional revenues of $109.49 ha−1 yr−1 for maize farms, equivalent to 6.02% increase in grain revenues. In comparisons, DMPP application produced less monetary benefit of $15.67 ha−1 yr−1. Our findings showed that DCD had an advantage of bringing more net monetary benefit over DMPP. But this may be weakened by the higher toxicity of DCD than DMPP especially after continuous DCD application. Alternatively, an option related to net monetary benefit may be achieved through applying DMPP in alkaline soil and reducing the cost of purchasing DMPP products. PMID:26902689

Efficiency of two nitrification inhibitors (dicyandiamide and 3, 4-dimethypyrazole phosphate) on soil nitrogen transformations and plant productivity: a meta-analysis.

PubMed

Yang, Ming; Fang, Yunting; Sun, Di; Shi, Yuanliang

2016-02-23

Dicyandiamide (DCD) and 3, 4-dimethypyrazole phosphate (DMPP) are often claimed to be efficient in regulating soil N transformations and influencing plant productivity, but the difference of their performances across field sites is less clear. Here we applied a meta-analysis approach to compare effectiveness of DCD and DMPP across field trials. Our results showed that DCD and DMPP were equally effective in altering soil inorganic N content, dissolve inorganic N (DIN) leaching and nitrous oxide (N2O) emissions. DCD was more effective than DMPP on increasing plant productivity. An increase of crop yield by DMPP was generally only observed in alkaline soil. The cost and benefit analysis (CBA) showed that applying fertilizer N with DCD produced additional revenues of $109.49 ha(-1) yr(-1) for maize farms, equivalent to 6.02% increase in grain revenues. In comparisons, DMPP application produced less monetary benefit of $15.67 ha(-1) yr(-1). Our findings showed that DCD had an advantage of bringing more net monetary benefit over DMPP. But this may be weakened by the higher toxicity of DCD than DMPP especially after continuous DCD application. Alternatively, an option related to net monetary benefit may be achieved through applying DMPP in alkaline soil and reducing the cost of purchasing DMPP products.

Organs and organisations: Situating ethics in organ donation after circulatory death in the UK.

PubMed

Cooper, Jessie

2018-05-25

Controlled organ donation after circulatory death (DCD) has recently been revived in the UK, as part of attempts to increase organ donation rates. The re-introduction of DCD has subsequently become the focus of bioethical controversy, since it necessitates intervening in the care of dying patients to obtain quality donor organs. Transplant policy responses to these concerns have generated new legal and ethical guidelines to address uncertainties around DCD, producing claims that the UK has overcome' the ethical challenge of DCD. In contrast, by drawing on Lynch's call to 'respecify' ethics, this paper argues that ethics in DCD cannot be reduced to abstract directives for practice, but, instead, are composed and dealt with as an organisational problem. To do this, I utilise data from an ethnographic study examining the production of the 'minority ethnic organ donor' within UK organ donation settings; in particular, the data pertains to a case hospital which was in the process of developing a DCD programme during the period of fieldwork. Findings show that the ethics of DCD are encountered as practical sets of problems, constructed in relation to particular institutional locales. I describe how these issues are worked-around by creating conditions to make DCD organisationally possible, and through the animation of standard procedures into acceptable forms of practice. I argue that ethics in DCD go far beyond normative bioethical principles, to encompass concerns around: the reputation of hospital Trusts, public perceptions of organ donation, the welfare of potential donor families, and challenges to the work of health professionals caring for dying patients. The paper enriches understanding of ethics in science and medicine by showing how ethics are assembled and negotiated as a practical-organisational concern, and calls for further examination of how DCD gets constructed as a potential problem and is made to happen in practice. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

Outcomes Using Grafts from Donors after Cardiac Death.

PubMed

Doyle, M B Majella; Collins, Kelly; Vachharajani, Neeta; Lowell, Jeffrey A; Shenoy, Surendra; Nalbantoglu, Ilke; Byrnes, Kathleen; Garonzik-Wang, Jacqueline; Wellen, Jason; Lin, Yiing; Chapman, William C

2015-07-01

Previous reports suggest that donation after cardiac death (DCD) liver grafts have increased primary nonfunction (PNF) and cholangiopathy thought to be due to the graft warm ischemia before cold flushing. In this single-center, retrospective study, 866 adult liver transplantations were performed at our institution from January 2005 to August 2014. Forty-nine (5.7%) patients received DCD donor grafts. The 49 DCD graft recipients were compared with all recipients of donation after brain death donor (DBD) grafts and to a donor and recipient age- and size-matched cohort. The DCD donors were younger (age 28, range 8 to 60 years) than non-DCD (age 44.3, range 9 to 80 years) (p < 0.0001), with similar recipient age. The mean laboratory Model for End-Stage Liver Disease (MELD) was lower in DCD recipients (18.7 vs 22.2, p = 0.03). Mean cold and warm ischemia times were similar. Median ICU and hospital stay were 2 days and 7.5 days in both groups (p = 0.37). Median follow-ups were 4.0 and 3.4 years, respectively. Long-term outcomes were similar between groups, with similar 1-, 3- and 5-year patient and graft survivals (p = 0.59). Four (8.5%) recipients developed ischemic cholangiopathy (IC) at 2, 3, 6, and 8 months. Primary nonfunction and hepatic artery thrombosis did not occur in any patient in the DCD group. Acute kidney injury was more common with DCD grafts (16.3% of DCD recipients required dialysis vs 4.1% of DBD recipients, p = 0.01). An increased donor age (>40 years) was shown to increase the risk of IC (p = 0.006). Careful selection of DCD donors can provide suitable donors, with results of liver transplantation comparable to those with standard brain dead donors. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Inferior long-term outcomes of liver-kidney transplantation using donation after cardiac death donors: single-center and organ procurement and transplantation network analyses.

PubMed

Wadei, Hani M; Bulatao, Ilynn G; Gonwa, Thomas A; Mai, Martin L; Prendergast, Mary; Keaveny, Andrew P; Rosser, Barry G; Taner, C Burcin

2014-06-01

Limited data are available for outcomes of simultaneous liver-kidney (SLK) transplantation using donation after cardiac death (DCD) donors. The outcomes of 12 DCD-SLK transplants and 54 SLK transplants using donation after brain death (DBD) donors were retrospectively compared. The baseline demographics were similar for the DCD-SLK and DBD-SLK groups except for the higher liver donor risk index for the DCD-SLK group (1.8 ± 0.4 versus 1.3 ± 0.4, P = 0.001). The rates of surgical complications and graft rejections within 1 year were comparable for the DCD-SLK and DBD-SLK groups. Delayed renal graft function was twice as common in the DCD-SLK group. At 1 year, the serum creatinine levels and the iothalamate glomerular filtration rates were similar for the groups. The patient, liver graft, and kidney graft survival rates at 1 year were comparable for the groups (83.3%, 75.0%, and 82.5% for the DCD-SLK group and 92.4%, 92.4%, and 92.6% for the DBD-SLK group, P = 0.3 for all). The DCD-SLK group had worse patient, liver graft, and kidney graft survival at 3 years (62.5%, 62.5%, and 58.9% versus 90.5%, 90.5%, and 90.6%, P = 0.03 for all) and at 5 years (62.5%, 62.5%, and 58.9% versus 87.4%, 87.4%, and 87.7%, P < 0.05 for all). An analysis of the Organ Procurement and Transplantation Network database showed inferior 1- and 5-year patient and graft survival rates for DCD-SLK patients versus DBD-SLK patients. In conclusion, despite comparable rates of surgical and medical complications and comparable kidney function at 1 year, DCD-SLK transplantation was associated with inferior long-term survival in comparison with DBD-SLK transplantation. © 2014 American Association for the Study of Liver Diseases.

Use of Lung Allografts From Donation After Cardiac Death Donors: A Single-Center Experience.

PubMed

Costa, Joseph; Shah, Lori; Robbins, Hilary; Raza, Kashif; Sreekandth, Sowmya; Arcasoy, Selim; Sonett, Joshua R; D'Ovidio, Frank

2018-01-01

Lung transplantation remains the only treatment for end-stage lung disease. Availability of suitable lungs does not parallel this growing trend. Centers using donation after cardiac death (DCD) donor lungs report comparable outcomes with those from brain-dead donors. Donor assessment protocols and consistent surgical teams have been advocated when considering using the use of DCD donors. We present our experience using lungs from Maastricht category III DCD donors. Starting 2007 to July 2016, 73 DCD donors were assessed, 44 provided suitable lungs that resulted in 46 transplants. A 2012 to October 2016 comparative cohort of 379 brain-dead donors were assessed. Recipient and donor characteristics and primary graft dysfunction (PGD) and survival were monitored. Seventy-three DCD (40% dry run rate) donors assessed yielded 46 transplants (23 double, 6 right, and 17 left). Comparative cohort of 379 brain-dead donors yielded 237 transplants (112 double, 43 right, and 82 left). One- and 3-year recipient survival was 91% and 78% for recipients of DCD lungs and 91% and 75% for recipients of lungs from brain-dead donors, respectively. PGD 2 and 3 in DCD recipients at 72 hours was 4 of 46 (9%) and 6 of 46 (13%), respectively. Comparatively, brain-dead donor recipient cohort at 72 hours with PGD 2 and 3 was 23 of 237 (10%) and 41 of 237 (17%), respectively. Our experience reaffirms the use of lungs from DCD donors as a viable source with favorable outcomes. Recipients from DCD donors showed equivalent PGD rate at 72 hours and survival compared with recipients from brain-dead donors. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

First Comparison of Hypothermic Oxygenated PErfusion Versus Static Cold Storage of Human Donation After Cardiac Death Liver Transplants: An International-matched Case Analysis.

PubMed

Dutkowski, Philipp; Polak, Wojciech G; Muiesan, Paolo; Schlegel, Andrea; Verhoeven, Cornelia J; Scalera, Irene; DeOliveira, Michelle L; Kron, Philipp; Clavien, Pierre-Alain

2015-11-01

Exposure of donor liver grafts to prolonged periods of warm ischemia before procurement causes injuries including intrahepatic cholangiopathy, which may lead to graft loss. Due to unavoidable prolonged ischemic time before procurement in donation after cardiac death (DCD) donation in 1 participating center, each liver graft of this center was pretreated with the new machine perfusion "Hypothermic Oxygenated PErfusion" (HOPE) in an attempt to improve graft quality before implantation. HOPE-treated DCD livers (n = 25) were matched and compared with normally preserved (static cold preservation) DCD liver grafts (n = 50) from 2 well-established European programs. Criteria for matching included duration of warm ischemia and key confounders summarized in the balance of risk score. In a second step, perfused and unperfused DCD livers were compared with liver grafts from standard brain dead donors (n = 50), also matched to the balance of risk score, serving as baseline controls. HOPE treatment of DCD livers significantly decreased graft injury compared with matched cold-stored DCD livers regarding peak alanine-aminotransferase (1239 vs 2065 U/L, P = 0.02), intrahepatic cholangiopathy (0% vs 22%, P = 0.015), biliary complications (20% vs 46%, P = 0.042), and 1-year graft survival (90% vs 69%, P = 0.035). No graft failure due to intrahepatic cholangiopathy or nonfunction occurred in HOPE-treated livers, whereas 18% of unperfused DCD livers needed retransplantation. In addition, HOPE-perfused DCD livers achieved similar results as control donation after brain death livers in all investigated endpoints. HOPE seems to offer important benefits in preserving higher-risk DCD liver grafts.

Developmental coordination disorder in children with specific language impairment: co-morbidity and impact on quality of life.

PubMed

Flapper, Boudien C T; Schoemaker, Marina M

2013-02-01

Co-morbidity of Developmental Coordination Disorder (DCD) in children with specific language impairment (SLI) and the impact of DCD on quality-of-life (QOL) was investigated in 65 5-8 year old children with SLI (43 boys, age 6.8±0.8; 22 girls, age 6.6±0.8). The prevalence of DCD was assessed using DSM-IV-TR criteria (American Psychiatric Association (APA), 2000) operationally defined in the clinical practice guideline (CPG): movement ABC scores below 15th percentile, scores on DCDQ and/or MOQ-T below 15th percentile, absence of medical condition according to paediatric-neurological exam. Quality of life (QOL) was measured with the TNO-AZL-Child-Quality-Of-Life (TACQOL) Questionnaire filled out by parents for the SLI group with and without DCD, and compared to a reference group (N=572; age 6.9±0.9). The TACQOL covers 7 QOL domains: physical, motor, cognitive and social functioning, autonomy, positive and negative moods. Prevalence of DCD in children with SLI was 32.3%. In children with SLI, mean QOL scores were significantly lower in the autonomy, cognitive, social and positive moods domains compared to the reference group. Children with SLI and DCD differed from children with SLI without DCD by significantly lower mean overall-, motor-, autonomy-, and cognitive domain-QOL scores. Clinicians should be aware that about one third of children with SLI can also be diagnosed with DCD. Assessment of QOL is warranted in order to assess which domains are affected in children with SLI with or without DCD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influence of delayed graft function and acute rejection on outcomes after kidney transplantation from donors after cardiac death.

PubMed

Nagaraja, Pramod; Roberts, Gareth W; Stephens, Michael; Horvath, Szabolcs; Fialova, Jana; Chavez, Rafael; Asderakis, Argiris; Kaposztas, Zsolt

2012-12-27

Delayed graft function (DGF) and acute rejection (AR) exert an adverse impact on graft outcomes after kidney transplantation using organs from donation after brain-stem death (DBD) donors. Here, we examine the impact of DGF and AR on graft survival in kidney transplants using organs from donation after cardiac death (DCD) donors. We conducted a single-center retrospective study of DCD and DBD donor kidney transplants. We compared 1- and 4-year graft and patient survival rates, as well as death-censored graft survival (DCGS) rates, between the two groups using univariate analysis, and the impact of DGF and AR on graft function was compared using multivariate analysis. Eighty DCD and 206 DBD donor transplants were analyzed. Median follow-up was 4.5 years. The incidence of DGF was higher among DCD recipients (73% vs. 27%, P<0.001), and AR was higher among DBD recipients (23% vs. 9%, P<0.001). One-year and 4-year graft survival rates were similar (DCD 94% and 79% vs. DBD 90% and 82%). Among recipients with DGF, the 4-year DCGS rate was better for DCD recipients compared with DBD recipients (100% vs. 92%, P=0.04). Neither DGF nor AR affected the 1-year graft survival rate in DCD recipients, whereas in DBD recipients, the 1-year graft survival rate was worse in the presence of DGF (88% vs. 96%, P=0.04) and the 4-year DCGS rate was worse in the presence of AR (88% vs. 96%, P=0.04). Despite the high incidence of DGF, medium-term outcomes of DCD kidney transplants are comparable to those from DBD transplants. Short-term graft survival from DCD transplants is not adversely influenced by DGF and AR, unlike in DBD transplants.

Self-reported mood, general health, wellbeing and employment status in adults with suspected DCD.

PubMed

Kirby, Amanda; Williams, Natalie; Thomas, Marie; Hill, Elisabeth L

2013-04-01

Developmental Coordination Disorder (DCD) affects around 2-6% of the population and is diagnosed on the basis of poor motor coordination in the absence of other neurological disorders. Its psychosocial impact has been delineated in childhood but until recently there has been little understanding of the implications of the disorder beyond this. This study aims to focus on the longer term impact of having DCD in adulthood and, in particular, considers the effect of employment on this group in relation to psychosocial health and wellbeing. Self-reported levels of life satisfaction, general health and symptoms of anxiety and depression were investigated in a group of adults with a diagnosis of DCD and those with suspected DCD using a number of published self-report questionnaire measures. A comparison between those in and out of employment was undertaken. As a group, the unemployed adults with DCD reported significantly lower levels of life satisfaction. Whilst there was no significant difference between those who were employed and unemployed on General Health Questionnaire scores; both groups reported numbers of health related issues reflective of general health problems in DCD irrespective of employment status. While both groups reported high levels of depressive symptoms and rated their satisfaction with life quite poorly, the unemployed group reported significantly more depressive symptoms and less satisfaction. Additionally, the results identified high levels of self-reported anxiety in both groups, with the majority sitting outside of the normal range using the Hospital Anxiety and Depression Scale. These findings add to the small but increasing body of literature on physical and mental health and wellbeing in adults with DCD. Furthermore, they are the first to provide insight into the possible mediating effects of employment status in adults with DCD. Copyright © 2013 Elsevier Ltd. All rights reserved.

The thin flat line: redefining who is legally dead in organ donation after cardiac death.

PubMed

Harrington, Maxine M

2009-01-01

The debate over whether donation after cardiac death (DCD) donors are truly dead is not new but has surfaced mostly in the academic community. In 2008, widespread publicity was given to the indictment of a transplant surgeon in California in connectionwith the alleged administration of excessive and inappropriate medications to a potential donor awaiting cardiac death after removal from a ventilator. This and other reports in the lay press mirror the expanding use of DCD to boost the supply of organs. This article explains the practice of donation after cardiac death, examines whether DCD donors are legally dead under the UDDA, explores whether it is appropriate to apply DCD as it is currently practiced, addresses the concern that DCD is causing the death of donors, and suggests several approaches to resolve the controversy over the determination of death in DCD donors. The author concludes with a call for this debate to move beyond scholarly journals into the public arena.

Procedural Learning in Children With Developmental Coordination, Reading, and Attention Disorders.

PubMed

Magallón, Sara; Crespo-Eguílaz, Nerea; Narbona, Juan

2015-10-01

The aim is to assess repetition-based learning of procedures in children with developmental coordination disorder (DCD), reading disorder (RD) and attention-deficit hyperactivity disorder (ADHD). Participants included 187 children, studied in 4 groups: (a) DCD comorbid with RD and ADHD (DCD+RD+ADHD) (n = 30); (b) RD comorbid with ADHD (RD+ADHD) (n = 48); (c) ADHD (n = 19); and typically developing children (control group) (n = 90). Two procedural learning tasks were used: Assembly learning and Mirror drawing. Children were tested on 4 occasions for each task: 3 trials were consecutive and the fourth trial was performed after an interference task. Task performance by DCD+RD+ADHD children improved with training (P < .05); however, the improvement was significantly lower than that achieved by the other groups (RD+ADHD, ADHD and controls) (P < .05). In conclusion, children with DCD+RD+ADHD improve in their use of cognitive-motor procedures over a short training period. Aims of intervention in DCD+RD+ADHD should be based on individual learning abilities. © The Author(s) 2015.

 Liver transplantation in the critically ill: donation after cardiac death compared to donation after brain death grafts.

PubMed

Taner, C Burcin; Bulatao, Ilynn G; Arasi, Lisa C; Perry, Dana K; Willingham, Darrin L; Sibulesky, Lena; Rosser, Barry G; Canabal, Juan M; Nguyen, Justin H; Kramer, David J

2012-01-01

 Patients with end stage liver disease may become critically ill prior to LT requiring admission to the intensive care unit (ICU). The high acuity patients may be thought too ill to transplant; however, often LT is the only therapeutic option. Choosing the correct liver allograft for these patients is often difficult and it is imperative that the allograft work immediately. Donation after cardiac death (DCD) donors provide an important source of livers, however, DCD graft allocation remains a controversial topic, in critically ill patients. Between January 2003-December 2008, 1215 LTs were performed: 85 patients at the time of LT were in the ICU. Twelve patients received DCD grafts and 73 received donation after brain dead (DBD) grafts. After retransplant cases and multiorgan transplants were excluded, 8 recipients of DCD grafts and 42 recipients of DBD grafts were included in this study. Post-transplant outcomes of DCD and DBD liver grafts were compared. While there were differences in graft and survival between DCD and DBD groups at 4 month and 1 year time points, the differences did not reach statistical significance. The graft and patient survival rates were similar among the groups at 3-year time point. There is need for other large liver transplant programs to report their outcomes using liver grafts from DCD and DBD donors. We believe that the experience of the surgical, medical and critical care team is important for successfully using DCD grafts for critically ill patients.

Relationship between perceived competence and performance during real and virtual motor tasks by children with developmental coordination disorder.

PubMed

Engel-Yeger, Batya; Sido, Rotem; Mimouni-Bloch, Aviva; Weiss, Patrice L

2017-10-01

(i) To compare children with DCD and typically developing participants via standard motor assessments, two interactive virtual games, measures of physical, social and cognitive self-competence and feedback while playing the virtual games and (ii) To examine the contribution of age and each motor assessment to predict self-competence. Participants were 25 boys with DCD and 25 typically developing boys, aged 5-9 years. They completed the M-ABC-2, the Pictorial Scale of Perceived Competence, the 6-Minute Walk Test, and then played the two Kinect games and completed the Short Feedback Questionnaire for Children. Children with DCD showed lower physical competence and lower performance than the typical controls in all standard motor assessments. This performance significantly correlated with the children achievements in part of virtual games and with their self-perceived experience while performing within virtual environments. Among the DCD group, Kinect Running game significantly predicted physical and social competence. The significant correlations between the virtual games and standard motor assessments support the feasibility of using these games when evaluating children with DCD for the richer profile they provide. Implications for rehabilitation Clinicians should refer to the impacts of DCD on child's self-competence and daily life. Technological rehabilitation and the use of VR games have the potential to improve self-competence of children with DCD. By including VR games that simulate real life in the intervention for DCD, clinicians may raise child's enjoyment, self-competence and involvement in therapy.

Impact of donor obesity and donation after cardiac death on outcomes after kidney transplantation.

PubMed

Ortiz, Jorge; Gregg, Austin; Wen, Xuerong; Karipineni, Farah; Kayler, Liise K

2012-01-01

The effect of donor body mass index (BMI) and donor type on kidney transplant outcomes has not been well studied. Scientific Registry of Transplant Recipients data on recipients of deceased-donor kidneys between 1997 and 2010 were reviewed. Donors were categorized by DCD status (DCD, 6932; non-DCD, 90,158) and BMI groups at 5 kg/m(2) increments: 18.5-24.9, 25-29.9, 30-34.9, 35-39.9, 40-44.9, and ≥ 45 kg/m(2) . The primary outcome, death-censored graft survival (DCGS), was adjusted for donor, recipient, and transplant characteristics. Among recipients of non-DCD kidneys, donor BMI was not associated with DCGS. Among DCD recipients, donor BMI was not associated with DCGS for donor BMI categories < 45 kg/m(2) ; however, donor BMI ≥ 45 kg/m(2) was independently associated with DCGS compared to BMI of 20-24.9 kg/m(2) (adjusted hazard ratio, 1.84; 95% CI, 1.23, 2.74). The adjusted odds of delayed graft function (DGF) was greater for each level of BMI above reference for both DCD and non-DCD groups. There was no association of donor BMI with one-yr acute rejection for either type of donor. Although BMI is associated with DGF, long-term graft survival is not affected except in the combination of DCD with extreme donor BMI ≥ 45. © 2012 John Wiley & Sons A/S.

Can balance trampoline training promote motor coordination and balance performance in children with developmental coordination disorder?

PubMed

Giagazoglou, Paraskevi; Sidiropoulou, Maria; Mitsiou, Maria; Arabatzi, Fotini; Kellis, Eleftherios

2015-01-01

The present study aimed to examine movement difficulties among typically developing 8- to 9-year-old elementary students in Greece and to investigate the possible effects of a balance training program to those children assessed with Developmental Coordination Disorder (DCD). The Body Coordination Test for Children (BCTC; Körperkoordinationstest fur Kinder, KTK, Kiphard & Schilling, 1974) was chosen for the purposes of this study and 20 children out of the total number of 200, exhibited motor difficulties indicating a probable DCD disorder. The 20 students diagnosed with DCD were equally separated into two groups where each individual of the experimental group was paired with an individual of the control group. The intervention group attended a 12-week balance training program while students of the second - control group followed the regular school schedule. All participants were tested prior to the start and after the end of the 12-week period by performing static balance control tasks while standing on an EPS pressure platform and structured observation of trampoline exercises while videotaping. The results indicated that after a 12-week balance training circuit including a trampoline station program, the intervention group improved both factors that were examined. In conclusion, balance training with the use of attractive equipment such as trampoline can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity. Copyright © 2014 Elsevier Ltd. All rights reserved.

ADHD and Comorbid Developmental Coordination Disorder: Implications and Recommendations for School Psychologists

ERIC Educational Resources Information Center

Lange, Stephen M.

2018-01-01

Developmental coordination disorder (DCD) is frequently comorbid with attention-deficit hyperactivity disorder (ADHD). DCD results in functional impairment in activities of daily living, and children's physical activities with peers. Children with DCD report fewer friendships, more bullying, and less confidence in their ability to participate in…

Sensory Organization of Balance Control in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Fong, Shirley S. M.; Lee, Velma Y. L.; Pang, Marco Y. C.

2011-01-01

This study aimed to (1) compare functional balance performance and sensory organization of postural control between children with and without developmental coordination disorder (DCD) and (2) determine the association between postural control and participation diversity among children with DCD. We recruited 81 children with DCD and 67 typically…

Action planning and position sense in children with Developmental Coordination Disorder.

PubMed

Adams, Imke L J; Ferguson, Gillian D; Lust, Jessica M; Steenbergen, Bert; Smits-Engelsman, Bouwien C M

2016-04-01

The present study examined action planning and position sense in children with Developmental Coordination Disorder (DCD). Participants performed two action planning tasks, the sword task and the bar grasping task, and an active elbow matching task to examine position sense. Thirty children were included in the DCD group (aged 6-10years) and age-matched to 90 controls. The DCD group had a MABC-2 total score ⩽5th percentile, the control group a total score ⩾25th percentile. Results from the sword-task showed that children with DCD planned less for end-state comfort. On the bar grasping task no significant differences in planning for end-state comfort between the DCD and control group were found. There was also no significant difference in the position sense error between the groups. The present study shows that children with DCD plan less for end-state comfort, but that this result is task-dependent and becomes apparent when more precision is needed at the end of the task. In that respect, the sword-task appeared to be a more sensitive task to assess action planning abilities, than the bar grasping task. The action planning deficit in children with DCD cannot be explained by an impaired position sense during active movements. Copyright © 2016 Elsevier B.V. All rights reserved.

Functional brain correlates of motor response inhibition in children with developmental coordination disorder and attention deficit/hyperactivity disorder.

PubMed

Thornton, Siobhan; Bray, Signe; Langevin, Lisa Marie; Dewey, Deborah

2018-06-01

Motor impairment is associated with developmental coordination disorder (DCD), and to a lesser extent with attention-deficit/hyperactivity disorder (ADHD). Previous functional imaging studies investigated children with DCD or ADHD only; however, these two disorders co-occur in up to 50% of cases, suggesting that similar neural correlates are associated with these disorders. This study compared functional brain activation in children and adolescents (age range 8-17, M = 11.73, SD = 2.88) with DCD (n = 9), ADHD (n = 20), co-occurring DCD and ADHD (n = 18) and typically developing (TD) controls (n = 20). When compared to TD controls, children with co-occurring DCD/ADHD showed decreased activation during response inhibition in primary motor and sensory cortices. These findings suggest that children with co-occurring DCD and ADHD display significant functional changes in brain activation that could interfere with inhibition of erroneous motor responses. In contrast to previous studies, significant alterations in brain activation relative to TD controls, were not found in children with isolated DCD or ADHD. These findings highlight the importance of considering co-occurring disorders when investigating brain function in children with neurodevelopmental disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Apoptosis transcriptional mechanism of feline infectious peritonitis virus infected cells.

PubMed

Shuid, Ahmad Naqib; Safi, Nikoo; Haghani, Amin; Mehrbod, Parvaneh; Haron, Mohd Syamsul Reza; Tan, Sheau Wei; Omar, Abdul Rahman

2015-11-01

Apoptosis has been postulated to play an important role during feline infectious peritonitis virus (FIPV) infection; however, its mechanism is not well characterized. This study is focused on apoptosis and transcriptional profiling of FIPV-infected cells following in vitro infection of CRFK cells with FIPV 79-1146 WSU. Flow cytometry was used to determine mode of cell death in first 42 h post infection (hpi). FIPV infected cells underwent early apoptosis at 9 hpi (p < 0.05) followed by late apoptosis at 12 hpi (p < 0.05) and necrosis from 24 hpi (p < 0.05). Then, next generation sequencing was performed on 9 hpi and control uninfected cells by Illumina analyzer. An aggregate of 4546 genes (2229 down-regulated and 2317 up-regulated) from 17 cellular process, 11 molecular functions and 130 possible biological pathways were affected by FIPV. 131 genes from apoptosis cluster (80 down-regulated and 51 up-regulated) along with increase of apoptosis, p53, p38 MAPK, VEGF and chemokines/cytokines signaling pathways were probably involved in apoptosis process. Six of the de-regulated genes expression (RASSF1, BATF2, MAGEB16, PDCD5, TNFα and TRAF2) and TNFα protein concentration were analyzed by RT-qPCR and ELISA, respectively, at different time-points. Up-regulations of both pro-apoptotic (i.e. PDCD5) and anti-apoptotic (i.e. TRAF2) were detected from first hpi and continuing to deregulate during apoptosis process in the infected cells.

Resveratrol Reduces Prostate Cancer Growth and Metastasis by Inhibiting the Akt/MicroRNA-21 Pathway

PubMed Central

Sheth, Sandeep; Jajoo, Sarvesh; Kaur, Tejbeer; Mukherjea, Debashree; Sheehan, Kelly; Rybak, Leonard P.; Ramkumar, Vickram

2012-01-01

The consumption of foods containing resveratrol produces significant health benefits. Resveratrol inhibits cancer by reducing cell proliferation and metastasis and by inducing apoptosis. These actions could be explained by its ability to inhibit (ERK-1/2), Akt and suppressing the levels of estrogen and insulin growth factor -1 (IGF-1) receptor. How these processes are manifested into the antitumor actions of resveratrol is not clear. Using microarray studies, we show that resveratrol reduced the expression of various prostate-tumor associated microRNAs (miRs) including miR-21 in androgen-receptor negative and highly aggressive human prostate cancer cells, PC-3M-MM2. This effect of resveratrol was associated with reduced cell viability, migration and invasiveness. Additionally, resveratrol increased the expression of tumor suppressors, PDCD4 and maspin, which are negatively regulated by miR-21. Short interfering (si) RNA against PDCD4 attenuated resveratrol’s effect on prostate cancer cells, and similar effects were observed following over expression of miR-21 with pre-miR-21 oligonucleotides. PC-3M-MM2 cells also exhibited high levels of phospho-Akt (pAkt), which were reduced by both resveratrol and LY294002 (a PI3-kinase inhibitor). MiR-21 expression in these cells appeared to be dependent on Akt, as LY294002 reduced the levels of miR-21 along with a concurrent increase in PDCD4 expression. These in vitro findings were further corroborated in a severe combined immunodeficient (SCID) mouse xenograft model of prostate cancer. Oral administration of resveratrol not only inhibited the tumor growth but also decreased the incidence and number of metastatic lung lesions. These tumor- and metastatic-suppressive effects of resveratrol were associated with reduced miR-21 and pAkt, and elevated PDCD4 levels. Similar anti-tumor effects of resveratrol were observed in DU145 and LNCaP prostate cancer cells which were associated with suppression of Akt and PDCD4, but independent of miR-21.These data suggest that resveratrol’s anti-tumor actions in prostate cancer could be explained, in part, through inhibition of Akt/miR-21 signaling pathway. PMID:23272133

The expression of selected molecular markers of immune tolerance in psoriatic patients.

PubMed

Bartosińska, Joanna; Purkot, Joanna; Kowal, Małgorzata; Michalak-Stoma, Anna; Krasowska, Dorota; Chodorowska, Grażyna; Giannopoulos, Krzysztof

2018-04-24

Psoriasis is a chronic autoinflammatory disease whose underlying molecular mechanisms remain unclear. The disease is mediated by the cells and molecules of both the innate and adaptive immune systems. Some T cell surface molecules, including neuropilin-1 (NRP1), programmed death 1 (PD-1) and the human leukocyte antigen G (HLA-G), are known to play a role in the maintenance of immune tolerance. The aim of this study was to investigate HLA-G, NRP1 and programmed cell death gene (PDCD1) mRNA expression in psoriatic patients. The study included 72 psoriatic patients and 35 healthy individuals. Twentyone patients (29.17%) suffered from concomitant psoriatic arthritis. The mRNA expression of HLA-G, NRP1, and PDCD1 were determined using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). The severity of skin lesions was assessed by means of the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA), the Patient Global Assessment (PGA), and the Dermatology Life Quality Index (DLQI). The median value of the PASI was 11.5, and of BSA was 15.8%. The expressions of NRP1 and PDCD1, but not HLA-G, were significantly lower in psoriatic patients in comparison with the control group. The expression of HLA-G, NRP1 and PDCD1 were not significantly different in the psoriatic arthritis and psoriasis vulgaris patients. The results of this study suggest that the molecular markers of immune tolerance, i.e., HLA-G, NRP1, and PD-1, may be involved in the immune response in psoriatic patients.

High-throughput sequencing of the entire genomic regions of CCM1/KRIT1, CCM2 and CCM3/PDCD10 to search for pathogenic deep-intronic splice mutations in cerebral cavernous malformations.

PubMed

Rath, Matthias; Jenssen, Sönke E; Schwefel, Konrad; Spiegler, Stefanie; Kleimeier, Dana; Sperling, Christian; Kaderali, Lars; Felbor, Ute

2017-09-01

Cerebral cavernous malformations (CCM) are vascular lesions of the central nervous system that can cause headaches, seizures and hemorrhagic stroke. Disease-associated mutations have been identified in three genes: CCM1/KRIT1, CCM2 and CCM3/PDCD10. The precise proportion of deep-intronic variants in these genes and their clinical relevance is yet unknown. Here, a long-range PCR (LR-PCR) approach for target enrichment of the entire genomic regions of the three genes was combined with next generation sequencing (NGS) to screen for coding and non-coding variants. NGS detected all six CCM1/KRIT1, two CCM2 and four CCM3/PDCD10 mutations that had previously been identified by Sanger sequencing. Two of the pathogenic variants presented here are novel. Additionally, 20 stringently selected CCM index cases that had remained mutation-negative after conventional sequencing and exclusion of copy number variations were screened for deep-intronic mutations. The combination of bioinformatics filtering and transcript analyses did not reveal any deep-intronic splice mutations in these cases. Our results demonstrate that target enrichment by LR-PCR combined with NGS can be used for a comprehensive analysis of the entire genomic regions of the CCM genes in a research context. However, its clinical utility is limited as deep-intronic splice mutations in CCM1/KRIT1, CCM2 and CCM3/PDCD10 seem to be rather rare. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Longterm results of liver transplantation from donation after circulatory death.

PubMed

Blok, Joris J; Detry, Olivier; Putter, Hein; Rogiers, Xavier; Porte, Robert J; van Hoek, Bart; Pirenne, Jacques; Metselaar, Herold J; Lerut, Jan P; Ysebaert, Dirk K; Lucidi, Valerio; Troisi, Roberto I; Samuel, Undine; den Dulk, A Claire; Ringers, Jan; Braat, Andries E

2016-08-01

Donation after circulatory death (DCD) liver transplantation (LT) may imply a risk for decreased graft survival, caused by posttransplantation complications such as primary nonfunction or ischemic-type biliary lesions. However, similar survival rates for DCD and donation after brain death (DBD) LT have been reported. The objective of this study is to determine the longterm outcome of DCD LT in the Eurotransplant region corrected for the Eurotransplant donor risk index (ET-DRI). Transplants performed in Belgium and the Netherlands (January 1, 2003 to December 31, 2007) in adult recipients were included. Graft failure was defined as either the date of recipient death or retransplantation whichever occurred first (death-uncensored graft survival). Mean follow-up was 7.2 years. In total, 126 DCD and 1264 DBD LTs were performed. Kaplan-Meier survival analyses showed different graft survival for DBD and DCD at 1 year (77.7% versus 74.8%, respectively; P = 0.71), 5 years (65.6% versus 54.4%, respectively; P = 0.02), and 10 years (47.3% versus 44.2%, respectively; P = 0.55; log-rank P = 0.038). Although there was an overall significant difference, the survival curves almost reach each other after 10 years, which is most likely caused by other risk factors being less in DCD livers. Patient survival was not significantly different (P = 0.59). Multivariate Cox regression analysis showed a hazard ratio of 1.7 (P < 0.001) for DCD (corrected for ET-DRI and recipient factors). First warm ischemia time (WIT), which is the time from the end of circulation until aortic cold perfusion, over 25 minutes was associated with a lower graft survival in univariate analysis of all DCD transplants (P = 0.002). In conclusion, DCD LT has an increased risk for diminished graft survival compared to DBD. There was no significant difference in patient survival. DCD allografts with a first WIT > 25 minutes have an increased risk for a decrease in graft survival. Liver Transplantation 22 1107-1114 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

Atypical within- and between-hemisphere motor network functional connections in children with developmental coordination disorder and attention-deficit/hyperactivity disorder.

PubMed

McLeod, Kevin R; Langevin, Lisa Marie; Dewey, Deborah; Goodyear, Bradley G

2016-01-01

Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are highly comorbid neurodevelopmental disorders; however, the neural mechanisms of this comorbidity are poorly understood. Previous research has demonstrated that children with DCD and ADHD have altered brain region communication, particularly within the motor network. The structure and function of the motor network in a typically developing brain exhibits hemispheric dominance. It is plausible that functional deficits observed in children with DCD and ADHD are associated with neurodevelopmental alterations in within- and between-hemisphere motor network functional connection strength that disrupt this hemispheric dominance. We used resting-state functional magnetic resonance imaging to examine functional connections of the left and right primary and sensory motor (SM1) cortices in children with DCD, ADHD and DCD + ADHD, relative to typically developing children. Our findings revealed that children with DCD, ADHD and DCD + ADHD exhibit atypical within- and between-hemisphere functional connection strength between SM1 and regions of the basal ganglia, as well as the cerebellum. Our findings further support the assertion that development of atypical motor network connections represents common and distinct neural mechanisms underlying DCD and ADHD. In children with DCD and DCD + ADHD (but not ADHD), a significant correlation was observed between clinical assessment of motor function and the strength of functional connections between right SM1 and anterior cingulate cortex, supplementary motor area, and regions involved in visuospatial processing. This latter finding suggests that behavioral phenotypes associated with atypical motor network development differ between individuals with DCD and those with ADHD.

Outcomes of simultaneous pancreas-kidney transplantation from brain-dead and controlled circulatory death donors.

PubMed

Qureshi, M S; Callaghan, C J; Bradley, J A; Watson, C J E; Pettigrew, G J

2012-06-01

Organ scarcity has prompted increased use of organs from donation after circulatory death (DCD) donors. An early single-centre experience of simultaneous pancreas-kidney (SPK) transplantation from controlled DCD donors is described here. Outcomes of SPK transplants from DCD and donation after brain death (DBD) donors between August 2008 and January 2011 were reviewed retrospectively. SPK transplants from 20 DCD and 40 DBD donors were carried out. Donor and recipient characteristics were similar for both groups, although pancreas cold ischaemia times were shorter in DCD recipients: median (range) 8·2 (5·9-10·5) versus 9·5 (3·8-12·5) h respectively (P = 0·004). Median time from treatment withdrawal to cold perfusion was 24 (range 16-110) min for DCD donors. There were no episodes of delayed pancreatic graft function in either group; the graft thrombosis rates were both 5 per cent. Similarly, there were no differences in haemoglobin A1c level at 12 months: median (range) 5·4 (4·9-7·7) per cent in DCD group versus 5·4 (4·1-6·2) per cent in DBD group (P = 0·910). Pancreas graft survival rates were not significantly different, with Kaplan-Meier 1-year survival estimates of 84 and 95 per cent respectively (P = 0·181). DCD SPK grafts had comparable short-term outcomes to DBD grafts, even when procured from selected donors with a prolonged agonal phase. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Actinopolysporins A-C and tubercidin as a Pdcd4 stabilizer from the halophilic actinomycete Actinopolyspora erythraea YIM 90600.

PubMed

Zhao, Li-Xing; Huang, Sheng-Xiong; Tang, Shu-Kun; Jiang, Cheng-Lin; Duan, Yanwen; Beutler, John A; Henrich, Curtis J; McMahon, James B; Schmid, Tobias; Blees, Johanna S; Colburn, Nancy H; Rajski, Scott R; Shen, Ben

2011-09-23

Our current natural product program utilizes new actinomycetes originating from unexplored and underexplored ecological niches, employing cytotoxicity against a selected panel of cancer cell lines as the preliminary screen to identify hit strains for natural product dereplication, followed by mechanism-based assays of the purified natural products to discover potential anticancer drug leads. Three new linear polyketides, actinopolysporins A (1), B (2), and C (3), along with the known antineoplastic antibiotic tubercidin (4), were isolated from the halophilic actinomycete Actinopolyspora erythraea YIM 90600, and the structures of the new compounds were elucidated on the basis of spectroscopic data interpretation. All four compounds were assayed for their ability to stabilize the tumor suppressor programmed cell death protein 4 (Pdcd4), which is known to antagonize critical events in oncogenic pathways. Only 4 significantly inhibited proteasomal degradation of a model Pdcd4-luciferase fusion protein, with an IC50 of 0.88±0.09 μM, unveiling a novel biological activity for this well-studied natural product.

A Trajectory of Troubles: Parents' Impressions of the Impact of Developmental Coordination Disorder

ERIC Educational Resources Information Center

Missiuna, Cheryl; Moll, Sandra; King, Susanne; King, Gillian; Law, Mary

2007-01-01

Objective: To explore parent perspectives regarding the early experiences of their children with Developmental Coordination Disorder (DCD). Methods: A phenomenological approach was used to explore the meaning of developmental experiences for children with DCD and their families. Parents of 13 children with DCD, aged 6-14, were recruited through…

An examination of writing pauses in the handwriting of children with developmental coordination disorder.

PubMed

Prunty, Mellissa M; Barnett, Anna L; Wilmut, Kate; Plumb, Mandy S

2014-11-01

Difficulties with handwriting are reported as one of the main reasons for the referral of children with Developmental Coordination Disorder (DCD) to healthcare professionals. In a recent study we found that children with DCD produced less text than their typically developing (TD) peers and paused for 60% of a free-writing task. However, little is known about the nature of the pausing; whether they are long pauses possibly due to higher level processes of text generation or fatigue, or shorter pauses related to the movements between letters. This gap in the knowledge-base creates barriers to understanding the handwriting difficulties in children with DCD. The aim of this study was to characterise the pauses observed in the handwriting of English children with and without DCD. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 TD age and gender matched controls. Participants completed the 10 min free-writing task from the Detailed Assessment of Speed of Handwriting (DASH) on a digitising writing tablet. The total overall percentage of pausing during the task was categorised into four pause time-frames, each derived from the literature on writing (250 ms to 2 s; 2-4 s; 4-10 s and >10 s). In addition, the location of the pauses was coded (within word/between word) to examine where the breakdown in the writing process occurred. The results indicated that the main group difference was driven by more pauses above 10 s in the DCD group. In addition, the DCD group paused more within words compared to TD peers, indicating a lack of automaticity in their handwriting. These findings may support the provision of additional time for children with DCD in written examinations. More importantly, they emphasise the need for intervention in children with DCD to promote the acquisition of efficient handwriting skill. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Variable training does not lead to better motor learning compared to repetitive training in children with and without DCD when exposed to active video games.

PubMed

Bonney, Emmanuel; Jelsma, Dorothee; Ferguson, Gillian; Smits-Engelsman, Bouwien

2017-03-01

Little is known about the influence of practice schedules on motor learning and skills transfer in children with and without developmental coordination disorder (DCD). Understanding how practice schedules affect motor learning is necessary for motor skills development and rehabilitation. The study investigated whether active video games (exergames) training delivered under variable practice led to better learning and transfer than repetitive practice. 111 children aged 6-10 years (M=8.0, SD=1.0) with no active exergaming experience were randomized to receive exergames training delivered under variable (Variable Game Group (VGG), n=56) or repetitive practice schedule (Repetitive Game Group (RGG), n=55). Half the participants were identified as DCD using the DSM-5 criteria, while the rest were typically developing (TD), age-matched children. Both groups participated in two 20min sessions per week for 5 weeks. Both participant groups (TD and DCD) improved equally well on game performance. There was no significant difference in positive transfer to balance tasks between practice schedules (Repetitive and Variable) and participant groups (TD and DCD). Children with and without DCD learn balance skills quite well when exposed to exergames. Gains in learning and transfer are similar regardless of the form of practice schedule employed. This is the first paper to compare the effect of practice schedules on learning in children with DCD and those with typical development. No differences in motor learning were found between repetitive and variable practice schedules. When children with and without DCD spend the same amount of time on exergames, they do not show any differences in acquisition of motor skills. Transfer of motor skills is similar in children with and without DCD regardless of differences in practice schedules. Copyright © 2017 Elsevier Ltd. All rights reserved.

Hepatitis C Virus Recurrence Occurs Earlier in Patients Receiving Donation After Circulatory Death Liver Transplant Grafts Compared With Those Receiving Donation After Brainstem Death Grafts.

PubMed

Townsend, S A; Monga, M A; Nightingale, P; Mutimer, D; Elsharkawy, A M; Holt, A

2017-11-01

Hepatitis C virus (HCV)-related cirrhosis remains the commonest indication for liver transplantation worldwide, yet few studies have investigated the impact of donation after circulatory death (DCD) graft use on HCV recurrence and patient outcomes. DCD grafts have augmented the limited donor organ pool and reduced wait-list mortality, although concerns regarding graft longevity and patient outcome persist. This was a single-center study of all HCV + adults who underwent DCD liver transplantation between 2004 and 2014. 44 HCV+ patients received DCD grafts, and were matched with 44 HCV+ recipients of donation after brainstem death (DBD) grafts, and their outcomes examined. The groups were matched for age, sex, and presence of hepatocellular carcinoma; no significant differences were found between the group's donor or recipient characteristics. Paired and unpaired analysis demonstrated that HCV recurrence was more rapid in recipients of DCD organs compared with DBD grafts (408 vs 657 days; P = .006). There were no significant differences in graft survival, patient survival, or rates of biliary complications between the cohorts despite DCD donors being 10 years older on average than those used in other published experience. In an era of highly effective direct acting antiviral therapy, rapid HCV recrudescence in grafts from DCD donors should not compromise long-term morbidity or mortality. In the context of rising wait-list mortality, it is prudent to use all available sources to expand the pool of donor organs, and our data support the practice of using extended-criteria DCD grafts based on donor age. Notwithstanding that, clinicians should be aware that HCV recrudescence is more rapid in DCD recipients, and early post-transplant anti-viral therapy is indicated to prevent graft injury. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Ethical controversies in organ donation after circulatory death.

PubMed

2013-05-01

The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be required to participate in DCD. Because the preparation for organ recovery in DCD begins before the declaration of death, there are potential conflicts between the donor's and recipient's interests. These conflicts can be managed in a variety of ways, including informed consent and separating the various participants' roles. For example, informed consent should be sought for premortem interventions to improve organ viability, and organ procurement organization personnel and members of the transplant team should not be involved in the discontinuation of life-sustaining treatment or the declaration of death. It is also important to emphasize that potential donors in cases of DCD should receive integrated interdisciplinary palliative care, including sedation and analgesia.

Direction-specific impairment of stability limits and falls in children with developmental coordination disorder: Implications for rehabilitation.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Chung, Louisa M Y; Ki, W Y; Chow, Lina P Y; Macfarlane, Duncan J

2016-01-01

Limit of stability (LOS) is an important yet under-examined postural control ability in children with developmental coordination disorder (DCD). This study aimed to (1) compare the LOS and fall frequencies of children with and without DCD, and (2) explore the relationships between LOS parameters and falls in the DCD population. Thirty primary school-aged children with DCD and twenty age- and sex-matched typically-developing children participated in the study. Postural control ability, specifically LOS in standing, was evaluated using the LOS test. Reaction time, movement velocity, maximum excursion, end point excursion, and directional control were then calculated. Self-reported fall incidents in the previous week were also documented. Multivariate analysis of variance results revealed that children with DCD had shorter LOS maximum excursion in the backward direction compared to the control group (p=0.003). This was associated with a higher number of falls in daily life (rho=-0.556, p=0.001). No significant between-groups differences were found in other LOS-derived outcomes (p>0.05). Children with DCD had direction-specific postural control impairment, specifically, diminished LOS in the backward direction. This is related to their falls in daily life. Therefore, improving LOS should be factored into rehabilitation treatment for children with DCD. Copyright © 2015 Elsevier B.V. All rights reserved.

Outcome of Kidney Transplantation From Donor After Cardiac Death: Reanalysis of the US Mycophenolic Renal Transplant Registry.

PubMed

Zhu, D; McCague, K; Lin, W; Rong, R; Xu, M; Chan, L; Zhu, T

2018-06-01

Kidney transplantation is limited by the shortage of donor kidneys. Donation after cardiac death (DCD) has been explored to alleviate this problem. To better understand the outcome of DCD kidney transplantation, we reanalyzed the Mycophenolic Renal Transplant (MORE) Registry. We compared delayed graft function (DGF), biopsy-proved acute rejection (BPAR), graft loss, and patient death between DCD and donation after brain death (DBD) kidney transplantations. Recipients were further stratified into depleting and nondepleting induction groups for exploratory analysis. There were 548 patients who received kidney transplants from deceased donor in the MORE Registry. Among them, 133 received grafts from DCD donors and 415 received from DBD donors. The incidence of DGF was 29.4% and 23.5% in the DCD group and the DBD group, respectively (P = .1812), and the incidence of BPAR at 12 months was 9.0% and 9.9% respectively (P = .7713). The 1-year graft loss rate in the DCD group was higher than that in the DBD group (7.5% vs 3.1%, P = .0283), and the 4-year graft loss rate and patient death rate were not significantly different between the 2 groups. The DCD kidney transplant group had acceptable short-term outcomes and good long-term outcomes as compared with the DBD kidney transplant group. Copyright © 2018 Elsevier Inc. All rights reserved.

Evidence to Practice Commentary: New Evidence in Developmental Coordination Disorder (DCD)

ERIC Educational Resources Information Center

Novak, Iona

2013-01-01

Developmental coordination disorder (DCD) is frequently under-recognized, but in fact, it occurs in as many as 5-6% of children. DCD is a disorder of motor coordination that is not explained by intellectual disability or any congenital or acquired neurological disorder. Families seek physical and occupational therapy (OT) to ameliorate a child…

Movement Difficulties Affect Children's Learning: An Overview of Developmental Coordination Disorder (DCD)

ERIC Educational Resources Information Center

Caçola, Priscila

2014-01-01

The study of children with Developmental Coordination Disorder (DCD) has emerged as a vibrant line of inquiry over the last three decades. DCD is defined as a neurodevelopmental condition characterized by poor motor proficiency that interferes with a child's activities of daily living (sometimes also known as dyspraxia). Common symptoms include…

Timing Abilities among Children with Developmental Coordination Disorders (DCD) in Comparison to Children with Typical Development

ERIC Educational Resources Information Center

Rosenblum, Sara; Regev, Noga

2013-01-01

Timing ability is essential for common everyday performance. The aim of the study was to compare timing abilities and temporal aspects of handwriting performance and relationships between these two components among children with Developmental Coordination Disorders (DCD) and a control group. Forty two children, 21 diagnosed as DCD and 21 with…

Evaluation of the Japanese Version of the Developmental Coordination Disorder Questionnaire as a Screening Tool for Clumsiness of Japanese Children

ERIC Educational Resources Information Center

Nakai, Akio; Miyachi, Taishi; Okada, Ryo; Tani, Iori; Nakajima, Shunji; Onishi, Masafumi; Fujita, Chikako; Tsujii, Masatsugu

2011-01-01

Developmental Coordination Disorder (DCD) is characterized by clumsiness and coordination difficulties. DCD interferes with academic performance and participation in physical activities and psychosocial functions, such as self-esteem, cognition, or emotion, from childhood through adolescence to adulthood. DCD is a common pediatric condition and…

Supporting Pupils with DCD and ASD with the Transition to Secondary School

ERIC Educational Resources Information Center

Foulder-Hughes, Lynda; Prior, Clare

2014-01-01

Children with autistic spectrum disorders (ASDs) and developmental coordination disorder (DCD) are at an increased risk for a range of motor, sensory and social challenges which affect their ability to function at school. The current small scale, qualitative study sought to investigate how children with ASD and/or DCD felt about the transition to…

Deficits in the Covert Orienting of Attention in Children with Developmental Coordination Disorder: Does Severity of DCD Count?

ERIC Educational Resources Information Center

Chen, Wei-Ying; Wilson, Peter H.; Wu, Sheng K.

2012-01-01

Children with Developmental Coordination Disorder (DCD) show deficits in the covert orienting of visuospatial attention, suggesting an underlying issue in attentional disengagement and/or inhibitory control. However, an important theoretical issue that remains unclear is whether the pattern of deficits varies with DCD severity. Fifty-one children…

Lungs from donation after circulatory death donors: an alternative source to brain-dead donors? Midterm results at a single institution.

PubMed

Zych, Bartlomiej; Popov, Aron-Frederik; Amrani, Mohamed; Bahrami, Toufan; Redmond, Karen Christina; Krueger, Heike; Carby, Martin; Simon, André Ruediger

2012-09-01

Donor organ shortage remains to be the major limitation in lung transplantation, and donation after circulatory death (DCD) might represent one way to alleviate this problem. DCD was introduced to our institution in 2007 and has been a part of our clinical routine since then. Here, we present the mid-term results of lung transplantation from DCD in a single institution and compare the outcomes with the lung recipient cohort receiving lungs from donation after brain death (DBD). Since initiation of the DCD programme in March 2007, of the 157 lung transplantations performed, 26 (16.5%) were retrieved from DCD donors, with 25 double- and 1 single-lung transplants being performed. Results were compared with standard DBD transplantations. Analyses included, amongst others, donor characteristics, survival, prevalence of primary graft dysfunction, acute rejection, lung function tests during follow-up, onset of bronchiolitis obliterans syndrome (BOS) as well as duration of mechanical ventilation, hospital and intensive care unit length of stay. While there was no significant difference between lung function, BOS and survival between the two groups, lungs from DCD donors had a higher PaO(2) (median; interquartile range) 498.3 (451.5; 525) vs. DBD 442.5 (371.25; 502) kPa before retrieval (P = 0.009). There was also a longer total ischaemic time in the DCD vs. DBD group: 320 min (298.75; 393.25) vs. 285.5 min (240; 373) (P = 0.025). All other parameters were comparable. Medium-term results after lung transplantation with organs procured after circulatory death are comparable with those obtained after standard lung transplantation. Therefore, DCD could be used to significantly increase the donor pool.

Liver transplant outcomes using ideal donation after circulatory death livers are superior to using older donation after brain death donor livers.

PubMed

Scalea, Joseph R; Redfield, Robert R; Foley, David P

2016-09-01

Multiple reports have demonstrated that liver transplantation following donation after circulatory death (DCD) is associated with poorer outcomes when compared with liver transplantation from donation after brain death (DBD) donors. We hypothesized that carefully selected, underutilized DCD livers recovered from younger donors have excellent outcomes. We performed a retrospective study of the United Network for Organ Sharing database to determine graft survivals for patients who received liver transplants from DBD donors of age ≥ 60 years, DBD donors < 60 years, and DCD donors < 50 years of age. Between January 2002 and December 2014, 52,271 liver transplants were performed in the United States. Of these, 41,181 (78.8%) underwent transplantation with livers from DBD donors of age < 60 years, 8905 (17.0%) from DBD donors ≥ 60 years old, and 2195 (4.2%) livers from DCD donors < 50 years of age. DCD livers of age < 50 years with < 6 hours of cold ischemia time (CIT) had superior graft survival when compared with DBD livers ≥ age 60 years (P < 0.001). In 2014, there were 133 discarded DCD livers; of these, 111 (83.4%) were from donors < age 50 years old. Young DCD donor livers (age < 50 years old) with short CITs yield results better than that seen with DBD livers > 60 years old. Careful donor organ and recipient selection can lead to excellent results, despite previous reports suggesting otherwise. Increased acceptance of these DCD livers would lead to shorter wait list times and increased national liver transplant rates. Liver Transplantation 22 1197-1204 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Donor age as a risk factor in donation after circulatory death liver transplantation in a controlled withdrawal protocol programme.

PubMed

Detry, O; Deroover, A; Meurisse, N; Hans, M F; Delwaide, J; Lauwick, S; Kaba, A; Joris, J; Meurisse, M; Honoré, P

2014-06-01

Results of donation after circulatory death (DCD) liver transplantation are impaired by graft loss, resulting mainly from non-anastomotic biliary stricture. Donor age is a risk factor in deceased donor liver transplantation, and particularly in DCD liver transplantation. At the authors' institute, age is not an absolute exclusion criterion for discarding DCD liver grafts, DCD donors receive comfort therapy before withdrawal, and cold ischaemia is minimized. All consecutive DCD liver transplantations performed from 2003 to 2012 were studied retrospectively. Three age groups were compared in terms of donor and recipient demographics, procurement and transplantation conditions, peak laboratory values during the first post-transplant 72 h, and results at 1 and 3 years. A total of 70 DCD liver transplants were performed, including 32 liver grafts from donors aged 55 years or less, 20 aged 56-69 years, and 18 aged 70 years or more. The overall graft survival rate at 1 month, 1 and 3 years was 99, 91 and 72 per cent respectively, with no graft lost secondary to non-anastomotic stricture. No difference other than age was noted between the three groups for donor or recipient characteristics, or procurement conditions. No primary non-function occurred, but one patient needed retransplantation for artery thrombosis. Biliary complications were similar in the three groups. Graft and patient survival rates were no different at 1 and 3 years between the three groups (P = 0.605). Results for DCD liver transplantation from younger and older donors were similar. Donor age above 50 years should not be a contraindication to DCD liver transplantation if other donor risk factors (such as warm and cold ischaemia time) are minimized. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

Donation after cardiac death liver transplantation in primary sclerosing cholangitis: proceed with caution.

PubMed

Sundaram, Vinay; Choi, Gina; Jeon, Christie Y; Ayoub, Walid S; Nissen, Nicholas N; Klein, Andrew S; Tran, Tram T

2015-05-01

Primary sclerosing cholangitis (PSC) patients suffer from comorbidities unaccounted for by the model for end-stage liver disease scoring system and may benefit from the increased donor organ pool provided by donation after cardiac death (DCD) liver transplantation. However, the impact of DCD transplantation on PSC graft outcomes is unknown. We studied 41,018 patients using the United Network for Organ Sharing database from 2002 through 2012. Kaplan-Meier analysis and Cox regression were used to evaluate graft survival and risk factors for graft failure, respectively. The PSC patients receiving DCD livers (n=75) showed greater overall graft failure (37.3% vs. 20.4%, P = 0.001), graft failure from biliary complications (47.4% vs. 13.9%, P = 0.002), and shorter graft survival time (P = 0.003), compared to PSC patients receiving donation after brain death organs (n=1592). Among DCD transplants (n=1943), PSC and non-PSC patients showed similar prevalence of graft failure and graft survival time, though a trend existed toward increased biliary-induced graft failure among PSC patients (47.4 vs. 26.4%, P = 0.063). Cox modeling demonstrated that PSC patients have a positive graft survival advantage compared to non-PSC patients (hazard ratio [HR]=0.72, P < 0.001), whereas DCD transplantation increased risk of graft failure (HR = 1.28, P < 0.001). Furthermore, the interaction between DCD transplant and PSC was significant (HR = 1.76, P = 0.015), indicating that use of DCD organs impacts graft survival more in PSC than non-PSC patients. Donation after cardiac death liver transplantation leads to significantly worse outcomes in PSC. We recommend cautious use of DCD transplantation in this population.

Hospital Resource Use with Donation after Cardiac Death Allografts in Liver Transplantation: A Matched Controlled Analysis from 2007 to 2011.

PubMed

Singhal, Ashish; Wima, Koffi; Hoehn, Richard S; Quillin, R Cutler; Woodle, E Steve; Paquette, Ian M; Paterno, Flavio; Abbott, Daniel E; Shah, Shimul A

2015-05-01

Although donation after cardiac death (DCD) liver allografts have been used to expand the donor pool, concerns exist regarding primary nonfunction and biliary complications. Our aim was to compare resource use and outcomes of DCD allografts with donation after brain death (DBD) liver allografts. Using a linkage between the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified 11,856 patients who underwent deceased donor liver transplantation (LT) from 2007 to 2011. Patients were divided into 2 cohorts based on type of allograft (DCD vs DBD). Matched pair analysis (n = 613 in each group) was used to compare outcomes of the 2 donor types. Donation after cardiac death allografts comprised 5.2% (n = 613) of all LTs in the studied cohort; DCD allograft recipients were healthier and had lower median Model of End-Stage Liver Disease (MELD) score (17 vs 19; p < 0.0001). Post LT, there was no significant difference in length of stay, perioperative mortality, and discharge to home rates. However, DCD allografts were associated with higher direct cost ($110,414 vs $99,543; p < 0.0001) and 30-day readmission rates (46.4% vs 37.1%; p < 0.0001). Matched analysis revealed that DCD allografts were associated with higher direct cost, readmission rates, and inferior graft survival. While confirming the previous reports of inferior graft survival associated with DCD allografts, this is the first national report to show increased financial and resource use associated with DCD compared with DBD allografts in a matched recipient cohort. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Dietary Predictors of Urinary Cadmium among Pregnant Women and Childrena

PubMed Central

Moynihan, Meghan; Peterson, Karen E.; Cantoral, Alejandra; Song, Peter X.K.; Jones, Andrew; Solano-González, Maritsa; Meeker, John D.; Basu, Niladri; Tellez-Rojo, Martha Maria

2017-01-01

Background Cadmium is a toxic metal with modifiable exposure sources including diet. In pregnant women and children, unique dietary habits may contribute to DCd, and the relationship of diet to overall cadmium exposure can depend on specific factors during these transitional time periods. Objectives This study aimed to identify and quantify food sources of DCd, describe the distribution of UCd, and determine the relationship of DCd and intake of specific foods with UCd, stratified by maternal smoking history, among pregnant women and children in a well-characterized Mexico City birth cohort. Methods Our sample included 192 pregnant women (third trimester) and 223 children (7-15 years). DCd was calculated using FFQ and the U.S. TDS. We also measured UCd, maternal history of smoking, and additional covariates. Results Pregnant women and children had geometric mean UCd concentrations of 0.19±0.78 μg/L and 0.14±0.60 μg/L, respectively. On average, estimated daily DCd intake was 9.3±3.5 μg for women and 12.2±5.4 μg for children. Adjusted linear regression models showed a positive association between DCd and UCd among women (p=0.03) and children (p=0.03) without a maternal history of smoking. Intake of fruit and vegetables among women and potato consumption among children were positively associated with UCd. Conclusions Pregnant women and their children are exposed to cadmium at dietary and urinary levels similar to those previously reported. Higher estimated DCd for children than for women could be attributed to the different FFQs or related to dietary pattern changes between age groups. DCd contributed to UCd in those without a maternal smoking history. PMID:27707662

Low-cost virtual reality intervention program for children with developmental coordination disorder: a pilot feasibility study.

PubMed

Ashkenazi, Tal; Weiss, Patrice L; Orian, Danielle; Laufer, Yocheved

2013-01-01

To explore the feasibility of using a low-cost, off-the-shelf virtual reality (VR) game to treat young children with developmental coordination disorder (DCD) and to determine the effect of this intervention on motor function. Nine children, aged 4 to 6 years, referred to physical therapy because of suspected DCD participated in 10 game-based intervention sessions. Outcome measures included Movement Assessment Battery for Children-2 (M-ABC-2), the DCD Questionnaire (DCD-Q), the 6-minute walk test, and 10-m walk test. Statistically significant changes were observed in the total standard score (P = .024) and the balance subscore (P = .012) of the M-ABC-2 and in the DCD-Q (P < .05). The children seemed to be motivated and to enjoy the interaction with the VR environment. VR games seemed to be beneficial in improving the children's motor function.

Normothermic extracorporeal perfusion of isolated porcine liver after warm ischaemia: a preliminary report.

PubMed

Bellomo, Rinaldo; Suzuki, Satoshi; Marino, Bruno; Starkey, Graeme K; Chambers, Brenton; Fink, Michael A; Wang, Bao Zhong; Houston, Shane; Eastwood, Glenn; Calzavacca, Paolo; Glassford, Neil; Skene, Alison; Jones, Daryl A; Jones, Robert

2012-09-01

Liver transplantation is a major life-saving procedure, and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. We conducted proof-of-concept experiments using a DCD model in the pig to assess the short-term (4 hours) feasibility and functional efficacy of NELP. Using extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion, and physiological perfusion pressures, we achieved NELP and evidence of function (bile production, paracetamol removal, maintenance of normal ammonia and lactate levels) for 4 hours in pig livers subjected to 15 and 30 minutes of cardiac arrest before explantation. Our experiments justify further investigations of the feasibility and efficacy of human DCD liver preservation by ex-vivo perfusion.

Procedural learning, consolidation, and transfer of a new skill in Developmental Coordination Disorder.

PubMed

Lejeune, Caroline; Wansard, Murielle; Geurten, Marie; Meulemans, Thierry

2016-01-01

The aim of this study was to explore the differences in procedural learning abilities between children with DCD and typically developing children by investigating the steps that lead to skill automatization (i.e., the stages of fast learning, consolidation, and slow learning). Transfer of the skill to a new situation was also assessed. We tested 34 children aged 6-12 years with and without DCD on a perceptuomotor adaptation task, a form of procedural learning that is thought to involve the cerebellum and the basal ganglia (regions whose impairment has been associated with DCD) but also other brain areas including frontal regions. The results showed similar rates of learning, consolidation, and transfer in DCD and control children. However, the DCD children's performance remained slower than that of controls throughout the procedural task and they reached a lower asymptotic performance level; the difficulties observed at the outset did not diminish with practice.

Functional Performance of Children with Developmental Coordination Disorder at Home and at School

ERIC Educational Resources Information Center

Wang, Tien-Ni; Tseng, Mei-Hui; Wilson, Brenda N.; Hu, Fu-Chang

2009-01-01

This study investigated the functional performance of daily activities at home and at school in a population-based sample of children with different degrees of motor coordination impairment and competence. Sixteen children (seven males, nine females; mean age 8y, SD 9mo) with developmental coordination disorder (DCD), 25 with suspected DCD ([sDCD]…

Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Wu, Sheng K.; Lin, Hsiao-Hui; Li, Yao-Chuen; Tsai, Chia-Liang; Cairney, John

2010-01-01

The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this…

Utilization of the Organ Care System Lung for the assessment of lungs from a donor after cardiac death (DCD) before bilateral transplantation.

PubMed

Mohite, P N; Sabashnikov, A; García Sáez, D; Pates, B; Zeriouh, M; De Robertis, F; Simon, A R

2015-07-01

In this manuscript, we present the first experience of evaluating donation after circulatory death (DCD) lungs, using the normothermic preservation Organ Care System (OCS) and subsequent successful transplantation. The OCS could be a useful tool for the evaluation of marginal lungs from DCD donors as it allows a proper recruitment and bronchoscopy in such donations in addition to continuous ex-vivo perfusion and assessment and treatment during transport. The OCS could potentially be a standard of care in the evaluation of marginal lungs from DCD. © The Author(s) 2014.

Kinesthetic deficit in children with developmental coordination disorder.

PubMed

Li, Kuan-yi; Su, Wei-jen; Fu, Hsuan-wei; Pickett, Kristen A

2015-03-01

The aim of this study was to measure and compare kinesthetic sensitivity in children with developmental coordination disorder (DCD) and typically developing (TD) children between 6 and 11 years old. 30 children with DCD aged 6 to 11 years (5 in each age group) and 30 TD children participated in the study. Participants placed their forearms on a passive motion apparatus which extended the elbow joint at constant velocities between 0.15 and 1.35°s(-1). Participants were required to concentrate on detection of passive arm motion and press a trigger held in their left hand once they sensed it. The detection time was measured for each trial. The DCD group was significantly less sensitive in detection of passive motion than TD children. Further analysis of individual age groups revealed that kinesthetic sensitivity was worse in DCD than TD children for age groups beyond six years of age. Our findings suggested that individual with DCD lag behind their TD counterparts in kinesthetic sensitivity. Between the ages of 7 and 11 years the difference between groups is quantifiable and significant with 11 year old children with DCD performing similar to 7 year old TD children. Copyright © 2014 Elsevier Ltd. All rights reserved.

"Why can't I give you my organs after my heart has stopped beating?" An overview of the main clinical, organisational, ethical and legal issues concerning organ donation after circulatory death in Italy.

PubMed

Giannini, Alberto; Abelli, Massimo; Azzoni, Giampaolo; Biancofiore, Gianni; Citterio, Franco; Geraci, Paolo; Latronico, Nicola; Picozzi, Mario; Procaccio, Francesco; Riccioni, Luigi; Rigotti, Paolo; Valenza, Franco; Vesconi, Sergio; Zamperetti, Nereo

2016-03-01

Donation after circulatory death (DCD) is a valuable option for the procurement of functioning organs for transplantation. Clinical results are promising and public acceptance is quite good in most western countries. Yet, although DCD is widespread in Europe, several problems still persist in Italy as well as in some other countries. This paper aims to describe the main clinical, organisational, ethical and legal issues at stake, bearing in mind the particular situation created by Italian legislation. Currently, as regards DCD, Italy is somewhat different from other countries. Therefore, every effort should be made for the safe and effective implementation of DCD programs: uncontrolled DCD programs should be promoted and encouraged, within the framework of shared and authoritative rules. At the same time, we need to tackle the question of controlled DCD, promoting debate among all involved subjects regarding the fundamental issues of end-of-life care within protocols that best integrate the highest standard of care for the dying and the legitimate interests of those awaiting a life-saving organ.

Novel genetic association of TNF-α-238 and PDCD1-7209 polymorphisms with long-term non-progressive HIV-1 infection.

PubMed

Nasi, Milena; Riva, Agostino; Borghi, Vanni; D'Amico, Roberto; Del Giovane, Cinzia; Casoli, Claudio; Galli, Massimo; Vicenzi, Elisa; Gibellini, Lara; De Biasi, Sara; Clerici, Mario; Mussini, Cristina; Cossarizza, Andrea; Pinti, Marcello

2013-10-01

About 2-5% of HIV-1-infected subjects, defined as long-term non-progressors (LTNPs), remain immunologically stable for a long time without treatment. The factors governing this condition are known only in part, and include genetic factors. Thus, we studied 20 polymorphisms of 15 genes encoding proinflammatory and immunoregulatory cytokines, chemokines and their receptors, genes involved in apoptosis, and the gene HCP5. We analyzed 47 Caucasian LTNPs infected for >9 years, compared with 131 HIV-1-infected Caucasian patients defined as 'usual progressors'. The genotypes were determined by methods based upon PCR, and the statistical analysis was performed by univariate logistic regression. The well-known CCR5Δ32 del32 allele, the cell death-related TNF-α-238 A and PDCD1-7209 T alleles, and HCP5 rs2395029 G, a non-coding protein associated with the HLA-B*5701, were found positively associated with the LTNP condition. No association was observed for other single nucleotide polymorphisms (SDF-1-801, IL-10-592, MCP-1-2518, CX3CR1 V249I, CCR2V64I, RANTES-403, IL-2-330, IL-1β-511, IL-4-590, FASL IVS3nt-169, FAS-670, FAS-1377, FASL IVS2nt-124, PDCD1-7146, MMP-7-181, and MMP7-153). The novel genetic associations between allelic variants of genes TNF-α-238 and PDCD1-7209 with the LTNP condition underline the importance of host genetic factors in the progression of HIV-1 infection and in immunological preservation. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD) Used in Human Orthotopic Liver Transplantation.

PubMed

Hrydziuszko, Olga; Perera, M Thamara P R; Laing, Richard; Kirwan, Jennifer; Silva, Michael A; Richards, Douglas A; Murphy, Nick; Mirza, Darius F; Viant, Mark R

2016-01-01

Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27) and DCD (n = 10), both during static cold storage (T1) as well as post-reperfusion (T2). Furthermore 6 biopsies from DBD donors prior to the organ donation (T0) were also profiled. Considering DBD and DCD together, significant metabolic differences were discovered between T1 and T2 (688 peaks) that were primarily related to amino acid metabolism, meanwhile T0 biopsies grouped together with T2, denoting the distinctively different metabolic activity of the perfused state. Major metabolic differences were discovered between DCD and DBD during cold-phase (T1) primarily related to glucose, tryptophan and kynurenine metabolism, and in the post-reperfusion phase (T2) related to amino acid and glutathione metabolism. We propose tryptophan/kynurenine and S-adenosylmethionine as possible biomarkers for the previously established higher graft failure of DCD livers, and conclude that the associated pathways should be targeted in more exhaustive and quantitative investigations.

Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD) Used in Human Orthotopic Liver Transplantation

PubMed Central

Laing, Richard; Kirwan, Jennifer; Silva, Michael A.; Richards, Douglas A.; Murphy, Nick; Mirza, Darius F.; Viant, Mark R.

2016-01-01

Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27) and DCD (n = 10), both during static cold storage (T1) as well as post-reperfusion (T2). Furthermore 6 biopsies from DBD donors prior to the organ donation (T0) were also profiled. Considering DBD and DCD together, significant metabolic differences were discovered between T1 and T2 (688 peaks) that were primarily related to amino acid metabolism, meanwhile T0 biopsies grouped together with T2, denoting the distinctively different metabolic activity of the perfused state. Major metabolic differences were discovered between DCD and DBD during cold-phase (T1) primarily related to glucose, tryptophan and kynurenine metabolism, and in the post-reperfusion phase (T2) related to amino acid and glutathione metabolism. We propose tryptophan/kynurenine and S-adenosylmethionine as possible biomarkers for the previously established higher graft failure of DCD livers, and conclude that the associated pathways should be targeted in more exhaustive and quantitative investigations. PMID:27835640

Impact of a National Controlled Donation After Circulatory Death (DCD) Program on Organ Donation in the United Kingdom: A 10-Year Study.

PubMed

Hodgson, R; Young, A L; Attia, M A; Lodge, J P A

2017-12-01

Organ transplantation is the most successful treatment for some forms of organ failure, yet a lack of organs means many die on the waiting list. In the United Kingdom, the Organ Donation Taskforce was set up to identify barriers to organ donation and in 2008 released its first report (Organ Donation Taskforce Report; ODTR). This study assesses the success since the ODTR and examines the impact of the United Kingdom's controlled donation after circulatory death (DCD) program and the controversies surrounding it. There were 12 864 intended donation after brain death (DBD) or DCD donors from April 2004 to March 2014. When the 5 years preceding the ODTR was compared to the 5 years following, intended DCD donors increased 292% (1187 to 4652), and intended DBD donors increased 11% (3327 to 3698). Organs retrieved per intended DBD donor remained static (3.30 to 3.26), whereas there was a decrease in DCD (1.54 to 0.99) due to a large rise in donors who did not proceed to donation (325 to 2464). The majority of DCD donors who proceeded did so within 30 min from time of withdrawal. Our study suggests further work on converting eligible referrals to organ donation and exploring methods of converting DCD to DBD donors. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

A Multicenter Study on Long-Term Outcomes After Lung Transplantation Comparing Donation After Circulatory Death and Donation After Brain Death.

PubMed

van Suylen, V; Luijk, B; Hoek, R A S; van de Graaf, E A; Verschuuren, E A; Van De Wauwer, C; Bekkers, J A; Meijer, R C A; van der Bij, W; Erasmus, M E

2017-10-01

The implementation of donation after circulatory death category 3 (DCD3) was one of the attempts to reduce the gap between supply and demand of donor lungs. In the Netherlands, the total number of potential lung donors was greatly increased by the availability of DCD3 lungs in addition to the initial standard use of donation after brain death (DBD) lungs. From the three lung transplant centers in the Netherlands, 130 DCD3 recipients were one-to-one nearest neighbor propensity score matched with 130 DBD recipients. The primary end points were primary graft dysfunction (PGD), posttransplant lung function, freedom from chronic lung allograft dysfunction (CLAD), and overall survival. PGD did not differ between the groups. Posttransplant lung function was comparable after bilateral lung transplantation, but seemed worse after DCD3 single lung transplantation. The incidence of CLAD (p = 0.17) nor the freedom from CLAD (p = 0.36) nor the overall survival (p = 0.40) were significantly different between both groups. The presented multicenter results are derived from a national context where one third of the lung transplantations are performed with DCD3 lungs. We conclude that the long-term outcome after lung transplantation with DCD3 donors is similar to that of DBD donors and that DCD3 donation can substantially enlarge the donor pool. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Mental health outcomes of developmental coordination disorder in late adolescence.

PubMed

Harrowell, Ian; Hollén, Linda; Lingam, Raghu; Emond, Alan

2017-09-01

To assess the relationship between developmental coordination disorder (DCD) and mental health outcomes in late adolescence. Data were analyzed from the Avon Longitudinal Study of Parents and Children. Moderate-to-severe DCD was defined at 7 to 8 years according to the DSM-IV-TR criteria. Mental health was assessed at 16 to 18 years using self-reported questionnaires: Strengths and Difficulties Questionnaire, Short Moods and Feelings Questionnaire, and the Warwick-Edinburgh Mental Well-being Scale. Logistic and linear regressions assessed the associations between DCD and mental health, using multiple imputation to account for missing data. Adjustments were made for socio-economic status, IQ, and social communication difficulties. Adolescents with DCD (n=168) had an increased risk of mental health difficulties (total Strengths and Difficulties Questionnaire score) than their peers (n=3750) (odds ratio 1.78, 95% confidence interval 1.12-2.83, adjusted for socio-economic status and IQ). This was, in part, mediated through poor social communication skills. Adolescent females with DCD (n=59) were more prone to mental health difficulties than males. Greater mental well-being was associated with better self-esteem (β 0.82, p<0.001). Individuals with DCD, particularly females, had increased risk of mental health difficulties in late adolescence. Interventions that aim to promote resilience in DCD should involve improving social communication skills and self-esteem. © 2017 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Phytoextraction of Cadmium and Zinc By Sedum plumbizincicola Using Different Nitrogen Fertilizers, a Nitrification Inhibitor and a Urease Inhibitor.

PubMed

Arnamwong, Suteera; Wu, Longhua; Hu, Pengjie; Yuan, Cheng; Thiravetyan, Paitip; Luo, Yongming; Christie, Peter

2015-01-01

Cadmium (Cd) and zinc (Zn) phytoavailability and their phytoextraction by Sedum plumbizincicola using different nitrogen fertilizers, nitrification inhibitor (dicyandiamide, DCD) and urease inhibitor (N-(n-Butyl) thiophosphoric triamide, NBPT) were investigated in pot experiments where the soil was contaminated with 0.99 mg kg(-1) of Cd and 241 mg kg(-1) Zn. The soil solution pH varied between 7.30 and 8.25 during plant growth which was little affected by the type of N fertilizer. The (NH4)2SO4+DCD treatment produced higher NH4+-N concentrations in soil solution than the (NH4)2SO4 and NaNO3 treatment which indicated that DCD addition inhibited the nitrification process. Shoot Cd and Zn concentrations across all treatments showed ranges of 52.9-88.3 and 2691-4276 mg kg(-1), respectively. The (NH4)2SO4+DCD treatment produced slightly higher but not significant Cd and Zn concentrations in the xylem sap than the NaNO3 treatment. Plant shoots grown with NaNO3 had higher Cd concentrations than (NH4)2SO4+DCD treatment at 24.0 and 15.4 mg kg(-1), respectively. N fertilizer application had no significant effect on shoot dry biomass. Total Cd uptake in the urea+DCD treatment was higher than in the control, urea+NBPT, urea+NBPT+DCD, or urea treatments, by about 17.5, 23.3, 10.7, and 25.1%, respectively.

Comparison of outcomes of kidney transplantation from donation after brain death, donation after circulatory death, and donation after brain death followed by circulatory death donors.

PubMed

Chen, Guodong; Wang, Chang; Ko, Dicken Shiu-Chung; Qiu, Jiang; Yuan, Xiaopeng; Han, Ming; Wang, Changxi; He, Xiaoshun; Chen, Lizhong

2017-11-01

There are three categories of deceased donors of kidney transplantation in China, donation after brain death (DBD), donation after circulatory death (DCD), and donation after brain death followed by circulatory death (DBCD) donors. The aim of this study was to compare the outcomes of kidney transplantation from these three categories of deceased donors. We retrospectively reviewed 469 recipients who received deceased kidney transplantation in our hospital from February 2007 to June 2015. The recipients were divided into three groups according to the source of their donor kidneys: DBD, DCD, or DBCD. The primary endpoints were delayed graft function (DGF), graft loss, and patient death. The warm ischemia time was much longer in DCD group compared to DBCD group (18.4 minutes vs 12.9 minutes, P < .001). DGF rate was higher in DCD group than in DBD and DBCD groups (22.5% vs 10.2% and 13.8%, respectively, P = .021). Urinary leakage was much higher in DCD group (P = .049). Kaplan-Meier analysis showed that 1-, 2-, and 3-year patient survivals were all comparable among the three groups. DBCD kidney transplantation has lower incidences of DGF and urinary leakage than DCD kidney transplant. However, the overall patient and graft survival were comparable among DBD, DCD, and DBCD kidney transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

PubMed

Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

2017-08-01

The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Self-Regulatory Skill Among Children with and without Developmental Coordination Disorder: An Exploratory Study.

PubMed

Sangster Jokić, Claire A; Whitebread, David

2016-11-01

Children with developmental coordination disorder (DCD) experience difficulty learning and performing everyday motor tasks due to poor motor coordination. Recent research applying a cognitive learning paradigm has argued that children with DCD have less effective cognitive and metacognitive skills with which to effectively acquire motor skills. However, there is currently limited research examining individual differences in children's use of self-regulatory and metacognitive skill during motor learning. This exploratory study aimed to compare the self-regulatory performance of children with and without DCD. Using a mixed methods approach, this study observed and compared the self-regulatory behavior of 15 children with and without DCD, aged between 7 and 9 years, during socially mediated motor practice. Observation was conducted using a quantitative coding scheme and qualitative analysis of video-recorded sessions. This paper will focus on the results of quantitative analysis, while data arising from the qualitative analysis will be used to support quantitative findings. In general, findings indicate that children with DCD exhibit less independent and more ineffective self-regulatory skill during motor learning than their typically developing peers. In addition, children with DCD rely more heavily on external support for effective regulation and are more likely to exhibit negative patterns of motivational regulation. These findings provide further support for the notion that children with DCD experience difficulty effectively self-regulating motor learning. Implications for practice and directions for future research are discussed.

Self-efficacy toward physical activity and the physical activity behavior of children with and without Developmental Coordination Disorder.

PubMed

Batey, C A; Missiuna, C A; Timmons, B W; Hay, J A; Faught, B E; Cairney, J

2014-08-01

Affecting 5-6% of children, Developmental Coordination Disorder (DCD) is a prevalent chronic condition. The nature of the disorder - impaired motor coordination - makes avoidance of physical activity (PA) common. The purpose of this study was to examine the effect of barrier and task self-efficacy on PA behavior in children with DCD and a group of typically developing (TD) children. Children were compared on their perceived ability to complete different intensities and duration of PA (task efficacy) and their confidence in completing PA when faced with everyday barriers (barrier efficacy). An accelerometer was used to record their activity over the subsequent week. Children with DCD were found to have significantly lower task efficacy and barrier efficacy. They also spent significantly less time in moderate to vigorous physical activity (MVPA). Multivariate analyses revealed that gender modified the relationship for both groups. Separate multivariate regressions, were therefore conducted by gender. A direct effect of DCD on PA was observed for boys, but not for girls. Further analyses showed that neither task efficacy nor barrier efficacy influenced the relationship between DCD and PA. Results from this study confirm that children with DCD have lower task and barrier self-efficacy than TD children and that males have lower PA levels than their TD peers; however neither task or barrier self-efficacy mediated the relationship between DCD and PA. Copyright © 2013. Published by Elsevier B.V.

Characterization of Motor Control in Handwriting Difficulties in Children with or without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Chang, Shao-Hsia; Yu, Nan-Ying

2010-01-01

Aim: The purpose of this study was to characterize handwriting deficits in children with developmental coordination disorder (DCD) using computerized movement analyses. Method: Seventy-two children (40 females, 32 males; mean age 7y, SD 7mo; range 6y 2mo to 7y 11mo) with handwriting deficits (33 with DCD, 39 without DCD); and 22 age- and…

Effects of Exercise Intervention on Event-Related Potential and Task Performance Indices of Attention Networks in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Tsai, Chia-Liang; Wang, Chun-Hao; Tseng, Yu-Ting

2012-01-01

The study investigated whether 10-week soccer training can benefit the inhibitory control and neuroelectric indices in children with developmental coordination disorder (DCD). Fifty-one children were divided into groups of typically developing (TD, n = 21), DCD-training (n = 16), and DCD non-training (n=14) individuals using the for Children test,…

Survival of Kidney Allograft of Donors after Circulatory Death Is Similar to Donors after Brain Death: Experience in a Regional Program.

PubMed

Gentil, M A; Castro, P; Ballesteros, L; Gracia-Guindo, M C; Cabello, M; Mazuecos, M A; Rodriguez-Benot, A; Gonzalez-Corvillo, C; Borrego, J; Ortega, A O; Alonso, M

2015-11-01

Donors after circulatory death (DCD) are an increasingly crucial source of organs to maintain deceased donor kidney transplant activity when faced with a standstill in donors after brain death (DBD). We analyzed the influence on graft survival since the use of DCD organs was implemented in Andalusia (2010-2014). We compared 164 kidney transplants from DCD (83 Maastricht type II and 81 type III) and 1488 DBD transplants in recipients over the age of 18, excluding combined transplants. DCD were more frequently men from the A blood group who were younger (48.9 ± 11 vs 55.2 ± 15 years old for DBD, P < .001). Kidneys from DCD were implanted in younger recipients (51.2 ± 11 vs 53.5 ± 13 years old for DBD, P = .03), more frequently in men from blood group A who spent less time in renal replacement therapy (39.8 vs 51.5 months), in a lower proportion of immunized recipients and re-transplant patients, and had worse HLA-DR compatibility. DCD presented a proportion of primary nonfunctional allografts and an initial need for dialysis of 8.8% and 69.6% vs 5.5% and 29.6% for DBD (P < .001). DCD allograft recipient survival was 96% and 96% at the first and third year respectively, vs 96% and 93% with a DBD graft (NS). Survival of the graft was 91% and 86% at the 1(st) and 3(rd) years, vs 90% and 86% with a DBD allograft (NS). No significant difference was found between Maastricht type II and III. DCD were related to lower graft survival versus DBD under the age of 50 (n = 445), 86% vs 92% (P = .02) in the third year, but were similar to DBD from age 50 to 59 (n = 407) and higher than DBD over age 60 (n = 636), 80% at the 3(rd) year (NS). The survival of DCD recipients was not different than DBD in those under 60 and was significantly better than DBD at or over the age of 60 (96% vs 87% in the 3(rd) year, P = .036). In the multivariable survival study (Cox, covariates of influence previously demonstrated in our region) DCD are not a significant survival prognosis factor for the recipient or the allograft. With the current guidelines of donor selection and allocation of organs applied in Andalusia, the survival of kidney transplants from DCD overall is similar to DBD. The graft performance tends to be better than DBD over the age of 60, the main source of donors at present. Copyright © 2015 Elsevier Inc. All rights reserved.

A Fast and Accurate Sparse Continuous Signal Reconstruction by Homotopy DCD with Non-Convex Regularization

PubMed Central

Wang, Tianyun; Lu, Xinfei; Yu, Xiaofei; Xi, Zhendong; Chen, Weidong

2014-01-01

In recent years, various applications regarding sparse continuous signal recovery such as source localization, radar imaging, communication channel estimation, etc., have been addressed from the perspective of compressive sensing (CS) theory. However, there are two major defects that need to be tackled when considering any practical utilization. The first issue is off-grid problem caused by the basis mismatch between arbitrary located unknowns and the pre-specified dictionary, which would make conventional CS reconstruction methods degrade considerably. The second important issue is the urgent demand for low-complexity algorithms, especially when faced with the requirement of real-time implementation. In this paper, to deal with these two problems, we have presented three fast and accurate sparse reconstruction algorithms, termed as HR-DCD, Hlog-DCD and Hlp-DCD, which are based on homotopy, dichotomous coordinate descent (DCD) iterations and non-convex regularizations, by combining with the grid refinement technique. Experimental results are provided to demonstrate the effectiveness of the proposed algorithms and related analysis. PMID:24675758

Extended normothermic extracorporeal perfusion of isolated human liver after warm ischaemia: a preliminary report.

PubMed

Bellomo, Rinaldo; Marino, Bruno; Starkey, Graeme; Fink, Michael; Wang, Bao Zhong; Eastwood, Glenn M; Peck, Leah; Young, Helen; Houston, Shane; Skene, Alison; Opdam, Helen; Jones, Robert

2014-09-01

Donation after circulatory death (DCD) livers are at markedly increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to transplant DCD livers and may allow their use for artificial extracorporeal liver support of patients with fulminant liver failure. We conducted two proof-of-concept experiments using human livers after DCD to assess the feasibility and functional efficacy of NELP over an extended period. We applied extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion and physiological perfusion pressures to two livers obtained after DCD. We achieved NELP and evidence of liver function (bile production, paracetamol removal and maintenance of normal lactate levels) in both livers; one for 24 hours and the other for 43 hours. Histological examination showed areas of patchy ischaemia but preserved biliary ducts and canaliculi. Our experiments justify further investigations of the feasibility and efficacy of extended DCD liver preservation by ex-vivo perfusion.

Head-Torso-Hand Coordination in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Elders, Vera; Sheehan, Sinead; Wilson, Andrew D.; Levesley, Martin; Bhakta, Bipin; Mon-Williams, Mark

2010-01-01

Aim: This study investigated the nature of coordination and control problems in children with developmental coordination disorder (DCD). Method: Seven adults (two males, five females, age range 20-28y; mean 23y, SD 2y 8mo) and eight children with DCD (six males, two females, age range 7-9y; mean 8y, SD 8mo), and 10 without DCD (seven males, three…

Urinary cadmium and estimated dietary cadmium in the Women's Health Initiative.

PubMed

Quraishi, Sabah M; Adams, Scott V; Shafer, Martin; Meliker, Jaymie R; Li, Wenjun; Luo, Juhua; Neuhouser, Marian L; Newcomb, Polly A

2016-01-01

Cadmium, a heavy metal dispersed in the environment as a result of industrial and agricultural applications, has been implicated in several human diseases including renal disease, cancers, and compromised bone health. In the general population, the predominant sources of cadmium exposure are tobacco and diet. Urinary cadmium (uCd) reflects long-term exposure and has been frequently used to assess cadmium exposure in epidemiological studies; estimated dietary intake of cadmium (dCd) has also been used in several studies. The validity of dCd in comparison with uCd is unclear. This study aimed to compare dCd, estimated from food frequency questionnaires, to uCd measured in spot urine samples from 1,002 participants of the Women's Health Initiative. Using linear regression, we found that dCd was not statistically significantly associated with uCd (β=0.006, P-value=0.14). When stratified by smoking status, dCd was not significantly associated with uCd both in never smokers (β=0.006, P-value=0.09) and in ever smokers (β=0.003, P-value=0.67). Our results suggest that because of the lack of association between estimated dCd and measured uCd, dietary estimation of cadmium exposure should be used with caution in epidemiologic studies.

Visual perceptual and handwriting skills in children with Developmental Coordination Disorder.

PubMed

Prunty, Mellissa; Barnett, Anna L; Wilmut, Kate; Plumb, Mandy

2016-10-01

Children with Developmental Coordination Disorder demonstrate a lack of automaticity in handwriting as measured by pauses during writing. Deficits in visual perception have been proposed in the literature as underlying mechanisms of handwriting difficulties in children with DCD. The aim of this study was to examine whether correlations exist between measures of visual perception and visual motor integration with measures of the handwriting product and process in children with DCD. The performance of twenty-eight 8-14year-old children who met the DSM-5 criteria for DCD was compared with 28 typically developing (TD) age and gender-matched controls. The children completed the Developmental Test of Visual Motor Integration (VMI) and the Test of Visual Perceptual Skills (TVPS). Group comparisons were made, correlations were conducted between the visual perceptual measures and handwriting measures and the sensitivity and specificity examined. The DCD group performed below the TD group on the VMI and TVPS. There were no significant correlations between the VMI or TVPS and any of the handwriting measures in the DCD group. In addition, both tests demonstrated low sensitivity. Clinicians should execute caution in using visual perceptual measures to inform them about handwriting skill in children with DCD. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Concurrent and construct validation of the short form of the Bruininks-Oseretsky Test of Motor Proficiency and the Movement-ABC when administered under field conditions: implications for screening.

PubMed

Spironello, C; Hay, J; Missiuna, C; Faught, B E; Cairney, J

2010-07-01

Among the most widely used instruments to assess developmental co-ordination disorder (DCD) in children are the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and the Movement Assessment Battery for Children (M-ABC). However, there is little research on agreement between these tests, when administered to children in field-based settings by trained non-clinicians. Ten of 75 schools participating in a larger study were randomly selected. All children in grade 4 (n= 340) in each of these schools were assessed at the same time using both the BOTMP-SF and the M-ABC in May of 2005. The order of tests was balanced, with an average gap in time between tests of 10-15 min. All tests were administered by trained research assistants. The correlation between tests was moderate (r= 0.50, P < 0.01). Kappas were low at the fifth (k= 0.19) and 15th (k= 0.29) percentile cut-points, which are generally used to identify cases of DCD. Re-analysis using the relative improvement over chance (RIOC) statistic, however, revealed slightly better agreement at both cut-points (fifth percentile, RIOC = 0.29; 15th percentile, RIOC = 0.47). Children who scored as probable for DCD on both motor tests, as well as on only the BOTMP-SF, had higher body mass index, poorer physical fitness and lower levels of teacher-reported physical ability than those positive for DCD on the M-ABC only or those who scored negatively on both tests. In general, the agreement between tests, even after adjustment for RIOC, was poor. Children identified with poor motor competence by both tests or by the BOTMP-SF only are at particular risk for poor physical fitness, overweight/obesity and physical inactivity. It appears that each assessment measures different dimensions of motor ability but that under field-based conditions the M-ABC may be less useful when applied by non-clinicians.

Controlled donation after circulatory death in the Netherlands: more organs, more efforts.

PubMed

Leiden, H; Haase-Kromwijk, B; Hoitsma, A; Jansen, N

2016-08-01

The Netherlands was one of the first countries in Europe to stimulate controlled donation after circulatory death (cDCD) at a national level in addition to donation after brain death (DBD). With this program the number of organ transplants increased, but it also proved to have challenges as will be shown in this 15-year review. Data about deceased organ donation in the Netherlands, from 2000 until 2014, were analysed taking into account the whole donation process from donor referral to the number of organs transplanted. Donor referral increased by 58%, from 213 to 336 donors per year, and the number of organs transplanted rose by 42%. Meanwhile the contribution of cDCD donors increased from 14% in 2000 to 54% in 2014 among all referrals. The organs were transplanted from 92-99% of referred DBD donors, but this percentage was significantly lower for cDCD donors and also decreased from 86% in 2000-2002 to 67% in 2012-2014. In 16% of all referred cDCD donors, organs were not recovered because donors did not die within the expected two-hour time limit after withdrawal of life- upporting treatment. Furthermore, cDCD is more often performed at a higher donor age, which is associated with a lower percentage of transplanted organs. Although cDCD resulted in more transplants, the effort in donor recruitment is considerably higher. Important challenges in cDCD that need further attention are the time limit after withdrawal of life-supporting treatment and donor age, as well as the possibilities to stimulate non-renal transplants including the heart by machine preservation.

Negative impact of prolonged cold storage time before machine perfusion preservation in donation after circulatory death kidney transplantation.

PubMed

Paloyo, Siegfredo; Sageshima, Junichiro; Gaynor, Jeffrey J; Chen, Linda; Ciancio, Gaetano; Burke, George W

2016-10-01

Kidney grafts are often preserved initially in static cold storage (CS) and subsequently on hypothermic machine perfusion (MP). However, the impact of CS/MP time on transplant outcome remains unclear. We evaluated the effect of prolonged CS/MP time in a single-center retrospective cohort of 59 donation after circulatory death (DCD) and 177 matched donation after brain death (DBD) kidney-alone transplant recipients. With mean overall CS/MP times of 6.0 h/30.0 h, overall incidence of delayed graft function (DGF) was higher in DCD transplants (30.5%) than DBD transplants (7.3%, P < 0.0001). In logistic regression, DCD recipient (P < 0.0001), longer CS time (P = 0.0002), male recipient (P = 0.02), and longer MP time (P = 0.08) were associated with higher DGF incidence. In evaluating the joint effects of donor type (DBD vs. DCD), CS time (<6 vs. ≥6 h), and MP time (<36 vs. ≥36 h) on DGF incidence, one clearly sees an unfavorable effect of MP time ≥36 h (P = 0.003) across each donor type and CS time stratum, whereas the unfavorable effect of CS time ≥6 h (P = 0.01) is primarily seen among DCD recipients. Prolonged cold ischemia time had no unfavorable effect on renal function or graft survival at 12mo post-transplant. Long CS/MP time detrimentally affects early DCD/DBD kidney transplant outcome when grafts were mainly preserved by MP; prolonged CS time before MP has a particularly negative impact in DCD kidney transplantation. © 2016 Steunstichting ESOT.

Waitlist Outcomes for Patients Relisted Following Failed Donation After Cardiac Death Liver Transplant: Implications for Awarding Model for End-Stage Liver Disease Exception Scores.

PubMed

Croome, K P; Lee, D D; Nguyen, J H; Keaveny, A P; Taner, C B

2017-09-01

Understanding of outcomes for patients relisted for ischemic cholangiopathy following a donation after cardiac death (DCD) liver transplant (LT) will help standardization of a Model for End-Stage Liver Disease exception scheme for retransplantation. Early relisting (E-RL) for DCD graft failure caused by primary nonfunction (PNF) or hepatic artery thrombosis (HAT) was defined as relisting ≤14 days after DCD LT, and late relisting (L-RL) due to biliary complications was defined as relisting 14 days to 3 years after DCD LT. Of 3908 DCD LTs performed nationally between 2002 and 2016, 540 (13.8%) patients were relisted within 3 years of transplant (168 [4.3%] in the E-RL group, 372 [9.5%] in the L-RL group). The E-RL and L-RL groups had waitlist mortality rates of 15.4% and 10.5%, respectively, at 3 mo and 16.1% and 14.3%, respectively, at 1 year. Waitlist mortality in the L-RL group was higher than mortality and delisted rates for patients with exception points for both hepatocellular carcinoma (HCC) and hepatopulmonary syndrome (HPS) at 3- to 12-mo time points (p < 0.001). Waitlist outcomes differed in patients with early DCD graft failure caused by PNF or HAT compared with those with late DCD graft failure attributed to biliary complications. In L-RL, higher rates of waitlist mortality were noted compared with patients listed with exception points for HCC or HPS. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Design, implementation, and evaluation of a knowledge translation intervention to increase organ donation after cardiocirculatory death in Canada: a study protocol.

PubMed

Squires, Janet E; Grimshaw, Jeremy M; Taljaard, Monica; Linklater, Stefanie; Chassé, Michaël; Shemie, Sam D; Knoll, Gregory A

2014-06-20

A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders' beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level.

Diversity of activity participation determines bone mineral content in the lower limbs of pre-pubertal children with developmental coordination disorder.

PubMed

Fong, S S M; Vackova, D; Choi, A W M; Cheng, Y T Y; Yam, T T T; Guo, X

2018-04-01

This study examined the relationships between activity participation and bone mineralization in children with developmental coordination disorder. Limited participation in physical, recreational, social, and skill-based and self-improvement activities contributed to lower bone mineral content. For improved bone health, these children should participate in a variety of activities, not only physical activities. Limited activity participation in children with developmental coordination disorder (DCD) may have a negative impact on bone mineral accrual. The objectives of this study were to compare bone mineralization and activity participation patterns of pre-pubertal children with DCD and those with typical development, and to determine the association between activity participation patterns and bone mineralization in children with DCD. Fifty-two children with DCD (mean age = 7.51 years) and 61 children with typical development (mean age = 7.22 years) participated in the study. Appendicular and total body (less head) bone mineral content (BMC) and bone mineral density (BMD) were evaluated by a whole-body dual-energy X-ray absorptiometry scan. Activity participation patterns were assessed using the Children's Assessment of Participation and Enjoyment (CAPE) questionnaire. Children with DCD had lower appendicular and total body BMCs and BMDs than children with typical development overall (p < 0.05). They also had lower CAPE total activity and physical activity diversity scores (p < 0.05). After accounting for the effects of age, sex, height, lean mass, and fat mass, the total activity diversity score remained independently associated with leg BMC in children with DCD, explaining 5.1% of the variance (p = 0.030). However, the physical activity diversity score was no longer associated with leg BMC (p = 0.090). Diversity of activity participation and bone mineralization were lower in pre-pubertal children with DCD. Decreased total activity participation diversity was a contributing factor to lower BMC in the legs of children with DCD.

Cognitive-motor interference during fine and gross motor tasks in children with Developmental Coordination Disorder (DCD).

PubMed

Schott, Nadja; El-Rajab, Inaam; Klotzbier, Thomas

2016-10-01

While typically developing children produce relatively automatized postural control processes, children with DCD seem to exhibit an automatization deficit. Dual tasks with various cognitive loads seem to be an effective way to assess the automatic deficit hypothesis. The aims of the study were: (1) to examine the effect of a concurrent cognitive task on fine and gross motor tasks in children with DCD, and (2) to determine whether the effect varied with different difficulty levels of the concurrent task. We examined dual-task performance (Trail-Making-Test, Trail-Walking-Test) in 20 children with DCD and 39 typically developing children. Based on the idea of the Trail-Making-Test, participants walked along a fixed pathway, following a prescribed path, delineated by target markers of (1) increasing sequential numbers, and (2) increasing sequential numbers and letters. The motor and cognitive dual-task effects (DTE) were calculated for each task. Regardless of the cognitive task, children with DCD performed equally well in fine and gross motor tasks, and were slower in the dual task conditions than under single task-conditions, compared with children without DCD. Increased cognitive task complexity resulted in slow trail walking as well as slower trail tracing. The motor interference for the gross motor tasks was least for the simplest conditions and greatest for the complex conditions and was more pronounced in children with DCD. Cognitive interference was low irrespective of the motor task. Children with DCD show a different approach to allocation of cognitive resources, and have difficulties making motor skills automatic. The latter notion is consistent with impaired cerebellar function and the "automatization deficit hypothesis", suggesting that any deficit in the automatization process will appear if conscious monitoring of the motor skill is made more difficult by integrating another task requiring attentional resources. Copyright © 2016 Elsevier Ltd. All rights reserved.

Design, implementation, and evaluation of a knowledge translation intervention to increase organ donation after cardiocirculatory death in Canada: a study protocol

PubMed Central

2014-01-01

Background A shortage of transplantable organs is a global problem. There are two types of organ donation: living and deceased. Deceased organ donation can occur following neurological determination of death (NDD) or cardiocirculatory death. Donation after cardiocirculatory death (DCD) accounts for the largest increments in deceased organ donation worldwide. Variations in the use of DCD exist, however, within Canada and worldwide. Reasons for these discrepancies are largely unknown. The purpose of this study is to develop, implement, and evaluate a theory-based knowledge translation intervention to provide practical guidance about how to increase the numbers of DCD organ donors without reducing the numbers of standard NDD donors. Methods We will use a mixed method three-step approach. In step one, we will conduct semi-structured interviews, informed by the Theoretical Domains Framework, to identify and describe stakeholders’ beliefs and attitudes about DCD and their perceptions of the multi-level factors that influence DCD. We will identify: determinants of the evidence-practice gap; specific behavioural changes and/or process changes needed to increase DCD; specific group(s) of clinicians or organizations (e.g., provincial donor organizations) in need of behaviour change; and specific targets for interventions. In step two, using the principles of intervention mapping, we will develop a theory-based knowledge translation intervention that encompasses behavior change techniques to overcome the identified barriers and enhance the enablers to DCD. In step three, we will roll out the intervention in hospitals across the 10 Canadian provinces and evaluate its effectiveness using a multiple interrupted time series design. Discussion We will adopt a behavioural approach to define and test novel, theory-based, and ethically-acceptable knowledge translation strategies to increase the numbers of available DCD organ donors in Canada. If successful, this study will ultimately lead to more transplantations, reducing patient morbidity and mortality at a population-level. PMID:24950719

Fundamental movement skills proficiency in children with developmental coordination disorder: does physical self-concept matter?

PubMed

Yu, Jie; Sit, Cindy H P; Capio, Catherine M; Burnett, Angus; Ha, Amy S C; Huang, Wendy Y J

2016-01-01

The purpose of this study was to (1) examine differences in fundamental movement skills (FMS) proficiency, physical self-concept, and physical activity in children with and without developmental coordination disorder (DCD), and (2) determine the association of FMS proficiency with physical self-concept while considering key confounding factors. Participants included 43 children with DCD and 87 age-matched typically developing (TD) children. FMS proficiency was assessed using the Test of Gross Motor Development - second edition. Physical self-concept and physical activity were assessed using self-report questionnaires. A two-way (group by gender) ANCOVA was used to determine whether between-group differences existed in FMS proficiency, physical self-concept, and physical activity after controlling for age and BMI. Partial correlations and hierarchical multiple regression models were used to examine the relationship between FMS proficiency and physical self-concept. Compared with their TD peers, children with DCD displayed less proficiency in various components of FMS and viewed themselves as being less competent in physical coordination, sporting ability, and physical health. Physical coordination was a significant predictor of ability in object control skills. DCD status and gender were significant predictors of FMS proficiency. Future FMS interventions should target children with DCD and girls, and should emphasize improving object control skills proficiency and physical coordination. Children with DCD tend to have not only lower FMS proficiency than age-matched typically developing children but also lower physical self-concept. Self-perceptions of physical coordination by children with DCD are likely to be valuable contributors to development of object control skills. This may then help to develop their confidence in performing motor skills. Children with DCD need supportive programs that facilitate the development of object control skills. Efficacy of training programs may be improved if children experience a greater sense of control and success when performing object control skills.

Long-term results after lung transplantation using organs from circulatory death donors: a propensity score-matched analysis†.

PubMed

Sabashnikov, Anton; Patil, Nikhil P; Popov, Aron-Frederik; Soresi, Simona; Zych, Bartlomiej; Weymann, Alexander; Mohite, Prashant N; García Sáez, Diana; Zeriouh, Mohamed; Wahlers, Thorsten; Choi, Yeong-Hoon; Wippermann, Jens; Wittwer, Thorsten; De Robertis, Fabio; Bahrami, Toufan; Amrani, Mohamed; Simon, André R

2016-01-01

Due to organ shortage in lung transplantation (LTx), donation after circulatory death (DCD) has been implemented in several countries, contributing to an increasing number of organs transplanted. We sought to assess long-term outcomes after LTx with organs procured following circulatory death in comparison with those obtained from donors after brain death (DBD). Between January 2007 and November 2013, 302 LTxs were performed in our institution, whereby 60 (19.9%) organs were retrieved from DCD donors. We performed propensity score matching (DCD:DBD = 1:2) based on preoperative donor and recipient factors that were significantly different in univariate analysis. After propensity matching, there were no statistically significant differences between the groups in terms of demographics and preoperative donor and recipient characteristics. There were no significant differences regarding intraoperative variables and total ischaemic time. Patients from the DCD group had significantly higher incidence of primary graft dysfunction grade 3 at the end of the procedure (P = 0.014), and significantly lower pO2/FiO2 ratio during the first 24 h after the procedure (P = 0.018). There was a trend towards higher incidence of the need for postoperative extracorporeal life support in the DCD group. Other postoperative characteristics were comparable. While the overall cumulative survival was not significantly different, the DCD group had significantly poorer results in terms of bronchiolitis obliterans syndrome (BOS)-free survival in the long-term follow-up. Long-term results after LTx with organs procured following DCD are in general comparable with those obtained after DBD LTx. However, patients transplanted using organs from DCD donors have a predisposition for development of BOS in the longer follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Pulmonary function in children with development coordination disorder.

PubMed

Wu, Sheng K; Cairney, John; Lin, Hsiao-Hui; Li, Yao-Chuen; Song, Tai-Fen

2011-01-01

The purpose of this study was to compare pulmonary function in children with developmental coordination disorder (DCD) with children who are typically developing (TD), and also analyze possible gender differences in pulmonary function between these groups. The Movement ABC test was used to identify the movement coordination ability of children. Two hundred and fifty participants (90 children with DCD and 160 TD children) aged 9-10 years old completed this study. Using the KoKo spirometry, forced vital capacity (FVC) and forced expiratory volume in 1s (FEV(1.0)) were used to measure pulmonary function. The 800-m run was also conducted to assess cardiopulmonary fitness of children in the field. There was a significant difference in pulmonary function between TD children and those with DCD. The values of FVC and FEV(1.0) in TD children were significantly higher than in children with DCD. A significant, but low correlation (r = -0.220, p < .001) was found between total score on the MABC and FVC; similarly, a positive but low correlation (r = 0.252, p < .001) was found between total score on the MABC and the completion time of 800-m run. However, no significant correlation between FVC and the time of 800-m run was found (p > .05). Significant correlations between total score on the MABC and the completion time of the 800-m run (r = 0.352, p < .05) and between FVC and the time of 800-m run (r = -0.285, p < .05) were observed in girls with DCD but not boys with this condition. Based on the results of this study, pulmonary function in children with DCD was significantly lower than that of TD children. The field test, 800-m run, may not be a good indicator to distinguish aerobic ability between children with DCD and those who are TD. It is possible that poor pulmonary function in children with DCD is due to reduced physical activity in this population. Copyright © 2010 Elsevier Ltd. All rights reserved.

Developmental Coordination Disorder in Children with Specific Language Impairment: Co-Morbidity and Impact on Quality of Life

ERIC Educational Resources Information Center

Flapper, Boudien C. T.; Schoemaker, Marina M.

2013-01-01

Co-morbidity of Developmental Coordination Disorder (DCD) in children with specific language impairment (SLI) and the impact of DCD on quality-of-life (QOL) was investigated in 65 5-8 year old children with SLI (43 boys, age 6.8 [plus or minus] 0.8; 22 girls, age 6.6 [plus or minus] 0.8). The prevalence of DCD was assessed using DSM-IV-TR criteria…

Effect of donor body mass index on the outcome of donation after cardiac death kidneys: how big is too big?

PubMed

Jin, L X; Pitt, S C; Doyle, M B; Klein, C; Shenoy, S; Lowell, J A; Chapman, W C; Wellen, J R

2014-01-01

Morbid obesity (MO) has become an epidemic in the United Sates and is associated with adverse effects on health. The purpose of this study was to examine the effects of MO on the short-term outcomes of kidneys transplanted from donation after cardiac death (DCD) donors. Using a prospectively collected database, we reviewed 467 kidney transplantations performed at a single center between January 2008 and June 2011 to identify 67 recipients who received transplants from 40 DCD donors. The outcomes of 14 MO DCD donor kidneys were compared with 53 non-MO DCD grafts. MO was defined as a body mass index ≥ 35. Mean patient follow-up was 16 months. The MO and non-MO DCD donor groups were similar with respect to donor and recipient age, gender, race, cause of death and renal disease, time from withdrawal of life support to organ perfusion, mean human leukocyte antigen (HLA) mismatch, and overall recipient survival. Organs from MO DCD donors also had comparable rates of delayed graft function (21.4% vs 20.0%; P = not significant [NS]). At 1 year post-transplantation, a small but statistically insignificant difference was observed in the graft survival rates of MO and non-MO donors (87% vs. 96%; P = NS). One MO kidney had primary nonfunction. These data demonstrate that kidneys procured from MO DCD donors have equivalent short-term outcomes compared with non-MO grafts and should continue to be used. Further investigation is needed to examine the effect of MO on long-term renal allograft survival. Copyright © 2014 Elsevier Inc. All rights reserved.

Development of Multisensory Reweighting Is Impaired for Quiet Stance Control in Children with Developmental Coordination Disorder (DCD)

PubMed Central

Bair, Woei-Nan; Kiemel, Tim; Jeka, John J.; Clark, Jane E.

2012-01-01

Background Developmental Coordination Disorder (DCD) is a leading movement disorder in children that commonly involves poor postural control. Multisensory integration deficit, especially the inability to adaptively reweight to changing sensory conditions, has been proposed as a possible mechanism but with insufficient characterization. Empirical quantification of reweighting significantly advances our understanding of its developmental onset and improves the characterization of its difference in children with DCD compared to their typically developing (TD) peers. Methodology/Principal Findings Twenty children with DCD (6.6 to 11.8 years) were tested with a protocol in which visual scene and touch bar simultaneously oscillateded medio-laterally at different frequencies and various amplitudes. Their data were compared to data on TD children (4.2 to 10.8 years) from a previous study. Gains and phases were calculated for medio-lateral responses of the head and center of mass to both sensory stimuli. Gains and phases were simultaneously fitted by linear functions of age for each amplitude condition, segment, modality and group. Fitted gains and phases at two comparison ages (6.6 and 10.8 years) were tested for reweighting within each group and for group differences. Children with DCD reweight touch and vision at a later age (10.8 years) than their TD peers (4.2 years). Children with DCD demonstrate a weak visual reweighting, no advanced multisensory fusion and phase lags larger than those of TD children in response to both touch and vision. Conclusions/Significance Two developmental perspectives, postural body scheme and dorsal stream development, are provided to explain the weak vision reweighting. The lack of multisensory fusion supports the notion that optimal multisensory integration is a slow developmental process and is vulnerable in children with DCD. PMID:22815872

Inferior survival in liver transplant recipients with hepatocellular carcinoma receiving donation after cardiac death liver allografts.

PubMed

Croome, Kris P; Wall, William; Chandok, Natasha; Beck, Gavin; Marotta, Paul; Hernandez-Alejandro, Roberto

2013-11-01

The impact of ischemia/reperfusion injury in the setting of transplantation for hepatocellular carcinoma (HCC) has not been thoroughly investigated. The present study examined data from the Scientific Registry of Transplant Recipients for all recipients of deceased donor liver transplants performed between January 1, 1995 and October 31, 2011. In a multivariate Cox analysis, significant predictors of patient survival included the following: HCC diagnosis (P < 0.01), donation after cardiac death (DCD) allograft (P < 0.001), hepatitis C virus-positive status (P < 0.01), recipient age (P < 0.01), donor age (P < 0.001), Model for End-Stage Liver Disease score (P < 0.001), recipient race, and an alpha-fetoprotein level > 400 ng/mL at the time of transplantation. In order to test whether the decreased survival seen for HCC recipients of DCD grafts was more than would be expected because of the inferior nature of DCD grafts and the diagnosis of HCC, a DCD allograft/HCC diagnosis interaction term was created to look for potentiation of effect. In a multivariate analysis adjusted for all other covariates, this interaction term was statistically significant (P = 0.049) and confirmed that there was potentiation of inferior survival with the use of DCD allografts in recipients with HCC. In conclusion, patient survival and graft survival were inferior for HCC recipients of DCD allografts versus recipients of donation after brain death allografts. This potentiation of effect of inferior survival remained even after adjustments for the inherent inferiority observed in DCD allografts as well as other known risk factors. It is hypothesized that this difference could reflect an increased rate of recurrence of HCC. © 2013 American Association for the Study of Liver Diseases.

Evaluation of a Public-sector, Provider-initiated Cryptococcal Antigen Screening and Treatment Program, Western Cape, South Africa

PubMed Central

Smith, Mariette; Smith, Rachel; Osler, Meg; Kelly, Nicola; Cross, Anna; Boulle, Andrew; Meintjes, Graeme; Govender, Nelesh P.

2016-01-01

Background Screening for serum cryptococcal antigen (CrAg) may identify those at risk for disseminated cryptococcal disease (DCD), and pre-emptive fluconazole treatment may prevent progression to DCD. In August 2012, the Western Cape Province (WC), South Africa, adopted provider-initiated CrAg screening. We evaluated the implementation and effectiveness of this large-scale public-sector program during its first year, September 1, 2012—August 31, 2013. Methods We used data from the South African National Health Laboratory Service, WC provincial HIV program, and nationwide surveillance data for DCD. We assessed the proportion of eligible patients screened for CrAg (CrAg test done within 30 days of CD4 date) and the prevalence of CrAg positivity. Incidence of DCD among those screened was compared with those not screened. Results Of 4,395 eligible patients, 26.6% (n=1170) were screened. The proportion of patients screened increased from 15.9% in September 2012 to 36.6% in August 2013. The prevalence of positive serum CrAg was 2.1%. Treatment data were available for 13 of 24 CrAg-positive patients; nine of 13 were treated with fluconazole. Nine (0.8%) incident cases of DCD occurred among the 1170 patients who were screened for CrAg vs. 49 (1.5%) incident cases among the 3225 patients not screened (p=0.07). Conclusions Relatively few eligible patients were screened under the WC provider-initiated CrAg screening program. Unscreened patients were nearly twice as likely to develop DCD. CrAg screening can reduce the burden of DCD, but needs to be implemented well. To improve screening rates, countries should consider laboratory-based reflexive screening when possible. PMID:26926942

Clinical results of an organ procurement organization effort to increase utilization of donors after cardiac death.

PubMed

Whiting, James F; Delmonico, Francis; Morrissey, Paul; Basadonna, Giacomo; Johnson, Scott; Lewis, W David; Rohrer, Richard; O'Connor, Kevin; Bradley, James; Lovewell, Tammy D; Lipkowitz, George

2006-05-27

To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers. In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively. DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.

Children with Developmental Coordination Disorder Benefit from Using Vision in Combination with Touch Information for Quiet Standing

PubMed Central

Bair, Woei-Nan; Barela, José A.; Whitall, Jill; Jeka, John J.; Clark, Jane E.

2011-01-01

In two experiments, the ability to use multisensory information (haptic information, provided by lightly touching a stationary surface, and vision) for quiet standing was examined in typically developing (TD) children, adults, and in 7-year-old children with Developmental Coordination Disorder (DCD). Four sensory conditions (no touch/no vision, with touch/no vision, no touch/with vision, and with touch/with vision) were employed. In experiment 1, we tested 4-, 6- and 8-year-old TD children and adults to provide a developmental landscape for performance on this task. In experiment 2, we tested a group of 7-year-old children with DCD and their age-matched TD peers. For all groups, touch robustly attenuated standing sway suggesting that children as young as 4 years old use touch information similarly to adults. Touch was less effective in children with DCD compared to their TD peers, especially in attenuating their sway velocity. Children with DCD, unlike their TD peers, also benefited from using vision to reduce sway. The present results suggest that children with DCD benefit from using vision in combination with touch information for standing control possibly due to their less well developed internal models of body orientation and self-motion. Internal model deficits, combined with other known deficits such as postural muscles activation timing deficits, may exacerbate the balance impairment in children with DCD. PMID:21571533

Functional connectivity of neural motor networks is disrupted in children with developmental coordination disorder and attention-deficit/hyperactivity disorder

PubMed Central

McLeod, Kevin R.; Langevin, Lisa Marie; Goodyear, Bradley G.; Dewey, Deborah

2014-01-01

Developmental coordination disorder (DCD) and attention deficit/hyperactivity disorder (ADHD) are prevalent childhood disorders that frequently co-occur. Evidence from neuroimaging research suggests that children with these disorders exhibit disruptions in motor circuitry, which could account for the high rate of co-occurrence. The primary objective of this study was to investigate the functional connections of the motor network in children with DCD and/or ADHD compared to typically developing controls, with the aim of identifying common neurophysiological substrates. Resting-state fMRI was performed on seven children with DCD, 21 with ADHD, 18 with DCD + ADHD and 23 controls. Resting-state connectivity of the primary motor cortex was compared between each group and controls, using age as a co-factor. Relative to controls, children with DCD and/or ADHD exhibited similar reductions in functional connectivity between the primary motor cortex and the bilateral inferior frontal gyri, right supramarginal gyrus, angular gyri, insular cortices, amygdala, putamen, and pallidum. In addition, children with DCD and/or ADHD exhibited different age-related patterns of connectivity, compared to controls. These findings suggest that children with DCD and/or ADHD exhibit disruptions in motor circuitry, which may contribute to problems with motor functioning and attention. Our results support the existence of common neurophysiological substrates underlying both motor and attention problems. PMID:24818082

Biliary complications after orthotopic liver transplantation from donors after cardiac death: broad spectrum of disease.

PubMed

Abou Abbass, A; Abouljoud, M; Yoshida, A; Kim, D Y; Slater, R; Hundley, J; Kazimi, M; Moonka, D

2010-11-01

Donation-after-death liver transplantation (DCD-LT) carries higher complication rates compared with donation-after-brain death liver transplantation (DBD-LT). In this report we describe our experience with biliary complications in DCD-LT with emphasis on anatomical patterns and outcomes. We performed retrospective review of patients' medical records from August 2004 to December 2008, during which time total of 26 DCD-LTs were performed. Mean follow-up was 29 months (range 3 to 51 months). Biliary complications occurred in 12 patients (46%), of whom 9 were related to DCD (35%). Four patients had more than 1 biliary complication, and 4 had concomitant arterial problems (stricture/thrombosis). Treatment of complications included: ERCP (n = 5, 3 resolved), conversion to roux (n = 5, 2 resolved), revision of roux (n = 1), percutaneous transhepatic cholangiography (n = 1), artery revision (n = 3). Three patients with casts had operative extraction of casts depicting a mummified biliary tree; histology showed casts and fibrosis and anastomotic suture material. Six patients underwent retransplantation (23%). Among retransplanted patients, 2 deaths occurred (7.7%). Our experience with DCD-LT reveals a high prevalence of biliary complications with a new and wide spectrum of clinicopathologic findings. Better strategies for prevention of these unique biliary complications are needed to better justify the added risks and costs for performance of DCD-LT. Copyright © 2010 Elsevier Inc. All rights reserved.

Suppression of nitrification and N2O emission by karanjin--a nitrification inhibitor prepared from karanja (Pongamia glabra Vent.).

PubMed

Majumdar, Deepanjan

2002-06-01

A laboratory incubation study was undertaken to study nitirification and N2O emission in an alluvial, sandy loam soil (typic ustochrept), fertilized with urea and urea combined with different levels of two nitrification inhibitors viz. karanjin and dicyandiamide (DCD). Karanjin [a furanoflavonoid, obtained from karanja (Pongamia glabra Vent.) seeds] and DCD were incorporated at the rate of 5%, 10%, 15%, 20% and 25% of applied urea-N (100 mg kg(-1) soil), to the soil (100 g) adjusted to field capacity moisture content. Mean N2O flux was appreciably reduced on addition of the inhibitors with urea. Amounts of nitrified N (i.e. (NO3- + NO2-)-N) in total inorganic N (i.e. (NO3 + NO2- + NH4+)-N) in soil were found to be much lower on the addition of karanjin with urea (2-8%) as compared to urea plus DCD (14-66%) during incubation, indicating that karanjin was much more potent nitrification inhibitor than DCD. Nitrification inhibition was appreciable on the application of different levels of karanjin (62-75%) and DCD (9-42%). Cumulative N2O-N loss was found to be in the range of 0.5-80% of the nitrified N at different stages of incubation. Application of karanjin resulted in higher mitigation of total N2O-N emission (92-96%) when compared with DCD (60-71%).

Increasing the donor pool: consideration of prehospital cardiac arrest in controlled donation after circulatory death for liver transplantation.

PubMed

Elaffandi, Ahmed H; Bonney, Glenn K; Gunson, Bridget; Scalera, Irene; Mergental, Hynek; Isaac, John R; Bramhall, Simon R; Mirza, Darius F; Perera, M Thamara P R; Muiesan, Paolo

2014-01-01

Donor warm ischemia has implications for outcomes after liver transplantation (LT) using organs from donation after circulatory death (DCD) donors. Prehospital cardiac arrest (PHCA) before donation may generate a further ischemic insult. The aim of this single-center study of 108 consecutive DCD LT procedures was to compare the outcomes of PHCA and non-PHCA cohorts. A review of a prospectively collected database of all DCD grafts transplanted between January 2007 and October 2011 was undertaken to identify donors who had sustained PHCA. The unit policy was to consider such donors when transaminase levels were ≤4 times the normal range and had an improving trend. Twenty-six of the 108 DCD transplants were from DCD donors with PHCA, and 82 were in the non-PHCA cohort. A comparative analysis of the PHCA and non-PHCA cohorts showed better short-term results (a low incidence of acute kidney injury) for the PHCA group but satisfactory long-term results for both groups with no significant differences in graft or patient survival between them. In conclusion, a careful donor selection policy for including PHCA DCD donors with normalized liver function tests or transaminase levels ≤ 4 times the norm resulted in successful transplantation and could boost the donor pool with no adverse outcomes. © 2013 American Association for the Study of Liver Diseases.

Attention deficit hyperactivity disorder and developmental coordination disorder: Two separate disorders or do they share a common etiology.

PubMed

Goulardins, Juliana B; Rigoli, Daniela; Licari, Melissa; Piek, Jan P; Hasue, Renata H; Oosterlaan, Jaap; Oliveira, Jorge A

2015-10-01

Attention deficit hyperactivity disorder (ADHD) has been described as the most prevalent behavioral disorder in children. Developmental coordination disorder (DCD) is one of the most prevalent childhood movement disorders. The overlap between the two conditions is estimated to be around 50%, with both substantially interfering with functioning and development, and leading to poorer psychosocial outcomes. This review provides an overview of the relationship between ADHD and DCD, discussing the common presenting features, etiology, neural basis, as well as associated deficits in motor functioning, attention and executive functioning. It is currently unclear which specific motor and cognitive difficulties are intrinsic to each disorder as many studies of ADHD have not been screened for DCD and vice-versa. The evidence supporting common brain underpinnings is still very limited, but studies using well defined samples have pointed to non-shared underpinnings for ADHD and DCD. The current paper suggests that ADHD and DCD are separate disorders that may require different treatment approaches. Copyright © 2015 Elsevier B.V. All rights reserved.

Boys with developmental coordination disorder: loneliness and team sports participation.

PubMed

Poulsen, Anne A; Ziviani, Jenny M; Cuskelly, Monica; Smith, Rachel

2007-01-01

This study investigated the mediational role of team sports and other leisure occupations for boys ages 10 to 13 years in the relationship between physical coordination ability and perceptions of loneliness. Sixty boys with developmental coordination disorder (DCD) and 113 comparison boys without DCD completed a self-report measure of loneliness. Parents recorded information on leisure involvement over 7 days. Boys with DCD recorded significantly higher loneliness and lower participation rates in all group physical activities, whether structured (e.g., team sports) or unstructured (e.g., informal outdoor play) than boys without DCD. An inverse relationship between physical coordination ability and loneliness was mediated by participation in team sports. No other leisure pursuits were found to be significant mediators. Childhood physical coordination difficulties were significantly associated with loneliness. Participation in team sports acted as one potential mechanism mediating the inverse relationship between physical coordination ability and loneliness in boys. Occupational therapists can act as advocates to support boys with DCD who choose to participate in team sports. Further investigations are recommended to determine aspects of team sports environments that promote an optimal fit among child, activity, and environment.

Wisconsin Card Sorting Test performance in children with developmental coordination disorder.

PubMed

Wuang, Yee-Pay; Su, Chwen-Yng; Su, Jui-Hsing

2011-01-01

The primary purpose of this study was to investigate and compare the executive functions measured by the Wisconsin Card Sorting Test (WCST) between children with developmental coordination disorder (DCD) and age-matched normal controls. A second purpose was to examine the relations between executive functions and school functions in DCD children. Seventy-one children with DCD and 70 children without motor problems were recruited from 14 public schools. Executive functions and school functions were assessed using the WCST, and the School Function Assessment--Chinese Version (SFA-C) respectively. Univariate analyses demonstrated significant between-group differences in five WCST measures. The logistic regression analysis showed differences between two groups on eight SFA-C subscales, and significant correlation between items measured on WCST and SFA-C was also found. The result of the study provides further evidence of impaired sub-domains of executive functions (i.e., mental shifting, flexibility) in children with DCD. The finding also adds to recent investigations into the relationship between executive functions and school functions in DCD. Implications for rehabilitation professionals and recommendations for further research are discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

COX-2 Promotes Migration and Invasion by the Side Population of Cancer Stem Cell-Like Hepatocellular Carcinoma Cells

PubMed Central

Guo, Zhe; Jiang, Jing-Hang; Zhang, Jun; Yang, Hao-Jie; Yang, Fu-Quan; Qi, Ya-Peng; Zhong, Yan-Ping; Su, Jie; Yang, Ri-Rong; Li, Le-Qun; Xiang, Bang-De

2015-01-01

Abstract Cancer stem cells (CSCs) are thought to be responsible for tumor relapse and metastasis due to their abilities to self-renew, differentiate, and give rise to new tumors. Cyclooxygenase-2 (COX-2) is highly expressed in several kinds of CSCs, and it helps promote stem cell renewal, proliferation, and radioresistance. Whether and how COX-2 contributes to CSC migration and invasion is unclear. In this study, COX-2 was overexpressed in the CSC-like side population (SP) of the human hepatocellular carcinoma (HCC) cell line HCCLM3. COX-2 overexpression significantly enhanced migration and invasion of SP cells, while reducing expression of metastasis-related proteins PDCD4 and PTEN. Treating SP cells with the selective COX-2 inhibitor celecoxib down-regulated COX-2 and caused a dose-dependent reduction in cell migration and invasion, which was associated with up-regulation of PDCD4 and PTEN. These results suggest that COX-2 exerts pro-metastatic effects on SP cells, and that these effects are mediated at least partly through regulation of PDCD4 and PTEN expression. These results further suggest that celecoxib may be a promising anti-metastatic agent to reduce migration and invasion by hepatic CSCs. PMID:26554780

Analysis of cursive letters, syllables, and words handwriting in a French second-grade child with Developmental Coordination Disorder and comparison with typically developing children.

PubMed

Jolly, Caroline; Gentaz, Edouard

2013-01-01

Poor handwriting is a core deficit in Developmental Coordination Disorder (DCD). In a previous study, we compared the evolution of cursive letters handwriting in a girl with DCD throughout her second-grade year with that of typically developing (TD) children. We found that her handwriting evolved much less than that of TD children and remained similar to that of pre-schoolers at all stages, suggesting that her handwriting skills have reached a steady state level. We present here a continuation of this work, in which we focused on the velocity aspects of handwriting in another French child with DCD. Indeed, different velocity patterns have been observed in Chinese and English children with DCD. In the French cursive style of writing, consecutive letters are joined, a major difference with the English script style of writing. We thus analyzed the handwriting of a second-grade French girl with DCD, not only for isolated letters but also for syllables and words, in comparison to that of TD first-graders (6-7 years old; N = 85) and second-graders (7-8 years old; N = 88). Each written track was digitized, and nine kinematic parameters were measured to evaluate writing fluency. Results showed that the productions of the child with DCD were more similar to those of first-graders than to those of second-graders. In line with our previous study, the most discriminative parameters between the child with DCD and TD children were size and mean speed. Moreover, her handwriting was less fluent than that of TD children. In contrast to previous observations, we observed a higher writing velocity of the child with DCD when compared to TD children, whatever the complexity of the item, and no significant difference with TD children in the pausing time during writing. These differences may reflect linguistic specificities. For syllables and words, each letter was treated separately as a single unit, thus reflecting a problem in anticipation and automation.

Physical fitness in children with developmental coordination disorder.

PubMed

Schott, Nadja; Alof, Verena; Hultsch, Daniela; Meermann, Dagmar

2007-12-01

The protective effects of physical activity and fitness on cardiovascular health have clearly been shown among normally developed children. However data are currently lacking pertaining to children with developmental coordination disorder (DCD). The purpose of this study was to examine differences in fitness measures, body composition, and physical activity among children with and without DCD. A cross-sectional design was implemented examining 261 children (118 girls, 143 boys) ages 4-12 years (mean age 7.8 +/- 1.9 years). Children were categorized as having DCD if they scored less than or equal to the 5th percentile (n=71) or between the 6th and the 15th percentile (n=5) on the Movement Assessment Battery for Children (MABC; Henderson & Sugden, 1992). The typically developing children had scores between the 16th and the 50th percentile (n=16) or above the 50th percentile (n=3) on the MABC. The age-related body mass index was used to characterize body composition. Physical fitness was assessed with a 6-min run, 20-m sprint, jump-and-reach test, medicine ball throw, curl-ups, and sit-and-reach test. Physical activity was estimated with a questionnaire. The percentage of overweight and obese children ages 10-12 years were significantly higher in the DCD groups (severe: 50%, moderate: 23.1%) than in the typically developing groups (medium: 5.6%, high: 0%; p < .05). Significant interactions (MABC x Age Group) were found for the fitness tests (p values < .05), except flexibility; whereby specifically, compared to the children in the typically developing groups children in the DCD groups ages 4-6 years achieved significantly worse results for the 20-m sprint, and children of the DCD groups ages 10-12 years achieved significantly worse results for the 6-min run, jump-and-reach test, and medicine ball throw. The study demonstrates poorer performance in fitness tests with high demands on coordination in children with DCD compared to their typically developing peers. Furthermore, the differences in fitness increased with age between children in the DCD groups versus the typically developing groups.

Analysis of cursive letters, syllables, and words handwriting in a French second-grade child with Developmental Coordination Disorder and comparison with typically developing children

PubMed Central

Jolly, Caroline; Gentaz, Edouard

2014-01-01

Poor handwriting is a core deficit in Developmental Coordination Disorder (DCD). In a previous study, we compared the evolution of cursive letters handwriting in a girl with DCD throughout her second-grade year with that of typically developing (TD) children. We found that her handwriting evolved much less than that of TD children and remained similar to that of pre-schoolers at all stages, suggesting that her handwriting skills have reached a steady state level. We present here a continuation of this work, in which we focused on the velocity aspects of handwriting in another French child with DCD. Indeed, different velocity patterns have been observed in Chinese and English children with DCD. In the French cursive style of writing, consecutive letters are joined, a major difference with the English script style of writing. We thus analyzed the handwriting of a second-grade French girl with DCD, not only for isolated letters but also for syllables and words, in comparison to that of TD first-graders (6–7 years old; N = 85) and second-graders (7–8 years old; N = 88). Each written track was digitized, and nine kinematic parameters were measured to evaluate writing fluency. Results showed that the productions of the child with DCD were more similar to those of first-graders than to those of second-graders. In line with our previous study, the most discriminative parameters between the child with DCD and TD children were size and mean speed. Moreover, her handwriting was less fluent than that of TD children. In contrast to previous observations, we observed a higher writing velocity of the child with DCD when compared to TD children, whatever the complexity of the item, and no significant difference with TD children in the pausing time during writing. These differences may reflect linguistic specificities. For syllables and words, each letter was treated separately as a single unit, thus reflecting a problem in anticipation and automation. PMID:24478735

Catching-up: Children with developmental coordination disorder compared to healthy children before and after sensorimotor therapy

PubMed Central

2017-01-01

The aims of the present study were to (a) compare healthy children in terms of sensorimotor maturity to untreated children diagnosed with developmental coordination disorder (DCD) and (b) compare healthy children to diagnosed children following completed treatment with sensorimotor therapy. Participants were 298 children, 196 boys and 102 girls, distributed into a Norm group of healthy children (n = 99) and a group of children diagnosed with DCD (n = 199) with a total mean age of 8.77 years (SD = 2.88). Participants in both groups were assessed on instruments aimed to detect sensorimotor deviations. The children in the DCD group completed, during on average 36 months, sensorimotor therapy which comprised stereotypical fetal- and infant movements, vestibular stimulation, tactile stimulation, auditory stimulation, complementary play exercises, gross motor milestones, and sports-related gross motor skills. At the final visit a full assessment was once more performed. Results showed that the Norm group performed better on all sensorimotor tests as compared to the untreated children from the DCD group, with the exception of an audiometric test where both groups performed at the same level. Girls performed better on tests assessing proprioceptive and balance abilities. Results also showed, after controls for natural maturing effects, that the children from the DCD group after sensorimotor therapy did catch up with the healthy children. The concept of “catching-up” is used within developmental medicine but has not earlier been documented with regard to children and youth in connection with DCD. PMID:29020061

Deep Surveying of the Transcriptional and Alternative Splicing Signatures for Decidual CD8+ T Cells at the First Trimester of Human Healthy Pregnancy.

PubMed

Zeng, Weihong; Liu, Xinmei; Liu, Zhicui; Zheng, Ying; Yu, Tiantian; Fu, Shaliu; Li, Xiao; Zhang, Jing; Zhang, Siming; Ma, Xiaoling; Liu, Xiao-Rui; Qin, Xiaoli; Khanniche, Asma; Zhang, Yan; Tian, Fuju; Lin, Yi

2018-01-01

Decidual CD8 + (dCD8) T cells have been proposed to play important roles in immune protection against the invading pathogens and in tolerance toward the growing semi-allogeneic fetus during early pregnancy. However, their phenotypic and functional characteristics remain poorly defined. Here, we performed the first analysis of the transcriptional and alternative splicing (AS) signatures for human first-trimester dCD8 T cells using high-throughput mRNA sequencing. Our data revealed that dCD8 T cells have distinct transcriptional and AS landscapes when compared with their autologous peripheral blood CD8 + (pCD8) T counterparts. Furthermore, human dCD8 T cells were observed to contain CD8-Treg and effector-memory T-cell subsets, and display enhanced functionality in terms of degranulation and cytokine production on a per-cell basis. Additionally, we have identified the novel splice junctions that use a high ratio of the non-canonical splicing motif GC-AG and found that AS is not a major contributor to the gene expression-level changes between paired pCD8 and dCD8 T cells. Together, our findings not only provide a comprehensive framework of the transcriptional and AS landscapes but also reveal the functional feature of human dCD8 T cells, which are of great importance in understanding the biology of these cells and the physiology of human healthy pregnancy.

Liver Transplantation Using Grafts From Donors After Circulatory Death: A Propensity Score-Matched Study From a Single Center.

PubMed

Laing, R W; Scalera, I; Isaac, J; Mergental, H; Mirza, D F; Hodson, J; Wilkin, R J W; Perera, M T P R; Muiesan, P

2016-06-01

The use of livers from donation after circulatory death (DCD) is increasing, but concerns exist regarding outcomes following use of grafts from "marginal" donors. To compare outcomes in transplants using DCD and donation after brain death (DBD), propensity score matching was performed for 973 patients with chronic liver disease and/or malignancy who underwent primary whole-liver transplant between 2004 and 2014 at University Hospitals Birmingham NHS Foundation Trust. Primary end points were overall graft and patient survival. Secondary end points included postoperative, biliary and vascular complications. Over 10 years, 234 transplants were carried out using DCD grafts. Of the 187 matched DCDs, 82.9% were classified as marginal per British Transplantation Society guidelines. Kaplan-Meier analysis of graft and patient survival found no significant differences for either outcome between the paired DCD and DBD patients (p = 0.162 and p = 0.519, respectively). Aspartate aminotransferase was significantly higher in DCD recipients until 48 h after transplant (p < 0.001). The incidences of acute kidney injury and ischemic cholangiopathy were greater in DCD recipients (32.6% vs. 15% [p < 0.001] and 9.1% vs. 1.1% [p < 0.001], respectively). With appropriate recipient selection, the use of DCDs, including those deemed marginal, can be safe and can produce outcomes comparable to those seen using DBD grafts in similar recipients. © Copyright 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

The microRNA Expression Profile in Donation after Cardiac Death (DCD) Livers and Its Ability to Identify Primary Non Function.

PubMed

Khorsandi, Shirin Elizabeth; Quaglia, Alberto; Salehi, Siamak; Jassem, Wayel; Vilca-Melendez, Hector; Prachalias, Andreas; Srinivasan, Parthi; Heaton, Nigel

2015-01-01

Donation after cardiac death (DCD) livers are marginal organs for transplant and their use is associated with a higher risk of primary non function (PNF) or early graft dysfunction (EGD). The aim was to determine if microRNA (miRNA) was able to discriminate between DCD livers of varying clinical outcome. DCD groups were categorized as PNF retransplanted within a week (n=7), good functional outcome (n=7) peak aspartate transaminase (AST) ≤ 1000 IU/L and EGD (n=9) peak AST ≥ 2500 IU/L. miRNA was extracted from archival formalin fixed post-perfusion tru-cut liver biopsies. High throughput expression analysis was performed using miRNA arrays. Bioinformatics for expression data analysis was performed and validated with real time quantitative PCR (RT-qPCR). The function of miRNA of interest was investigated using computational biology prediction algorithms. From the array analysis 16 miRNAs were identified as significantly different (p<0.05). On RT-qPCR miR-155 and miR-940 had the highest expression across all three DCD clinical groups. Only one miRNA, miR-22, was validated with marginal significance, to have differential expression between the three groups (p=0.049). From computational biology miR-22 was predicted to affect signalling pathways that impact protein turnover, metabolism and apoptosis/cell cycle. In conclusion, microRNA expression patterns have a low diagnostic potential clinically in discriminating DCD liver quality and outcome.

A literature-based cost analysis of tissue plasminogen activator for prevention of biliary stricture in donation after circulatory death liver transplantation.

PubMed

Jones, J M; Bhutiani, N; Wei, D; Goldstein, L; Jones, C M; Cannon, R M

2018-04-17

This study sought to approximate the cost-effectiveness of tPA utilization for prevention of biliary strictures (PTBS) in donation after circulatory death liver transplantation (DCD-LT). Previously-reported PTBS rates in DCD-LT with and without tPA were used to calculate the number needed to treat (NNT) for prevention of one PTBS. The incremental cost of PTBS was then used to determine the cost effectiveness of tPA for prevention of PTBS. The incidence of PTBS in the setting of tPA administration was 20%, while incidence in patients without tPA use was 43% (p < 0.001). Meta-analysis demonstrated a risk reduction of 15.7%, which translated into a NNT of 6.4. Cost associated with treating 6.4 patients was $50,353. Based on an incremental cost of $81,888 associated with PTBS management, use of tPA in DCD-LT protocols was estimated to save $31,528 per PTBS prevented. Utilization of tPA in DCD-LT protocols represents one possible cost-effective strategy for prevention of PTBS in DCD-LT. Copyright © 2018 Elsevier Inc. All rights reserved.

Handwriting speed in children with Developmental Coordination Disorder: are they really slower?

PubMed

Prunty, Mellissa M; Barnett, Anna L; Wilmut, Kate; Plumb, Mandy S

2013-09-01

Handwriting difficulties are often included in descriptions of Developmental Coordination Disorder (DCD). They are cited as the most common reason for referral to health professionals following parent and teacher concerns about slow and untidy writing. The aim of this study was to compare handwriting performance in English children with and without DCD across a range of writing tasks, to gain a better understanding of the nature of 'slowness' so commonly reported. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 typically developing age and gender matched controls. Participants completed the four handwriting tasks from the Detailed Assessment of Speed of Handwriting (DASH) and wrote their own name; all on a digitising writing tablet. The number of words written, speed of pen movements and the time spent pausing during the tasks were calculated. The findings confirmed what many professionals report, that children with DCD produce less text than their peers. However, this was not due to slow movement execution, but rather a higher percentage of time spent pausing. Discussion centres on the understanding of the pausing phenomenon in children with DCD and areas for further research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Perceived freedom in leisure and physical co-ordination ability: impact on out-of-school activity participation and life satisfaction.

PubMed

Poulsen, A A; Ziviani, J M; Cuskelly, M

2007-07-01

Perceived freedom in leisure (PFL) is explored as a potential mechanism mediating relationships between physical co-ordination ability and both global life satisfaction and leisure-time physical activity participation for boys with differing levels of physical co-ordination ability. Understanding psychological mechanisms contributing to low rates of participation in physical activities for boys with developmental co-ordination disorder (DCD) is a clinical and research priority with potential to inform clinical interventions and preventive health initiatives. Sixty boys aged 10-13 years with DCD and 113 boys without DCD completed self-report measures of PFL and life satisfaction. Seven-day leisure-time activity diaries and 12-month retrospective recall questionnaires were completed by parents. Lower self-appraisals of PFL and overall life satisfaction were found for boys with DCD compared with boys without DCD. PFL mediated relationships between physical ability and both life satisfaction and team sport participation. Perceived freedom in leisure, comprising self-appraisals of leisure needs satisfaction and competence, depth of involvement and perceived control over leisure outcomes, was a significant mechanism influencing leisure-time participation and life satisfaction for boys. The implications for effective intervention and preventive health programmes are discussed.

The effect of an integrated perceived competence and motor intervention in children with developmental coordination disorder.

PubMed

Noordstar, Johannes J; van der Net, Janjaap; Voerman, Lia; Helders, Paul J M; Jongmans, Marian J

2017-01-01

Children with DCD have lower self-perceptions and are less physically active than typically developing children. The aim of this quasi-experimental study was to investigate whether an integrated perceived competence and motor intervention affects DCD children's motor performance, self-perceptions, and physical activity compared with a motor intervention only. The intervention group consisted of 20 children and the care-as-usual group consisted of 11 children, all aged 7-10 years. The perceived competence component of the intervention focused primarily on providing positive, specific, and progress feedback to enhance self-perceptions. We assessed children at baseline, after 12 treatment sessions (trial end-point), and at 3-month follow-up. Mixed linear models revealed no differences between the intervention and the care-as-usual group on any of the outcome measures. Children improved their motor performance and increased their perceived athletic competence, global self-esteem, and perceived motor competence after 12 treatment sessions. This improvement was maintained at 3-month follow-up. Motor task values and physical activity remained unchanged for all children. A perceived competence and motor intervention is as effective as care-as-usual in children with DCD. Future research should focus on improving physical activity in children with DCD. This is the first study that has investigated the effect of an integrated perceived competence and motor intervention (intervention group) on motor performance, self-perceptions, and physical activity compared with a motor intervention (care-as-usual group) in children with DCD. We made the perceived competence component explicit by providing positive, specific, and progress feedback to enhance children's self-perceptions. Also, this is one of the first studies that has investigated the effect after both 12 treatment sessions (trial end-point) and after 3 months of no intervention (3-month follow-up). We found no differences between the intervention and the care-as-usual group, but children improved their motor performance and increased (most) of their self-perceptions after 12 treatment sessions, while physical activity remained the same. The improvement was still present at the 3-month follow-up. We also benchmarked our results about self-perceptions and physical activity to a group of typically developing children. Self-perceptions in children with DCD had improved to the level of typically developing children after 12 treatment sessions, but their physical activity levels remained significantly lower. This result was the same at the 3-month follow-up, except for perceived athletic competence, which was lower in children with DCD at the 3-month follow-up. In accordance with previous intervention studies that have investigated children with DCD, we found large intra-group variability in the change in motor performance and self-perceptions in children with DCD. We argue that we need to better understand why some children with DCD improve and others do not after a motor intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Combination of wet irrigation and nitrification inhibitor reduced nitrous oxide and methane emissions from a rice cropping system.

PubMed

Liu, Gang; Yu, Haiyang; Zhang, Guangbin; Xu, Hua; Ma, Jing

2016-09-01

To conserve water resources and guarantee food security, a new technology termed as "wet irrigation" is developed and practiced in rice fields; thus, its impact on radiative forcing derived from nitrous oxide (N2O) and methane (CH4) emissions merits serious attention. Dicyandiamide (DCD), a kind of nitrification inhibitor, is proposed as a viable means to mitigate greenhouse gas (GHG) emission while enhancing crop productivity. However, little is known about the response of GHG emission and grain yield to DCD application in a rice system under wet irrigation. In these regard, effects of water regime and DCD application on CH4 and N2O emissions, grain yield, global warming potential (GWP), and greenhouse gas intensity (GHGI) from rice fields were studied. For this study, a field experiment, designed: Treatment II (intermittent irrigation), Treatment WI (wet irrigation), Treatment IID (II plus DCD), and Treatment WID (WI plus DCD), was conducted in Jurong, Jiangsu Province, China, from 2011 to 2012. Relative to Treatment II, Treatment WI decreased CH4 emission significantly by 49-71 % while increasing N2O emission by 33-72 %. By integrating CH4 and N2O emissions and grain yield, Treatment WI was 20-28 and 11-15 % lower than Treatment II in GWP and GHGI, respectively. The use of DCD under wet irrigation reduced N2O emission significantly by 25-38 % (p < 0.05) and CH4 emission by 7-8 %, relative to Treatment WI, resulting in a decline of 18-30 % in GWP. Due to the increase in N use efficiency, maximal grain yield (6-7 %) and minimal GHGI (22-34 %) was observed in Treatment WID. These findings indicate that combined application of N fertilizer and DCD is a win-win strategy in water-saving high-yield rice production with less GHG emission.

Expanded criteria donor and donation after circulatory death renal allografts in the West of Scotland: Their place in the kidney allocation process.

PubMed

Hesse, Kerrick; Aitken, Emma; Clancy, Marc; Vesey, Alex

2016-06-01

Due to the rising disparity between demand and availability, organs from expanded criteria donors (ECD) and donors after determination of circulatory death (DCD) are increasingly used. The purpose of this study was to report outcomes in recipients of ECD and DCD renal allografts from a single centre. A retrospective analysis from a single centre for all renal transplants performed between 2001 and 2010 inclusive was undertaken. SCD (standard criteria donor) and ECD organs were compared, as were DCD and DBD (donation after determination of brain stem death) organs. Baseline data and predefined standard transplant outcomes were collected and compared using appropriate statistical tests. P < 0.05 was defined as significant. 729 renal transplants were performed. Comparing ECD to SCD organs, there was a significant difference in graft survival between groups (logrank for trend, p = 0.032) with ECD organs doing worse than SCD organs. Short-term outcomes showed a similar disparity with a higher 1-year post-transplant creatinine and delayed graft function (DGF) rate in ECD grafts. Nevertheless, outcomes were still clinically acceptable. When comparing DCD to DBD organs, no such differences were apparent, with DCD organs appearing to perform at least as well as DBD organs. In our cohort, unlike some previous studies, DGF rates were similar in both DCD and DBD groups. Although ECD organs perform less well than SCD organs, outcomes are still acceptable and our results support their continuing use. When considering DCD organs, our data support the view that they should no longer be necessarily regarded as marginal grafts. Our low DGF rates are perhaps explained by local factors contributing to a short CIT. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Organ donation and transplantation statistics in Belgium for 2012 and 2013.

PubMed

Desschans, B; Evrard, P

2014-11-01

The 2012 and 2013 solid organ transplantation statistics were presented during the annual meeting of the Belgian Transplant Society. All data presented were collected from Eurotransplant International Foundation and/or from all individual Belgian transplant centers. It was demonstrated that the highest number of deceased donors detected (1310) from which 47.8% were an effective organ donor that corresponded to 29 per million inhabitants (pmi) in 2012 and 27.4 pmi in 2013. Out of 626 effective deceased organ donors, 491 (79%) were donors after brain death (DBD) and 135 (21%) donors after circulatory death (DCD), respectively. The majority (125/135; 93%) of DCD donors were DCD Maastricht category III donors and there were 7 (5%) donations following euthanasia. Family refusal tended to be lower for DCD (10.4%) compared to DBD donors (13.4%). Despite the increasing DCD donation rate, DBD donation remains stable in Belgium. The donor age is still increasing, reaching a median age of 53 years (range 0-90). Spontaneous intracranial bleeding (39.3%) and cranio-cerebral trauma (25%) remained the most frequent reasons of death. The number of living related kidney transplantations (57 in 2012 and 63 in 2013) followed the international trend albeit in Belgium it is still very limited. Nevertheless this activity could explain that the number of patients waiting for kidney transplantation (770) reached an absolute minimum in 2013. Except the reduced waiting list for lung transplantation (from 119 patients in 2011 to 85 in 2013), the waiting list remained stable for the other organs but almost 200 patients still died while on the waiting list. Belgium demonstrated the highest number of effective organ donors that corresponded to 29 per million inhabitants (pmi) in 2012 and 27.4 pmi in 2013. Thus far, and in contrast with other countries, there is no erosion of DBD in the DCD donor organ pool, but it is the important responsibility of all transplant centers and donor hospitals to avoid a substitution from DBD by DCD donors.

Best practice principles for management of children with developmental coordination disorder (DCD): results of a scoping review.

PubMed

Camden, C; Wilson, B; Kirby, A; Sugden, D; Missiuna, C

2015-01-01

Developmental coordination disorder (DCD) is a prevalent health condition that is frequently unrecognized despite the substantial evidence that has accumulated regarding how it affects children's health, education and skills. Most literature focuses on measurement of impairment and description of intervention approaches for individual children; little is known about the principles that should guide best practice and service delivery for children with DCD as a population. The purpose of this study was to identify these principles. A scoping review was used to 'map' the information available to inform intervention and service delivery. Scholarly and grey literature written in English was identified in six databases, using a combination of keywords (e.g. guidelines, management, models and DCD); a 'snow-balling' technique was also used in Canada and the UK to access clinical protocols used in publicly funded health care systems. Over 500 documents were screened: 31 met inclusion criteria as they outlined practice principles for children with DCD as a population. Data regarding best practices were independently extracted by two reviewers and then compared with achieve consistency and consensus. Two over-arching themes emerged, with five principles: (1) Organizing services to efficiently meet the comprehensive needs of children (e.g. Increasing awareness of DCD and coordination; Implementing clearly defined pathways; Using a graduated/staged approach); (2) Working collaboratively to offer evidence-based services (e.g. Integration of child and family views; Evidence-based interventions fostering function, participation and prevention). Numerous documents support each of the principles, reflecting agreement across studies about recommended organization of services. While these principles may apply to many populations of children with disabilities, this review highlights how essential these principles are in DCD. Researchers, managers, clinicians, community partners and families are encouraged to work together in designing, implementing and evaluating interventions that reflect these principles. © 2014 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.

First experience of liver transplantation with type 2 donation after cardiac death in France.

PubMed

Savier, Eric; Dondero, Federica; Vibert, Eric; Eyraud, Daniel; Brisson, Hélène; Riou, Bruno; Fieux, Fabienne; Naili-Kortaia, Salima; Castaing, Denis; Rouby, Jean-Jacques; Langeron, Olivier; Dokmak, Safi; Hannoun, Laurent; Vaillant, Jean-Christophe

2015-05-01

Organ donation after unexpected cardiac death [type 2 donation after cardiac death (DCD)] is currently authorized in France and has been since 2006. Following the Spanish experience, a national protocol was established to perform liver transplantation (LT) with type 2 DCD donors. After the declaration of death, abdominal normothermic oxygenated recirculation was used to perfuse and oxygenate the abdominal organs until harvesting and cold storage. Such grafts were proposed to consenting patients < 65 years old with liver cancer and without any hepatic insufficiency. Between 2010 and 2013, 13 LTs were performed in 3 French centers. Six patients had a rapid and uneventful postoperative recovery. However, primary nonfunction occurred in 3 patients, with each requiring urgent retransplantation, and 4 early allograft dysfunctions were observed. One patient developed a nonanastomotic biliary stricture after 3 months, whereas 8 patients showed no sign of ischemic cholangiopathy at their 1-year follow-up. In comparison with a control group of patients receiving grafts from brain-dead donors (n = 41), donor age and cold ischemia time were significantly lower in the type 2 DCD group. Time spent on the national organ wait list tended to be shorter in the type 2 DCD group: 7.5 months [interquartile range (IQR), 4.0-11.0 months] versus 12.0 months (IQR, 6.8-16.7 months; P = 0.08. The 1-year patient survival rates were similar (85% in the type 2 DCD group versus 93% in the control group), but the 1-year graft survival rate was significantly lower in the type 2 DCD group (69% versus 93%; P = 0.03). In conclusion, to treat borderline hepatocellular carcinoma, LT with type 2 DCD donors is possible as long as strict donor selection is observed. © 2015 American Association for the Study of Liver Diseases.

Pathological characteristics of liver allografts from donation after brain death followed by cardiac death in pigs.

PubMed

Ye, Hui; Wang, Dong-Ping; Zhang, Chuan-Zhao; Zhang, Long-Juan; Wang, Hao-Chen; Li, Zhuo-Hui; Chen, Zhen; Zhang, Tao; Cai, Chang-Jie; Ju, Wei-Qiang; Ma, Yi; Guo, Zhi-Yong; He, Xiao-Shun

2014-10-01

Donation after brain death followed by circulatory death (DBCD) is a unique practice in China. The aim of this study was to define the pathologic characteristics of DBCD liver allografts in a porcine model. Fifteen male pigs (25-30 kg) were allocated randomly into donation after brain death (DBD), donation after circulatory death (DCD) and DBCD groups. Brain death was induced by augmenting intracranial pressure. Circulatory death was induced by withdrawal of life support in DBCD group and by venous injection of 40 mL 10% potassium chloride in DCD group. The donor livers were perfused in situ and kept in cold storage for 4 h. Liver tissue and common bile duct samples were collected for hematoxylin and eosin staining, TUNEL testing and electron microscopic examination. Spot necrosis was found in hepatic parenchyma of DBD and DBCD groups, while a large area of necrosis was shown in DCD group. The apoptosis rate of hepatocytes in DBD [(0.56±0.30)%] and DBCD [(0.50 ± 0.11)%] groups was much lower than that in DCD group [(3.78±0.33)%] (P<0.05). And there was no significant difference between DBD group and DBCD group (P>0.05)). The structures of bile duct were intact in both DBD and DBCD groups, while the biliary epithelium was totally damaged in DCD group. Under electron microscope, the DBD hepatocytes were characterized by intact cell membrane, well-organized endoplasmic reticulum, mild mitochondria edema and abundant glycogens. Broken cell membrane, mild inflammatory cell infiltration and sinusoidal epithelium edema, as well as reduced glycogen volume, were found in the DBCD hepatocytes. The DCD hepatocytes had more profound cell organelle injury and much less glycogen storage. In conclusion, the preservation injury of DBCD liver allografts is much less severe than that of un-controlled DCD, but more severe than that of DBD liver allografts under electron microscope, which might reflect post-transplant liver function to some extent.

A meta-analysis and meta-regression of outcomes including biliary complications in donation after cardiac death liver transplantation.

PubMed

O'Neill, Stephen; Roebuck, Amanda; Khoo, Emily; Wigmore, Stephen J; Harrison, Ewen M

2014-11-01

Donation after cardiac death (DCD) liver transplantation is increasingly common but concerns exist over the development of biliary complications and ischemic cholangiopathy (IC). This study aimed to compare outcomes between DCD and donation after brain death (DBD) liver grafts. Studies reporting on post-transplantation outcomes after Maastricht category III DCD liver transplantation were screened for inclusion. Odds ratios (OR) with 95% confidence intervals were produced using random-effects models for the incidence of biliary complications, IC, graft and recipient survival. Meta-regression was undertaken to identify between-study predictors of effect size for biliary complications and IC. PROSPERO Record: CRD42012002113. Twenty-five studies with 62 184 liver transplant recipients (DCD = 2478 and DBD = 59 706) were included. In comparison with DBD, there was a significant increase in biliary complications [OR = 2.4 (1.9, 3.1); P < 0.00001] and IC [OR = 10.5 (5.7, 19.5); P < 0.00001] following DCD liver transplantation. In comparison with DBD, at 1 year [OR = 0.7 (0.5, 0.8); P = 0.0002] and 3 years [OR = 0.6 (0.5, 0.8); P = 0.001], there was a significant decrease in graft survival following DCD liver transplantation. At 1 year, there was also a nonsignificant decrease [OR = 0.8 (0.6, 1.0); P = 0.08] and by 3 years a significant decrease [OR = 0.7 (0.5, 1.0); P = 0.04] found in recipient survival following DCD liver transplantation. Eleven factors were entered into meta-regression models, but none explained the variability in effect size between studies. DCD liver transplantation is associated with an increase in biliary complications, IC, graft loss and mortality. Significant unexplained differences in effect size exist between centers. © 2014 Steunstichting ESOT.

In Vitro Validation of Real-Time Three-Dimensional Color Doppler Echocardiography for Direct Measurement of Proximal Isovelocity Surface Area in Mitral Regurgitation

PubMed Central

Little, Stephen H.; Igo, Stephen R.; Pirat, Bahar; McCulloch, Marti; Hartley, Craig J.; Nosé, Yukihiko; Zoghbi, William A.

2012-01-01

The 2-dimensional (2D) color Doppler (2D-CD) proximal isovelocity surface area (PISA) method assumes a hemispheric flow convergence zone to estimate transvalvular flow. Recently developed 3-dimensional (3D)-CD can directly visualize PISA shape and surface area without geometric assumptions. To validate a novel method to directly measure PISA using real-time 3D-CD echocardiography, a circulatory loop with an ultrasound imaging chamber was created to model mitral regurgitation (MR). Thirty-two different regurgitant flow conditions were tested using symmetric and asymmetric flow orifices. Three-dimensional–PISA was reconstructed from a hand-held real-time 3D-CD data set. Regurgitant volume was derived using both 2D-CD and 3D-CD PISA methods, and each was compared against a flowmeter standard. The circulatory loop achieved regurgitant volume within the clinical range of MR (11 to 84 ml). Three-dimensional–PISA geometry reflected the 2D geometry of the regurgitant orifice. Correlation between the 2D-PISA method regurgitant volume and actual regurgitant volume was significant (r2 = 0.47, p <0.001). Mean 2D-PISA regurgitant volume underestimate was 19.1 ± 25 ml (2 SDs). For the 3D-PISA method, correlation with actual regurgitant volume was significant (r2 = 0.92, p <0.001), with a mean regurgitant volume underestimate of 2.7 ± 10 ml (2 SDs). The 3D-PISA method showed less regurgitant volume underestimation for all orifice shapes and regurgitant volumes tested. In conclusion, in an in vitro model of MR, 3D-CD was used to directly measure PISA without geometric assumption. Compared with conventional 2D-PISA, regurgitant volume was more accurate when derived from 3D-PISA across symmetric and asymmetric orifices within a broad range of hemodynamic flow conditions. PMID:17493476

Ball catching in children with developmental coordination disorder: control of degrees of freedom.

PubMed

Utley, Andrea; Steenbergen, Bert; Astill, Sarah Louise

2007-01-01

This study investigated two-handed catching in eight children (four males, four females) aged 7 to 8 years (mean 7y 4mo [SD 3mo]) with developmental coordination disorder (DCD) and their age-matched controls (AMCs). Kinematic data were collected to examine Bernstein's (1967) notion of freezing and releasing degrees of freedom (DF). Participants were asked to catch a ball 30 times, delivered in three blocks of 10 trials. Video analysis showed that children with DCD caught significantly fewer balls than their AMCs (p< or =0.001) counterparts. Kinematic analyses showed that children with DCD exhibited smaller ranges of motion and less variable angular excursions of the elbow joints than their AMCs, and that their elbows are more rigidly coupled (p< or =0.001). These data suggest that children with DCD rigidly fix and couple their limbs to reduce the number of DF actively involved in the task.

Ethical, legal, and societal issues and recommendations for controlled and uncontrolled DCD.

PubMed

Haase, Bernadette; Bos, Michael; Boffa, Catherine; Lewis, Penney; Rudge, Chris; Valero, Ricard; Wind, Tineke; Wright, Linda

2016-07-01

This report deals with organ retrieval procedures in both controlled and uncontrolled DCD, looking at the ethical, legal, and psychosocial aspects during the different phases of the process. A recently published report by the UK Donation Ethics Committee (UKDEC) has served as an important reference document to outline the steps in the controlled DCD patient-donor pathway (Academy of Medical Royal Colleges. UK Donation Ethics Committee. An ethical framework for controlled donation after circulatory death. December 2011). For uncontrolled DCD, the UKDEC pathway description was adapted. At the 6th International Conference in Organ Donation held in Paris in 2013, an established expert European Working Group reviewed the UKDEC reports, which were then considered along with the available published literature. Along this pathway, the crucial ethical, legal, and psychosocial aspects have been flagged, and relevant recommendations have been formulated based on a consensus of the working group. © 2015 Steunstichting ESOT.

Donation after cardiac death liver transplantation is associated with increased risk of end-stage renal disease.

PubMed

Ruebner, Rebecca L; Reese, Peter P; Abt, Peter L

2014-12-01

Limited organ supply has led to greater use of liver allografts with higher donor risk indices (DRI) and/or donated after cardiac death (DCD). DCD status is associated with acute kidney injury after liver transplantation; however, less is known about the association between donor quality and end-stage renal disease (ESRD). Using SRTR data, we assembled a cohort of liver transplant recipients from 2/2002 to 12/2010. We fit multivariable Cox regression models for ESRD. Model 1 included total DRI; model 2 included components of DRI, including DCD, as separate variables. Forty thousand four hundred and sixty-three liver transplant recipients were included. Median DRI was 1.40 (IQR 1.14, 1.72); 1822 (5%) received DCD livers. During median follow-up of 3.93 years, ESRD occurred in 2008 (5%) and death in 11 075 (27%) subjects. There was a stepwise increase in ESRD risk with higher DRI (DRI ≥1.14 and <1.40: HR 1.17, P = 0.06; DRI ≥1.40 and <1.72: HR 1.29, P = 0.003; DRI ≥1.72: HR 1.39, P < 0.001, compared with DRI <1.14). Adjusting for DRI components separately, DCD status was most strongly associated with ESRD (HR 1.40, P = 0.008). Higher DRI is associated with ESRD after liver transplantation, driven in part by DCD status. Donor quality is an important predictor of long-term renal outcomes in liver transplant recipients. © 2014 Steunstichting ESOT.

Improving Donor Conversion Rates at a Level One Trauma Center: Impact of Best Practice Guidelines.

PubMed

Alban, Rodrigo F; Gibbons, Bobby L; Bershad, Vanessa L

2016-11-22

Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability. Retrospective analysis of a prospectively collected database from TransLife, our local organ procurement organization (OPO), as well as the Orlando Regional Medical Center (ORMC) trauma registry, from 2009-2012 (up to 2013 for DCD). During which time, this organization implemented best practice guidelines to improve conversions and DCD utilization. We analyzed yearly conversion rates, DCD donations and population demographics before and after implementation of these policies. During the study period, donor conversion rates significantly improved from 58% in 2009 to 82% percent in 2012 hospital-wide (P<0.05); and from 50% in 2009 to 81% in 2012 among trauma patients alone (P<0.05). In addition, total organs transplanted increased from 13 to 31 organs (P<0.05) after implementation of best practice guidelines. No significant differences in trauma population demographics were noted during the study period. Based on our experience, the establishment of best practice policies for referral of potential donors, coupled with programs to educate hospital staff on the existence and importance of these policies, leads to significant improvement in donor conversion rates and increased utilization of DCD donors.

Coupling of online control and inhibitory systems in children with atypical motor development: A growth curve modelling study.

PubMed

Ruddock, Scott; Caeyenberghs, Karen; Piek, Jan; Sugden, David; Hyde, Christian; Morris, Sue; Rigoli, Daniela; Steenbergen, Bert; Wilson, Peter

2016-11-01

Previous research indicates that children with Developmental Coordination Disorder (DCD) show deficits performing online corrections, an issue exacerbated by adding inhibitory constraints; however, cross-sectional data suggests that these deficits may reduce with age. Using a longitudinal design, the aim of the study presented here was to model the coupling that occurs between inhibitory systems and (predictive) online control in typically developing children (TDC) and in those with Developmental Coordination Disorder (DCD) over an extended period of time, using a framework of interactive specialization. We predicted that TDC would show a non-linear growth pattern, consistent with re-organisation in the coupling during the middle childhood period, while DCD would display a developmental lag. A group of 196 children (111 girls and 85 boys) aged between 6 and 12years participated in the study. Children were classified as DCD according to research criteria. Using a cohort sequential design, both TDC and DCD groups were divided into age cohorts. Predictive (online) control was defined operationally by performance on a Double-Jump Reaching Task (DJRT), which was assessed at 6-month intervals over two years (5 time points in total). Inhibitory control was examined using an anti-jump condition of the DJRT paradigm whereby children were instructed to touch a target location in the hemispace opposite a cued location. For the TDC group, model comparison using growth curve analysis revealed that a quadratic trend was the most appropriate fit with evidence of rapid improvement in anti-reach performance up until middle childhood (around 8-9years of age), followed by a more gradual rate of improvement into late childhood and early adolescence. This pattern was evident on both chronometric and kinematic measures. In contrast, for children with DCD, a linear function provided the best to fit on the key metrics, with a slower rate of improvement than controls. We conclude that children with DCD require a more extended period of development to effectively couple online motor control and executive systems when completing anti-reach movements, whereas TDC show rapid improvement in early and middle childhood. These group differences in growth curves are likely to reflect a maturational lag in the development of motor-cognitive networks in children with DCD. Copyright © 2016 Elsevier Inc. All rights reserved.

Events in procurement as risk factors for ischemic cholangiopathy in liver transplantation using donation after cardiac death donors.

PubMed

Taner, C Burcin; Bulatao, Ilynn G; Willingham, Darrin L; Perry, Dana K; Sibulesky, Lena; Pungpapong, Surakit; Aranda-Michel, Jaime; Keaveny, Andrew P; Kramer, David J; Nguyen, Justin H

2012-01-01

The use of donation after cardiac death (DCD) liver grafts is controversial because of the overall increased rates of graft loss and morbidity, which are mostly related to the consequences of ischemic cholangiopathy (IC). In this study, we sought to determine the factors leading to graft loss and the development of IC and to compare patient and graft survival rates for recipients of DCD liver grafts and recipients of donation after brain death (DBD) liver grafts in a large series at a single transplant center. Two hundred liver transplants with DCD donors were performed between 1998 and 2010 at Mayo Clinic Florida. Logistic regression models were used in the univariate and multivariate analyses of predictors for the development of IC. Additional analyses using Cox regression models were performed to identify predictors of graft survival and to compare outcomes for DCD and DBD graft recipients. In our series, the patient survival rates for the DCD and DBD groups at 1, 3, and 5 years was 92.6%, 85%, and 80.9% and 89.8%, 83.0%, and 76.6%, respectively (P = not significant). The graft survival rates for the DCD and DBD groups at 1, 3, and 5 years were 80.9%, 72.7%, and 68.9% and 83.3%, 75.1%, and 68.6%, respectively (P = not significant). In the DCD group, 5 patients (2.5%) had primary nonfunction, 7 patients (3.5%) had hepatic artery thrombosis, and 3 patients (1.5%) experienced hepatic necrosis. IC was diagnosed in 24 patients (12%), and 11 of these patients (5.5%) required retransplantation. In the multivariate analysis, the asystole-to-cross clamp duration [odds ratio = 1.161, 95% confidence interval (CI) = 1.021-1.321] and African American recipient race (odds ratio = 5.374, 95% CI = 1.368-21.103) were identified as significant factors for predicting the development of IC (P < 0.05). This study has established a link between the development of IC and the asystole-to-cross clamp duration. Procurement techniques that prolong the nonperfusion period increase the risk for the development of IC in DCD liver grafts. Copyright © 2011 American Association for the Study of Liver Diseases.

DCD lung donation: donor criteria, procedural criteria, pulmonary graft function validation, and preservation.

PubMed

Erasmus, Michiel E; van Raemdonck, Dirk; Akhtar, Mohammed Zeeshan; Neyrinck, Arne; de Antonio, David Gomez; Varela, Andreas; Dark, John

2016-07-01

In an era where there is a shortage of lungs for transplantation is increased utilization of lungs from donation after circulatory death (DCD) donors. We review the reports of 11 controlled and 1 uncontrolled DCD programs focusing on donor criteria, procedural criteria, graft assessment, and preservation techniques including the use of ex vivo lung perfusion. We have formulated conclusions and recommendations for each of these areas, which were presented at the 6th International Conference on Organ Donation. A table of recommendations, the grade of recommendations, and references are provided. © 2015 Steunstichting ESOT.

Atypical inter-hemispheric communication correlates with altered motor inhibition during learning of a new bimanual coordination pattern in developmental coordination disorder.

PubMed

Blais, Mélody; Amarantini, David; Albaret, Jean-Michel; Chaix, Yves; Tallet, Jessica

2018-05-01

Impairment of motor learning skills in developmental coordination disorder (DCD) has been reported in several studies. Some hypotheses on neural mechanisms of motor learning deficits in DCD have emerged but, to date, brain-imaging investigations are scarce. The aim of the present study is to assess possible changes in communication between brain areas during practice of a new bimanual coordination task in teenagers with DCD (n = 10) compared to matched controls (n = 10). Accuracy, stability and number of mirror movements were computed as behavioural variables. Neural variables were assessed by electroencephalographic coherence analyses of intra-hemispheric and inter-hemispheric fronto-central electrodes. In both groups, accuracy of the new coordination increased concomitantly with right intra-hemispheric fronto-central coherence. Compared to typically developing teenagers, DCD teenagers presented learning difficulties expressed by less stability, no stabilization of the new coordination and a greater number of mirror movements despite practice. These measures correlated with reduced inter-hemispheric communication, even after practice of the new coordination. For the first time, these findings provide neuro-imaging evidence of a kind of inter-hemispheric 'disconnection' related to altered inhibition of mirror movements during motor learning in DCD. © 2017 John Wiley & Sons Ltd.

Urinary Cadmium and Estimated Dietary Cadmium in the Women’s Health Initiative

PubMed Central

Quraishi, Sabah M.; Adams, Scott V.; Shafer, Martin; Meliker, Jaymie R.; Li, Wenjun; Luo, Juhua; Neuhouser, Marian L.; Newcomb, Polly A.

2016-01-01

Cadmium, a heavy metal dispersed in the environment as a result of industrial and agricultural applications, has been implicated in several human diseases including renal disease, cancers, and compromised bone health. In the general population, the predominant sources of cadmium exposure are tobacco and diet. Urinary cadmium (uCd) reflects long-term exposure and has been frequently used to assess cadmium exposure in epidemiological studies; estimated dietary intake of cadmium (dCd) has also been used in several studies. The validity of dCd in comparison to uCd is unclear. This study aimed to compare dCd, estimated from food frequency questionnaires (FFQs), to uCd measured in spot urine samples from 1,002 participants of the Women’s Health Initiative. Using linear regression, we found that dCd was not statistically significantly associated with uCd (β=0.006, p-value=0.14). When stratified by smoking status, dCd was not significantly associated with uCd both in never smokers (β=0.006, p-value=0.09) and in ever smokers (β=0.003, p-value=0.0.67). Our results suggest that because of the lack of association between estimated dietary cadmium and measured urinary cadmium exposure, dietary estimation of cadmium exposure should be used with caution in epidemiologic studies. PMID:26015077

Handwriting features of children with developmental coordination disorder--results of triangular evaluation.

PubMed

Rosenblum, Sara; Margieh, Jumana Aassy; Engel-Yeger, Batya

2013-11-01

Developmental coordination disorders (DCD) is one of the most common disorders affecting school-aged children. The study aimed to characterize the handwriting performance of children with DCD who write in Arabic, based on triangular evaluation. Participants included 58 children aged 11-12 years, 29 diagnosed with DCD based on the DSM-IV criteria and the M-ABC, and 29 matched typically developed controls. Children were asked to copy a paragraph on a sheet of paper affixed to a digitizer supplying objective measures of the handwriting process. The handwriting proficiency screening questionnaire (HPSQ) was completed by their teachers while observing their performance and followed by evaluation of their final written product. Results indicated that compared to controls, children with DCD required significantly more on-paper and in-air time per stroke while copying. In addition, global legibility, unrecognizable letters and spatial arrangement measures of their written product were significantly inferior. Significant group differences were also found between the HPSQ subscales scores. Furthermore, 82.8% of all participants were correctly classified into groups based on one discriminate function which included two handwriting performance measures. These study results strongly propose application of triangular standardized evaluation to receive better insight of handwriting deficit features of individual children with DCD who write in Arabic. Copyright © 2013 Elsevier Ltd. All rights reserved.

Changing Patterns of Organ Donation: Brain Dead Donors Are Not Being Lost by Donation After Circulatory Death.

PubMed

Nelson, Helen M; Glazier, Alexandra K; Delmonico, Francis L

2016-02-01

The clinical characteristics of all New England Organ Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June 30, 2014. During that 5-year period, there were 494 authorized medically suitable potential DCDs that the NEOB evaluated, constituting more than 30% of deceased donors coordinated annually by the NEOB. From the cohort of 494 authorized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) transitioned to an actual donor after brain death (DBD). Two hundred seventy-six organs were transplanted from the 81 donors that transitioned from DCD to actual DBD, including 24 heart, 70 liver, 12 single and 14 bilateral lung, and 12 pancreas transplants. When patients with devastating brain injury admitted to the intensive care units are registered donors, the Organ Procurement Organization staff should share the patient's donation decision with the health care team and the patient's family, as early as possible after the comfort measures only discussion has been initiated. The experience of the NEOB becomes an important reference of the successful implementation of DCD that enables an expansion of deceased donation (inclusive of DBD).

Neural changes associated to procedural learning and automatization process in Developmental Coordination Disorder and/or Developmental Dyslexia.

PubMed

Biotteau, Maëlle; Péran, Patrice; Vayssière, Nathalie; Tallet, Jessica; Albaret, Jean-Michel; Chaix, Yves

2017-03-01

Recent theories hypothesize that procedural learning may support the frequent overlap between neurodevelopmental disorders. The neural circuitry supporting procedural learning includes, among others, cortico-cerebellar and cortico-striatal loops. Alteration of these loops may account for the frequent comorbidity between Developmental Coordination Disorder (DCD) and Developmental Dyslexia (DD). The aim of our study was to investigate cerebral changes due to the learning and automatization of a sequence learning task in children with DD, or DCD, or both disorders. fMRI on 48 children (aged 8-12) with DD, DCD or DD + DCD was used to explore their brain activity during procedural tasks, performed either after two weeks of training or in the early stage of learning. Firstly, our results indicate that all children were able to perform the task with the same level of automaticity, but recruit different brain processes to achieve the same performance. Secondly, our fMRI results do not appear to confirm Nicolson and Fawcett's model. The neural correlates recruited for procedural learning by the DD and the comorbid groups are very close, while the DCD group presents distinct characteristics. This provide a promising direction on the neural mechanisms associated with procedural learning in neurodevelopmental disorders and for understanding comorbidity. Published by Elsevier Ltd.

Appropriateness of different pedagogical approaches to road safety education for children with Developmental Coordination Disorder (DCD).

PubMed

Purcell, C; Romijn, A R

2017-11-01

In 2016, 29% of pedestrians killed or seriously injured on the roads in Great Britain were under 15 years of age. Children with Developmental Coordination Disorder (DCD), a chronic disorder affecting the acquisition and execution of motor skills, may be more vulnerable at the roadside than typically developing (TD) children. Current methods used to teach road safety are typically knowledge-based and do not necessarily improve behaviour in real traffic situations. Virtual reality road crossing tasks may be a viable alternative. The present study aimed to test the road crossing accuracy of children with and without DCD in virtual reality tasks that varied the viewpoint to simulate the teaching methods currently used in road safety educational programmes. Twenty-one children with DCD and twenty-one age and gender matched TD peers were required to locate the safest road crossing sites in two conditions: allocentric (aerial viewpoint) and egocentric (first-person viewpoint). All children completed both conditions and were required to navigate either themselves or an avatar across the road using the safest crossing route. The primary outcome was accuracy defined as the number of trials, out of 10, on which the child successfully identified and used the safest crossing route. Children with DCD performed equally poorly in both conditions, while TD children were significantly more accurate in the egocentric condition. This difference cannot be explained by self-reported prior road crossing education, practice or confidence. While TD children may benefit from the development of an egocentric virtual reality road crossing task, multimodal methods may be needed to effectively teach road safety to children with DCD. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Children with developmental coordination disorder play active virtual reality games differently than children with typical development.

PubMed

Gonsalves, Leandra; Campbell, Amity; Jensen, Lynn; Straker, Leon

2015-03-01

Active virtual reality gaming (AVG) may be useful for children with developmental coordination disorder (DCD) to practice motor skills if their movement patterns are of good quality while engaged in AVG. This study aimed to examine: (1) the quality of motor patterns of children with DCD participating in AVG by comparing them with children with typical development (TD) and (2) whether differences existed in the motor patterns utilized with 2 AVG types: Sony PlayStation 3 Move and Microsoft Xbox 360 Kinect. This was a quasi-experimental, biomechanical laboratory-based study. Twenty-one children with DCD, aged 10 to 12 years, and 19 age- and sex-matched children with TD played a match of table tennis on each AVG type. Hand path, wrist angle, and elbow angle were recorded using a motion analysis system. Linear mixed-model analyses were used to determine differences between DCD and TD groups and Move and Kinect AVG type for forehands and backhands. Children with DCD utilized a slower hand path speed (backhand mean difference [MD]=1.20 m/s; 95% confidence interval [95% CI]=0.41, 1.98); greater wrist extension (forehand MD=34.3°; 95% CI=22.6, 47.0); and greater elbow flexion (forehand MD=22.3°; 95% CI=7.4, 37.1) compared with children with TD when engaged in AVG. There also were differences in movement patterns utilized between AVG types. Only simple kinematic measures were compared, and no data regarding movement outcome were assessed. If a therapeutic treatment goal is to promote movement quality in children with DCD, clinical judgment is required to select the most appropriate AVG type and determine whether movement quality is adequate for unsupervised practice. © 2015 American Physical Therapy Association.

Copy-number variations are enriched for neurodevelopmental genes in children with developmental coordination disorder.

PubMed

Mosca, Stephen J; Langevin, Lisa Marie; Dewey, Deborah; Innes, A Micheil; Lionel, Anath C; Marshall, Christian C; Scherer, Stephen W; Parboosingh, Jillian S; Bernier, Francois P

2016-12-01

Developmental coordination disorder is a common neurodevelopment disorder that frequently co-occurs with other neurodevelopmental disorders including attention-deficit hyperactivity disorder (ADHD). Copy-number variations (CNVs) have been implicated in a number of neurodevelopmental and psychiatric disorders; however, the proportion of heritability in developmental coordination disorder (DCD) attributed to CNVs has not been explored. This study aims to investigate how CNVs may contribute to the genetic architecture of DCD. CNV analysis was performed on 82 extensively phenotyped Canadian children with DCD, with or without co-occurring ADHD and/or reading disorder, and 2988 healthy European controls using identical genome-wide SNP microarrays and CNV calling algorithms. An increased rate of large and rare genic CNVs (p=0.009) was detected, and there was an enrichment of duplications spanning brain-expressed genes (p=0.039) and genes previously implicated in other neurodevelopmental disorders (p=0.043). Genes and loci of particular interest in this group included: GAP43, RBFOX1, PTPRN2, SHANK3, 16p11.2 and distal 22q11.2. Although no recurrent CNVs were identified, 26% of DCD cases, where sample availability permitted segregation analysis, were found to have a de novo rare CNV. Of the inherited CNVs, 64% were from a parent who also had a neurodevelopmental disorder. These findings suggest that there may be shared susceptibility genes for DCD and other neurodevelopmental disorders and highlight the need for thorough phenotyping when investigating the genetics of neurodevelopmental disorders. Furthermore, these data provide compelling evidence supporting a genetic basis for DCD, and further implicate rare CNVs in the aetiology of neurodevelopmental disorders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Palliative care consultation in the process of organ donation after cardiac death.

PubMed

Kelso, Catherine McVearry; Lyckholm, Laurie J; Coyne, Patrick J; Smith, Thomas J

2007-02-01

Palliative care consultation has been demonstrated to be useful in many situations in which expert symptom management, communication around sensitive issues, and family support may serve to enhance or improve care. The process of organ donation is an example of this concept, specifically the process of donation after cardiac death (DCD). DCD allows patients with severe, irreversible brain injuries that do not meet standard criteria for brain death to donate organs when death is declared by cardiopulmonary criteria. The DCD method of donation has been deemed an ethically appropriate means of organ donation and is supported by the organ procurement and medical communities, as well as the public. The palliative care (PC) team can make a significant contribution to the care of the patient and family in the organ donation process. In this paper we describe the controlled DCD process at one institution that utilizes the PC team to provide expert end-of-life care, including comprehensive medical management and family support. PC skills and principles applicable to the DCD process include communication, coordination of care, and skillful ventilator withdrawal. If death occurs within 90 minutes of withdrawal of life support, organs may be successfully recovered for transplantation. If the patient survives longer than 90 minutes, his or her care continues to be provided by the PC team. Palliative care can contribute to standardizing quality end-of-life care practices in the DCD process and provide education for involved personnel. Further experience, research and national discussions will be helpful in refining these practices, to make this difficult and challenging experience as gentle and supportive as possible for the courageous families who participate in this process.

Attitudes and barriers to the use of donation after cardiac death livers: Comparison of a United States transplant center survey to the united network for organ sharing data.

PubMed

Sher, Linda; Quintini, Cristiano; Fayek, Sameh Adel; Abt, Peter; Lo, Mary; Yuk, Pui; Ji, Lingyun; Groshen, Susan; Case, Jamie; Marsh, Christopher Lee

2017-11-01

Transplantation of liver grafts from donation after cardiac death (DCD) is limited. To identify barriers of DCD liver utilization, all active US liver transplant centers (n = 138) were surveyed, and the responses were compared with the United Network for Organ Sharing (UNOS) data. In total, 74 (54%) centers responded, and diversity in attitudes was observed, with many not using organ and/or recipient prognostic variables defined in prior studies and UNOS data analysis. Most centers (74%) believed lack of a system allowing a timely retransplant is a barrier to utilization. UNOS data demonstrated worse 1- and 5-year patient survival (PS) and graft survival (GS) in DCD (PS, 86% and 64%; GS, 82% and 59%, respectively) versus donation after brain death (DBD) recipients (PS, 90% and 71%; GS, 88% and 69%, respectively). Donor alanine aminotransferase (ALT), recipient Model for End-Stage Liver Disease (MELD), and cold ischemia time (CIT) significantly impacted DCD outcomes to a greater extent than DBD outcomes. At 3 years, relisting and retransplant rates were 7.9% and 4.6% higher in DCD recipients. To optimize outcome, our data support the use of DCD liver grafts with CIT <6-8 hours in patients with MELD ≤ 20. In conclusion, standardization of donor and recipient criteria, defining the impact of ischemic cholangiopathy, addressing donor hospital policies, and developing a strategy for timely retransplant may help to expand the use of these organs. Liver Transplantation 23 1372-1383 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

Improving Donor Conversion Rates at a Level One Trauma Center: Impact of Best Practice Guidelines

PubMed Central

Gibbons, Bobby L; Bershad, Vanessa L

2016-01-01

Background Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability. Study design Retrospective analysis of a prospectively collected database from TransLife, our local organ procurement organization (OPO), as well as the Orlando Regional Medical Center (ORMC) trauma registry, from 2009-2012 (up to 2013 for DCD). During which time, this organization implemented best practice guidelines to improve conversions and DCD utilization. We analyzed yearly conversion rates, DCD donations and population demographics before and after implementation of these policies. Results During the study period, donor conversion rates significantly improved from 58% in 2009 to 82% percent in 2012 hospital-wide (P<0.05); and from 50% in 2009 to 81% in 2012 among trauma patients alone (P<0.05). In addition, total organs transplanted increased from 13 to 31 organs (P<0.05) after implementation of best practice guidelines. No significant differences in trauma population demographics were noted during the study period. Conclusions Based on our experience, the establishment of best practice policies for referral of potential donors, coupled with programs to educate hospital staff on the existence and importance of these policies, leads to significant improvement in donor conversion rates and increased utilization of DCD donors. PMID:28018761

Optimization of Perioperative Conditions to Prevent Ischemic Cholangiopathy in Donation After Circulatory Death Donor Liver Transplantation.

PubMed

Kubal, Chandrashekhar; Mangus, Richard; Fridell, Jonathan; Saxena, Romil; Rush, Natalia; Wingler, Matthew; Ekser, Burcin; Tector, Joseph

2016-08-01

Donation after circulatory death (DCD) donor pool remains underutilized for liver transplantation (LT). We describe optimizing "modifiable risk factors," such as cold ischemia time (CIT) recipient warm ischemia time (WIT) and the use of thrombolytic flush at the time of procurement to minimize ischemic cholangiopathy (IC). From July 2011 (era II), to improve outcomes after DCD LT, measures were taken to minimize CIT, operative time and recipient WIT along with the use of tissue plasminogen activator (tPA) flush during DCD procurements. Thirty consecutive DCD LTs were performed prospectively in era II. Outcomes were compared with 61 historic controls (era I). Reperfusion biopsies were evaluated for the presence of necrosis and biliary epithelial damage. Median CIT (4.9 [3.5-5.9] vs 6.4 [4.3-12]; P < 0.001), hepatectomy time (70 [42-120] vs 81 [58-207]; P = 0.02), and recipient WIT (16 [13-31] vs 24[15-40]; P < 0.001) were significantly shorter in era II. All patients in era II received tPA flushed liver grafts. None of the patients in era II developed IC (0% vs 18%; P = 0.013). There were fewer biliary complications in era II, and there was no increased risk of bleeding associated with the use of tPA. One-year graft survival was slightly better in era II (n = 24 patients with 1 year follow-up) (88% vs 80%; P = 0.14). Optimizing peritransplant conditions, such as shortening ischemic times with the use of thrombolytic donor flush, may prevent IC after DCD LT. With this approach, the DCD donor pool may be expanded.

Deficits in Lower Limb Muscle Reflex Contraction Latency and Peak Force Are Associated With Impairments in Postural Control and Gross Motor Skills of Children With Developmental Coordination Disorder: A Cross-Sectional Study.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Guo, X; Wang, Yuling; Chung, Raymond C K; Stat, Grad; Ki, W Y; Macfarlane, Duncan J

2015-10-01

This cross-sectional, exploratory study aimed to compare neuromuscular performance, balance and motor skills proficiencies of typically developing children and those with developmental coordination disorder (DCD) and to determine associations of these neuromuscular factors with balance and motor skills performances in children with DCD.One hundred thirty children with DCD and 117 typically developing children participated in the study. Medial hamstring and gastrocnemius muscle activation onset latencies in response to an unexpected posterior-to-anterior trunk perturbation were assessed by electromyography and accelerometer. Hamstring and gastrocnemius muscle peak force and time to peak force were quantified by dynamometer, and balance and motor skills performances were evaluated with the Movement Assessment Battery for Children (MABC).Independent t tests revealed that children with DCD had longer hamstring and gastrocnemius muscle activation onset latencies (P < 0.001) and lower isometric peak forces (P < 0.001), but not times to peak forces (P > 0.025), than the controls. Multiple regression analysis accounting for basic demographics showed that gastrocnemius peak force was independently associated with the MABC balance subscore and ball skills subscore, accounting for 5.7% (P = 0.003) and 8.5% (P = 0.001) of the variance, respectively. Gastrocnemius muscle activation onset latency also explained 11.4% (P < 0.001) of the variance in the MABC ball skills subscore.Children with DCD had delayed leg muscle activation onset times and lower isometric peak forces. Gastrocnemius peak force was associated with balance and ball skills performances, whereas timing of gastrocnemius muscle activation was a determinant of ball skill performance in the DCD population.

Role of p70S6K1-mediated phosphorylation of eIF4B and PDCD4 proteins in the regulation of protein synthesis.

PubMed

Dennis, Michael D; Jefferson, Leonard S; Kimball, Scot R

2012-12-14

Modulation of mRNA binding to the 40 S ribosomal subunit during translation initiation controls not only global rates of protein synthesis but also regulates the pattern of protein expression by allowing for selective inclusion, or exclusion, of mRNAs encoding particular proteins from polysomes. The mRNA binding step is modulated by signaling through a protein kinase known as the mechanistic target of rapamycin complex 1 (mTORC1). mTORC1 directly phosphorylates the translational repressors eIF4E binding proteins (4E-BP) 1 and 2, releasing them from the mRNA cap binding protein eIF4E, thereby promoting assembly of the eIF4E·eIF4G complex. mTORC1 also phosphorylates the 70-kDa ribosomal protein S6 kinase 1 (p70S6K1), which subsequently phosphorylates eIF4B, and programmed cell death 4 (PDCD4), which sequesters eIF4A from the eIF4E·eIF4G complex, resulting in repressed translation of mRNAs with highly structured 5'-untranslated regions. In the present study, we compared the role of the 4E-BPs in the regulation of global rates of protein synthesis to that of eIF4B and PDCD4. We found that maintenance of eIF4E interaction with eIF4G was not by itself sufficient to sustain global rates of protein synthesis in the absence of mTORC1 signaling to p70S6K1; phosphorylation of both eIF4B and PDCD4 was additionally required. We also found that the interaction of eIF4E with eIF4G was maintained in the liver of fasted rats as well as in serum-deprived mouse embryo fibroblasts lacking both 4E-BP1 and 4E-BP2, suggesting that the interaction of eIF4G with eIF4E is controlled primarily through the 4E-BPs.

Processed electroencephalogram during donation after cardiac death.

PubMed

Auyong, David B; Klein, Stephen M; Gan, Tong J; Roche, Anthony M; Olson, Daiwai; Habib, Ashraf S

2010-05-01

We present a case series of increased bispectral index values during donation after cardiac death (DCD). During the DCD process, a patient was monitored with processed electroencephalogram (EEG), which showed considerable changes traditionally associated with lighter planes of anesthesia immediately after withdrawal of care. Subsequently, to validate the findings of this case, processed EEG was recorded during 2 other cases in which care was withdrawn without the use of hypnotic or anesthetic drugs. We found that changes in processed EEG immediately after withdrawal of care were not only reproducible, but can happen in the absence of changes in major electromyographic or electrocardiographic artifact. It is well documented that processed EEG is prone to artifacts. However, in the setting of DCD, these changes in processed EEG deserve some consideration. If these changes are not due to artifact, dosing of hypnotic or anesthetic drugs might be warranted. Use of these drugs during DCD based primarily on processed EEG values has never been addressed.

Activities of daily living in children with developmental coordination disorder: dressing, personal hygiene, and eating skills.

PubMed

Summers, Janet; Larkin, Dawne; Dewey, Deborah

2008-04-01

In order to understand how age, culture, and problems in motor coordination impact the performance of activities of daily living, we used focus groups and in-depth interviews with Australian and Canadian parents to examine activities of daily living of younger (5-7 years of age) and older (8-9 years of age) children with and without DCD. By comparison with their typically developing age group, children with DCD had more difficulty with dressing, personal hygiene, and eating skills. Difficulties with postural control and fine-motor skills were reported to contribute to poorer performance of activities of daily living. As expected, competence in the performance of activities of daily living improved in the older children with and without DCD and there were few differences in the performance of daily living tasks between typical children in Australia and Canada. Overall, the motor difficulties of children with DCD had a significant impact on performance of a wide range of daily activities.

A Service Delivery Model for Children with DCD Based on Principles of Best Practice.

PubMed

Camden, Chantal; Léger, France; Morel, Julie; Missiuna, Cheryl

2015-01-01

In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Lessons learned are shared to facilitate development of other practice models to support children with DCD.

Amelioration of an acidic ultisol by straw-derived biochars combined with dicyandiamide under application of urea.

PubMed

Mehmood, Khalid; Li, Jiu-Yu; Jiang, Jun; Shi, Ren-Yong; Liu, Zhao-Dong; Xu, Ren-Kou

2017-03-01

The rapid increase in agricultural pollution demands judicious use of inputs and outputs for sustainable crop production. Crop straws were pyrolyzed under oxygen-limited conditions at 400 °C for 2 h to prepare peanut straw biochar (PB), canola straw biochar (CB), and wheat straw biochar (WB). Then, 300-g soils were incubated each with urea nitrogen (UN) and UN + biochars with or without dicyandiamide (DCD) for 60 days. During the incubations, soil acidification induced by urea was somewhat inhibited by biochars, but nitrification of hydrolyzed NH 4 + produced much more acidity than the neutralization potential of the biochars. In single UN (200 mg/kg) treatment, soil pH decreased drastically and the final pH after incubation was lower than the control. Antagonistic to UN, all three biochars neutralized the soil acidity, which was consistent to their inherent alkalinity. DCD inhibited nitrification which was obvious throughout the incubations, as 30 mg/kg DCD + 200 mg/kg UN combined with 1  % PB, CB, and WB retained 0.94, 0.79, and 1.19 units higher pH, respectively, and significantly reduced exchangeable acidity over the treatments without DCD (P < 0.05). The treatments of UN + biochars with and without DCD had highly significant effects on soil pH, exchangeable Al 3+ , NH 4 + -N, (NO 3 - +NO 2 - )-N, and available P (P < 0.05). Amplified NH 4 + -N retentions at higher rates of PB referred increased negatively charged sites for nutrient adsorptions. Applied UN transformations varied among different treatments, and the maximum amounts of total mineral N recovered were 218.3, 218.5, and 223.8 mg/kg in the presence of DCD by PB, CB, and WB, compared to 198.2, 201.6, and 205.2 mg/kg, respectively, in no DCD treatments. Urea induced severe soil acidification and even lowered the ameliorative effects of applied biochars. Thus, ammonium-based fertilizers must include nitrification inhibitor (DCD) and, if used in combination with biochars will offer a suitable choice to reduce the acidity, improve base saturation and fertility of soil for sustainable agriculture.

Decision modeling in donation after circulatory death liver transplantation.

PubMed

McLean, Kenneth A; Camilleri-Brennan, Julian; Knight, Stephen R; Drake, Thomas M; Ots, Riinu; Shaw, Catherine A; Wigmore, Stephen J; Harrison, Ewen M

2017-05-01

Donation after circulatory death (DCD) liver allografts are increasingly used for transplantation. However, the posttransplantation clinical and quality of life outcomes of DCD recipients are traditionally considered to be inferior compared with donation after brain death (DBD) allograft recipients. Decision making for such marginal organs can be difficult. This study investigated the optimal decision to accept or decline a DCD liver allograft for a patient based on their current health. A Markov decision process model was constructed to predict the 5-year clinical course of patients on the liver transplant waiting list. Clinical outcomes were determined from the UK transplant registry or appropriate literature. Quality-adjusted life years (QALYs) were determined using the condition-specific short form of liver disease quality of life (SF-LDQoL) questionnaire. There were 293/374 (78.3%) eligible patients who completed the SF-LDQoL questionnaire. A total of 73 respondents (24.9%) were before transplant and 220 were after transplant (DBD recipient, 56.3%; DCD recipient, 8.5%; ischemic cholangiopathy patient, 2.4%; retransplant recipient, 7.9%). Predictive modeling indicated that QALYs gained at 5 years were significantly higher in DCD recipients (3.77; 95% confidence interval [CI], 3.44-4.10) compared with those who remained on the waiting list for a DBD transplant with Model for End-Stage Liver Disease (MELD) scores of 15-20 (3.36; 95% CI, 3.28-3.43), or >20 (3.07; 95% CI, 3.00-3.14). There was no significant advantage for individuals with MELD scores <15 (3.55; 95% CI, 3.47-3.63). In conclusion, this model predicts that patients on the UK liver transplant waiting list with MELD scores >15 should receive an offered DCD allograft based on the QALYs gained at 5 years. This analysis only accounts for donor-recipient risk pairings seen in current practice. The optimal decision for patients with MELD scores <15 remains unclear. However, a survival benefit was observed when a DCD organ was accepted. Liver Transplantation 23 594-603 2017 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Effects of nitrogen application rate and a nitrification inhibitor dicyandiamide on ammonia oxidizers and N2O emissions in a grazed pasture soil.

PubMed

Dai, Yu; Di, Hong J; Cameron, Keith C; He, Ji-Zheng

2013-11-01

Ammonia oxidizers, including ammonia oxidizing bacteria (AOB) and ammonia oxidizing archaea (AOA) are important drivers of a key step of the nitrogen cycle - nitrification, which affects the production of the potent greenhouse gas, nitrous oxide (N2O). A field experiment was conducted to determine the effect of nitrogen application rates and the nitrification inhibitor dicyandiamide (DCD) on the abundance of AOB and AOA and on N2O emissions in a grazed pasture soil. Nitrogen (N) was applied at four different rates, with urea applied at 50 and 100 kg N ha(-1) and animal urine at 300 and 600 kg N ha(-1). DCD was applied to some of the N treatments at 10 kg ha(-1). The results showed that the AOB amoA gene copy numbers were greater than those of AOA. The highest ratio of the AOB to AOA amoA gene copy numbers was 106.6 which occurred in the urine-N 600 treatment. The AOB amoA gene copy numbers increased with increasing nitrogen application rates. DCD had a significant impact in reducing the AOB amoA gene copy numbers especially in the high nitrogen application rates. N2O emissions increased with the N application rates. DCD had the most significant effect in reducing the daily and total N2O emissions in the highest nitrogen application rate. The greatest reduction of total N2O emissions by DCD was 69% in the urine-N 600 treatment. The reduction in the N2O emission factor by DCD ranged from 58% to 83%. The N2O flux and NO3(-)-N concentrations were significantly correlated to the growth of AOB, rather than AOA. This study confirms the importance of AOB in nitrification and the effect of DCD in inhibiting AOB growth and in decreasing N2O emissions in grazed pasture soils under field conditions. Copyright © 2012 Elsevier B.V. All rights reserved.

Donation after cardiocirculatory death in Canada

PubMed Central

Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

2006-01-01

These recommendations are the result of a national, multidisciplinary, year-long process to discuss whether and how to proceed with organ donation after cardiocirculatory death (DCD) in Canada. A national forum was held in February 2005 to discuss and develop recommendations on the principles, procedures and practice related to DCD, including ethical and legal considerations. At the forum's conclusion, a strong majority of participants supported proceeding with DCD programs in Canada. The forum also recognized the need to formulate and emphasize core values to guide the development of programs and protocols based on the medical, ethical and legal framework established at this meeting. Although end-of-life care should routinely include the opportunity to donate organs and tissues, the duty of care toward dying patients and their families remains the dominant priority of health care teams. The complexity and profound implications of death are recognized and should be respected, along with differing personal, ethnocultural and religious perspectives on death and donation. Decisions around withdrawal of life-sustaining therapies, management of the dying process and the determination of death by cardiocirculatory criteria should be separate from and independent of donation and transplant processes. The recommendations in this report are intended to guide individual programs, regional health authorities and jurisdictions in the development of DCD protocols. Programs will develop based on local leadership and advance planning that includes education and engagement of stakeholders, mechanisms to assure safety and quality and public information. We recommend that programs begin with controlled DCD within the intensive care unit where (after a consensual decision to withdraw life-sustaining therapy) death is anticipated, but has not yet occurred, and unhurried consent discussions can be held. Uncontrolled donation (where death has occurred after unanticipated cardiac arrest) should only be considered after a controlled DCD program is well established. Although we recommend that programs commence with kidney donation, regional transplant expertise may guide the inclusion of other organs. The impact of DCD, including pre-and post-mortem interventions, on donor family experiences, organ availability, graft function and recipient survival should be carefully documented and studied. PMID:17124739

Urine Metabonomics Reveals Early Biomarkers in Diabetic Cognitive Dysfunction.

PubMed

Song, Lili; Zhuang, Pengwei; Lin, Mengya; Kang, Mingqin; Liu, Hongyue; Zhang, Yuping; Yang, Zhen; Chen, Yunlong; Zhang, Yanjun

2017-09-01

Recently, increasing attention has been paid to diabetic encephalopathy, which is a frequent diabetic complication and affects nearly 30% of diabetics. Because cognitive dysfunction from diabetic encephalopathy might develop into irreversible dementia, early diagnosis and detection of this disease is of great significance for its prevention and treatment. This study is to investigate the early specific metabolites biomarkers in urine prior to the onset of diabetic cognitive dysfunction (DCD) by using metabolomics technology. An ultra-high performance liquid-chromatography-quadrupole time-of-flight-mass spectrometry (UPLC-Q/TOF-MS) platform was used to analyze the urine samples from diabetic mice that were associated with mild cognitive impairment (MCI) and nonassociated with MCI in the stage of diabetes (prior to the onset of DCD). We then screened and validated the early biomarkers using OPLS-DA model and support vector machine (SVM) method. Following multivariate statistical and integration analysis, we found that seven metabolites could be accepted as early biomarkers of DCD, and the SVM results showed that the prediction accuracy is as high as 91.66%. The identities of four biomarkers were determined by mass spectrometry. The identified biomarkers were largely involved in nicotinate and nicotinamide metabolism, glutathione metabolism, tryptophan metabolism, and sphingolipid metabolism. The present study first revealed reliable biomarkers for early diagnosis of DCD. It provides new insight and strategy for the early diagnosis and treatment of DCD.

Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium.

PubMed

Jochmans, Ina; Darius, Tom; Kuypers, Dirk; Monbaliu, Diethard; Goffin, Eric; Mourad, Michel; Ledinh, Hieu; Weekers, Laurent; Peeters, Patrick; Randon, Caren; Bosmans, Jean-Louis; Roeyen, Geert; Abramowicz, Daniel; Hoang, Anh-Dung; De Pauw, Luc; Rahmel, Axel; Squifflet, Jean-Paul; Pirenne, Jacques

2012-08-01

Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis. Five-year patient/graft survival was assessed using Kaplan-Meier curves. The evolution of the kidney donor type and the impact of DCDs on the total KT activity in Belgium were compared with the Netherlands. Between 2000 and 2009, 287 DCD KT were performed. Primary nonfunction occurred in 1% and DGF in 31%. Five-year patient and death-censored graft survival were 93% and 95%, respectively. In multivariate analysis, cold storage (versus machine perfusion), cold ischemic time, and histidine-tryptophan-ketoglutarate solution were independent risk factors for the development of DGF. Despite an increased number of DCD donations and transplantations, the total number of deceased KT did not increase significantly. This could suggest a shift from DBDs to DCDs. To increase KT activity, Belgium should further expand controlled DCD programs while simultaneously improve the identification of all potential DBDs and avoid their referral for donation as DCDs before brain death occurs. Furthermore, living donation remains underused. © 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.

Children with developmental coordination disorder (DCD) can adapt to perceptible and subliminal rhythm changes but are more variable.

PubMed

Roche, Renuka; Viswanathan, Priya; Clark, Jane E; Whitall, Jill

2016-12-01

Children with DCD demonstrate impairments in bimanual finger tapping during self-paced tapping and tapping in synchrony to different frequencies. In this study, we investigated the ability of children with DCD to adapt motorically to perceptible or subliminal changes of the auditory stimuli without a change in frequency, and compared their performance to typically developing controls (TDC). Nineteen children with DCD between ages 6-11years (mean age±SD=114±21months) and 17 TDC (mean age±SD=113±21months) participated in this study. Auditory perceptual threshold was established. Children initially tapped bimanually to an antiphase beat and then to either a perceptible change in rhythm or to gradual subliminal changes in rhythm. Children with DCD were able to perceive changes in rhythm similar to TDC. They were also able to adapt to both perceptible and subliminal changes in rhythms similar to their age- and gender- matched TDC. However, these children were significantly more variable compared with TDC in all phasing conditions. The results suggest that the performance impairments in bilateral tapping are not a result of poor conscious or sub-conscious perception of the auditory cue. The increased motor variability may be associated with cerebellar dysfunction but further behavioral and neurophysiological studies are needed. Copyright © 2016 Elsevier B.V. All rights reserved.

Obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder.

PubMed

Zhu, Yi-Ching; Wu, Sheng K; Cairney, John

2011-01-01

The purpose of this study was to investigate the associations between obesity and motor coordination ability in Taiwanese children with and without developmental coordination disorder (DCD). 2029 children (1078 boys, 951 girls) aged nine to ten years were chosen randomly from 14 elementary schools across Taiwan. We used bioelectrical impedance analysis to measure percentage of body fat (PBF) and the Movement Assessment Battery for Children test (MABC test) to evaluate the motor coordination ability. Using cut-off points based on PBF from past studies, boys and girls were divided into obese, overweight and normal-weight groups, respectively. In boys, total impairment scores and scores on balance subtest in the MABC were significantly higher in the obese and overweight groups when compared against the normal-weight group. Girls in the obese and the overweight groups had higher balance impairment scores than those of the normal-weight group. Among boys, the prevalence of obesity was highest in the DCD group, when compared to the borderline DCD and TD boys. A higher percentage of DCD girls were overweight and obese than TD girls. Obesity may be associated with poor motor coordination ability among boys and girls, and particularly in relation to balance ability. Children with DCD may have a higher risk to be overweight or obese in Taiwan. Copyright © 2010 Elsevier Ltd. All rights reserved.

Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder.

PubMed

Bart, Orit; Daniel, Liron; Dan, Orrie; Bar-Haim, Yair

2013-06-01

Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children with comorbid DCD and ADHD. Participants were 30 children (24 boys) aged 5.10-12.7 years diagnosed with both DCD and ADHD. Conners' Parent Rating Scale was used to reaffirm ADHD diagnosis and the Developmental Coordination Disorder Questionnaire was used to diagnose DCD. The Movement Assessment Battery for Children-2 and the online continuous performance test were administrated to all participants twice, with and without methylphenidate. The tests were administered on two separate days in a blind design. Motor performance and attention scores were significantly better with methylphenidate than without it (p<0.001 for improvement in the Movement Assessment Battery for Children-2 and p<0.006 for the online continuous performance test scores). The findings suggest that methylphenidate improves both attention and motor coordination in children with coexisting DCD and ADHD. More research is needed to disentangle the causality of the improvement effect and whether improvement in motor coordination is directly affected by methylphenidate or mediated by improvement in attention. Copyright © 2013 Elsevier Ltd. All rights reserved.

Goal-Orientated Group Intervention for Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Dunford, Carolyn

2011-01-01

This study measures the effectiveness of a goal-orientated group intervention using concentrated practice schedules for children with developmental coordination disorder (DCD). The study design is repeated measures. The sample comprises eight children with DCD, aged 7-11 years. Outcome measures are the Movement Assessment Battery for Children…

Everyday Memory in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Chen, I-Chen; Tsai, Pei-Luen; Hsu, Yung-Wen; Ma, Hui-Ing; Lai, Hsuan-An

2013-01-01

Children with developmental coordination disorder (DCD) have deficits in working memory, but little is known about the everyday memory of these children in real-life situations. We investigated the everyday memory function in children with DCD, and explored the specific profile of everyday memory across different domains. Nineteen children with…

Practitioner Review: Approaches to Assessment and Treatment of Children with DCD--An Evaluative Review

ERIC Educational Resources Information Center

Wilson, Peter H.

2005-01-01

Background: Movement clumsiness (or Developmental Coordination Disorder--DCD) has gained increasing recognition as a significant condition of childhood. However, some uncertainty still exists about diagnosis. Accordingly, approaches to assessment and treatment are varied, each drawing on distinct theoretical assumptions about the aetiology of the…

Dissecting Online Control in Developmental Coordination Disorder: A Kinematic Analysis of Double-Step Reaching

ERIC Educational Resources Information Center

Hyde, Christian; Wilson, Peter H.

2011-01-01

In a recent study, children with movement clumsiness (or Developmental Coordination Disorder--DCD) were shown to have difficulties making rapid online corrections when reaching, demonstrated by slower and less accurate movements to double-step targets (Hyde & Wilson, 2011). These results suggest that children with DCD have difficulty using…

Comparing Activity Patterns, Biological, and Family Factors in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Beutum, Monique Natalie; Cordier, Reinie; Bundy, Anita

2013-01-01

The association between motor proficiency and moderate to vigorous physical activity (MVPA) suggests children with developmental coordination disorder (DCD) may be susceptible to inactivity-related conditions such as cardiovascular diseases. The aim of this study was to compare children with and without DCD on physical activity patterns, activity…

Left Ventricular Structure and Function in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Chirico, Daniele; O'Leary, Deborah; Cairney, John; Klentrou, Panagiota; Haluka, Karen; Hay, John; Faught, Brent

2011-01-01

Children with developmental coordination disorder (DCD) are more likely to develop cardiovascular disease risk factors such as obesity and reduced cardio-respiratory fitness. However, there is limited data using laboratory measures for assessing the risk of cardiovascular disease associated with DCD. The purpose of this study was to examine…

Can Gymnastic Teacher Predict Leisure Activity Preference among Children with Developmental Coordination Disorders (DCD)?

ERIC Educational Resources Information Center

Engel-Yeger, Batya; Hanna-Kassis, Amany; Rosenblum, Sara

2012-01-01

The aims of the study were to analyze: (1) whether significant differences exist between children with typical development and children with developmental coordination disorders (DCD) in their preference to participate in leisure activities (2) whether the teacher estimation of activity form (TEAF) evaluation predicts participation preference.…

Activity Participation Intensity Is Associated with Skeletal Development in Pre-Pubertal Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Tsang, William W. N.; Guo, X.; Fong, Shirley S. M.; Mak, Kwok-Kei; Pang, Marco Y. C.

2012-01-01

Purpose: This study aimed (1) to compare the skeletal maturity and activity participation pattern between children with and without developmental coordination disorder (DCD); and (2) to determine whether activity participation pattern was associated with the skeletal development among children with DCD. Materials and methods: Thirty-three children…

76 FR 78096 - U.S. Advanced Boiling Water Reactor Aircraft Impact Design Certification Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

... Environmental Impact: Availability IX. Paperwork Reduction Act Statement X. Regulatory Analysis XI. Regulatory.... ABWR; one commenter, GE Hitachi Nuclear Energy (GEH), was against the proposed amendment to the U.S... information from both the DCD developed by GE Nuclear Energy (GE) and the DCD developed by the STPNOC. The...

Wisconsin Card Sorting Test Performance in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Wuang, Yee-Pay; Su, Chwen-Yng; Su, Jui-Hsing

2011-01-01

The primary purpose of this study was to investigate and compare the executive functions measured by the Wisconsin Card Sorting Test (WCST) between children with developmental coordination disorder (DCD) and age-matched normal controls. A second purpose was to examine the relations between executive functions and school functions in DCD children.…

[Children with developmental coordination disorder have difficulty with action representation].

PubMed

Gabbard, Carl; Cacola, Priscila

The study of children with developmental coordination disorder (DCD) has emerged as a vibrant line of inquiry over the last two decades. The literature indicates quite clearly that children with DCD display deficits with an array of perceptual-motor and daily living skills. The movements of children with DCD are often described as clumsy and uncoordinated and lead to difficulties with performing many of the activities of daily living and sports that typically developing children perform easily. It has been hypothesized, based on limited research, that an underlying problem is a deficit in generating and/or monitoring an action representation termed the internal modeling deficit hypothesis. According to the hypothesis, children with DCD have significant limitations in their ability to accurately generate and utilize internal models of motor planning and control. The focus of this review is on one of the methods used to examine action representation-motor imagery, which theorists argue provides a window into the process of action representation. Included are research methods and possible brain structures involved. An addition, a paradigm unique with this population-estimation of reachability (distance) via motor imagery, will be described.

[Soil biological activities at maize seedling stage under application of slow/controlled release nitrogen fertilizers].

PubMed

Li, Dongpo; Wu, Zhijie; Chen, Lijun; Liang, Chenghua; Zhang, Lili; Wang, Weicheng; Yang, Defu

2006-06-01

With pot experiment and simulating field ecological environment, this paper studied the effects of different slow/ controlled release N fertilizers on the soil nitrate - reductase and urease activities and microbial biomass C and N at maize seedling stage. The results showed that granular urea amended with dicyandiamide (DCD) and N-(n-bultyl) thiophosphoric triamide (NBPT) induced the highest soil nitrate-reductase activity, granular urea brought about the highest soil urease activity and microbial biomass C and N, while starch acetate (SA)-coated granular urea, SA-coated granular urea amended with DCD, methyl methacrylate (MMA) -coated granular urea amended with DCD, and no N fertilization gave a higher soil urease activity. Soil microbial C and N had a similar variation trend after applying various kinds of test slow/controlled release N fertilizers, and were the lowest after applying SA-coated granular urea amended with DCD and NBPT. Coated granular urea amended with inhibitors had a stronger effect on soil biological activities than coated granular urea, and MMA-coating had a better effect than SA-coating.

Successful transplantation of kidneys from elderly circulatory death donors by using microscopic and macroscopic characteristics to guide single or dual implantation.

PubMed

Mallon, D H; Riddiough, G E; Summers, D M; Butler, A J; Callaghan, C J; Bradbury, L L; Bardsley, V; Broecker, V; Saeb-Parsy, K; Torpey, N; Bradley, J A; Pettigrew, G J

2015-11-01

Most kidneys from potential elderly circulatory death (DCD) donors are declined. We report single center outcomes for kidneys transplanted from DCD donors over 70 years old, using preimplantation biopsy Remuzzi grading to inform implantation as single or dual transplants. Between 2009 and 2012, 43 single transplants and 12 dual transplants were performed from elderly DCD donors. Remuzzi scores were higher for dual than single implants (4.4 vs. 3.4, p < 0.001), indicating more severe baseline injury. Donor and recipient characteristics for both groups were otherwise similar. Early graft loss from renal vein thrombosis occurred in two singly implanted kidneys, and in one dual-implanted kidney; its pair continued to function satisfactorily. Death-censored graft survival at 3 years was comparable for the two groups (single 94%; dual 100%), as was 1 year eGFR. Delayed graft function occurred less frequently in the dual-implant group (25% vs. 65%, p = 0.010). Using this approach, we performed proportionally more kidney transplants from elderly DCD donors (23.4%) than the rest of the United Kingdom (7.3%, p < 0.001), with graft outcomes comparable to those achieved nationally for all deceased-donor kidney transplants. Preimplantation biopsy analysis is associated with acceptable transplant outcomes for elderly DCD kidneys and may increase transplant numbers from an underutilized donor pool. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Social participation of teenagers and young adults with developmental co-ordination disorder and strategies that could help them: results from a scoping review.

PubMed

Gagnon-Roy, M; Jasmin, E; Camden, C

2016-11-01

The impact of developmental co-ordination disorder (DCD) on teenagers' and young adults' participation is not well documented. This article aims to synthesize the current knowledge on social participation, which is the performance of an individual in realizing his or her daily activities and social roles within its life environment. Strategies and interventions to support youths (15-25 years old) with DCD were also synthesized. A scoping review interrogating three databases and using 'snowballing techniques' was performed to identify both scientific and grey literature published between 2004 and 2014. Over 1000 documents were screened and 57 were read in full; 28 met inclusion criteria. A charting form based on 12 life habits described in the disability creation process and developed by two reviewers was used to extract data and report the results. All life habits were reported to be affected for teenagers and young adults with DCD, with education and interpersonal relationships being the most frequently discussed. During adolescence and adulthood, new tasks and subsequent difficulties emerge, such as driving. Mental health difficulties emerged as a key theme. Few strategies and interventions were described to support social participation of youths with DCD. Many life habits are challenging for youths with DCD, but few evidence-based strategies and interventions have been designed to help them to increase their social participation. © 2016 John Wiley & Sons Ltd.

Participation in Physical Activity, Fitness, and Risk for Obesity in Children with Developmental Coordination Disorder: A Cross-cultural Study.

PubMed

Cermak, S A; Katz, N; Weintraub, N; Steinhart, S; Raz-Silbiger, S; Munoz, M; Lifshitz, N

2015-12-01

Decreased physical activity has been linked to poor fitness and obesity, resulting in increased risk for health concerns. The objective is to study the relationships between children's motor coordination and their physical activity, sedentary behaviour, fitness and weight status in a cross-cultural study in the United States and Israel. Participants included 118 children 6-11 years of age: 53 children with developmental coordination disorder (DCD) and 65 typical children. The US sample included 31 DCD children and 44 typical children. The Israeli sample included 22 DCD children and 21 typical children. Participants were assessed on Movement Assessment Battery for Children 2, strength test of the Bruininks-Oseretsky Test of Motor Proficiency 2 and Six-minute Walk Test and wore an accelerometer. Parents completed physical activity questionnaires and demographic information. Body mass index was calculated based on height and weight. Testing took place in two sessions. Findings are that in both Israel and the United States, children with DCD demonstrated significantly reduced physical activity, increased sedentary behaviour, poorer fitness and increased overweight compared with typical children. No significant differences were found for country. With relevance to clinical practice, fitness and obesity are major concerns for children with DCD in both countries. Inclusion of occupational therapy in health promotion for this population is critical. Additional studies with testers blind to group, larger samples and other countries are recommended. Copyright © 2015 John Wiley & Sons, Ltd.

Successful donation after cardiac death liver transplants with prolonged warm ischemia time using normothermic regional perfusion.

PubMed

De Carlis, Riccardo; Di Sandro, Stefano; Lauterio, Andrea; Ferla, Fabio; Dell'Acqua, Antonio; Zanierato, Marinella; De Carlis, Luciano

2017-02-01

The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary nonfunction (PNF) and ischemia-related complications. Even greater concern exists toward uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes. We examined our first 7 cases for the incidence of PNF, early graft dysfunction, and biliary complications. Acceptance of the graft was based on the trend of serum transaminase and lactate during NRP, the macroscopic appearance, and the liver biopsy. Hypothermic machine perfusion (HMP) was associated in selected cases to improve cold storage. Most notably, no cases of PNF were observed. Median posttransplant transaminase peak was 1014 IU/L (range, 393-3268 IU/L). Patient and graft survival were both 100% after a mean follow-up of 6.1 months (range, 3-9 months). No cases of ischemic cholangiopathy occurred during the follow-up. Only 1 anastomotic stricture completely resolved with endoscopic stenting. In conclusion, DCD liver transplantation is feasible in Italy despite the protracted no-touch period. The use of NRP and HMP seems to earn good graft function and proves safe in these organs. Liver Transplantation 23 166-173 2017 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Comparing the Effects of Self-Controlled and Examiner-Controlled Feedback on Learning in Children With Developmental Coordination Disorder.

PubMed

Zamani, Mohamad Hosein; Fatemi, Rouholah; Soroushmoghadam, Keyvan

2015-12-01

Feedback can improve task learning in children with developmental coordination disorder (DCD). However, the frequency and type of feedback may play different role in learning and needs to more investigations. The aim of this study was to evaluate the acquisition and retention of new feedback skills in children with DCD under different frequency of self-control and control examiner feedback. In this quasi-experimental study with pretest-posttest design, participants based on their retention were divided into four feedback groups: self-controlled feedback groups with frequencies of 50% and75%, experimenter controls with frequencies of 50% and 75%. The study sample consisted of 24 boys with DCD aged between 9 to 11 years old in Ahvaz City, Iran. Then subjects practiced 30 throwing (6 blocks of 5 attempts) in eighth session. Acquisition test immediately after the last training session, and then the retention test were taken. Data were analyzed using the paired t-test, ANOVA and Tukey tests. The results showed no significant difference between groups in the acquisition phase (P > 0.05). However,in the retention session, group of self-control showed better performance than the control tester group (P < 0.05). Based on the current findings, self-control feedback with high frequency leads to more learning in DCD children. The results of this study can be used in rehabilitation programs to improve performance and learning in children with DCD.

Histopathologic and molecular evaluation of the Organ Procurement and Transplantation Network selection criteria for intestinal graft donation.

PubMed

Roskott, Anne Margot C; van Haaften, Wouter T; Leuvenink, Henri G D; Ploeg, Rutger J; van Goor, Harry; Blokzijl, Tjasso; Ottens, Petra J; Dijkstra, Gerard; Nieuwenhuijs, Vincent B

2014-06-01

The Organ Procurement and Transplantation Network (OPTN) has formulated criteria for the selection of donors for intestinal transplantation. To date, however, no study has correlated histologic findings of intestinal injury with the OPTN criteria. We aimed to describe histopathologic and molecular features of allograft injury in relation to donor conditions defined by the OPTN criteria. Graft histology (Park Score), Claudin-3 staining, systemic inflammatory markers (C-reactive protein/lipopolysaccharide-binding protein) and expression of heat shock protein 70, heme oxygenase 1, and interleukin 6 were evaluated in multiorgan deceased donors (donation after brain death [DBD] and donation after cardiac death [DCD]). Ninety-seven samples (52 jejunum/45 ileum) were recovered from 59 donors (46 DBD/13 DCD). The OPTN criterion cold ischemia time correlated with histologic injury (Park score) to which the jejunum appeared more susceptible than the ileum. Claudin-3 staining was higher, and heat shock protein 70 expression lower in donors meeting the OPTN criteria compared with donors not meeting the criteria and in DBD versus DCD. In DBD donors, interleukin 6 expression was higher compared with DCD donors and inversely related to C-reactive protein. Our multiparameter analysis suggests that the OPTN criteria can be discriminative concerning intestinal graft quality. Our data suggest that DCD intestinal allografts are qualitatively inferior and that the jejunum is more sensitive to ischemia than the ileum. Copyright © 2014 Elsevier Inc. All rights reserved.

Phenotypic variability in developmental coordination disorder: Clustering of generalized joint hypermobility with attention deficit/hyperactivity disorder, atypical swallowing and narrative difficulties.

PubMed

Celletti, Claudia; Mari, Giorgia; Ghibellini, Giulia; Celli, Mauro; Castori, Marco; Camerota, Filippo

2015-03-01

Developmental coordination disorder (DCD) is a recognized childhood disorder mostly characterized by motor coordination difficulties. Joint hypermobility syndrome, alternatively termed Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly featuring generalized joint hypermobility (gJHM), musculoskeletal pain, and minor skin features. Although these two conditions seem apparently unrelated, recent evidence highlights a high rate of motor and coordination findings in children with gJHM or JHS/EDS-HT. Here, we investigated the prevalence of gJHM in 41 Italian children with DCD in order to check for the existence of recognizable phenotypic subgroups of DCD in relation to the presence/absence of gJHM. All patients were screened for Beighton score and a set of neuropsychological tests for motor competences (Movement Assessment Battery for Children and Visual-Motor Integration tests), and language and learning difficulties (Linguistic Comprehension Test, Peabody Picture Vocabulary Test, Boston Naming Test, Bus Story Test, and Memoria-Training tests). All patients were also screening for selected JHS/EDS-HT-associated features and swallowing problems. Nineteen (46%) children showed gJHM and 22 (54%) did not. Children with DCD and gJHM showed a significant excess of frequent falls (95 vs. 18%), easy bruising (74 vs. 0%), motor impersistence (89 vs. 23%), sore hands for writing (53 vs. 9%), attention deficit/hyperactivity disorder (89 vs. 36%), constipation (53 vs. 0%), arthralgias/myalgias (58 vs. 4%), narrative difficulties (74 vs. 32%), and atypical swallowing (74 vs. 18%). This study confirms the non-causal association between DCD and gJHM, which, in turn, seems to increase the risk for non-random additional features. The excess of language, learning, and swallowing difficulties in patients with DCD and gJHM suggests a wider effect of lax tissues in the development of the nervous system. © 2015 Wiley Periodicals, Inc.

Handwriting measures as reflectors of executive functions among adults with Developmental Coordination Disorders (DCD)

PubMed Central

Rosenblum, Sara

2013-01-01

Planning ahead and organizational abilities in time and space are ingredients of high-level cognitive functions labeled as ‘Executive Functions’ (EF) required for daily activities such as writing or home management. EF deficits are considered a possible underlying brain mechanism involved in Developmental Coordination Disorders (DCD). The aim: of the study was to compare the handwriting process measures and the planning and organizational abilities in space and time of students with DCD with those of matched controls and to find whether handwriting measures can predict daily planning and organizational abilities among students with DCD. Method: 30 students diagnosed with DCD, between the ages of 24–41, and 30 age- and gender-matched controls participated in the study. They filled out the Handwriting Proficiency Screening Questionnaire (HPSQ) and the Adult Developmental Co-ordination Disorders Checklist (ADC). Furthermore, they copied a paragraph on a digitizer that is part of a computerized system Computerised Penmanship Evaluation Toll (ComPET). Results: Significant group differences were found for the HPSQ subscales scores as well as for the temporal and spatial measures of the paragraph copy task. Significant group differences were also found for the planning and organizational abilities in space and time as reflected through the ADC subscales. Significant medium correlations were found in both groups between the mean HPSQ time subscale and the ADC-B subscale mean score (r = 0.50/0.58, p < 0.05). Series of regression analyses indicated that two handwriting performance measures (mean HPSQ time subscale and mean stroke duration) predicted 19% of planning and organizational abilities as reflected through daily functions (ADC-B) [F(3, 54) = 38.37, β = 0.40, p < 0.0001]. Conclusion: The results support previous evidence about EF deficits as an underlying brain mechanism involved in motor coordination disorders, their significance as related to theoretical models of handwriting and daily function among DCD will be examined. PMID:23805113

Motor Learning: An Analysis of 100 Trials of a Ski Slalom Game in Children with and without Developmental Coordination Disorder

PubMed Central

Smits-Engelsman, Bouwien C. M.; Jelsma, Lemke Dorothee; Ferguson, Gillian D.; Geuze, Reint H.

2015-01-01

Objective Although Developmental Coordination Disorder (DCD) is often characterized as a skill acquisition deficit disorder, few studies have addressed the process of motor learning. This study examined learning of a novel motor task; the Wii Fit ski slalom game. The main objectives were to determine: 1) whether learning occurs over 100 trial runs of the game, 2) if the learning curve is different between children with and without DCD, 3) if learning is different in an easier or harder version of the task, 4) if learning transfers to other balance tasks. Method 17 children with DCD (6–10 years) and a matched control group of 17 typically developing (TD) children engaged in 20 minutes of gaming, twice a week for five weeks. Each training session comprised of alternating trial runs, with five runs at an easy level and five runs at a difficult level. Wii scores, which combine speed and accuracy per run, were recorded. Standardized balance tasks were used to measure transfer. Results Significant differences in initial performance were found between groups on the Wii score and balance tasks. Both groups improved their Wii score over the five weeks. Improvement in the easy and in the hard task did not differ between groups. Retention in the time between training sessions was not different between TD and DCD groups either. The DCD group improved significantly on all balance tasks. Conclusions The findings in this study give a fairly coherent picture of the learning process over a medium time scale (5 weeks) in children novice to active computer games; they learn, retain and there is evidence of transfer to other balance tasks. The rate of motor learning is similar for those with and without DCD. Our results raise a number of questions about motor learning that need to be addressed in future research. PMID:26466324

Living Donation Versus Donation After Circulatory Death Liver Transplantation for Low MELD Recipients.

PubMed

Kling, Catherine E; Perkins, James D; Reyes, Jorge D; Montenovo, Martin I

2018-04-10

Background In this era of organ scarcity, living donor liver transplant (LDLT) is an alternative to using deceased donors and in Western countries is more often used in low model for end-stage liver disease (MELD) recipients. We sought to compare the patient survival and graft survival between recipients of liver transplantation from living donors and donation after circulatory death (DCD) donors in patients with low MELD scores. Methods Retrospective cohort analysis of adult liver transplant recipients with a laboratory MELD <= 20 who underwent transplantation between 01/01/2003 and 03/31/2016. Recipients were categorized by donor graft type (DCD or LDLT) and recipient and donor characteristics were compared. Ten-year patient and graft survival curves were calculated using Kaplan-Meier analyses and a mixed-effects model was performed to determine the contributions of recipient, donor and center variables on patient and graft survival. Results 36,705 liver transplants were performed - 2,166 (5.9%) were from DCD donors and 2,284 (6.2%) from living donors. In the mixed-effects model, DCD status was associated with a higher risk of graft failure (RR 1.27, 95% CI 1.16-1.38) but not worse patient survival (RR 1.27, 95% CI: 0.96-1.67). Lower DCD center experience was associated with a 1.21 higher risk of patient death (95% CI: 1.17-1.25) and 1.13 higher risk of graft failure (95% CI: 1.12-1.15). LDLT center experience was also predictive of patient survival (RR 1.03, 95% CI: 1.02-1.03) and graft failure (RR 1.05, 95% CI: 1.05-1.06). Conclusion For liver transplant recipients with low laboratory MELD, LDLT offers better graft survival and a tendency to better patient survival than DCD donors. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

Atypical speech lateralization in adults with developmental coordination disorder demonstrated using functional transcranial Doppler ultrasound.

PubMed

Hodgson, Jessica C; Hudson, John M

2017-03-01

Research using clinical populations to explore the relationship between hemispheric speech lateralization and handedness has focused on individuals with speech and language disorders, such as dyslexia or specific language impairment (SLI). Such work reveals atypical patterns of cerebral lateralization and handedness in these groups compared to controls. There are few studies that examine this relationship in people with motor coordination impairments but without speech or reading deficits, which is a surprising omission given the prevalence of theories suggesting a common neural network underlying both functions. We use an emerging imaging technique in cognitive neuroscience; functional transcranial Doppler (fTCD) ultrasound, to assess whether individuals with developmental coordination disorder (DCD) display reduced left-hemisphere lateralization for speech production compared to control participants. Twelve adult control participants and 12 adults with DCD, but no other developmental/cognitive impairments, performed a word-generation task whilst undergoing fTCD imaging to establish a hemispheric lateralization index for speech production. All participants also completed an electronic peg-moving task to determine hand skill. As predicted, the DCD group showed a significantly reduced left lateralization pattern for the speech production task compared to controls. Performance on the motor skill task showed a clear preference for the dominant hand across both groups; however, the DCD group mean movement times were significantly higher for the non-dominant hand. This is the first study of its kind to assess hand skill and speech lateralization in DCD. The results reveal a reduced leftwards asymmetry for speech and a slower motor performance. This fits alongside previous work showing atypical cerebral lateralization in DCD for other cognitive processes (e.g., executive function and short-term memory) and thus speaks to debates on theories of the links between motor control and language production. © 2016 The Authors. Journal of Neuropsychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.

Outcomes for primary kidney transplantation from donation after Citizens' death in China: a single center experience of 367 cases.

PubMed

Xue, Wujun; Tian, Puxun; Xiang, Heli; Ding, Xiaoming; Pan, Xiaoming; Yan, Hang; Hou, Jun; Feng, Xinshun; Liu, Linjuan; Ding, Chenguang; Tian, Xiaohui; Li, Yang; Zheng, Jin

2017-04-04

The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD. Retrospective analysis of the clinical data of 367donations after citizens' death kidney transplant procedures (donors and recipients) between July 2012 and August 2015 at our center. During the study period, the donation success rate was 25.3%. 164 cases of DBCD and 35 cases of DCD had been implemented and 367 kidneys were transplanted. The incidence of DGF in DBCD group were significantly lower than that of DCD group (12.0% vs. 27.0%, p = 0.002). The 1-year percent freedom from acute rejection (AR) was significantly higher in DBCD group compared with it of DCD group (94% vs. 82%, p = 0.036). Multivariate logistic regression analysis of the kidney transplants revealed that the high risk factors for DGF after renal transplantation in DBCD were history of hypertension (Odds Ratio [OR] = 5.88, 95% CI: 1.90 to 18.2, p = 0.002), low blood pressure (BP < 80 mmHg) (OR = 4.86, 95% CI: 1.58 to 14.9, p = 0.006) and serum creatinine of donor (OR = 1.09, 95% CI: 1.03 to 1.16, p = 0.003) before donation. The outcomes of DBCD could be better than DCD in DGF and AR. The main risk factors for DGF in DBCD kidney transplants are donors with a history of hypertension, low blood pressure, and serum creatinine of donor before donation.

The effect of a motor skills training program in the improvement of practiced and non-practiced tasks performance in children with developmental coordination disorder (DCD).

PubMed

Farhat, Faiçal; Hsairi, Ines; Baati, Hamza; Smits-Engelsman, B C M; Masmoudi, Kaouthar; Mchirgui, Radhouane; Triki, Chahnez; Moalla, Wassim

2016-04-01

The purpose of the present study was to examine the effect of a group-based task oriented skills training program on motor and physical ability for children with DCD. It was also investigated if there was an effect on fine motor and handwriting tasks that were not specifically practiced during the training program. Forty-one children aged 6-10years took part in this study. Children were assigned to three groups: an experimental training group consisting of 14 children with DCD, a control non-training group consisted of 13 children with DCD and a control non-training group consisting of 14 typically developed children. The measurements included were, the Movement Assessment Battery for Children (MABC), the Modified Agility Test (MAT), the Triple Hop Distance (THD), the 5 Jump-test (5JT) and the Handwriting Performance Test. All measures were administered pre and post an 8-week training program. The results showed that 10 children of the DCD training-group improved their performance in MABC test, attaining a score above the 15th percentile after their participation in the training program. DCD training-group showed a significant improvement on all cluster scores (manual dexterity (t (13)=5.3, p<.001), ball skills (t (13)=2.73, p<.05) and balance (t (13)=5.13, p<.001). Significant performance improvements were also found in MAT, THD, 5JT (t (13)=-4.55; p<.01), handwriting quality (t (12)=-2.73; p<.05) and speed (t (12)=-4.2; p<.01) after the training program. In conclusion, improvement in both practiced and non-practiced skills, in the training program, may reflect improvement in motor skill but also transfer to other skills. Copyright © 2015 Elsevier B.V. All rights reserved.

Gesture Production in School vs. Clinical Samples of Children with Developmental Coordination Disorder (DCD) and Typically Developing Children

ERIC Educational Resources Information Center

Sinani, Charikleia; Sugden, David A.; Hill, Elisabeth L.

2011-01-01

Dyspraxia, a difficulty in executing an operationalised act, has been associated with Developmental Coordination Disorder (DCD). However, issues relating to the area such as comparisons across modalities, comparisons of school vs. clinical populations, and developmental delay vs. pathology have not been addressed in the same, comprehensive study.…

Neuromotor Task Training for Children with Developmental Coordination Disorder: A Controlled Trial

ERIC Educational Resources Information Center

Niemeijer, A. S.; Smits-Engelsman, B. C. M.; Schoemaker, M. M.

2007-01-01

The aim of this study was to evaluate neuromotor task training (NTT), a recently developed child-centred and task-oriented treatment programme for children with developmental coordination disorder (DCD). A treatment and a non-treatment control group of children with DCD were included. Children were selected if they scored below the 15th centile on…

Intact Procedural Motor Sequence Learning in Developmental Coordination Disorder

ERIC Educational Resources Information Center

Lejeune, Caroline; Catale, Corinne; Willems, Sylvie; Meulemans, Thierry

2013-01-01

The purpose of the present study was to explore the possibility of a procedural learning deficit among children with developmental coordination disorder (DCD). We tested 34 children aged 6-12 years with and without DCD using the serial reaction time task, in which the standard keyboard was replaced by a touch screen in order to minimize the impact…

Assessment of Body Composition Using Whole Body Air-Displacement Plethysmography in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Cairney, John; Hay, John; Veldhuizen, Scott; Faught, Brent

2011-01-01

Developmental coordination disorder (DCD) is a neuro-developmental disorder characterized by poor fine and/or gross motor coordination. Children with DCD are hypothesized to be at increased risk for overweight and obesity from inactivity due to their motor coordination problems. Although previous studies have found evidence to support this…

Verbal Self-Guidance as a Treatment Approach for Children with Developmental Coordination Disorder: A Systematic Replication Study.

ERIC Educational Resources Information Center

Martini, Rose; Polatajko, Helene J.

1998-01-01

Replicating a 1994 study, four children with developmental coordination disorder (DCD) were taught a verbal self-guidance strategy (Goal, Plan, Do, Check) by an occupational therapist. All four improved performance in attaining their occupational goals, supporting the possible use of a cognitive strategy with children with DCD. (SK)

Identifying Subtypes among Children with Developmental Coordination Disorder and Mathematical Learning Disabilities, Using Model-Based Clustering

ERIC Educational Resources Information Center

Pieters, Stefanie; Roeyers, Herbert; Rosseel, Yves; Van Waelvelde, Hilde; Desoete, Annemie

2015-01-01

A relationship between motor and mathematical skills has been shown by previous research. However, the question of whether subtypes can be differentiated within developmental coordination disorder (DCD) and/or mathematical learning disability (MLD) remains unresolved. In a sample of children with and without DCD and/or MLD, a data-driven…

Psychosocial Adjustment and Attention in Children with Developmental Coordination Disorder Using Different Motor Tests

ERIC Educational Resources Information Center

Chen, Yu-Wei; Tseng, Mei-Hui; Hu, Fu-Chang; Cermak, Sharon A.

2009-01-01

This study examined the consistency between the findings of developmental coordination disorder (DCD) as identified by the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) and the Movement Assessment Battery for Children (MABC), and explored the psychosocial and attention characteristics of children with DCD identified by the two motor tests,…

Anxiety Profiles in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Pratt, Michelle L.; Hill, Elisabeth L.

2011-01-01

Previous work has highlighted that children diagnosed with DCD may be at risk of greater problems related to emotional wellbeing. However, to date much work has relied on population based samples, and anxiety has not been examined within a group of children given a clinical diagnosis of DCD. Additionally, the profile of individual differences has…

Dyslexia and Developmental Co-Ordination Disorder in Further and Higher Education--Similarities and Differences. Does the "Label" Influence the Support Given?

ERIC Educational Resources Information Center

Kirby, Amanda; Sugden, David; Beveridge, Sally; Edwards, Lisa; Edwards, Rachel

2008-01-01

Developmental co-ordination disorder (DCD) is a developmental disorder affecting motor co-ordination. The "Diagnostics Statistics Manual"--IV classification for DCD describes difficulties across a range of activities of daily living, impacting on everyday skills and academic performance in school. Recent evidence has shown that…

The Impact of Obesity on Developmental Coordination Disorder in Adolescence

ERIC Educational Resources Information Center

Wagner, Matthias Oliver; Kastner, Julia; Petermann, Franz; Jekauc, Darko; Worth, Annette; Bos, Klaus

2011-01-01

Developmental coordination disorder (DCD) as well as overweight and obesity are of increasing importance in the study of human development. Data on the relation between DCD and obesity in adolescence are of particular interest because both phenomena are unlikely to disappear with age. The objective of this study was to determine the impact of…

Aquatic Physical Therapy for Children with Developmental Coordination Disorder: A Pilot Randomized Controlled Trial

ERIC Educational Resources Information Center

Hillier, Susan; McIntyre, Auburn; Plummer, Leanne

2010-01-01

Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7…

Self-Reported Mood, General Health, Wellbeing and Employment Status in Adults with Suspected DCD

ERIC Educational Resources Information Center

Kirby, Amanda; Williams, Natalie; Thomas, Marie; Hill, Elisabeth L.

2013-01-01

Developmental Coordination Disorder (DCD) affects around 2-6% of the population and is diagnosed on the basis of poor motor coordination in the absence of other neurological disorders. Its psychosocial impact has been delineated in childhood but until recently there has been little understanding of the implications of the disorder beyond this.…

Working Memory and Learning in Children with Developmental Coordination Disorder and Specific Language Impairment

ERIC Educational Resources Information Center

Alloway, Tracy Packiam; Archibald, Lisa

2008-01-01

The authors compared 6- to 11-year-olds with developmental coordination disorder (DCD) and those with specific language impairment (SLI) on measures of memory (verbal and visuospatial short-term and working memory) and learning (reading and mathematics). Children with DCD with typical language skills were impaired in all four areas of memory…

Anticipatory Postural Adjustments in a Bimanual Load-Lifting Task in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Jover, Marianne; Schmitz, Christina; Centelles, Laurie; Chabrol, Brigitte; Assaiante, Christine

2010-01-01

Aim: Postural control is a fundamental component of action in which deficits have been shown to contribute to motor difficulties in children with developmental coordination disorder (DCD). The purpose of this study was to examine anticipatory postural adjustments (APAs) in children with DCD in a bimanual load-lifting task. Method: Sixteen children…

Neuromotor Deficits in Developmental Coordination Disorder: Evidence from a Reach-to-Grasp Task

ERIC Educational Resources Information Center

Biancotto, Marina; Skabar, Aldo; Bulgheroni, Maria; Carrozzi, Marco; Zoia, Stefania

2011-01-01

Developmental coordination disorder (DCD) has been classified as a specific learning disability, nonetheless the underlying cognitive mechanisms are still a matter of discussion. After a summary of the main hypotheses on the principal neuromotor causes of DCD, this study applies a causal model framework to describe the possible coexistence of more…

Metabolic Syndrome in Children with and without Developmental Coordination Disorder

ERIC Educational Resources Information Center

Wahi, Gita; LeBlanc, Paul J.; Hay, John A.; Faught, Brent E.; O'Leary, Debra; Cairney, John

2011-01-01

Children with developmental coordination disorder (DCD) have higher rates of obesity compared to children with typical motor development, and, as a result may be at increased risk for developing metabolic syndrome (MetS). The purpose of this study was to determine the presence of MetS and its components among children with and without DCD. This…

Evaluating Physical Activity Using Accelerometry in Children at Risk of Developmental Coordination Disorder in the Presence of Attention Deficit Hyperactivity Disorder

ERIC Educational Resources Information Center

Baerg, Sally; Cairney, John; Hay, John; Rempel, Lynn; Mahlberg, Nadilein; Faught, Brent E.

2011-01-01

Physical activity (PA) is compromised in children and adolescents with developmental coordination disorder (DCD). Approximately half of all children with DCD suffer from attention-deficit hyperactive disorder (ADHD); a cohort often considered more physically active than typically developing youth. Accelerometry is an effective method of assessing…

A Preliminary Study on the Effect of Methylphenidate on Motor Performance in Children with Comorbid DCD and ADHD

ERIC Educational Resources Information Center

Bart, Orit; Podoly, Tamar; Bar-Haim, Yair

2010-01-01

Attention Deficit Hyperactive Disorder (ADHD) and Developmental Coordination Disorder (DCD) are two developmental disorders with considerable comorbidity. The impact of Methylphenidate (MPH) on ADHD symptoms is well documented. However, the effects of MPH on motor coordination are less studied. We assessed the influence of MPH on motor performance…

[Cognitive Profiles of Preschool Children with Developmental Coordination Disorders and ADHD].

PubMed

Jascenoka, Julia; Korsch, Franziska; Petermann, Franz; Petermann, Ulrike

2015-01-01

Cognitive Profiles of Preschool Children with Developmental Coordination Disorders and ADHD Studies confirm that developmental coordination disorders (DCD) are often accompanied by ADHD. It is important to know why children with combined disorders show a special profile in a common intelligence test (WPPSI-III). For this purpose, the WPPSI-III results of a total of 125 children aged five to six years with diagnosed isolated DCD, isolated ADHD, combined disorders and a normative sample were compared. Children with isolated ADHD showed the best cognitive profile. Children of all three diagnosis subgroups presented significantly poorer abilities in all WPPSI-III scales than the normative sample. In comparison with preschoolers showing isolated ADHD, children with DCD and ADHD have a significant lower Processing Speed Quotient.

A decoy chain deployment method based on SDN and NFV against penetration attack

PubMed Central

Zhao, Qi; Zhang, Chuanhao

2017-01-01

Penetration attacks are one of the most serious network security threats. However, existing network defense technologies do not have the ability to entirely block the penetration behavior of intruders. Therefore, the network needs additional defenses. In this paper, a decoy chain deployment (DCD) method based on SDN+NFV is proposed to address this problem. This method considers about the security status of networks, and deploys decoy chains with the resource constraints. DCD changes the attack surface of the network and makes it difficult for intruders to discern the current state of the network. Simulation experiments and analyses show that DCD can effectively resist penetration attacks by increasing the time cost and complexity of a penetration attack. PMID:29216257

A decoy chain deployment method based on SDN and NFV against penetration attack.

PubMed

Zhao, Qi; Zhang, Chuanhao; Zhao, Zheng

2017-01-01

Penetration attacks are one of the most serious network security threats. However, existing network defense technologies do not have the ability to entirely block the penetration behavior of intruders. Therefore, the network needs additional defenses. In this paper, a decoy chain deployment (DCD) method based on SDN+NFV is proposed to address this problem. This method considers about the security status of networks, and deploys decoy chains with the resource constraints. DCD changes the attack surface of the network and makes it difficult for intruders to discern the current state of the network. Simulation experiments and analyses show that DCD can effectively resist penetration attacks by increasing the time cost and complexity of a penetration attack.

IL-10 -1082 SNP and IL-10 in primary CNS and vitreoretinal lymphomas.

PubMed

Ramkumar, Hema L; Shen, De Fen; Tuo, Jingsheng; Braziel, Rita M; Coupland, Sarah E; Smith, Justine R; Chan, Chi-Chao

2012-10-01

Most primary central nervous system lymphomas (PCNSLs) and primary vitreoretinal lymphomas (PVRLs) are B-cell lymphomas that produce high levels of interleukin (IL)-10, which is linked to rapid disease progression. The IL-10 (-1082) G → A polymorphism (IL-10 SNP) is associated with improved survival in certain non-CNS lymphoma patients. PDCD4 is a tumor suppressor gene and upstream regulator of IL-10. This study examined the correlation between the IL-10 SNP, PDCD4 mRNA expression, and IL-10 expression (at transcript and protein levels) in these lymphoma cells. Single-nucleotide polymorphism (SNP)-typing at IL-10 (-1082) was performed after microdissecting cytospun PVRL cells from 26 specimens. Vitreal IL-10 and IL-6 levels were measured by ELISA. PCNSL cells from 52 paraffin-embedded sections were microdissected and SNP typed on genomic DNA. RT-PCR was performed to analyze expression of IL-10 and PDCD4 mRNA. IL-10 (-1082) SNP typing was performed on blood samples of 96 healthy controls. We measured IL-10 (-1082) SNP expression in 26 PVRLs and 52 PCNSLs and examined its relationship with IL-10 protein and gene expression, respectively. More PVRL patients expressed one copy of the IL-10 ( -1082 )  G → A SNP with the GA genotype compared to controls. The frequencies of the three genotypes (AA, AG, GG) significantly differed in PVRL versus controls and in PCNSL versus controls. In PVRLs, the vitreal IL-10/IL-6 ratio was higher in IL-10 (-1082) AG and IL-10 (-1082) AA patients, compared to IL-10 (-1082) GG patients. IL-10 mRNA expression was higher in IL-10 (-1082) AG and IL-10 (-1082) AA PCNSLs, compared to IL-10 (-1082) GG PCNSLs. No correlation was found between IL-10 and PDCD4 expression levels in 37 PCNSL samples. PVRL and PCNSL patients had similar IL-10 (-1082) A allele frequencies, but genotype distributions differed from healthy controls. The findings suggest that the IL-10 (-1082) A allele is a risk factor for higher IL-10 levels in PVRLs and PCNSLs. Higher IL-10 levels have been correlated with more aggressive disease in both PVRLs and PCNSLs, making this finding an important and potentially clinically significant observation.

IL-10 -1082 SNP and IL-10 in primary CNS and vitreoretinal lymphomas

PubMed Central

Ramkumar, Hema L.; Shen, De Fen; Tuo, Jingsheng; Braziel, Rita M.; Coupland, Sarah E.; Smith, Justine R.

2012-01-01

Objectives Most primary central nervous system lymphomas (PCNSLs) and primary vitreoretinal lymphomas (PVRLs) are B-cell lymphomas that produce high levels of interleukin (IL)-10, which is linked to rapid disease progression. The IL-10-1082G→A polymorphism (IL-10 SNP) is associated with improved survival in certain non-CNS lymphoma patients. PDCD4 is a tumor suppressor gene and upstream regulator of IL-10. This study examined the correlation between the IL-10 SNP, PDCD4 mRNA expression, and IL-10 expression (at transcript and protein levels) in these lymphoma cells. Materials and methods Single-nucleotide polymorphism (SNP)-typing at IL-10-1082 was performed after micro-dissecting cytospun PVRL cells from 26 specimens. Vitreal IL-10 and IL-6 levels were measured by ELISA. PCNSL cells from 52 paraffin-embedded sections were microdissected and SNP typed on genomic DNA. RT-PCR was performed to analyze expression of IL-10 and PDCD4 mRNA. IL-10-1082 SNP typing was performed on blood samples of 96 healthy controls. We measured IL-10-1082 SNP expression in 26 PVRLs and 52 PCNSLs and examined its relationship with IL-10 protein and gene expression, respectively. Results More PVRL patients expressed one copy of the IL-10-1082G→A SNP with the GA genotype compared to controls. The frequencies of the three genotypes (AA, AG, GG) significantly differed in PVRL versus controls and in PCNSL versus controls. In PVRLs, the vitreal IL-10/IL-6 ratio was higher in IL-10-1082 AG and IL-10-1082 AA patients, compared to IL-10-1082 GG patients. IL-10 mRNA expression was higher in IL-10-1082 AG and IL-10-1082 AA PCNSLs, compared to IL-10-1082 GG PCNSLs. No correlation was found between IL-10 and PDCD4 expression levels in 37 PCNSL samples. Conclusions PVRL and PCNSL patients had similar IL-10-1082 A allele frequencies, but genotype distributions differed from healthy controls. The findings suggest that the IL-10-1082 A allele is a risk factor for higher IL-10 levels in PVRLs and PCNSLs. Higher IL-10 levels have been correlated with more aggressive disease in both PVRLs and PCNSLs, making this finding an important and potentially clinically significant observation. PMID:22628023

Pediatric Donor to Adult Recipients in Donation After Cardiac Death Liver Transplantation: A Single-Center Experience.

PubMed

Lan, C; Song, J L; Yan, L N; Yang, J Y; Wen, T F; Li, B; Xu, M Q

The impact of using liver allografts from donors who are younger than 14 years at the time of donation after cardiac death (DCD) liver transplantation in terms of early allograft dysfunction (EAD) and graft survival is undefined. To determine if adults undergoing DCD liver transplantation who receive a graft from a donor age younger than or equal to 13 years have similar outcomes to recipients of organs from older than 18-year-old donors. Records from adult patients undergoing DCD liver transplantation between March 2012 and December 2015 who received whole grafts from donors after cardiac death were reviewed. Patients with donors younger than or equal to 13 years (group 1) and older than 18 years (group 2) were compared for EAD rates, hepatic artery thrombosis (HAT), and graft survival. Records of 60 DCD liver transplantation patients were analyzed. The 90-day and 1-year graft survival rate of both groups was 90% versus 96% (P = .427) and 80% versus 84% (P = .668), respectively. The EAD rates of groups 1 and 2 were 30% versus 34% (P = .806). The incidence of HAT was 20% in group 1 compared with 12% in group 2 (P = .610). Also, 0.7% < graft to recipient weight ratio (GRWR) <0.8% was also usable for pediatric donor to adult recipients. Whole liver grafts from donors younger than or equal to 13 years can potentially be used in selected size-matched (GRWR >0.7%) DCD adult recipients. Copyright © 2017 Elsevier Inc. All rights reserved.

Donor cause of death and mid-term survival in lung transplantation.

PubMed

Ganesh, J Saravana; Rogers, Chris A; Banner, Nicholas R; Bonser, Robert S

2005-10-01

The influence of donor cause of death (DCD) on survival after lung transplantation (LTx) is uncertain. This was investigated using data from a national prospective cohort study of adult single and bilateral LTx undertaken between July 1995 and June 2002. DCD was categorized a priori into vascular and tumor (V), traumatic (T), hypoxic brain damage (H) and infective (I) causes. All T donor deaths were the result of blunt trauma. Risk factors for early (30 days), late (30 days to 5 years) and overall (5 years) mortality were identified using Cox regression analysis. Of 580 eligible transplants, DCDs were classified as V (n = 372), T (n = 153), H (n = 38) and I (n = 17). V donors were older (median 42 years) than the others (medians < 27 years) (p < 0.001). T donors were more likely to be of male gender (p < 0.001). Two hundred fifty-nine patients died within 5 years of surgery. The median follow-up time of survivors was 37 months. Unadjusted 5-year Kaplan-Meier survival rates did not vary with DCD (p = 0.6). Cox analysis identified donor age group, recipient diagnosis, pre-operative recipient ventilation, donor-recipient size mismatch, donor-recipient blood group variance, cytomegalovirus (CMV) mismatch and recipient creatinine clearance as predictors of mortality. After adjustment for these risk factors, DCD was not identified as a predictor of early (p = 0.2), late (p = 0.5) or overall mortality (p = 0.4) in LTx recipients. We found that DCD did not affect mid-term survival after LTx.

Identifying play characteristics of pre-school children with developmental coordination disorder via parental questionnaires.

PubMed

Rosenblum, Sara; Waissman, Pola; Diamond, Gary W

2017-06-01

Motor coordination deficits that characterize children with Developmental Coordination Disorder (DCD) affect their quality of participation. The aim of the current study was to identify play characteristics of young children with DCD, compared to those of children with typical development in three dimensions: activity and participation, environmental factors and children's impairments. Sixty-four children, aged four to six years, participated. Thirty were diagnosed as having DCD; the remaining 34 children were age, gender and socioeconomic level matched controls with typical development. The children were evaluated by the M-ABC. In addition, their parents completed a demographic questionnaire, the Children's Activity Scale for Parents (CHAS-P), the Children's Leisure Assessment Scale for preschoolers (CLASS-Pre), and My Child's Play Questionnaire (MCP). Children with DCD performed significantly poorer in each of the four play activity and participation domains: variety, frequency, sociability, and preference (CLASS-Pre). Furthermore, their environmental characteristics were significantly different (MCP). They displayed significantly inferior performance (impairments) in interpersonal interaction and executive functioning during play, in comparison to controls (MCP). Moreover, the children's motor and executive control as reflected in their daily function as well as their activities of daily living (ADL) performance level, contributed to the prediction of their global play participation. The results indicate that the use of both the CLASS-Pre and the MCP questionnaires enables the identification of unique play characteristics of pre-school children with DCD via parents' reports. A better insight into these characteristics may contribute to theoretical knowledge and clinical practice to improve the children's daily participation. Copyright © 2016 Elsevier B.V. All rights reserved.

Does relative body fat influence the Movement ABC-2 assessment in children with and without developmental coordination disorder?

PubMed

Faught, Brent E; Demetriades, Stephen; Hay, John; Cairney, John

2013-12-01

Developmental coordination disorder (DCD) is a condition that results in an impairment of gross and/or fine motor coordination. Compromised motor coordination contributes to lower levels of physical activity, which is associated with elevated body fat. The impact of elevated body fat on motor coordination diagnostic assessments in children with DCD has not been established. The purpose of this study was to determine if relative body fat influences performance on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) test items in children with and without DCD. A nested case-control, design was conducted within the Physical Health Activity Study Team longitudinal cohort study. The MABC-2 was used to assess motor coordination to categorize cases and matched controls. Relative body fat was assessed using whole body air displacement plethysmography. Relative body fat was negatively associated with the MABC-2 "balance" subcategory after adjusting for physical activity and DCD status. Relative body fat did not influence the subcategories of "manual dexterity" or "aiming and catching". Item analysis of the three balance tasks indicated that relative body fat significantly influences both "2-board balance" and "zig-zag hopping", but not "walking heel-toe backwards". Children with higher levels of relative body fat do not perform as well on the MABC-2, regardless of whether the have DCD or not. Dynamic balance test items are most negatively influenced by body fat. Health practitioners and researchers should be aware that body fat can influence results when interpreting MABC-2 test scores. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Donation After Circulatory Death for Liver Transplantation: A Meta-Analysis on the Location of Life Support Withdrawal Affecting Outcomes.

PubMed

Cao, Yiming; Shahrestani, Sara; Chew, Hong Chee; Crawford, Michael; Macdonald, Peter Simon; Laurence, Jerome; Hawthorne, Wayne John; Dhital, Kumud; Pleass, Henry

2016-07-01

Liver transplantation using donation after circulatory death (DCD) donors is associated with inferior outcomes compared to donation after brain death (DBD). Prolonged donor warm ischemic time has been identified as the key factor responsible for this difference. Various aspects of the donor life support withdrawal procedure, including location of withdrawal and administration of antemortem heparin, are thought to play important roles in mitigating the effects of warm ischemia. However, a systematic exploration of these factors is important for more confident integration of these practices into a standard DCD protocol. Medline, EMBASE, and Cochrane libraries were systematically searched and 23 relevant studies identified for analysis. Donation after circulatory death recipients were stratified according to location of life support withdrawal (intensive care unit or operating theater) and use of antemortem heparin. Donation after circulatory death recipients had comparable 1-year patient survival to DBD recipients if the location of withdrawal of life support was the operating theater, but not if the location was the intensive care unit. Likewise, the inferior 1-year graft survival and higher incidence of ischemic cholangiopathy of DCD compared with DBD recipients were improved by withdrawal in operating theater, although higher rates of ischemic cholangiopathy and worse graft survival were still observed in DCD recipients. Furthermore, administering heparin before withdrawal of life support reduced the incidence of primary nonfunction of the allograft. Our evidence suggests that withdrawal in the operating theater and premortem heparin administration improve DCD liver transplant outcomes, thus allowing for the most effective usage of these valuable organs.

Radiologic Characterization of Ischemic Cholangiopathy in Donation-After-Cardiac-Death Liver Transplants and Correlation With Clinical Outcomes.

PubMed

Giesbrandt, Kirk J; Bulatao, Ilynn G; Keaveny, Andrew P; Nguyen, Justin H; Paz-Fumagalli, Ricardo; Taner, C Burcin

2015-11-01

The purpose of this study was to define the cholangiographic patterns of ischemic cholangiopathy and clinically silent nonanastomotic biliary strictures in donation-after-cardiac-death (DCD) liver grafts in a large single-institution series. We also examined the correlation of the radiologic findings with laboratory data and clinical outcomes. Data were collected for all DCD liver transplants at one institution from December 1998 to December 2011. Posttransplant cholangiograms were obtained during postoperative weeks 1 and 3 and when clinically indicated. Intrahepatic biliary strictures were classified by anatomic distribution and chronologic development. Radiologic findings were correlated with laboratory data and with 1-, 3-, and 5-year graft and patient survival rates. A total of 231 patients received DCD grafts. Cholangiograms were available for 184 of these patients. Postoperative cholangiographic findings were correlated with clinical data and divided into the following three groups: A, normal cholangiographic findings with normal laboratory values; B, radiologic abnormalities and cholangiopathy according to laboratory values; and C, radiologic abnormalities without laboratory abnormalities. Group B had four distinct abnormal cholangiographic patterns that were predictive of graft survival. Group C had mild nonprogressive multifocal stenoses and decreased graft and patient survival rates, although cholangiopathy was not detected in these patients according to laboratory data. Patterns and severity of nonanastomotic biliary abnormalities in DCD liver transplants can be defined radiologically and correlate with clinical outcomes. Postoperative cholangiography can depict the mild biliary abnormalities that occur in a subclinical manner yet cause a marked decrease in graft and patient survival rates in DCD liver transplants.

Mechanisms of Deficit of Visuospatial Attention Shift in Children with Developmental Coordination Disorder: A Neurophysiological Measure of the Endogenous Posner Paradigm

ERIC Educational Resources Information Center

Tsai, Chia-Liang; Pan, Chien-Yu; Cherng, Rong-Ju; Hsu, Ya-Wen; Chiu, Hsing-Hui

2009-01-01

The purpose of this study was to investigate and compare the mechanisms of brain activity, as revealed by a combination of the visuospatial attention shifting paradigm and event-related potentials (ERP) in children with developmental coordination disorder (DCD) and typically developing children. Twenty-eight DCD children and 26 typically…

Participation Patterns of School-Aged Children with and without DCD

ERIC Educational Resources Information Center

Jarus, Tal; Lourie-Gelberg, Yael; Engel-Yeger, Batya; Bart, Orit

2011-01-01

Participation is recognized as a key to one's health and well-being and is considered to be a vital part of the development of children and youth. The purpose of this study was to examine the participation patterns of children with and without Developmental Coordination Disorder (DCD) in their out-of-school-time (OST) activities, and to see…

Developmental Co-Ordination Disorder (DCD) in Adolescents and Adults in Further and Higher Education

ERIC Educational Resources Information Center

Kirby, Amanda; Sugden, David; Beveridge, Sally; Edwards, Lisa

2008-01-01

Few studies have looked at the strengths and weaknesses and needs of students with developmental co-ordination disorder (DCD). This paper describes a cohort of 93 UK students currently studying at further or higher education and who have reported motor difficulties present since childhood. The study group consisted of 21 reporting to have DCD…

Can the Movement Assessment Battery for Children-Test Be the "Gold Standard" for the Motor Assessment of Children with Developmental Coordination Disorder?

ERIC Educational Resources Information Center

Venetsanou, Fotini; Kambas, Antonis; Ellinoudis, Theodoros; Fatouros, Ioannis; Giannakidou, Dimitra; Kourtessis, Thomas

2011-01-01

Developmental Coordination Disorder (DCD) is an important risk factor in the development of children that can have a significant academic and social impact. This reinforces the need for its timely identification using appropriate assessment methods and accurate screening tests. The commonly used standardized motor test for the DCD identification…

Reliability and Responsiveness of the Movement Assessment Battery for Children--Second Edition Test in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Wuang, Yee-Pay; Su, Jui-Hsing; Su, Chwen-Yng

2012-01-01

Aim: To examine the internal consistency, test-retest reliability, and responsiveness of the Movement Assessment Battery for Children--Second Edition (MABC-2) Test for children with developmental coordination disorder (DCD). Method: One hundred and forty-four Taiwanese children with DCD aged 6 to 12 years (87 males, 57 females) were tested on…

Reading and Writing Performances of Children 7-8 Years of Age with Developmental Coordination Disorder in Taiwan

ERIC Educational Resources Information Center

Cheng, Hsiang-Chun; Chen, Jenn-Yeu; Tsai, Chia-Liang; Shen, Miau-Lin; Cherng, Rong-Ju

2011-01-01

Developmental coordination disorder (DCD) refers to a delay in motor development that does not have any known medical cause. Studies conducted in English speaking societies have found that children with DCD display a higher co-occurrence rate of learning difficulties (e.g., problems in reading and writing) than typically developing (TD) children.…

Aquatic physical therapy for children with developmental coordination disorder: a pilot randomized controlled trial.

PubMed

Hillier, Susan; McIntyre, Auburn; Plummer, Leanne

2010-05-01

Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7 years 1 month; 10 males) with DCD were randomly allocated to receive either six sessions of aquatic therapy (once weekly session of 30 min for 6-8 weeks) or to a wait-list (control group). The intervention and measures were demonstrated to be feasible, but barriers, such as limited appointment times and accessibility, were encountered. Analysis of covariance indicated that at posttest, mean scores on the Movement Assessment Battery were higher for children who received aquatic therapy compared to those on the wait-list (p = .057). Similar trends were noted on the physical competence portion of the Pictorial Scale of Perceived Competence and Social Acceptance (p = .058). Participation levels, as measured by a parent questionnaire, showed improvement for both groups. Potential facilitators and barriers to implementation of an aquatic therapy for children with DCD are discussed.

Recovery of transplantable organs after cardiac or circulatory death: Transforming the paradigm for the ethics of organ donation

PubMed Central

Verheijde, Joseph L; Rady, Mohamed Y; McGregor, Joan

2007-01-01

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. PMID:17519030

Feasibility of Motor Imagery Training for Children with Developmental Coordination Disorder – A Pilot Study

PubMed Central

Adams, Imke L. J.; Smits-Engelsman, Bouwien; Lust, Jessica M.; Wilson, Peter H.; Steenbergen, Bert

2017-01-01

Children with Developmental Coordination Disorder (DCD) experience movement difficulties that may be linked to processes involved in motor imagery (MI). This paper discusses recent advances in theory that underpin the use of MI training for children with DCD. This knowledge is translated in a new MI training protocol which is compared with the cognitive orientation to daily occupational performance (CO-OP). Children meeting DSM-5 criteria for DCD were assigned to MI (n = 4) or CO-OP (n = 4) interventions and completed nine treatment sessions, including homework exercises. Results were positive, with two children in the MI group and three in the CO-OP group improving their m-ABC-2 score by ≥ 2 standard scores, interpreted as a clinically meaningful change. Moreover, all children and parents noticed improvements in motor skills after training. This is the first study to demonstrate the feasibility of a theoretically principled treatment protocol for MI training in children with DCD, and extends earlier work. Trial registration: The complete trial is registered at the Dutch trial register, www.trialregister.nl (NTR5471). http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5471 PMID:28798707

Children with developmental coordination disorder demonstrate a spatial mismatch when estimating coincident-timing ability with tools.

PubMed

Caçola, Priscila; Ibana, Melvin; Ricard, Mark; Gabbard, Carl

2016-01-01

Coincident timing or interception ability can be defined as the capacity to precisely time sensory input and motor output. This study compared accuracy of typically developing (TD) children and those with Developmental Coordination Disorder (DCD) on a task involving estimation of coincident timing with their arm and various tool lengths. Forty-eight (48) participants performed two experiments where they imagined intercepting a target moving toward (Experiment 1) and target moving away (Experiment 2) from them in 5 conditions with their arm and tool lengths: arm, 10, 20, 30, and 40 cm. In Experiment 1, the DCD group overestimated interception points approximately twice as much as the TD group, and both groups overestimated consistently regardless of the tool used. Results for Experiment 2 revealed that those with DCD underestimated about three times as much as the TD group, with the exception of when no tool was used. Overall, these results indicate that children with DCD are less accurate with estimation of coincident-timing; which might in part explain their difficulties with common motor activities such as catching a ball or striking a baseball pitch. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dynamic context discrimination : psychological evidence for the Sandia Cognitive Framework.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Speed, Ann Elizabeth

Human behavior is a function of an iterative interaction between the stimulus environment and past experience. It is not simply a matter of the current stimulus environment activating the appropriate experience or rule from memory (e.g., if it is dark and I hear a strange noise outside, then I turn on the outside lights and investigate). Rather, it is a dynamic process that takes into account not only things one would generally do in a given situation, but things that have recently become known (e.g., there have recently been coyotes seen in the area and one is known to bemore » rabid), as well as other immediate environmental characteristics (e.g., it is snowing outside, I know my dog is outside, I know the police are already outside, etc.). All of these factors combine to inform me of the most appropriate behavior for the situation. If it were the case that humans had a rule for every possible contingency, the amount of storage that would be required to enable us to fluidly deal with most situations we encounter would rapidly become biologically untenable. We can all deal with contingencies like the one above with fairly little effort, but if it isn't based on rules, what is it based on? The assertion of the Cognitive Systems program at Sandia for the past 5 years is that at the heart of this ability to effectively navigate the world is an ability to discriminate between different contexts (i.e., Dynamic Context Discrimination, or DCD). While this assertion in and of itself might not seem earthshaking, it is compelling that this ability and its components show up in a wide variety of paradigms across different subdisciplines in psychology. We begin by outlining, at a high functional level, the basic ideas of DCD. We then provide evidence from several different literatures and paradigms that support our assertion that DCD is a core aspect of cognitive functioning. Finally, we discuss DCD and the computational model that we have developed as an instantiation of DCD in more detail. Before commencing with our overview of DCD, we should note that DCD is not necessarily a theory in the classic sense. Rather, it is a description of cognitive functioning that seeks to unify highly similar findings across a wide variety of literatures. Further, we believe that such convergence warrants a central place in efforts to computationally emulate human cognition. That is, DCD is a general principle of cognition. It is also important to note that while we are drawing parallels across many literatures, these are functional parallels and are not necessarily structural ones. That is, we are not saying that the same neural pathways are involved in these phenomena. We are only saying that the different neural pathways that are responsible for the appearance of these various phenomena follow the same functional rules - the mechanisms are the same even if the physical parts are distinct. Furthermore, DCD is not a causal mechanism - it is an emergent property of the way the brain is constructed. DCD is the result of neurophysiology (cf. John, 2002, 2003). Finally, it is important to note that we are not proposing a generic learning mechanism such that one biological algorithm can account for all situation interpretation. Rather, we are pointing out that there are strikingly similar empirical results across a wide variety of disciplines that can be understood, in part, by similar cognitive processes. It is entirely possible, even assumed in some cases (i.e., primary language acquisition) that these more generic cognitive processes are complemented and constrained by various limits which may or may not be biological in nature (cf. Bates & Elman, 1996; Elman, in press).« less

Overlapping Phenotypes in Autism Spectrum Disorder and Developmental Coordination Disorder: A Cross-Syndrome Comparison of Motor and Social Skills.

PubMed

Sumner, Emma; Leonard, Hayley C; Hill, Elisabeth L

2016-08-01

Motor and social difficulties are often found in children with an autism spectrum disorder (ASD) and with developmental coordination disorder (DCD), to varying degrees. This study investigated the extent of overlap of these problems in children aged 7-10 years who had a diagnosis of either ASD or DCD, compared to typically-developing controls. Children completed motor and face processing assessments. Parents completed questionnaires concerning their child's early motor and current motor and social skills. There was considerable overlap between the ASD and DCD groups on the motor and social assessments, with both groups more impaired than controls. Furthermore, motor skill predicted social functioning for both groups. Future research should consider the relationships between core symptoms and their consequences in other domains.

Deficits of Visuospatial Attention with Reflexive Orienting Induced by Eye-Gazed Cues in Children with Developmental Coordination Disorder in the Lower Extremities: An Event-Related Potential Study

ERIC Educational Resources Information Center

Tsai, Chia-Liang; Pan, Chien-Yu; Chang, Yu-Kai; Wang, Chun-Hao; Tseng, Ko-Da

2010-01-01

The present study aims to investigate and compare the behavioral performance and event-related potentials (ERPs) measures in children with developmental coordination disorder (DCD) and typically developing (TD) children when performing the visuospatial attention task with reflexive orienting. Thirty children with DCD and 30 TD children were…

Developmental Coordination Disorder, Sex, and Activity Deficit over Time: A Longitudinal Analysis of Participation Trajectories in Children with and without Coordination Difficulties

ERIC Educational Resources Information Center

Cairney, John; Hay, John A.; Veldhuizen, Scott; Missiuna, Cheryl; Faught, Brent E.

2010-01-01

Aim: Children with developmental coordination disorder (DCD) are known to participate in active play less than typically developing children. However, it is not known whether the activity deficit between children with and without DCD widens or diminishes over time. Method: Data were obtained from a large, prospective cohort study of children…

The Role of Self-Regulatory and Metacognitive Competence in the Motor Performance Difficulties of Children with Developmental Coordination Disorder: A Theoretical and Empirical Review

ERIC Educational Resources Information Center

Jokic, Claire Sangster; Whitebread, David

2011-01-01

Children with developmental coordination disorder (DCD) experience difficulty coping with everyday demands due to difficulties in performing motor tasks. Recently, a cognitive learning paradigm has been applied to studying the nature of the problems experienced by children with DCD, which assumes that these children have fewer cognitive and…

Suitability of the "'Little DCDQ" for the Identification of DCD in a Selected Group of 3-5-Year-Old South African Children

ERIC Educational Resources Information Center

Venter, Amné; Pienaar, Anita E.; Coetzee, Dané

2015-01-01

Background: In order to identify Developmental Coordination Disorder (DCD) as soon as possible, we need validated screening instruments that can be used for the early identification of motor coordination delays. The aim of this study was to establish the suitability of the Little Developmental Coordination Disorder Questionnaire (Little DCDQ) for…

The Functional Profile of Young Adults with Suspected Developmental Coordination Disorder (DCD)

ERIC Educational Resources Information Center

Tal-Saban, Miri; Zarka, Salman; Grotto, Itamar; Ornoy, Asher; Parush, Shula

2012-01-01

We assessed the non-academic and academic functioning of young adults with DCD, and investigated the emotional influences and the role of strategy use within this population. A random sample of 2379 adolescents and young adults aged 19-25 (1081 males [45.4%]; mean age = 20.68, SD = 3.42) was used to develop the instruments. From this sample, three…

Overlapping Phenotypes in Autism Spectrum Disorder and Developmental Coordination Disorder: A Cross-Syndrome Comparison of Motor and Social Skills

ERIC Educational Resources Information Center

Sumner, Emma; Leonard, Hayley C.; Hill, Elisabeth L.

2016-01-01

Motor and social difficulties are often found in children with an autism spectrum disorder (ASD) and with developmental coordination disorder (DCD), to varying degrees. This study investigated the extent of overlap of these problems in children aged 7-10 years who had a diagnosis of either ASD or DCD, compared to typically-developing controls.…

ENGULFMENT OF APOPTOTIC CELLS BY MACROPHAGES: A ROLE OF MICRO-RNA-21 IN THE RESOLUTION OF WOUND INFLAMMATION1

PubMed Central

Das, Amitava; Ganesh, Kasturi; Khanna, Savita; Sen, Chandan K.; Roy, Sashwati

2014-01-01

SUMMARY At an injury-site, efficient clearance of apoptotic cells by wound macrophages or efferocytosis is a pre-requisite for the timely resolution of inflammation. Emerging evidence indicates that miR-21 may regulate the inflammatory response. In this work, we sought to elucidate the significance of miR-21 in the regulation of efferocytosis mediated suppression of innate immune response, a key process implicated in resolving inflammation following injury. An increased expression of inducible miR-21 was noted in post-efferocytotic peripheral blood monocyte-derived macrophages (MDM). Such induction of miR-21 was associated with silencing of its target genes PTEN and PDCD4. Successful efferocytosis of apoptotic cells by MDM resulted in the suppression of LPS-induced NF-κB activation and TNFα expression. Interestingly, bolstering of miR-21 levels alone using miR mimic resulted in significant suppression of LPS-induced TNFα expression and NFκB activation. We report that efferocytosis-induced miR-21, by silencing PTEN and GSK3β, tempers LPS-induced inflammatory response. Macrophage efferocytosis is known to trigger the release of anti-inflammatory cytokine IL-10. This study demonstrates that following successful efferocytosis, miR-21 induction in macrophages silence PDCD4 favoring cJun-AP1 activity which in turn results in elevated production of anti-inflammatory IL-10. In summary, this work provides direct evidence implicating miRNA in the process of turning-on an anti-inflammatory phenotype in the post-efferocytotic macrophage. Elevated macrophage miR-21 promotes efferocytosis and silences target genes PTEN and PDCD4 which in turn accounts for a net anti-inflammatory phenotype. Findings of this study highlight the significance of miRNAs in the resolution of wound inflammation. PMID:24391209

Effects of dicyandiamide and acetylene on N2O emissions and ammonia oxidizers in a fluvo-aquic soil applied with urea.

PubMed

Wang, Qing; Zhang, Li-Mei; Shen, Ju-Pei; Du, Shuai; Han, Li-Li; He, Ji-Zheng

2016-11-01

Ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) are crucial for N 2 O emission as they carry out the key step of nitrification. Dicyandiamide (DCD) and acetylene (C 2 H 2 ) are typical nitrification inhibitors (NIs), while the comparative effects of these NIs on N 2 O production and ammonia oxidizers' (AOB and AOA) growth are unclear. Four treatments including a control, urea, urea + DCD, and urea + C 2 H 2 were set up to investigate their effect of inhibiting soil nitrification, nitrification-related N 2 O emission as well as the growth of ammonia oxidizers with a fluvo-aquic soil using microcosms for 28 days. N 2 O emission and net nitrification rate increased after the application of urea, but were significantly restrained in urea + NI treatments, while C 2 H 2 was more effective in reducing N 2 O emission and nitrification rate than DCD. The abundance of AOB, which was significantly correlated with N 2 O emission and net nitrification rate, was more inhibited by C 2 H 2 than DCD. Furthermore, the application of urea in all the soils had little impact on the AOA community, while obvious shifts of AOB community structure were found compared with the control. All AOB sequences fell within Nitrosospira cluster 3, and the AOA community was clustered to group 1.1b. Collectively, it indicated that application of urea combined with NIs (DCD or C 2 H 2 ) could potentially alter N 2 O emission, mainly through regulating the growth of AOB but not AOA in this fluvo-aquic soil.

A novel redox-active metalloporphyrin reduces reactive oxygen species and inflammatory markers but does not improve marginal mass engraftment in a murine donation after circulatory death islet transplantation model

PubMed Central

Bruni, Antonio; Pepper, Andrew R.; Gala-Lopez, Boris; Pawlick, Rena; Abualhassan, Nasser; Crapo, James D.; Piganelli, Jon D.; Shapiro, A. M. James

2016-01-01

ABSTRACT Islet transplantation is a highly effective treatment for stabilizing glycemic control for select patients with type-1 diabetes. Despite improvements to clinical transplantation, single-donor transplant success has been hard to achieve routinely, necessitating increasing demands on viable organ availability. Donation after circulatory death (DCD) may be an alternative option to increase organ availability however, these organs tend to be more compromised. The use of metalloporphyrin anti-inflammatory and antioxidant (MnP) compounds previously demonstrated improved in vivo islet function in preclinical islet transplantation. However, the administration of MnP (BMX-001) in a DCD islet isolation and transplantation model has yet to be established. In this study, murine donors were subjected to a 15-min warm ischemic (WI) period prior to isolation and culture with or without MnP. Subsequent to one-hour culture, islets were assessed for in vitro viability and in vivo function. A 15-minute WI period significantly reduced islet yield, regardless of MnP-treatment relative to yields from standard isolation. MnP-treated islets did not improve islet viability compared to DCD islets alone. MnP-treatment did significantly reduce the presence of extracellular reactive oxygen species (ROS) (p < 0 .05). Marginal, syngeneic islets (200 islets) transplanted under the renal capsule exhibited similar in vivo outcomes regardless of WI or MnP-treatment. DCD islet grafts harvested 7 d post-transplant exhibited sustained TNF-α and IL-10, while MnP-treated islet-bearing grafts demonstrated reduced IL-10 levels. Taken together, 15-minute WI in murine islet isolation significantly impairs islet yield. DCD islets do indeed demonstrate in vivo function, though MnP therapy was unable to improve viability and engraftment outcomes. PMID:27220256

A novel redox-active metalloporphyrin reduces reactive oxygen species and inflammatory markers but does not improve marginal mass engraftment in a murine donation after circulatory death islet transplantation model.

PubMed

Bruni, Antonio; Pepper, Andrew R; Gala-Lopez, Boris; Pawlick, Rena; Abualhassan, Nasser; Crapo, James D; Piganelli, Jon D; Shapiro, A M James

2016-07-03

Islet transplantation is a highly effective treatment for stabilizing glycemic control for select patients with type-1 diabetes. Despite improvements to clinical transplantation, single-donor transplant success has been hard to achieve routinely, necessitating increasing demands on viable organ availability. Donation after circulatory death (DCD) may be an alternative option to increase organ availability however, these organs tend to be more compromised. The use of metalloporphyrin anti-inflammatory and antioxidant (MnP) compounds previously demonstrated improved in vivo islet function in preclinical islet transplantation. However, the administration of MnP (BMX-001) in a DCD islet isolation and transplantation model has yet to be established. In this study, murine donors were subjected to a 15-min warm ischemic (WI) period prior to isolation and culture with or without MnP. Subsequent to one-hour culture, islets were assessed for in vitro viability and in vivo function. A 15-minute WI period significantly reduced islet yield, regardless of MnP-treatment relative to yields from standard isolation. MnP-treated islets did not improve islet viability compared to DCD islets alone. MnP-treatment did significantly reduce the presence of extracellular reactive oxygen species (ROS) (p < 0 .05). Marginal, syngeneic islets (200 islets) transplanted under the renal capsule exhibited similar in vivo outcomes regardless of WI or MnP-treatment. DCD islet grafts harvested 7 d post-transplant exhibited sustained TNF-α and IL-10, while MnP-treated islet-bearing grafts demonstrated reduced IL-10 levels. Taken together, 15-minute WI in murine islet isolation significantly impairs islet yield. DCD islets do indeed demonstrate in vivo function, though MnP therapy was unable to improve viability and engraftment outcomes.

Do motor ability and handwriting kinematic measures predict organizational ability among children with Developmental Coordination Disorders?

PubMed

Rosenblum, Sara

2015-10-01

Children with Developmental Coordination Disorders (DCD) exhibit deficient daily performance concealed in their perception-action mechanism. The aim of this study was to analyze behavior organization of children with DCD, in varied tasks that require generating and monitoring mental representations related to space and time inputs/requirements, for achieving better insight about their perception-action mechanism. Participants included 42 children aged 7-10, half of whom were defined with DCD and half were typically developing (TD). The children were matched for age, gender and school. They were evaluated using the Movement-ABC and performed three handwriting tasks on an electronic tablet that is part of a computerized system (ComPET - Computerized Penmanship Evaluation Tool). In addition, their teachers completed the Questionnaire for Assessing Students' Organizational Abilities-Teachers (QASOA-T) to assess the children's daily organizational ability. Significant group differences (DCD versus controls) were found for all handwriting kinematic measures across the three handwriting tasks and for the children's organizational abilities. Motor ability predicted a considerable percentage of the variance of the kinematic handwriting measures (30-37%), as well as a high percentage of the variance of their organizational abilities (67%). The coefficient of variance of the pen tilt added an additional 3% to the prediction of their organizational abilities. The results of this study exhibited deficient ability among children with DCD in organizing their behavior in varied real-world tasks requiring generation and monitoring representation related to space and time. The significance of the results to understanding the performance mechanism and implication to the clinical field are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Defining the neuroanatomic basis of motor coordination in children and its relationship with symptoms of attention-deficit/hyperactivity disorder.

PubMed

Shaw, P; Weingart, D; Bonner, T; Watson, B; Park, M T M; Sharp, W; Lerch, J P; Chakravarty, M M

2016-08-01

When children have marked problems with motor coordination, they often have problems with attention and impulse control. Here, we map the neuroanatomic substrate of motor coordination in childhood and ask whether this substrate differs in the presence of concurrent symptoms of attention-deficit/hyperactivity disorder (ADHD). Participants were 226 children. All completed Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)-based assessment of ADHD symptoms and standardized tests of motor coordination skills assessing aiming/catching, manual dexterity and balance. Symptoms of developmental coordination disorder (DCD) were determined using parental questionnaires. Using 3 Tesla magnetic resonance data, four latent neuroanatomic variables (for the cerebral cortex, cerebellum, basal ganglia and thalamus) were extracted and mapped onto each motor coordination skill using partial least squares pathway modeling. The motor coordination skill of aiming/catching was significantly linked to latent variables for both the cerebral cortex (t = 4.31, p < 0.0001) and the cerebellum (t = 2.31, p = 0.02). This effect was driven by the premotor/motor cortical regions and the superior cerebellar lobules. These links were not moderated by the severity of symptoms of inattention, hyperactivity and impulsivity. In categorical analyses, the DCD group showed atypical reduction in the volumes of these regions. However, the group with DCD alone did not differ significantly from those with DCD and co-morbid ADHD. The superior cerebellar lobules and the premotor/motor cortex emerged as pivotal neural substrates of motor coordination in children. The dimensions of these motor coordination regions did not differ significantly between those who had DCD, with or without co-morbid ADHD.

Services for children with developmental co-ordination disorder: an evaluation against best practice principles.

PubMed

Pentland, Jacqueline; Maciver, Donald; Owen, Christine; Forsyth, Kirsty; Irvine, Linda; Walsh, Mike; Crowe, Miriam

2016-01-01

The National Health Service in Scotland published a best practice framework to support occupational therapists and physiotherapists to deliver effective services for children with developmental co-ordination disorder (DCD); however, adherence is variable. To highlight areas for development, this study compared the care pathway within a paediatric DCD service against the NHS Scotland framework. A partnership of researchers and clinicians based in the United Kingdom conducted a qualitative study with 37 participants (N = 13 interview participants, N = 24 workshop participants). In-depth interviews and/or workshops were used to map the DCD service against the NHS framework. Identified gaps were aligned with four key stages of the care pathway. Qualitative analysis software was used to analyse the data. Core principles to guide future development were identified for each phase of the pathway. These core principles related to the NHS framework and focused on issues such as involving the family, defining clear pathways and enhancing children's participation. Participants identified potential strategies for service improvement such as developing community-based interventions and information provision. Challenges when providing services for children with DCD include confusing service pathways and poor partnership working. It is, therefore, important that clinicians utilise collaborative working strategies that support children's participation. There are numerous challenges related to the implementation of best practice principles into the provision of therapy services for children with developmental coordination disorder (DCD). It is important that AHPs seek ways of engaging parents and educational professionals at all stages of the care pathway in order to ensure optimum service provision for the child. Addressing participation is an important aspect and community-based strategies may be particularly beneficial, both as a preventative activity and as an intervention approach.

Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD.

PubMed

Flapper, Boudien C T; Schoemaker, Marina M

2008-04-01

Measurement of health-related quality of life (HRQOL) in attention-deficit-hyperactivity disorder (ADHD) gives a more complete picture of day-to-day functioning and treatment effects than behavioural rating alone. The aim of this pilot study was to investigate the impact of the combined diagnoses of developmental coordination disorder (DCD) and ADHD on HRQOL, and the effectiveness of methylphenidate (MPH) on HRQOL. HRQOL was established using the Dutch-Child-AZL-TNO-Quality-of-Life (DUX-25) and the TNO-AZL-Child-Quality-of-Life (TACQOL) questionnaires, completed by children and parents. HRQOL of these children was compared with that of 23 age- and sex-matched healthy controls. Twenty-three children (21 males, two females; mean age 8 y 6 mo, [SD 3 mo] range 7 y-10 y 8 mo) with ADHD/DCD entered a 4-week, open-label MPH study, after MPH-sensitivity was established, in a double-blind, placebo-controlled trial. In these children's self- and proxy reports, impact of both DCD and ADHD was reflected in lower general well-being (self and proxy report p=0.001) due to lower functioning in motor (selfp=0.026; proxy 0.001), autonomic (self p<0.001; proxy p=0.047), cognitive (self p=0.001; proxy p=0.01), and social (self and proxy p<0.001) domains. HRQOL scores improved in 18 children receiving MPH (p=0.001) versus controls. The ADHD /DCD group also demonstrated a significant improvement in ADHD symptoms (p<0.001) and motor functioning (p<0.001). Additional motor therapy will still be needed in about half of the children with ADHD/DCD receiving MPH, within multimodal treatment including educational and psychosocial assistance.

Association Between Delayed Graft Function and Graft Loss in Donation After Cardiac Death Kidney Transplants-A Paired Kidney Registry Analysis.

PubMed

Lim, Wai H; McDonald, Stephen P; Russ, Graeme R; Chapman, Jeremy R; Ma, Maggie Km; Pleass, Henry; Jaques, Bryon; Wong, Germaine

2017-06-01

Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry. Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models. Of the 74 pairs of DCD kidneys followed for a median of 1.9 years (408 person-years), a greater proportion of recipients with DGF had experienced overall graft loss and death-censored graft loss at 3 years compared with those without DGF (14% vs 4%, P = 0.04 and 11% vs 0%, P < 0.01, respectively). Compared with recipients without DGF, the adjusted hazard ratio for overall graft loss at 3 years for recipients with DGF was 4.31 (95% confidence interval [95% CI], 1.13-16.44). The adjusted hazard ratio for acute rejection and all-cause mortality at 3 years in recipients who have experienced DGF were 0.98 (95% CI, 0.96-1.01) and 1.70 (95% CI, 0.36-7.93), respectively, compared with recipients without DGF. Recipients of DCD kidneys with DGF experienced a higher incidence of overall and death-censored graft loss compared with those without DGF. Strategies aim to reduce the risk of DGF could potentially improve graft survival in DCD kidney transplants.

Role of donor hemodynamic trajectory in determining graft survival in liver transplantation from donation after circulatory death donors.

PubMed

Firl, Daniel J; Hashimoto, Koji; O'Rourke, Colin; Diago-Uso, Teresa; Fujiki, Masato; Aucejo, Federico N; Quintini, Cristiano; Kelly, Dympna M; Miller, Charles M; Fung, John J; Eghtesad, Bijan

2016-11-01

Donation after circulatory death (DCD) donors show heterogeneous hemodynamic trajectories following withdrawal of life support. Impact of hemodynamics in DCD liver transplant is unclear, and objective measures of graft viability would ease transplant surgeon decision making and inform safe expansion of the donor organ pool. This retrospective study tested whether hemodynamic trajectories were associated with transplant outcomes in DCD liver transplantation (n = 87). Using longitudinal clustering statistical techniques, we phenotyped DCD donors based on hemodynamic trajectory for both mean arterial pressure (MAP) and peripheral oxygen saturation (SpO 2 ) following withdrawal of life support. Donors were categorized into 3 clusters: those who gradually decline after withdrawal of life support (cluster 1), those who maintain stable hemodynamics followed by rapid decline (cluster 2), and those who decline rapidly (cluster 3). Clustering outputs were used to compare characteristics and transplant outcomes. Cox proportional hazards modeling revealed hepatocellular carcinoma (hazard ratio [HR] = 2.53; P = 0.047), cold ischemia time (HR = 1.50 per hour; P = 0.027), and MAP cluster 1 were associated with increased risk of graft loss (HR = 3.13; P = 0.021), but not SpO 2 cluster (P = 0.172) or donor warm ischemia time (DWIT; P = 0.154). Despite longer DWIT, MAP and SpO 2 clusters 2 showed similar graft survival to MAP and SpO 2 clusters 3, respectively. In conclusion, despite heterogeneity in hemodynamic trajectories, DCD donors can be categorized into 3 clinically meaningful subgroups that help predict graft prognosis. Further studies should confirm the utility of liver grafts from cluster 2. Liver Transplantation 22 1469-1481 2016 AASLD. © 2016 by the American Association for the Study of Liver Diseases.

Expanding the donor lung pool: how many donations after circulatory death organs are we missing?

PubMed

Chancellor, William Zachary; Charles, Eric J; Mehaffey, James Hunter; Hawkins, Robert B; Foster, Carrie A; Sharma, Ashish K; Laubach, Victor E; Kron, Irving L; Tribble, Curtis G

2018-03-01

The number of patients with end-stage pulmonary disease awaiting lung transplantation is at an all-time high, while the supply of available organs remains stagnant. Utilizing donation after circulatory death (DCD) donors may help to address the supply-demand mismatch. The objective of this study is to determine the potential donor pool expansion with increased procurement of DCD organs from patients who die at hospitals. The charts of all patients who died at a single, rural, quaternary-care institution between August 2014 and June 2015 were reviewed for lung transplant candidacy. Inclusion criteria were age <65 y, absence of cancer and lung pathology, and cause of death other than respiratory or sepsis. A total of 857 patients died within a 1-year period and were stratified by age: pediatric <15 y (n = 32, 4%), young 15-64 y (n = 328, 38%), and old >65 y (n = 497, 58%). Those without cancer totaled 778 (90.8%) and 512 (59%) did not have lung pathology. This leaves 85 patients qualifying for DCD lung donation (pediatric n = 10, young n = 75, and old n = 0). Potential donors were significantly more likely to have clear chest X-rays (24.3% versus 10.0%, P < 0.0001) and higher mean PaO2/FiO2 (342.1 versus 197.9, P < 0.0001) compared with ineligible patients. A significant number of DCD lungs are available every year from patients who die within hospitals. We estimate the use of suitable DCD lungs could potentially result in a significant increase in the number of lungs available for transplantation. Copyright © 2017 Elsevier Inc. All rights reserved.

Ammonia and greenhouse gas emissions from a subtropical wheat field under different nitrogen fertilization strategies.

PubMed

Liu, Shuai; Wang, Jim J; Tian, Zhou; Wang, Xudong; Harrison, Stephen

2017-07-01

Minimizing soil ammonia (NH 3 ) and nitrous oxide (N 2 O) emission factors (EFs) has significant implications in regional air quality and greenhouse gas (GHG) emissions besides nitrogen (N) nutrient loss. The aim of this study was to investigate the impacts of different N fertilizer treatments of conventional urea, polymer-coated urea, ammonia sulfate, urease inhibitor (NBPT, N-(n-butyl) thiophosphoric triamide)-treated urea, and nitrification inhibitor (DCD, dicyandiamide)-treated urea on emissions of NH 3 and GHGs from subtropical wheat cultivation. A field study was established in a Cancienne silt loam soil. During growth season, NH 3 emission following N fertilization was characterized using active chamber method whereas GHG emissions of N 2 O, carbon dioxide (CO 2 ), and methane (CH 4 ) were by passive chamber method. The results showed that coated urea exhibited the largest reduction (49%) in the EF of NH 3 -N followed by NBPT-treated urea (39%) and DCD-treated urea (24%) over conventional urea, whereas DCD-treated urea had the greatest suppression on N 2 O-N (87%) followed by coated urea (76%) and NBPT-treated urea (69%). Split fertilization of ammonium sulfate-urea significantly lowered both NH 3 -N and N 2 O-N EF values but split urea treatment had no impact over one-time application of urea. Both NBPT and DCD-treated urea treatments lowered CO 2 -C flux but had no effect on CH 4 -C flux. Overall, application of coated urea or urea with NPBT or DCD could be used as a mitigation strategy for reducing NH 3 and N 2 O emissions in subtropical wheat production in Southern USA. Copyright © 2017. Published by Elsevier B.V.

[Liver transplant with donated graft after controlled cardiac death. Current situation].

PubMed

Abradelo De Usera, Manuel; Jiménez Romero, Carlos; Loinaz Segurola, Carmelo; Moreno González, Enrique

2013-11-01

An increasing pressure on the liver transplant waiting list, forces us to explore new sources, in order to expand the donor pool. One of the most interesting and with a promising potential, is donation after cardiac death (DCD). Initially, this activity has developed in Spain by means of the Maastricht type II donation in the uncontrolled setting. For different reasons, donation after controlled cardiac death has been reconsidered in our country. The most outstanding circumstance involved in DCD donation is a potential ischemic stress, that could cause severe liver graft cell damage, resulting in an adverse effect on liver transplant results, in terms of complications and outcomes. The complex and particular issues related to DCD Donation will be discussed in this review. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

Lipidomics comparing DCD and DBD liver allografts uncovers lysophospholipids elevated in recipients undergoing early allograft dysfunction.

PubMed

Xu, Jin; Casas-Ferreira, Ana M; Ma, Yun; Sen, Arundhuti; Kim, Min; Proitsi, Petroula; Shkodra, Maltina; Tena, Maria; Srinivasan, Parthi; Heaton, Nigel; Jassem, Wayel; Legido-Quigley, Cristina

2015-12-04

Finding specific biomarkers of liver damage in clinical evaluations could increase the pool of available organs for transplantation. Lipids are key regulators in cell necrosis and hence this study hypothesised that lipid levels could be altered in organs suffering severe ischemia. Matched pre- and post-transplant biopsies from donation after circulatory death (DCD, n = 36, mean warm ischemia time = 2 min) and donation after brain death (DBD, n = 76, warm ischemia time = none) were collected. Lipidomic discovery and multivariate analysis (MVA) were applied. Afterwards, univariate analysis and clinical associations were conducted for selected lipids differentiating between these two groups. MVA grouped DCD vs. DBD (p = 6.20 × 10(-12)) and 12 phospholipids were selected for intact lipid measurements. Two lysophosphatidylcholines, LysoPC (16:0) and LysoPC (18:0), showed higher levels in DCD at pre-transplantation (q < 0.01). Lysophosphatidylcholines were associated with aspartate aminotransferase (AST) 14-day post-transplantation (q < 0.05) and were more abundant in recipients undergoing early allograft dysfunction (EAD) (p < 0.05). A receiver-operating characteristics (ROC) curve combining both lipid levels predicted EAD with 82% accuracy. These findings suggest that LysoPC (16:0) and LysoPC (18:0) might have a role in signalling liver tissue damage due to warm ischemia before transplantation.

Developmental coordination disorders: state of art.

PubMed

Vaivre-Douret, L

2014-01-01

In the literature, descriptions of children with motor coordination difficulties and clumsy movements have been discussed since the early 1900s. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is a marked impairment in the development of fine or global motor coordination, affecting 6% of school-age children. All these children are characterized for developmental coordination disorder (DCD) in motor learning and new motor skill acquisition, in contrast to adult apraxia which is a disorder in the execution of already learned movements. No consensus has been established about etiology of DCD. Intragroup approach through factor and cluster analysis highlights that motor impairment in DCD children varies both in severity and nature. Indeed, most studies have used screening measures of performance on some developmental milestones derived from global motor tests. A few studies have investigated different functions together with standardized assessments, such as neuromuscular tone and soft signs, qualitative and quantitative measures related to gross and fine motor coordination and the specific difficulties -academic, language, gnosic, visual motor/visual-perceptual, and attentional/executive- n order to allow a better identification of DCD subtypes with diagnostic criteria and to provide an understanding of the mechanisms and of the cerebral involvement. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

microRNA-124-3p inhibits the progression of congenital hypothyroidism via targeting programmed cell death protein 6.

PubMed

Li, Wenjie; Song, Dongpo; Sun, Yingmei; Lv, Yanan; Lv, Jinfeng

2018-06-01

The incidence of congenital hypothyroidism (CH) in newborn infants ranges from 1 in 3,000 to 1 in 4,000. Previous studies have indicated the neuroprotective role of microRNA (miR)-124-3p, however the expression and role of miR-124-3p in CH remain unclear. Therefore, the present study was performed to investigate the role and precise molecular mechanism of miR-124-3p in CH. Propylthiouracil (50 mg/day) was injected into the stomach of pregnant rats from gestational day 15 until parturition in order to establish a thyroid hypofunction model. Newborn rats were divided into the following four groups: The control group; the thyroid hypofunction group; the miR-124-3p mimic group; and the miR-124-3p negative control group. Reverse transcription-quantitative polymerase chain reaction indicated that miR-124-3p was significantly decreased in the hippocampus of the thyroid hypofunction group compared with the control group. Bioinformatics software was used to predict mRNA targets recognized by miR-124-3p and the programmed cell death protein 6 (PDCD6) 3' untranslated region (UTR) was demonstrated to exhibit the seed sequence of miR-124-3p. The interaction between miRNA-124-3p and PDCD6 was then verified using a dual-luciferase reporter assay system. PDCD6 expression was significantly increased in the hippocampus of rats with CH compared with the control group. Flow cytometry was performed to investigate the effects of miR-124-3p on neuronal cell apoptosis and the results indicated that the apoptosis rate in the thyroid hypofunction group was significantly increased compared with the control group; this increase was reversed by transfection with miR-124-3p mimics. Western blot analysis was used to detect the levels of cleaved poly [ADP-ribose] polymerase (PARP), full-length PARP, caspase-3, B cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax) proteins. The results indicated that the expression of cleaved PARP, caspase-3 and Bax protein were significantly increased and the expression of full-length PARP and Bcl-2 protein was significantly decreased compared with the control group. These effects were reversed by miRNA-124-3p mimic transfection. Taken together, the results of the present study demonstrate that miRNA-124-3p serves a protective role in CH via targeting PDCD6.

Differential Effect of Taekwondo Training on Knee Muscle Strength and Reactive and Static Balance Control in Children with Developmental Coordination Disorder: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Fong, Shirley S. M.; Chung, Joanne W. Y.; Chow, Lina P. Y.; Ma, Ada W. W.; Tsang, William W. N.

2013-01-01

This randomized controlled trial aimed to investigate the effect of short-term intensive TKD training on the isokinetic knee muscle strength and reactive and static balance control of children with developmental coordination disorder (DCD). Among the 44 children with DCD (mean age: 7.6 plus or minus 1.3 years) recruited, 21 were randomly assigned…

Liver Transplant From Unexpected Donation After Circulatory Determination of Death Donors: A Challenge in Perioperative Management.

PubMed

Blasi, A; Hessheimer, A J; Beltrán, J; Pereira, A; Fernández, J; Balust, J; Martínez-Palli, G; Fuster, J; Navasa, M; García-Valdecasas, J C; Taurá, P; Fondevila, C

2016-06-01

Unexpected donation after circulatory determination of death (uDCD) liver transplantation is a complex procedure, in particular when it comes to perioperative recipient management. However, very little has been published to date regarding intraoperative and immediate postoperative care in this setting. Herein, we compare perioperative events in uDCD liver recipients with those of a matched group of donation after brain death liver recipients. We demonstrate that the former group of recipients suffers significantly greater hemodynamic instability and derangements in coagulation following graft reperfusion. Based on our experience, we recommend a proactive recipient management strategy in uDCD liver transplantation that involves early use of vasopressor support; maintaining adequate intraoperative levels of red cells, platelets, and fibrinogen; and routinely administering tranexamic acid before graft reperfusion. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

The inability to mentally represent action may be associated with performance deficits in children with developmental coordination disorder.

PubMed

Gabbard, Carl; Bobbio, Tatiana

2011-03-01

Several research studies indicate that children with developmental coordination disorder (DCD) show delays with an array of perceptual-motor skills. One of the explanations, based on limited research, is that these children have problems generating and/or monitoring a mental (action) representation of intended actions, termed the "internal modeling deficit" (IMD) hypothesis. According to the hypothesis, children with DCD have significant limitations in their ability to accurately generate and utilize internal models of motor planning and control. The focus of this review is on one of the methods used to examine action representation-motor imagery, which theorists argue provides a window into the process of action representation (e.g., Jeannerod, 2001 . Neural simulation of action: A unifying mechanism for motor cognition. Neuroimage, 14, 103-109.). Included in the review are performance studies of typically developing and DCD children, and possible brain structures involved.

Developmental Coordination Disorder, An Umbrella Term for Motor Impairments in Children: Nature and Co-Morbid Disorders

PubMed Central

Vaivre-Douret, Laurence; Lalanne, Christophe; Golse, Bernard

2016-01-01

Background: Developmental Coordination Disorder (DCD) defines a heterogeneous class of children exhibiting marked impairment in motor coordination as a general group of deficits in fine and gross motricity (subtype mixed group) common to all research studies, and with a variety of other motor disorders that have been little investigated. No consensus about symptoms and etiology has been established. Methods: Data from 58 children aged 6 to 13 years with DCD were collected on DSM-IV criteria, similar to DSM-5 criteria. They had no other medical condition and inclusion criteria were strict (born full-term, no medication, no occupational/physical therapy). Multivariate statistical methods were used to evidence relevant interactions between discriminant features in a general DCD subtype group and to highlight specific co-morbidities. The study examined age-calibrated standardized scores from completed assessments of psychological, neuropsychological, and neuropsychomotor functions, and more specifically the presence of minor neurological dysfunctions (MND) including neurological soft signs (NSS), without evidence of focal neurological brain involvement. These were not considered in most previous studies. Results: Findings show the salient DCD markers for the mixed subtype (imitation of gestures, digital perception, digital praxia, manual dexterity, upper, and lower limb coordination), vs. surprising co-morbidities, with 33% of MND with mild spasticity from phasic stretch reflex (PSR), not associated with the above impairments but rather with sitting tone (p = 0.004) and dysdiadochokinesia (p = 0.011). PSR was not specific to a DCD subtype but was related to increased impairment of coordination between upper and lower limbs and manual dexterity. Our results highlight the major contribution of an extensive neuro-developmental assessment (mental and physical). Discussion: The present study provides important new evidence in favor of a complete physical neuropsychomotor assessment, including neuromuscular tone examination, using appropriate standardized neurodevelopmental tools (common tasks across ages with age-related normative data) in order to distinguish motor impairments gathered under the umbrella term of developmental coordination disorders (subcortical vs. cortical). Mild spasticity in the gastrocnemius muscles, such as phasic stretch reflex (PSR), suggests disturbances of the motor pathway, increasing impairment of gross and fine motricity. These findings contribute to understanding the nature of motor disorders in DCD by taking account of possible co-morbidities (corticospinal tract disturbances) to improve diagnosis and adapt treatment programmes in clinical practice. PMID:27148114

Organ procurement after cardiocirculatory death: a critical analysis.

PubMed

Rady, Mohamed Y; Verheijde, Joseph L; McGregor, Joan

2008-01-01

To shorten the transplantation waiting time in the United States, federal regulations have been introduced requiring hospitals to develop policies for organ donation after cardiac (or circulatory) death (DCD). The practice of DCD is invoked based on the validity of the University of Pittsburgh Medical Center (UPMC) protocol and relies on the accuracy of the University of Wisconsin (UW) evaluation tool to appropriately identify organ donors. There is little evidence to support the position that the criteria for organ procurement adopted from the UPMC protocol complies with the dead donor rule. A high false-positive rate of the UW evaluation tool can expose many dying patients to unnecessary perimortem interventions because of donation failure. The medications and/or interventions for the sole purpose of maintaining organ viability can have unintended negative consequences on the timing and quality of end-of-life care offered to organ donors. It is essential to address and manage the evolving conflict between optimal end-of-life care and the necessary sacrifices for the procurement of transplantable organs from the terminally ill. The recipients of marginal organs recovered from DCD can also suffer higher mortality and morbidity than recipients of other types of donated organs. Finally, transparent disclosure to the public of the risks involved to both organ donors and recipients may contribute to open societal debate on the ethical acceptability of DCD.

[Organ donation after circulatory death].

PubMed

de Jonge, J; Kalisvaart, M; van der Hoeven, M; Epker, J; de Haan, J; IJzermans, J N M; Grüne, F

2016-02-01

Approximately 17 million inhabitants live in the Netherlands. The number of potential organ donors in 1999 was the lowest in Europe with only 10 donors per million inhabitants. Medical associations, public health services, health insurance companies and the government had to find common solutions in order to improve organ allocation, logistics of donations and to increase the number of transplantations. After a prolonged debate on medical ethical issues of organ transplantation, all participants were able to agree on socio-medico-legal regulations for organ donation and transplantation. In addition to improving the procedure for organ donation after brain death (DBD) the most important step was the introduction of organ donation after circulatory death (DCD). Measures such as the introduction of a national organ donor database, improved information to the public, further education on intensive care units (ICU), guidelines for end of life care on the ICU, establishment of transplantation coordinators on site, introduction of autonomous explantation teams and strict procedures on the course of organ donations, answered many practical issues about logistics and responsibilities for DBD and DCD. In 2014 the number of postmortem organ donations rose to 16.4 per million inhabitants. Meanwhile, up to 60 % of organ donations in the Netherlands originate from a DCD procedure compared to approximately 10 % in the USA. This overview article discusses the developments and processes of deceased donation in the Netherlands after 15 years of experience with DCD.

Hypothermic oxygenated machine perfusion reduces bile duct reperfusion injury after transplantation of donation after circulatory death livers

PubMed Central

van Rijn, Rianne; van Leeuwen, Otto B.; Matton, Alix P. M.; Burlage, Laura C.; Wiersema‐Buist, Janneke; van den Heuvel, Marius C.; de Kleine, Ruben H. J.; de Boer, Marieke T.; Gouw, Annette S. H.

2018-01-01

Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia/reperfusion injury (IRI). This study aimed to determine whether DHOPE reduces IRI of the bile ducts in donation after circulatory death (DCD) liver transplantation. In a recently performed phase 1 trial, 10 DCD livers were preserved with DHOPE after static cold storage (SCS; http://www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient. Histological severity of biliary injury was graded according to an established semiquantitative grading system. Twenty liver transplantations using DCD livers not preserved with DHOPE served as controls. Baseline characteristics and the degree of bile duct injury at baseline (end of SCS) were similar between both groups. In controls, the degree of stroma necrosis (P = 0.002) and injury of the deep peribiliary glands (PBG; P = 0.02) increased after reperfusion compared with baseline. In contrast, in DHOPE‐preserved livers, the degree of bile duct injury did not increase after reperfusion. Moreover, there was less injury of deep PBG (P = 0.04) after reperfusion in the DHOPE group compared with controls. In conclusion, this study suggests that DHOPE reduces IRI of bile ducts after DCD liver transplantation. Liver Transplantation 24 655–664 2018 AASLD. PMID:29369470

Dual Constant Domain-Fab: A novel strategy to improve half-life and potency of a Met therapeutic antibody.

PubMed

Cignetto, Simona; Modica, Chiara; Chiriaco, Cristina; Fontani, Lara; Milla, Paola; Michieli, Paolo; Comoglio, Paolo M; Vigna, Elisa

2016-06-01

The kinase receptor encoded by the Met oncogene is a sensible target for cancer therapy. The chimeric monovalent Fab fragment of the DN30 monoclonal antibody (MvDN30) has an odd mechanism of action, based on cell surface removal of Met via activation of specific plasma membrane proteases. However, the short half-life of the Fab, due to its low molecular weight, is a severe limitation for the deployment in therapy. This issue was addressed by increasing the Fab molecular weight above the glomerular filtration threshold through the duplication of the constant domains, in tandem (DCD-1) or reciprocally swapped (DCD-2). The two newly engineered molecules showed biochemical properties comparable to the original MvDN30 in vitro, acting as full Met antagonists, impairing Met phosphorylation and activation of downstream signaling pathways. As a consequence, Met-mediated biological responses were inhibited, including anchorage-dependent and -independent cell growth. In vivo DCD-1 and DCD-2 showed a pharmacokinetic profile significantly improved over the original MvDN30, doubling the circulating half-life and reducing the clearance. In pre-clinical models of cancer, generated by injection of tumor cells or implant of patient-derived samples, systemic administration of the engineered molecules inhibited the growth of Met-addicted tumors. Copyright © 2016 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

A novel combination technique of cold crystalloid perfusion but not cold storage facilitates transplantation of canine hearts donated after circulatory death.

PubMed

Rosenfeldt, Franklin; Ou, Ruchong; Salamonsen, Robert; Marasco, Silvana; Zimmet, Adam; Byrne, Joshua; Cosic, Filip; Saxena, Pankaj; Esmore, Donald

2016-11-01

Donation after circulatory death (DCD) represents a potential new source of hearts to increase the donor pool. We showed previously that DCD hearts in Greyhound dogs could be resuscitated and preserved by continuous cold crystalloid perfusion but not by cold static storage and could demonstrate excellent contractile and metabolic function on an in vitro system. In the current study, we demonstrate that resuscitated DCD hearts are transplantable. Donor Greyhound dogs (n = 12) were divided into perfusion (n = 8) and cold static storage (n = 4) groups. General anesthesia was induced and ventilation ceased for 30 minutes to achieve circulatory death. Donor cardiectomy was performed, and for 4 hours the heart was preserved by controlled reperfusion, followed by continuous cold perfusion with an oxygenated crystalloid perfusate or by static cold storage, after which orthotopic heart transplantation was performed. Recovery was assessed over 4 hours by hemodynamic monitoring. During cold perfusion, hearts showed continuous oxygen consumption and low lactate levels, indicating aerobic metabolism. The 8 dogs in the perfusion group were weaned off bypass, and 4 hours after bypass produced cardiac output of 4.73 ± 0.51 liters/min, left ventricular power of 7.63 ± 1.32 J/s, right ventricular power of 1.40 ± 0.43 J/s, and left ventricular fractional area shortening of 39.1% ± 5.2%, all comparable to pre-transplant values. In the cold storage group, 3 of 4 animals could not be weaned from cardiopulmonary bypass, and the fourth exhibited low-level function. Cold crystalloid perfusion, but not cold static storage, can resuscitate and preserve the DCD donor heart in a canine model of heart transplantation, thus rendering it transplantable. Controlled reperfusion and cold crystalloid perfusion have potential for clinical application in DCD transplantation. Copyright © 2016. Published by Elsevier Inc.

Improving National Results in Liver Transplantation Using Grafts From Donation After Cardiac Death Donors.

PubMed

Croome, Kristopher P; Lee, David D; Keaveny, Andrew P; Taner, C Burcin

2016-12-01

Published reports describing the national experience with liver grafts from donation after cardiac death (DCD) donors have resulted in reservations with their widespread utilization. The present study aimed to investigate if temporal improvements in outcomes have been observed on a national level and to determine if donor and recipient selection have been modified in a fashion consistent with published data on DCD use in liver transplantation (LT). Patients undergoing DCD LT between 2003 and 2014 were obtained from the United Network of Organ Sharing Standard Transplant Analysis and Research file and divided into 3 equal eras based on the date of DCD LT: era 1 (2003-2006), era 2 (2007-2010), and era 3 (2011-2014). Improvement in graft survival was seen between era 1 and era 2 (P = 0.001) and between era 2 and era 3 (P < 0.001). Concurrently, an increase in the proportion of patients with hepatocellular carcinoma and a decrease in critically ill patients, retransplant recipients, donor age, warm ischemia time greater than 30 minutes and cold ischemic time also occurred over the same period. On multivariate analysis, significant predictors of graft survival included: recipient age, biologic MELD score, recipient on ventilator, recipient hepatitis C virus + serology, donor age and cold ischemic time. In addition, even after adjustment for all of the aforementioned variables, both era 2 (hazard ratio, 0.81; confidence interval, 0.69-0.94; P = 0.007), and era 3 (hazard ratio, 0.61; confidence interval, 0.5-0.73; P < 0.001) had a protective effect compared to era 1. The national outcomes for DCD LT have improved over the last 12 years. This change was associated with modifications in both recipient and donor selection. Furthermore, an era effect was observed, even after adjustment for all recipient and donor variables on multivariate analysis.

When an object appears unexpectedly: anticipatory movement and object circumvention in individuals with and without Developmental Coordination Disorder.

PubMed

Wilmut, K; Barnett, A L

2017-05-01

Obstacles often appear unexpectedly in our pathway and these require us to make adjustments to avoid collision. Previous research has demonstrated that healthy adults will make anticipatory adjustments to gait where they have been told there is the possibility of an obstacle appearing. One population that may find this type of anticipatory movement difficult is individuals with Developmental Coordination Disorder (DCD). The current study considered how individuals with and without DCD adjust to the possibility of an obstacle appearing which would require circumvention. Fortyfour individuals with DCD and 44 age-matched controls (aged from 7 to 34 years of age) walked down an 11 m walkway under three conditions. Initially they were told this was a clear pathway and nothing in the environment would change (1, no possibility of an obstacle, no obstacle). They then performed a series of trials in which a gate may (2, possibility of an obstacle, obstacle) or may not (3, possibility of an obstacle, no obstacle) partially obstruct their pathway. We found that all participants increased medio-lateral trunk acceleration when there was the possibility of an obstacle but before the obstacle appeared, in addition the typical adults and older children also increased step width. When describing circumvention we found that the younger children showed an increase in trunk velocity and acceleration in all three directions compared to older children and adults. We also found that the individuals with DCD adjusted their path sooner and deviated more than their peers. The degree of adjustment to step width in anticipation of an obstacle was related to later medio-lateral velocity and timing of the deviation. Therefore, the lack of 'readying' the system where there is the possibility of an obstacle appearing seen in the individuals with DCD and the younger typical children may explain the increased medio-lateral velocity seen during circumvention.

Liver graft preservation using perfluorocarbon improves the outcomes of simulated donation after cardiac death liver transplantation in rats.

PubMed

Okumura, Shinya; Uemura, Tadahiro; Zhao, Xiangdong; Masano, Yuki; Tsuruyama, Tatsuaki; Fujimoto, Yasuhiro; Iida, Taku; Yagi, Shintaro; Bezinover, Dmitri; Spiess, Bruce; Kaido, Toshimi; Uemoto, Shinji

2017-09-01

The outcomes of liver transplantation (LT) from donation after cardiac death (DCD) donors remain poor due to severe warm ischemia injury. Perfluorocarbon (PFC) is a novel compound with high oxygen carrying capacity. In the present study, a rat model simulating DCD LT was used, and the impact of improved graft oxygenation provided by PFC addition on liver ischemia/reperfusion injury (IRI) and survival after DCD LT was investigated. Orthotopic liver transplants were performed in male Lewis rats, using DCD liver grafts preserved with cold University of Wisconsin (UW) solution in the control group and preserved with cold oxygenated UW solution with addition of 20% PFC in the PFC group. For experiment I, in a 30-minute donor warm ischemia model, postoperative graft injury was analyzed at 3 and 6 hours after transplantation. For experiment II, in a 50-minute donor warm ischemia model, the postoperative survival was assessed. For experiment I, the levels of serum aspartate aminotransferase, alanine aminotransferase, hyaluronic acid, malondialdehyde, and several inflammatory cytokines were significantly lower in the PFC group. The hepatic expression levels of tumor necrosis factor α and interleukin 6 were significantly lower, and the expression level of heme oxygenase 1 was significantly higher in the PFC group. Histological analysis showed significantly less necrosis and apoptosis in the PFC group. Sinusoidal endothelial cells and microvilli of the bile canaliculi were well preserved in the PFC group. For experiment II, the postoperative survival rate was significantly improved in the PFC group. In conclusion, graft preservation with PFC attenuated liver IRI and improved postoperative survival. This graft preservation protocol might be a new therapeutic option to improve the outcomes of DCD LT. Liver Transplantation 23 1171-1185 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

Preimplant Histologic Acute Tubular Necrosis and Allograft Outcomes

PubMed Central

Hall, Isaac E.; Reese, Peter P.; Weng, Francis L.; Schröppel, Bernd; Doshi, Mona D.; Hasz, Rick D.; Reitsma, William; Goldstein, Michael J.; Hong, Kwangik

2014-01-01

Background and objectives The influence of deceased-donor AKI on post-transplant outcomes is poorly understood. The few published studies about deceased-donor preimplant biopsy have reported conflicting results regarding associations between AKI and recipient outcomes. Design, setting, participants, & measurements This multicenter study aimed to evaluate associations between deceased-donor biopsy reports of acute tubular necrosis (ATN) and delayed graft function (DGF), and secondarily for death-censored graft failure, first adjusting for the kidney donor risk index and then stratifying by donation after cardiac death (DCD) status. Results Between March 2010 and April 2012, 651 kidneys (369 donors, 4 organ procurement organizations) were biopsied and subsequently transplanted, with ATN reported in 110 (17%). There were 262 recipients (40%) who experienced DGF and 38 (6%) who experienced graft failure. DGF occurred in 45% of kidneys with reported ATN compared with 39% without ATN (P=0.31) resulting in a relative risk (RR) of 1.13 (95% confidence interval [95% CI], 0.9 to 1.43) and a kidney donor risk index–adjusted RR of 1.11 (95% CI, 0.88 to 1.41). There was no significant difference in graft failure for kidneys with versus without ATN (8% versus 5%). In stratified analyses, the adjusted RR for DGF with ATN was 0.97 (95% CI, 0.7 to 1.34) for non-DCD kidneys and 1.59 (95% CI, 1.23 to 2.06) for DCD kidneys (P=0.02 for the interaction between ATN and DCD on the development of DGF). Conclusions Despite a modest association with DGF for DCD kidneys, this study reveals no significant associations overall between preimplant biopsy-reported ATN and the outcomes of DGF or graft failure. The potential benefit of more rigorous ATN reporting is unclear, but these findings provide little evidence to suggest that current ATN reports are useful for predicting graft outcomes or deciding to accept or reject allograft offers. PMID:24558049

Donation after cardiac death and the emergency department: ethical issues.

PubMed

Simon, Jeremy R; Schears, Raquel M; Padela, Aasim I

2014-01-01

Organ donation after cardiac death (DCD) is increasingly considered as an option to address the shortage of organs available for transplantation, both in the United States and worldwide. The procedures for DCD differ from procedures for donation after brain death and are likely less familiar to emergency physicians (EPs), even as this process is increasingly involving emergency departments (EDs). This article explores the ED operational and ethical issues surrounding this procedure. © 2013 by the Society for Academic Emergency Medicine.

Utilization of organs from donors after circulatory death for vascularized pancreas and islet of Langerhans transplantation: recommendations from an expert group.

PubMed

Berney, Thierry; Boffa, Catherine; Augustine, Titus; Badet, Lionel; de Koning, Eelco; Pratschke, Johann; Socci, Carlo; Friend, Peter

2016-07-01

Donation after circulatory death (DCD) donors are increasingly being used as a source of pancreas allografts for vascularized organ and islet transplantation. We provide practice guidelines aiming to increase DCD pancreas utilization. We review risk assessment and donor selection criteria. We report suggested factors in donor and recipient clinical management and provide an overview of the activities and outcomes of vascularized pancreas and islet transplantation. © 2015 Steunstichting ESOT.

Association of PDCD1 polymorphism to systemic lupus erythematosus and rheumatoid arthritis susceptibility.

PubMed

do Canto, Luisa Matos; Farias, Ticiana Della Justina; Medeiros, Mayara Delagnelo; Coêlho, Cíntia Callegari; Sereia, Aline Fernanda Rodrigues; de Carlos Back, Lia Kubelka Fernandes; de Mello, Filipe Martins; Zimmermann, Adriana Fontes; Pereira, Ivânio Alves; de Souza, Ilíada Rainha

This study aims to analyze the relationship of programmed cell death 1 (PDCD1) gene polymorphism (PD1.3G/A - rs11568821) with features of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in a Southern Brazilian population. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was performed in 95 SLE and 87 RA patients and 128 control group individuals from Santa Catarina, Southern Brazil. The Hardy-Weinberg equilibrium (HWE) test, and odds ratio (OR) were analyzed, considering CI 95% and p≤0.05. The PD1.3A allele frequencies were 0.095 (SLE), 0.115 (RA) and 0.078 (controls). The genotypes of the control group were in HWE, while those of SLE and RA patients were not. However, we found no association between PD1.3 polymorphism and the SLE or RA susceptibility, nor clinical or epidemiological data. There was no significant association between PD1.3 polymorphism and SLE or RA susceptibility in this Southern Brazilian population. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

Association of PDCD1 polymorphism to Systemic Lupus Erythematosus and Rheumatoid Arthritis susceptibility.

PubMed

Canto, Luisa Matos do; Farias, Ticiana Della Justina; Medeiros, Mayara Delagnelo; Coêlho, Cíntia Callegari; Sereia, Aline Fernanda Rodrigues; Back, Lia Kubelka Fernandes de Carlos; Mello, Filipe Martins de; Zimmermann, Adriana Fontes; Pereira, Ivânio Alves; Souza, Ilíada Rainha de

2015-07-17

This study aims to analyze the relationship of programmed cell death 1 (PDCD1) gene polymorphism (PD1.3G/A - rs11568821) with features of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) in a Southern Brazilian population. Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) was performed in 95 SLE and 87 RA patients and 128 control group individuals from Santa Catarina, Southern Brazil. The Hardy-Weinberg Equilibrium (HWE) test, and odds ratio (OR) were analyzed, considering CI 95% and p≤0.05. The PD1.3A allele frequencies were 0.095 (SLE), 0.115 (RA) and 0.078 (controls). The genotypes of the control group were in HWE, while those of SLE and RA patients were not. However, we found no association between PD1.3 polymorphism and the SLE or RA susceptibility, nor clinical or epidemiological data. There was no significant association between PD1.3 polymorphism and SLE or RA susceptibility in this Southern Brazilian population. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

Strength training for a child with suspected developmental coordination disorder.

PubMed

Menz, Stacy M; Hatten, Kristin; Grant-Beuttler, Marybeth

2013-01-01

Children with developmental coordination disorder (DCD) demonstrate difficulty with feedforward motor control and use varied compensatory strategies. To examine gross motor function changes following strength training in a child with motor control difficulties. A girl aged 6 years 11 months, with apraxia and hypotonia, and demonstrating motor delays consistent with DCD. Twenty-four strength training sessions were completed using a universal exercise unit. Postintervention scores significantly improved on the Bruininks-Oseretsky test of motor proficiency, second edition, and the Canadian occupational performance measure scores and raised the developmental coordination disorder questionnaire, revised 2007, scores above the range where DCD is suspected. Nonsignificant changes in strength were observed. Improved function and significant gains in manual coordination were observed following blocked practice of isolated, simple joint movements during strength training. Improved motor skills may be because of effective use of feedforward control and improved stabilization. Strength training does not rehearse skills using momentum, explaining nonsignificant changes in locomotor or locomotion areas.

Correlation between lower balance of Th2 helper T-cells and expression of PD-L1/PD-1 axis genes enables prognostic prediction in patients with glioblastoma.

PubMed

Takashima, Yasuo; Kawaguchi, Atsushi; Kanayama, Tomohiko; Hayano, Azusa; Yamanaka, Ryuya

2018-04-10

Common cancer treatments include radiation therapy, chemotherapy including molecular targeted drugs and anticancer drugs, and surgical treatment. Recent studies have focused on investigating the mechanisms by which immune cells attack cancer cells and produce immune tolerance-suppressing cytokines, as well as on their potential application in cancer immunotherapy. We conducted expression profiling of CD274 ( PD-L1 ), GATA3, IFNG, IL12R, IL12RB2, IL4, PDCD1 ( PD-1 ), PDCD1LG2 ( PD-L2 ), and TBX21 ( T-bet ) using data of 158 glioblastoma multiforme (GBM) patients with clinical information available at The Cancer Genome Atlas. Principal component analysis of the expression profiling data was used to derive an equation for evaluating the status of Th1 and Th2 cells. GBM specimens were divided based on the median of the Th scores. The results revealed that Th1 High Th2 Low and Th1 Low Th2 Low statuses indicated better prognosis than Th1 High Th2 High , and were evaluated based on the downregulation of PD-L1, PD-L2, and PD-1. Furthermore, Th2 Low divided based on the threshold, as well as CD274 Low and PDCD1 Low , were associated with good prognosis. In the Th2 Low subgroup, 14 genes were identified as potential prognostic markers. Of these, SLC11A1 Low , TNFRSF1B Low , and LTBR Low also indicated good prognosis. These results suggest that low Th2 balance and low activity of the PD-L1/PD-1 axis predict good prognosis in GBM. The set of genes identified in the present study could reliably predict survival in GBM patients and serve as useful molecular markers. Furthermore, this set of genes could prove to be novel targets for cancer immunotherapy.

Learning better by repetition or variation? Is transfer at odds with task specific training?

PubMed

Bonney, Emmanuel; Jelsma, Lemke Dorothee; Ferguson, Gillian D; Smits-Engelsman, Bouwien C M

2017-01-01

Transfer of motor skills is the ultimate goal of motor training in rehabilitation practice. In children with Developmental Coordination Disorder (DCD), very little is known about how skills are transferred from training situations to real life contexts. In this study we examined the influence of two types of practice on transfer of motor skills acquired in a virtual reality (VR) environment. One hundred and eleven children with DCD and their typically developing (TD) peers, aged 6-10 years (M = 8.0 SD = 1.0) were randomly assigned to either variable (n = 56) or repetitive practice (n = 55). Participants in the repetitive practice played the same exergame (ski slalom) twice weekly for 20 minutes, over a period of 5 weeks, while those in the variable group played 10 different games. Motor skills such as balance tasks (hopping), running and agility tasks, ball skills and functional activities were evaluated before and after 5 weeks of training. ANOVA repeated measures indicated that both DCD and TD children demonstrated transfer effects to real life skills with identical and non-identical elements at exactly the same rate, irrespective of the type of practice they were assigned to. Based on these findings, we conclude that motor skills acquired in the VR environment, transfers to real world contexts in similar proportions for both TD and DCD children. The type of practice adopted does not seem to influence children's ability to transfer skills acquired in an exergame to life situations but the number of identical elements does.

Donation after cardiac death liver transplantation: predictors of outcome.

PubMed

Mathur, A K; Heimbach, J; Steffick, D E; Sonnenday, C J; Goodrich, N P; Merion, R M

2010-11-01

We aimed to identify recipient, donor and transplant risk factors associated with graft failure and patient mortality following donation after cardiac death (DCD) liver transplantation. These estimates were derived from Scientific Registry of Transplant Recipients data from all US liver-only DCD recipients between September 1, 2001 and April 30, 2009 (n = 1567) and Cox regression techniques. Three years post-DCD liver transplant, 64.9% of recipients were alive with functioning grafts, 13.6% required retransplant and 21.6% died. Significant recipient factors predictive of graft failure included: age ≥ 55 years, male sex, African-American race, HCV positivity, metabolic liver disorder, transplant MELD ≥ 35, hospitalization at transplant and the need for life support at transplant (all, p ≤ 0.05). Donor characteristics included age ≥ 50 years and weight >100 kg (all, p ≤ 0.005). Each hour increase in cold ischemia time (CIT) was associated with 6% higher graft failure rate (HR 1.06, p < 0.001). Donor warm ischemia time ≥ 35 min significantly increased graft failure rates (HR 1.84, p = 0.002). Recipient predictors of mortality were age ≥ 55 years, hospitalization at transplant and retransplantation (all, p ≤ 0.006). Donor weight >100 kg and CIT also increased patient mortality (all, p ≤ 0.035). These findings are useful for transplant surgeons creating DCD liver acceptance protocols. ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

Prenatal lead, cadmium and mercury exposure and associations with motor skills at age 7 years in a UK observational birth cohort.

PubMed

Taylor, Caroline M; Emond, Alan M; Lingam, Raghu; Golding, Jean

2018-08-01

Lead and mercury are freely transferred across the placenta, while cadmium tends to accumulate in the placenta. Each contributes to adverse neurological outcomes for the child. Although prenatal heavy metal exposure has been linked with an array of neurodevelopmental outcomes in childhood, its association with the development of motor skills in children has not been robustly studied. The aim of the present study was to investigate the association between prenatal exposure to lead, cadmium and mercury, measured as maternal blood concentrations during pregnancy, and motor skills, measured as subtests of the Movement Assessment Battery for Children (Movement ABC) at age 7 years in a large sample of mother-child pairs enrolled in a UK observational birth cohort study (Avon Longitudinal Study of Parents and Children, ALSPAC). Whole blood samples from pregnant women enrolled in ALSPAC were analysed for lead, cadmium and mercury. In a complete case analysis (n = 1558), associations between prenatal blood concentrations and child motor skills assessed by Movement ABC subtests of manual dexterity, ball skills and balance at 7 years were examined in adjusted regression models. Associations with probable developmental coordination disorder (DCD) were also investigated. The mean prenatal blood levels were: lead 3.66 ± 1.55 μg/dl; cadmium 0.45 ± 0.54 μg/l; mercury 2.23 ± 1.14 μg/l. There was no evidence for any adverse associations of prenatal lead, cadmium or mercury exposure with motor skills measured at age 7 years with Movement ABC subtests in adjusted regression models. Further, there were no associations with probable DCD. There was no evidence to support a role of prenatal exposure to heavy metals at these levels on motor skills in the child at age 7 years measured using the Movement ABC. Early identification of symptoms of motor skills impairment is important, however, to enable investigation, assessment and treatment. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Determinants of developmental coordination disorder in 7-year-old children: a study of children in the Danish National Birth Cohort.

PubMed

Faebo Larsen, Rikke; Hvas Mortensen, Laust; Martinussen, Torben; Nybo Andersen, Anne-Marie

2013-11-01

The aim of this study was to investigate early life determinants of developmental coordination disorder (DCD) in 7-year-old children. The study was based on data from 33,354 women and their children who participated in the 7-year follow-up study of the Danish National Birth Cohort. Information on several potential determinants (maternal age at conception, maternal occupational status, smoking and alcohol consumption during pregnancy, child's sex, intrauterine growth restriction, degree of preterm birth, and age at walking) was obtained from population registries, from interviews during pregnancy and when the child was 18 months old. The outcome in this study was DCD at 7 years of age, measured by the validated Developmental Coordination Disorder Questionnaire. The associations between the potential determinants and DCD were estimated using logistic regression. The study population consisted of 17,065 males and 16,289 females (141 [0.4%] born very preterm [23(+0)-31(+6) wk]; 1281 [3.8%] born moderately preterm [32(+0)-36(+6) wk]; 29,044 [87.1%] were born term [37(+0)-41(+6) wk], and 2888 [8.7%] were born post-term [≥ 42(+0) wk]). Independently of each other, the following determinants were predictors of DCD: being a female (odds ratio [OR] 0.36 [95% confidence interval {CI} 0.31-0.41]); being born very preterm (OR 6.28 [95% CI 3.99-9.89]) or moderately preterm (OR 2.10 [95% CI 1.65-2.67]); being small for gestational age (OR 1.74 [95% CI 1.46-2.08]); being 15 months of age or more at walking attainment (OR 3.05 [95% CI 2.57-3.60]); and maternal occupational status (higher grade professionals (OR 1.28 [95% CI 1.02-1.61); economically inactive (OR 1.43 [95% CI 1.07-1.91]). Young maternal age and smoking were risk factors among term-born children. The risk of DCD increases with decreasing gestational age. Intrauterine growth restriction is also a strong risk factor, as well as delayed walking. © 2013 Mac Keith Press.

Dual hypothermic oxygenated machine perfusion in liver transplants donated after circulatory death.

PubMed

van Rijn, R; Karimian, N; Matton, A P M; Burlage, L C; Westerkamp, A C; van den Berg, A P; de Kleine, R H J; de Boer, M T; Lisman, T; Porte, R J

2017-06-01

Experimental studies have suggested that end-ischaemic dual hypothermic oxygenated machine perfusion (DHOPE) may restore hepatocellular energy status and reduce reperfusion injury in donation after circulatory death (DCD) liver grafts. The aim of this prospective case-control study was to assess the safety and feasibility of DHOPE in DCD liver transplantation. In consecutive DCD liver transplantations, liver grafts were treated with end-ischaemic DHOPE. Outcome was compared with that in a control group of DCD liver transplantations without DHOPE, matched for donor age, donor warm ischaemia time, and recipient Model for End-stage Liver Disease (MELD) score. All patients were followed for 1 year. Ten transplantations involving liver grafts treated with DHOPE were compared with 20 control procedures. There were no technical problems. All 6-month and 1-year graft and patient survival rates were 100 per cent in the DHOPE group. Six-month graft survival and 1-year graft and patient survival rates in the control group were 80, 67 and 85 per cent respectively. During DHOPE, median (i.q.r.) hepatic adenosine 5'-triphosphate (ATP) content increased 11-fold, from 6 (3-10) to 66 (42-87) µmol per g protein (P = 0·005). All DHOPE-preserved livers showed excellent early function. At 1 week after transplantation peak serum alanine aminotransferase (ALT) and bilirubin levels were twofold lower in the DHOPE group than in the control group (ALT: median 966 versus 1858 units/l respectively, P = 0·006; bilirubin: median 1·0 (i.q.r. 0·7-1·4) versus 2·6 (0·9-5·1) mg/dl, P = 0·044). None of the ten DHOPE-preserved livers required retransplantation for non-anastomotic biliary stricture, compared with five of 20 in the control group (P = 0·140). This clinical study of end-ischaemic DHOPE in DCD liver transplantation suggests that the technique restores hepatic ATP, reduces reperfusion injury, and is safe and feasible. RCTs with larger numbers of patients are warranted to assess the efficacy in reducing post-transplant biliary complications. © 2017 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

Impacts of feedlot floor condition, deposition frequency, and inhibitors on N2O and CH4 emissions from feedlot dung and urine patches.

PubMed

Liao, Wenhua; Liu, Chunjing; Gao, Zhiling

2018-04-09

Patches of dung and urine are major contributors to the feedlot gas emissions. This study investigated the impacts of dung deposition frequency (partly reflecting animal stocking density of a feedlot), dairy feedlot floor conditions (old floor indicated with the presence of consolidated manure pad [CMP] vs. new floor with the absence of consolidated manure pad [CMPn]), and application of dicyandiamide (DCD) and hydroquinone (HQ) on nitrous oxide (N 2 O) and methane (CH 4 ) emissions from patches in the laboratory, and the integrative impacts were expressed in terms of global warming potential (CO 2 -equivalent). Dung deposition frequency, feedlot floor condition, and application of inhibitors showed inverse impacts on N 2 O and CH 4 emissions from patches. Greenhouse gas (GHG) emissions from the dung, urine, and dung+urine patches on the CMP feedlot surface were approximately 7.48, 87.35, and 7.10 times those on the CMPn feedlot surface (P < 0.05). Meanwhile, GHG emissions from CMP and CMPn feedlot surfaces under high deposition frequency condition were approximately 10 and 1.7 times those under low-frequency condition. Moreover, application of HQ slightly reduced the GHG emission from urine patches, by 14.9% (P > 0.05), while applying DCD or DCD+HQ significantly reduced the GHG, by 60.3% and 65.0%, respectively (P < 0.05). Overall, it is necessary to include feedlot management such as animal stocking density and feedlot floor condition to the process of determining emission factors for feedlots. In the future, field measurements to quantitatively evaluate the relative contribution of nitrification and denitrification to the N 2 O emissions of feedlot surfaces are highly required for effective N 2 O control. This study shows that feedlot CH 4 and N 2 O emissions inversely respond to the dicyandiamide (DCD) application. Applying DCD significantly reduces GHG emissions of feedlot urine patches. Feedlot floor condition and stocking density strongly impact feedlot GHG emissions. Including feedlot floor condition and stocking density in the feedlot EF determining process is necessary.

Islet transplantation using donors after cardiac death: report of the Japan Islet Transplantation Registry.

PubMed

Saito, Takuro; Gotoh, Mitsukazu; Satomi, Susumu; Uemoto, Shinji; Kenmochi, Takashi; Itoh, Toshinori; Kuroda, Yoshikazu; Yasunami, Youichi; Matsumoto, Shnichi; Teraoka, Satoshi

2010-10-15

This report summarizes outcomes of islet transplantation employing donors after cardiac death (DCD) between 2004 and 2007 as reported to the Japan Islet Transplantation Registry. Sixty-five islet isolations were performed for 34 transplantations in 18 patients with insulin-dependent diabetes mellitus, including two patients who had prior kidney transplantation. All but one donor (64/65) was DCD at the time of harvesting. Factors influencing criteria for islet release included duration of low blood pressure of the donor, cold ischemic time, and usage of Kyoto solution for preservation. Multivariate analysis selected usage of Kyoto solution as most important. Of the 18 recipients, 8, 4, and 6 recipients received 1, 2, and 3 islet infusions, respectively. Overall graft survival defined as C-peptide level more than or equal to 0.3 ng/mL was 76.5%, 47.1%, and 33.6% at 1, 2, and 3 years, respectively, whereas corresponding graft survival after multiple transplantations was 100%, 80.0%, and 57.1%, respectively. All recipients remained free of severe hypoglycemia while three achieved insulin independence for 14, 79, and 215 days. HbA1c levels and requirement of exogenous insulin were significantly improved in all patients. Islet transplantation employing DCD can ameliorate severe hypoglycemic episodes, significantly improve HbA1c levels, sustain significant levels of C-peptide, and achieve insulin independence after multiple transplantations. Thus, DCD can be an important resource for islet transplantation if used under strict releasing criteria and in multiple transplantations, particularly in countries where heart-beating donors are not readily available.

Using an evidence-based online module to improve parents' ability to support their child with Developmental Coordination Disorder.

PubMed

Camden, Chantal; Foley, Véronique; Anaby, Dana; Shikako-Thomas, Keiko; Gauthier-Boudreault, Camille; Berbari, Jade; Missiuna, Cheryl

2016-07-01

Developmental Coordination Disorder (DCD) is a prevalent neurodevelopmental disorder. Best practices include raising parents' awareness and building capacity but few interventions incorporating these best practices are documented. To examine whether an evidence-based online module can increase the perceived knowledge and skills of parents of children with DCD, and lead to behavioral changes when managing their child's health condition. A mixed-methods, before-after design guided by the Theory of Planned Behavior was employed. Data about the knowledge, skills and behaviors of parents of children with DCD were collected using questionnaires prior to completing the module, immediately after, and three months later. Paired T-tests, sensitivity analyses and thematic analyses were performed on data as appropriate. One hundred-sixteen, 81 and 58 participants respectively completed the three questionnaires. For knowledge and skills, post- and follow-up scores were significantly higher than baseline scores (p < 0.01). Fifty-two (64%) participants reported an intention to change behavior post-intervention and 29 (50%) participants had tried recommended strategies at follow-up. Three themes emerged to describe parents' behavioral change: sharing information, trialing strategies and changing attitudes. Factors influencing parents' ability to implement these behavioral changes included clear recommendations, time, and 'right' attitude. Perceived outcomes associated with the parental behavioral changes involved improvement in well-being for the children at school, at home, and for the family as a whole. The online module increased parents' self-reported knowledge and skills in DCD management. Future research should explore its impacts on children's long-term outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Cortical activity in fine-motor tasks in children with Developmental Coordination Disorder: A preliminary fNIRS study.

PubMed

Caçola, Priscila; Getchell, Nancy; Srinivasan, Dhivya; Alexandrakis, Georgios; Liu, Hanli

2018-04-01

Developmental Coordination Disorder (DCD) is as a neurodevelopmental condition characterized by poor motor proficiency, which impacts academic performance and activities of daily living. Several studies have determined that children with DCD activate different regions of the brain when performing motor skills in comparison to typically developing (TD) children. However, none have used Functional Near-Infrared Spectroscopy (fNIRS) to explore cortical activation in this population. With that, the goal of this preliminary study was to investigate cortical activation using fNIRS in six children with DCD and six TD children between ages of 8 and 12 years. Three fine-motor tasks were performed: Finger Tapping (FT), Curve Tracing (CT), and Paragraph Writing (PW). Tasks were presented in counterbalanced order and had a baseline of 30s. Cortical activity elicited during performance of the FT, CT, and PW tasks was measured by fNIRS, and activation areas within each group were statistically compared. Results indicated that participant groups used different focal activation areas as well as different neural networks to perform the tasks. These distinct patterns were also task-specific, with differences in the right Pre-Motor Cortex (Pre-MC) and Supplementary Motor Area (SMA) for CT, and the right Dorsolateral Prefrontal Cortex (DLPFC) and the right Pre-MC for the PW task. These results add to the body of research exploring neurological alterations in children with DCD, and establish the feasibility of using fNIRS technology with this population. Copyright © 2017 ISDN. Published by Elsevier Ltd. All rights reserved.

Learning better by repetition or variation? Is transfer at odds with task specific training?

PubMed Central

Bonney, Emmanuel; Ferguson, Gillian D.; Smits-Engelsman, Bouwien C. M.

2017-01-01

Objective Transfer of motor skills is the ultimate goal of motor training in rehabilitation practice. In children with Developmental Coordination Disorder (DCD), very little is known about how skills are transferred from training situations to real life contexts. In this study we examined the influence of two types of practice on transfer of motor skills acquired in a virtual reality (VR) environment. Method One hundred and eleven children with DCD and their typically developing (TD) peers, aged 6–10 years (M = 8.0 SD = 1.0) were randomly assigned to either variable (n = 56) or repetitive practice (n = 55). Participants in the repetitive practice played the same exergame (ski slalom) twice weekly for 20 minutes, over a period of 5 weeks, while those in the variable group played 10 different games. Motor skills such as balance tasks (hopping), running and agility tasks, ball skills and functional activities were evaluated before and after 5 weeks of training. Results ANOVA repeated measures indicated that both DCD and TD children demonstrated transfer effects to real life skills with identical and non-identical elements at exactly the same rate, irrespective of the type of practice they were assigned to. Conclusion Based on these findings, we conclude that motor skills acquired in the VR environment, transfers to real world contexts in similar proportions for both TD and DCD children. The type of practice adopted does not seem to influence children’s ability to transfer skills acquired in an exergame to life situations but the number of identical elements does. PMID:28333997

Basiliximab induction in kidney transplantation with donation after cardiac death donors

PubMed Central

YAO, XUPING; WENG, GUOBIN; WEI, JUNJUN; GAO, WENBO

2016-01-01

Basiliximab is a monoclonal antibody that binds to the α-chain of the interleukin (IL)-2 receptor. It is used as induction therapy in kidney transplantation. The objective of the present study was to evaluate induction therapy with single-dose basiliximab (Simulect®) in kidney transplantation with donation after cardiac death (DCD) donors. A total of 33 DCD kidney transplants were performed between December 2010 and July 2013 in patients who received single-dose basiliximab (20 mg) as induction therapy. The maintenance immunosuppression included calcineurin inhibitor (cyclosporine A or tacrolimus), mycophenolate mofetil and corticosteroids. The follow-up time was 1 year. The mean ages of the DCD donors and recipients were 29.3 and 41.1 years, respectively. Within the 1-year follow-up, the overall incidence of acute rejection was 9.1%. There were 10 cases of delayed graft function among the recipients. Mean serum creatinine values at 1 week and at 1, 3, 6, 9 and 12 months post-transplantation were 257.6, 238.2, 194.5, 159.3, 137.9 and 110.8 µmol/l, respectively, with a favorable trend to allograft function recovery over time. The 1-year patient and graft survival rates were 96.9 and 90.9%, respectively, with an infection rate of 24.2%. Increased alanine aminotransferase/aspartate transaminase levels in only 2 patients were considered to be associated with basiliximab. This experience with single-dose basiliximab for induction therapy in DCD kidney transplantation showed that favorable clinical outcomes were achieved in terms of graft survival and function within 1 year. PMID:27284346

2 × 2 MIMO OFDM/OQAM radio signals over an elliptical core few-mode fiber.

PubMed

Mo, Qi; He, Jiale; Yu, Dawei; Deng, Lei; Fu, Songnian; Tang, Ming; Liu, Deming

2016-10-01

We experimentally demonstrate a 4.46  Gb/s2×2 multi-input multi-output (MIMO) orthogonal frequency division multiplexing (OFDM)/OQAM radio signal over a 2 km elliptical core 3-mode fiber, together with 0.4 m wireless transmission. Meanwhile, to cope with differential channel delay (DCD) among involved MIMO channels, we propose a time-offset crosstalk cancellation algorithm to extend the DCD tolerance from 10 to 60 ns without using a circle prefix (CP), leading to an 18.7% improvement of spectral efficiency. For the purpose of comparison, we also examine the transmission performance of CP-OFDM signals with different lengths of CPs, under the same system configuration. The proposed algorithm is also effective for the DCD compensation of a radio signal over a 2 km 7-core fiber. These results not only demonstrate the feasibility of space division multiplexing for RoF application but also validate that the elliptical core few-mode fiber can provide the same independent channels as the multicore fiber.

Predictors of Donor Heart Utilization for Transplantation in United States.

PubMed

Trivedi, Jaimin R; Cheng, Allen; Gallo, Michele; Schumer, Erin M; Massey, H Todd; Slaughter, Mark S

2017-06-01

Optimum use of donor organs can increase the reach of the transplantation therapy to more patients on waiting list. The heart transplantation (HTx) has remained stagnant in United States over the past decade at approximately 2,500 HTx annually. With the use of the United Network of Organ Sharing (UNOS) deceased donor database (DCD) we aimed to evaluate donor factors predicting donor heart utilization. UNOS DCD was queried from 2005 to 2014 to identify total number of donors who had at least one of their organs donated. We then generated a multivariate logistic regression model using various demographic and clinical donor factors to predict donor heart use for HTx. Donor hearts not recovered due to consent or family issues or recovered for nontransplantation reasons were excluded from the analysis. During the study period there were 80,782 donors of which 23,606 (29%) were used for HTx, and 38,877 transplants (48%) were not used after obtaining consent because of poor organ function (37%), donor medical history (13%), and organ refused by all programs (5%). Of all, 22,791 donors with complete data were used for logistic regression (13,389 HTx, 9,402 no-HTx) which showed significant predictors of donor heart use for HTx. From this model we assigned probability of donor heart use and identified 3,070 donors with HTx-eligible unused hearts for reasons of poor organ function (28%), organ refused by all programs (15%), and recipient not located (9%). An objective system based on donor factors can predict donor heart use for HTx and may help increase availability of hearts for transplantation from existing donor pool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Real-time display of flow-pressure-volume loops.

PubMed

Morozoff, P E; Evans, R W

1992-01-01

Graphic display of respiratory waveforms can be valuable for monitoring the progress of ventilated patients. A system has been developed that can display flow-pressure-volume loops as derived from a patient's respiratory circuit in real time. It can also display, store, print, and retrieve ventilatory waveforms. Five loops can be displayed at once: current, previous, reference, "ideal," and previously saved. Two components, the data-display device (DDD) and the data-collection device (DCD), comprise the system. An IBM 286/386 computer with a graphics card (VGA) and bidirectional parallel port is used for the DDD; an eight-bit microprocessor card and an A/D convertor card make up the DCD. A real-time multitasking operating system was written to control the DDD, while the DCD operates from in-line assembly code. The DCD samples the pressure and flow sensors at 100 Hz and looks for a complete flow waveform pattern based on flow slope. These waveforms are then passed to the DDD via the mutual parallel port. Within the DDD a process integrates the flow to create a volume signal and performs a multilinear regression on the pressure, flow, and volume data to calculate the elastance, resistance, pressure offset, and coefficient of determination. Elastance, resistance, and offset are used to calculate Pr and Pc where: Pr[k] = P[k]-offset-(elastance.V[k]) and Pc[k] = P[k]-offset-(resistance.F[k]). Volume vs. Pc and flow vs. Pr can be displayed in real time. Patient data from previous clinical tests were loaded into the device to verify the software calculations. An analog waveform generator was used to simulate flow and pressure waveforms that validated the system.(ABSTRACT TRUNCATED AT 250 WORDS)

Lung physiology during ECS resuscitation of DCD donors followed by in situ assessment of lung function.

PubMed

Reoma, Junewai L; Rojas, Alvaro; Krause, Eric M; Obeid, Nabeel R; Lafayette, Nathan G; Pohlmann, Joshua R; Padiyar, Niru P; Punch, Jeffery D; Cook, Keith E; Bartlett, Robert H

2009-01-01

Extracorporeal cardiopulmonary support (ECS) of donors after cardiac death (DCD) has been shown to improve abdominal organs for transplantation. This study assesses whether pulmonary congestion occurs during ECS with the heart arrested and describes an in vivo method to assess if lungs are suitable for transplantation from DCD donors after ECS resuscitation. Cardiac arrest was induced in 30 kg pigs, followed by 10 min of warm ischemia. Cannulae were placed into the right atrium (RA) and iliac artery, and veno-arterial ECS was initiated for 90 min with lungs inflated, group 1 (n = 5) or deflated, group 2 (n = 3). Left atrial pressures were measured as a marker for pulmonary congestion. After 90 min of ECS, lung function was evaluated. Cannulae were placed into the pulmonary artery (PA) and left ventricle (LV). A second pump was included, and ECS was converted to a bi-ventricular (bi-VAD) system. The RVAD drained from the RA and pumped into the PA, and the LVAD drained the LV and pumped into the iliac. This brought the lungs back into circulation for a 1-hr assessment period. The oxygenator was turned off, and ventilation was restarted. Flows, blood gases, PA and left atrial pressures, and compliance were recorded. In both the groups, LA pressure was <15 mm Hg during ECS. During the lung assessment period, PA flows were 1.4-2.2 L/min. PO2 was >300 mm Hg, with normal PCO2. Extracorporeal cardiopulmonary support resuscitation of DCD donors is feasible and allows for assessment of function before procurement. Extracorporeal cardiopulmonary support does not cause pulmonary congestion, and the lungs retain adequate function for transplantation. Compliance correlated with lung function.

Price difference as a predictor of the selection between brand name and generic statins in Japan.

PubMed

Takizawa, Osamu; Urushihara, Hisashi; Tanaka, Shiro; Kawakami, Koji

2015-05-01

This study aimed to explore the predictors of the selection between brand name drug (BR) and generic drug (GE) and to clarify the quantitative relationship about selection. We identified "incident users" who dispensed statins between April 2008 and June 2011 in commercially databases consisted of dispensing claims databases (DCD) of out-of-hospital pharmacies and hospital claims databases (HCD) of in-house pharmacies in Japan. Predictors of the selection between BR and GE, including price difference (PD), the price of BR, their interaction and percent change of the price of GE relative to BR were explored by logistic regression using DCD and HCD separately. We extracted records of 670 patients who have opportunity for selection both BR and GE. Logistic regression analysis demonstrated that PD, the price of BR, interaction between them, and prescriber affiliation were factors significantly associated with the selection in the DCD; logit (p)=9.735-0.251×PD-0.071×the price of BR+0.002×PD×the price of BR-1.816×affiliation+0.220×gender-0.008×age+0.038×monthly medical fee. PD was inversely proportional to BR choice in DCD and lead to the opposite result in HCD. Numerical simulation of selection revealed that the quantitative relationships heavily depend on situations. PD and the price of BR are predictors of the selection between BR and GE interactively in out-of-hospital pharmacies, but not in in-house pharmacies of medical facilities. Results may support policies which increase the power of out-of-hospital pharmacies for selection. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

LUNG PHYSIOLOGY DURING ECS RESUSCITATION OF DCD DONORS FOLLOWED BY IN-SITU ASSESSMENT OF LUNG FUNCTION

PubMed Central

Reoma, Junewai L.; Rojas, Alvaro; Krause, Eric M.; Obeid, Nabeel R.; Lafayette, Nathan G.; Pohlmann, Joshua R.; Padiyar, Niru P.; Punch, Jeffery D; Cook, Keith E.; Bartlett, Robert H

2009-01-01

Extracorporeal cardiopulmonary support(ECS) of donors following cardiac death(DCD) has been shown to improve abdominal organs for transplantation. This study assesses whether pulmonary congestion occurs during ECS with the heart arrested and describes an in-vivo method to assess if lungs are suitable for transplantation from DCD donors following ECS resuscitation. Cardiac arrest was induced in 30 kg pigs, followed by 10min. of warm ischemia. Cannulas were placed into right atrium (RA) and iliac artery, and veno-arterial ECS was initiated for 90min with lungs inflated, Group 1 (n=5) or deflated Group 2 (n=3). Left atrial pressures were measured as a marker for pulmonary congestion. After 90 min of ECS, lung function was evaluated. Cannulae were placed into the pulmonary artery (PA) and left ventricle (LV). A second pump was included, and ECS was converted to a bi-VAD system. The RVAD drained from the RA and pumped into the PA, and the LVAD drained the LV and pumped into the iliac. This brought the lungs back into circulation for a 1hr assessment period. The oxygenator was turned off, and ventilation restarted. Flows, blood gases, pulmonary artery and left atrial pressures, and compliance were recorded. In both groups: LA pressure was <15mmHg during ECS. During the lung assessment period, PA flows were 1.4−2.2 liter/min. PO2 was >300mmHg, with normal PCO2. ECS resuscitation of DCD donors is feasible and allows for assessment of function prior to procurement. ECS does not cause pulmonary congestion, and lungs retain adequate function for transplantation. Compliance correlated with lung function. PMID:19506464

Extended-criteria donors in liver transplantation Part II: reviewing the impact of extended-criteria donors on the complications and outcomes of liver transplantation.

PubMed

Nemes, Balázs; Gámán, György; Polak, Wojciech G; Gelley, Fanni; Hara, Takanobu; Ono, Shinichiro; Baimakhanov, Zhassulan; Piros, Laszlo; Eguchi, Susumu

2016-07-01

Extended-criteria donors (ECDs) have an impact on early allograft dysfunction (EAD), biliary complications, relapse of hepatitis C virus (HCV), and survivals. Early allograft dysfunction was frequently seen in grafts with moderate and severe steatosis. Donors after cardiac death (DCD) have been associated with higher rates of graft failure and biliary complications compared to donors after brain death. Extended warm ischemia, reperfusion injury and endothelial activation trigger a cascade, leading to microvascular thrombosis, resulting in biliary necrosis, cholangitis, and graft failure. The risk of HCV recurrence increased by donor age, and associated with using moderately and severely steatotic grafts. With the administration of protease inhibitors sustained virological response was achieved in majority of the patients. Donor risk index and EC donor scores (DS) are reported to be useful, to assess the outcome. The 1-year survival rates were 87% and 40% respectively, for donors with a DS of 0 and 3. Graft survival was excellent up to a DS of 2, however a DS >2 should be avoided in higher-risk recipients. The 1, 3 and 5-year survival of DCD recipients was comparable to optimal donors. However ECDs had minor survival means of 85%, 78.6%, and 72.3%. The graft survival of split liver transplantation (SLT) was comparable to that of whole liver orthotopic liver transplantation. SLT was not regarded as an ECD factor in the MELD era any more. Full-right-full-left split liver transplantation has a significant advantage to extend the high quality donor pool. Hypothermic oxygenated machine perfusion can be applied clinically in DCD liver grafts. Feasibility and safety were confirmed. Reperfusion injury was also rare in machine perfused DCD livers.

Effects of organic nitrification inhibitors on methane and nitrous oxide emission from tropical rice paddy

NASA Astrophysics Data System (ADS)

Datta, A.; Adhya, T. K.

2014-08-01

We have studied the effects of application of different nitrification inhibitors on methane (CH4) and nitrous oxide (N2O) emissions from rice paddy and associated soil chemical and biological dynamics during wet and dry seasons of rice crop in a tropical climate of eastern India. The experiment consisted of four treatments viz. (i) Prilled urea amended control (ii) urea + Dicyandiamide (DCD), (iii) urea + Nimin and (iv) urea + Karanjin. CH4 emission was significantly higher from the DCD (372.36 kg ha-1) and Karanjin (153.07 kg ha-1) applied plots during the wet and dry season, respectively. N2O emission was significantly inhibited in the Nimin applied plots during both seasons (69% and 85% over control during wet season and dry season respectively). CH4 and N2O emissions per Mg of rice grain yield were lowest from the Nimin applied plots during both seasons. Global warming potential (GWP) of the plot treated with DCD (13.93) was significantly higher during the experimental period. CH4 production potential was significantly higher from the nitrification inhibitor applied plots compared to control. While, CH4 oxidation potential followed the order; urea + Nimin > urea + Karanjin > urea + DCD > control. Application of Nimin significantly increased the methanotrophic bacterial population in the soil during the maximum tillering to flowering stage and may be attributed to low CH4 emission from the plots. Denitrification enzyme activity (DEA) of the soil was significantly low from the Nimin and Karanjin applied plots. Results suggest that apart from being potent nitrification inhibitors, Nimin and Karanjin also have the potential to reduce the denitrification activity in the soil. This in turn, would reduce N2O emission from flooded paddy where both nitrification and denitrification processes causes N2O emission.

Na+/Ca2+ exchange and regulation of cytoplasmic concentration of calcium in rat cerebellar neurons treated with glutamate.

PubMed

Storozhevykh, T P; Sorokina, E G; Vabnitz, A V; Senilova, Ya E; Tukhbatova, G R; Pinelis, V G

2007-07-01

In the present work, the forward and/or reversed Na+/Ca2+ exchange in cerebellar granular cells was suppressed by substitution of Na+o by Li+ before, during, and after exposure to glutamate for varied time and also using the inhibitor KB-R7943 of the reversed exchange. After glutamate challenge for 1 min, Na+o/Li+ substitution did not influence the recovery of low [Ca2+]i in a calcium-free medium. A 1-h incubation with 100 microM glutamate induced in the neurons a biphasic and irreversible [Ca2+]i rise (delayed calcium deregulation (DCD)), enhancement of [Na+]i, and decrease in the mitochondrial potential. If Na+o had been substituted by Li+ before the application of glutamate, i.e. the exchange reversal was suppressed during the exposure to glutamate, the number of cells with DCD was nearly fourfold lowered. However, addition of the Na+/K+-ATPase inhibitor ouabain (0.5 mM) not preventing the exchange reversal also decreased DCD in the presence of glutamate. Both exposures decreased the glutamate-caused loss of intracellular ATP. Glucose deprivation partially abolished protective effects of the Na+o/Li+ substitution and ouabain. KB-R7943 (10 microM) increased 7.4-fold the number of cells with the [Ca2+]i decreased to the basal level after the exposure to glutamate. Thus, reversal of the Na+/Ca2+ exchange reinforced the glutamate-caused perturbations of calcium homeostasis in the neurons and slowed the recovery of the decreased [Ca2+]i in the post-glutamate period. However, for development of DCD, in addition to the exchange reversal, other factors are required, in particular a decrease in the intracellular concentration of ATP.

Making a case for controlled organ donation after cardiac death: the story of Italy's first experience.

PubMed

Vergano, Marco; Magavern, Emma; Baroncelli, Francesca; Frisenda, Valeria; Fonsato, Alessia; Artusio, Diego; Castioni, Carlo Alberto; De Piero, Maria Elena; Abelli, Massimo; Ticozzelli, Elena; Livigni, Sergio

2017-04-01

Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process. In our case, the death of the patient subsequent to the withdrawal of life-sustaining therapies was consistent with the patient's wishes, showing respect for his dignity and honoring his autonomy, as expressed to his family previously. By making donation possible, the medical team was able to fulfill the family's last request on behalf of the patient. This case should stimulate deliberation regarding the potential to shorten the 20-minute no-touch period currently in place in Italy. Such an action would not have injured this patient and would certainly have increased the quality of the procured organs. Copyright © 2016 Elsevier Inc. All rights reserved.

Strategies for safe donor expansion: donor management, donations after cardiac death, ex-vivo lung perfusion.

PubMed

Cypel, Marcelo; Keshavjee, Shaf

2013-10-01

The number of patients listed for lung transplantation largely exceeds the number of available transplantable organs because of both a shortage of organ donors and a low utilization rate of lungs from those donors. Two major innovations in recent years include the use of lungs from donations after cardiac death (DCD) and the use of ex-vivo lung perfusion (EVLP) to assess and improve injured donor lungs. DCD lung transplants now account for about 20% of lung transplants in many centres and outcomes after transplantation have been excellent with this source of donation. Clinical experience using EVLP has shown the method to be well tolerated and allow for reassessment and improvement in function from high-risk donor lungs. When these lungs were transplanted, low rates of primary graft dysfunction were achieved and long-term survival was comparable with standard transplantation. Preclinical studies have shown a great potential of EVLP as a platform for the delivery of novel therapies to repair injured donor lungs. A significant increase on the number of available lungs for transplantation is expected in the coming years with the wider use of DCD lungs and with organ-specific ex-vivo treatment strategies.

Generalised joint hypermobility and neurodevelopmental traits in a non-clinical adult population

PubMed Central

Glans, Martin; Humble, Mats B.

2017-01-01

Background Generalised joint hypermobility (GJH) is reportedly overrepresented among clinical cases of attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and developmental coordination disorder (DCD). It is unknown if these associations are dimensional and, therefore, also relevant among non-clinical populations. Aims To investigate if GJH correlates with sub-syndromal neurodevelopmental symptoms in a normal population. Method Hakim-Grahame’s 5-part questionnaire (5PQ) on GJH, neuropsychiatric screening scales measuring ADHD and ASD traits, and a DCD-related question concerning clumsiness were distributed to a non-clinical, adult, Swedish population (n=1039). Results In total, 887 individuals met our entry criteria. We found no associations between GJH and sub-syndromal symptoms of ADHD, ASD or DCD. Conclusions Although GJH is overrepresented in clinical cases with neurodevelopmental disorders, such an association seems absent in a normal population. Thus, if GJH serves as a biomarker cutting across diagnostic boundaries, this association is presumably limited to clinical populations. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:28959454

Deoxycytidine Deaminase-Deficient Escherichia coli Strains Display Acute Sensitivity to Cytidine, Adenosine, and Guanosine and Increased Sensitivity to a Range of Antibiotics, Including Vancomycin

PubMed Central

Kang, Tina Manzhu; Yuan, Jessica; Zhou, Alice; Beppler, Casey

2014-01-01

We show here that deoxycytidine deaminase (DCD)-deficient mutants of Escherichia coli are hypersensitive to killing by exogenous cytidine, adenosine, or guanosine, whereas wild-type cells are not. This hypersensitivity is reversed by exogenous thymidine. The mechanism likely involves the allosteric regulation of ribonucleotide reductase and severe limitations of the dTTP pools, resulting in thymineless death, the phenomenon of cell death due to thymidine starvation. We also report here that DCD-deficient mutants of E. coli are more sensitive to a series of different antibiotics, including vancomycin, and we show synergistic killing with the combination of vancomycin and cytidine. One possibility is that a very low, subinhibitory concentration of vancomycin enters Gram-negative cells and that this concentration is potentiated by chromosomal lesions resulting from the thymineless state. A second possibility is that the metabolic imbalance resulting from DCD deficiency affects the assembly of the outer membrane, which normally presents a barrier to drugs such as vancomycin. We consider these findings with regard to ideas of rendering Gram-negative bacteria sensitive to drugs such as vancomycin. PMID:24633874

Relationship of ocular accommodation and motor skills performance in developmental coordination disorder.

PubMed

Rafique, Sara A; Northway, Nadia

2015-08-01

Ocular accommodation provides a well-focussed image, feedback for accurate eye movement control, and cues for depth perception. To accurately perform visually guided motor tasks, integration of ocular motor systems is essential. Children with motor coordination impairment are established to be at higher risk of accommodation anomalies. The aim of the present study was to examine the relationship between ocular accommodation and motor tasks, which are often overlooked, in order to better understand the problems experienced by children with motor coordination impairment. Visual function, gross and fine motor skills were assessed in children with developmental coordination disorder (DCD) and typically developing control children. Children with DCD had significantly poorer accommodation facility and amplitude dynamics compared to controls. Results indicate a relationship between impaired accommodation and motor skills. Specifically, accommodation anomalies correlated with visual motor, upper limb and fine dexterity task performance. Consequently, we argue accommodation anomalies influence the ineffective coordination of action and perception in DCD. Furthermore, reading disabilities were related to poorer motor performance. We postulate the role of the fastigial nucleus as a common pathway for accommodation and motor deficits. Implications of the findings and recommended visual screening protocols are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Multiple-year nitrous oxide emissions from a greenhouse vegetable field in China: Effects of nitrogen management.

PubMed

Zhang, Jing; Li, Hu; Wang, Yingchun; Deng, Jia; Wang, Ligang

2018-03-01

The greenhouse vegetable (GV) field is an important agricultural system in China. It may also be a hot spot of nitrous oxide (N 2 O) emissions. However, knowledge on N 2 O emission from GV fields and its mitigation are limited due to considerable variations of N 2 O emissions. In this study, we performed a multi-year experiment at a GV field in Beijing, China, using the static opaque chamber method, to quantify N 2 O emissions from GV fields and evaluated N 2 O mitigation efficiency of alternative nitrogen (N) managements. The experiment period spanned three rotation periods and included seven vegetable growing seasons. We measured N 2 O emissions under four treatments, including no N fertilizer use (CK), farmers' conventional fertilizer application (FP), reduced N fertilizer rate (R), and R combined with the nitrification inhibitor "dicyandiamide (DCD)" (R+DCD). The seasonal cumulative N 2 O emissions ranged between 2.09 and 19.66, 1.13 and 11.33, 0.94 and 9.46, and 0.15 and 3.27kgNha -1 for FP, R, R+DCD, and CK, respectively. The cumulative N 2 O emissions of three rotational periods varied from 18.71 to 26.58 (FP), 9.58 to 15.96 (R), 7.11 to 13.42 (R+DCD), and 1.66 to 3.73kgNha -1 (CK). The R and R+DCD treatments significantly (P<0.05) reduced the N 2 O emissions under FP by 38.1% to 48.8% and 49.5% to 62.0%, across the three rotational periods, although their mitigation efficiencies were highly variable among different vegetable seasons. This study suggests that GV fields associated with intensive N application and frequent flooding irrigation may substantially contribute to the N 2 O emissions and great N 2 O mitigations can be achieved through reasonably reducing the N-fertilizer rate and/or applying a nitrification inhibitor. The large variations in the N 2 O emission and mitigation across different vegetable growing seasons and rotational periods stress the necessity of multi-year observations for reliably quantifying and mitigating N 2 O emissions for GV systems. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of feeding palm oil by-products based diets on total bacteria, cellulolytic bacteria and methanogenic archaea in the rumen of goats.

PubMed

Abubakr, Abdelrahim; Alimon, Abdul Razak; Yaakub, Halimatun; Abdullah, Norhani; Ivan, Michael

2014-01-01

Rumen microorganisms are responsible for digestion and utilization of dietary feeds by host ruminants. Unconventional feed resources could be used as alternatives in tropical areas where feed resources are insufficient in terms of quality and quantity. The objective of the present experiment was to evaluate the effect of diets based on palm oil (PO), decanter cake (DC) or palm kernel cake (PKC) on rumen total bacteria, selected cellulolytic bacteria, and methanogenic archaea. Four diets: control diet (CD), decanter cake diet (DCD), palm kernel cake diet (PKCD) and CD plus 5% PO diet (CPOD) were fed to rumen cannulated goats and rumen samples were collected at the start of the experimental diets (day 0) and on days 4, 6, 8, 12, 18, 24 and 30 post dietary treatments. Feeding DCD and PKCD resulted in significantly higher (P<0.05) DNA copy number of total bacteria, Fibrobacter succinogenes, Ruminococcus flavefeciens, and Ruminococcus albus. Rumen methanogenic archaea was significantly lower (P<0.05) in goats fed PKCD and CPOD and the trend showed a severe reduction on days 4 and 6 post experimental diets. In conclusion, results indicated that feeding DCD and PKC increased the populations of cellulolytic bacteria and decreased the density of methanogenic archaea in the rumen of goats.

Leukocyte and platelet depletion improves blood flow and function in a renal transplant model.

PubMed

Yates, Phillip J; Hosgood, Sarah A; Nicholson, Michael L

2012-01-01

Donation after cardiac death (DCD) donors are an important source of organs for transplantation. Due to warm and cold ischemic injury, DCD kidneys undergo a significant reperfusion insult when transplanted. This is manifested clinically as a high incidence of delayed graft function (DGF) and primary non-function (PNF). The importance of leukocytes in the generation of reperfusion injury is pivotal. Using an ex vivo porcine model of kidney transplantation, the effects of reperfusion with leukocyte and platelet depleted blood (LDB) and whole blood (WB) on renal blood flow and function were compared. Hemodynamic measurements were recorded, and biochemical, hematological, and histologic samples taken at set time-points. Reperfusion with LDB improved renal blood flow significantly compared with WB reperfusion. In addition, there was a significant improvement in creatinine clearance and renal oxygen consumption, but not fractional excretion of sodium, acid-base homeostasis, urinary nitric oxide (NO), or 8-isoprostane levels. This study represents a good model for the initial reperfusion period in renal transplantation. Improvement in only some functional markers and neither urinary NO nor 8-isoprostane levels indicates that improved blood flow alone is not sufficient to reverse the severe ischemic insult endured by DCD kidneys. Copyright © 2012 Elsevier Inc. All rights reserved.

Heart valve scaffold fabrication: Bioinspired control of macro-scale morphology, mechanics and micro-structure.

PubMed

D'Amore, Antonio; Luketich, Samuel K; Raffa, Giuseppe M; Olia, Salim; Menallo, Giorgio; Mazzola, Antonino; D'Accardi, Flavio; Grunberg, Tamir; Gu, Xinzhu; Pilato, Michele; Kameneva, Marina V; Badhwar, Vinay; Wagner, William R

2018-01-01

Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial. This study aimed to overcome these limitations by introducing double component deposition (DCD), an electrodeposition technique that employs multi-phase electrodes to dictate valve macro and microstructure and resultant function. Results in this report demonstrate the capacity of the DCD method to simultaneously control scaffold macro-scale morphology, mechanics and microstructure while producing fully assembled stent-less multi-leaflet valves composed of microscopic fibers. DCD engineered valve characterization included: leaflet thickness, biaxial properties, bending properties, and quantitative structural analysis of multi-photon and scanning electron micrographs. Quasi-static ex-vivo valve coaptation testing and dynamic organ level functional assessment in a pressure pulse duplicating device demonstrated appropriate acute valve functionality. Copyright © 2017. Published by Elsevier Ltd.

Feedforward motor control in developmental dyslexia and developmental coordination disorder: Does comorbidity matter?

PubMed

Cignetti, Fabien; Vaugoyeau, Marianne; Fontan, Aurelie; Jover, Marianne; Livet, Marie-Odile; Hugonenq, Catherine; Audic, Frédérique; Chabrol, Brigitte; Assaiante, Christine

2018-05-01

Feedforward and online controls are two facets of predictive motor control from internal models, which is suspected to be impaired in learning disorders. We examined whether the feedforward component is affected in children (8-12 years) with developmental dyslexia (DD) and/or with developmental coordination disorder (DCD) compared to typically developing (TD) children. Children underwent a bimanual unloading paradigm during which a load supported to one arm, the postural arm, was either unexpectedly unloaded by a computer or voluntary unloaded by the subject with the other arm. All children showed a better stabilization (lower flexion) of the postural arm and an earlier inhibition of the arm flexors during voluntary unloading, indicating anticipation of unloading. Between-group comparisons of kinematics and electromyographic activity of the postural arm revealed that the difference during voluntary unloading was between DD-DCD children and the other groups, with the former showing a delayed inhibition of the flexor muscles. Deficit of the feedforward component of motor control may particularly apply to comorbid subtypes, here the DD-DCD subtype. The development of a comprehensive framework for motor performance deficits in children with learning disorders will be achieved only by dissociating key components of motor prediction and focusing on subtypes and comorbidities. Copyright © 2018 Elsevier Ltd. All rights reserved.

An in silico argument for mitochondrial microRNA as a determinant of primary non function in liver transplantation.

PubMed

Khorsandi, Shirin Elizabeth; Salehi, Siamak; Cortes, Miriam; Vilca-Melendez, Hector; Menon, Krishna; Srinivasan, Parthi; Prachalias, Andreas; Jassem, Wayel; Heaton, Nigel

2018-02-15

Mitochondria have their own genomic, transcriptomic and proteomic machinery but are unable to be autonomous, needing both nuclear and mitochondrial genomes. The aim of this work was to use computational biology to explore the involvement of Mitochondrial microRNAs (MitomiRs) and their interactions with the mitochondrial proteome in a clinical model of primary non function (PNF) of the donor after cardiac death (DCD) liver. Archival array data on the differential expression of miRNA in DCD PNF was re-analyzed using a number of publically available computational algorithms. 10 MitomiRs were identified of importance in DCD PNF, 7 with predicted interaction of their seed sequence with the mitochondrial transcriptome that included both coding, and non coding areas of the hypervariability region 1 (HVR1) and control region. Considering miRNA regulation of the nuclear encoded mitochondrial proteome, 7 hypothetical small proteins were identified with homolog function that ranged from co-factor for formation of ATP Synthase, REDOX balance and an importin/exportin protein. In silico, unconventional seed interactions, both non canonical and alternative seed sites, appear to be of greater importance in MitomiR regulation of the mitochondrial genome. Additionally, a number of novel small proteins of relevance in transplantation have been identified which need further characterization.

Exploring inter-task transfer following a CO-OP approach with four children with DCD: A single subject multiple baseline design.

PubMed

Capistran, Julie; Martini, Rose

2016-10-01

Cognitive Orientation to daily Occupational Performance (CO-OP) approach has been shown to be effective for improving the performance of tasks worked on in therapy and the use of cognitive strategies. No study to date seems to have explored its effectiveness for improving performance of untrained tasks (inter-task transfer) in children with Developmental Coordination Disorder (DCD). This study aimed to determine whether CO-OP leads to improved performance in an untrained task. A single-subject design with multiple baselines across skills was adopted, with three replications. Four children with DCD (7-12years) received 10 sessions of CO-OP intervention where each child worked on three tasks during therapy sessions and a fourth task was identified, but not worked on, to verify inter-task transfer. Task performance was rated over four phases (baseline, intervention, post-intervention, follow-up) using the Performance Quality Rating Scale (PQRS-OD). Graphed data was statistically analyzed using a two or three standard deviation band method. Significant improvement was obtained for 11 of 12 tasks worked on during therapy and for two of the four untrained tasks. These results indicate that the effectiveness of CO-OP to improve untrained tasks in children merit further exploration. Copyright © 2016 Elsevier B.V. All rights reserved.

Airway Pressure Release Ventilation During Ex Vivo Lung Perfusion Attenuates Injury

PubMed Central

Mehaffey, J. Hunter; Charles, Eric J.; Sharma, Ashish K.; Money, Dustin; Zhao, Yunge; Stoler, Mark H; Lau, Christine L; Tribble, Curtis G.; Laubach, Victor E.; Roeser, Mark E.; Kron, Irving L.

2016-01-01

Objective Critical organ shortages have resulted in Ex Vivo Lung Perfusion (EVLP) gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of Donation after Circulatory Death (DCD) organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation (APRV) during EVLP improves lung function after transplantation. Methods Two groups (n=4 animals/group) of porcine DCD donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of EVLP rehabilitation with either standard conventional volume-based ventilation or pressure-based APRV. Left lungs were subsequently transplanted into recipient animals and reperfused for 4 hours. Blood gases for PaO2/FiO2 ratios, airway pressures for calculation of compliance, and percent wet weight gain during EVLP and reperfusion were measured. Results APRV during EVLP significantly improved left-lung oxygenation at 2-hours (561.5±83.9 vs 341.1±136.1 mmHg) and 4-hours (569.1±18.3 vs 463.5±78.4 mmHg). Similarly, compliance was significantly higher at 2-hours (26.0±5.2 vs 15.0±4.6 mL/cmH2O) and 4-hours (30.6±1.3 vs 17.7±5.9 mL/cmH2O) after transplantation. Finally, APRV significantly reduced lung edema development on EVLP based on percentage weight gain (36.9±14.6 vs 73.9±4.9%). There was no difference in additional edema accumulation 4 hours after reperfusion. Conclusions Pressure-directed APRV ventilation strategy during EVLP improves rehabilitation of severely injured DCD lungs. After transplant these lungs demonstrate superior lung-specific oxygenation and dynamic compliance compared to lungs ventilated with standard conventional ventilation. This strategy, if implemented into clinical EVLP protocols, could advance the field of DCD lung rehabilitation to expand the lung donor pool. PMID:27742245

Renal Resistance Trend During Hypothermic Machine Perfusion Is More Predictive of Postoperative Outcome Than Biopsy Score: Preliminary Experience in 35 Consecutive Kidney Transplantations.

PubMed

Bissolati, Massimiliano; Gazzetta, Paolo Giovanni; Caldara, Rossana; Guarneri, Giovanni; Adamenko, Olga; Giannone, Fabio; Mazza, Michele; Maggi, Giulia; Tomanin, Deborah; Rosati, Riccardo; Secchi, Antonio; Socci, Carlo

2018-03-30

Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD. All grafts underwent pretransplantation biopsy evaluation using Karpinski's histological score. Only organs that reached RR value ≤1.0 within 3 hours of perfusion were transplanted. Single kidney transplantation (SKT) or double kidney transplantation (DKT) were performed according to biopsy score results. Sixty-five HMPs were performed (58 from ECDs and 7 from DCD/ECMO donors). Fifteen kidneys were insufficiently reconditioned (RR > 1) and were therefore discarded. Forty-nine kidneys were transplanted, divided between 21 SKT and 14 DKT. Overall primary nonfunction (PNF) and delayed graft function (DGF) rate were 2.9 and 17.1%, respectively. DGF were more common in kidneys from DCD (67 vs. 7%; P = 0.004). Biopsy score did not correlate with PNF/DGF rate (P = 0.870) and postoperative creatinine trend (P = 0.796). Recipients of kidneys that reached RR ≤ 1.0 within 1 hour of HMP had a lower PNF/DGF rate (11 vs. 44%; P = 0.033) and faster serum creatinine decrease (POD10 creatinine: 1.79 mg/dL vs. 4.33 mg/dL; P = 0.019). RR trend is more predictive of post-transplantation outcome than biopsy score. Hence, RR trend should be taken into account in the pretransplantation evaluation of the organs. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Does Traumatic Donor Cause of Death Influence Outcome after Lung Transplantation? A Single-Centre Analysis.

PubMed

Pilarczyk, Kevin; Heckmann, Jens; Carstens, Henning; Lubarski, Jura; Jakob, Heinz; Pizanis, Nikolaus; Kamler, Markus

2017-08-01

Background  Owing to the shortage of donor organs in lung transplantation (LuTX), liberalization of donor selection criteria has been proposed. However, some studies suggested that donor traumatic brain damage might influence posttransplantation allograft function. This article aimed to investigate the association of donor cause of death (DCD) and outcome after LuTX. Methods  A retrospective analysis of 186 consecutive double LuTXs at our institution from January 2000 to December 2008 was performed. DCD was categorized into traumatic brain injury (TBI) and nontraumatic brain injury (NTBI). In addition, NTBI was sub classified as spontaneous intracerebral bleeding (B), hypoxic brain damage (H), and intracerebral neoplasia (N). Results  DCD was classified as TBI in 50 patients (26.9%) and NTBI in 136 patients (73.1%): B in 112 patients (60.2%), H in 21 patients (11.3%), and N in 3 patients (1.6%). Young male donors predominated in group TBI (mean age 36.0 ± 14.5 vs. 42.8 ± 10.7, p  < 0.01; 29 males in the TBI group [58.0%] vs. 48 males in the NTBI group [35.3%], p  < 0.01). Groups of DCD did not differ significantly by recipient age or gender, recipient diagnosis, donor ventilation time, or paO 2 /FiO 2 before harvesting. TBI donors received significantly more blood (3.4 ± 3.8 vs. 1.8 ± 1.9, p  = 0.03). A chest trauma was evident only in group T ( n  = 7 [3.7%] vs. 0 [0%], p  < 0.001). Mode of donor death did not affect the following indices of graft function: length of postoperative ventilation, paO 2 /FiO 2 ratio up to 48 hours, and lung function up to 36 months. One- and three-year survival was comparable with 84.4 and 70.4% for TBI donors versus 89.4% and 69.2% for NTBI donors. Five-year survival tended to be lower in the TBI group but did not reach statistical significance (43.4 vs. 53.9%). Conclusion  This study indicates that traumatic DCD does not affect outcome after LuTX. These results can be achieved with an ideal donor management combined with an individual case-to-case evaluation by an experienced LuTX surgeon. Georg Thieme Verlag KG Stuttgart · New York.

Expression of miR-21 and its targets (PTEN, PDCD4, TM1) in flat epithelial atypia of the breast in relation to ductal carcinoma in situ and invasive carcinoma

PubMed Central

2009-01-01

Background Flat epithelial atypia (FEA) of the breast is characterised by a few layers of mildly atypical luminal epithelial cells. Genetic changes found in ductal carcinoma in situ (DCIS) and invasive ductal breast cancer (IDC) are also found in FEA, albeit at a lower concentration. So far, miRNA expression changes associated with invasive breast cancer, like miR-21, have not been studied in FEA. Methods We performed miRNA in-situ hybridization (ISH) on 15 cases with simultaneous presence of normal breast tissue, FEA and/or DCIS and 17 additional cases with IDC. Expression of the miR-21 targets PDCD4, TM1 and PTEN was investigated by immunohistochemistry. Results Two out of fifteen cases showed positive staining for miR-21 in normal breast ductal epithelium, seven out of fifteen cases were positive in the FEA component and nine out of twelve cases were positive in the DCIS component. A positive staining of miR-21 was observed in 15 of 17 IDC cases. In 12 cases all three components were present in one tissue block and an increase of miR-21 from normal breast to FEA and to DCIS was observed in five cases. In three cases the FEA component was negative, whereas the DCIS component was positive for miR-21. In three other cases, normal, FEA and DCIS components were negative for miR-21 and in the last case all three components were positive. Overall we observed a gradual increase in percentage of miR-21 positive cases from normal, to FEA, DCIS and IDC. Immunohistochemical staining for PTEN revealed no obvious changes in staining intensities in normal, FEA, DCIS and IDC. Cytoplasmic staining of PDCD4 increased from normal to IDC, whereas, the nuclear staining decreased. TM1 staining decreased from positive in normal breast to negative in most DCIS and IDC cases. In FEA, the staining pattern for TM1 was similar to normal breast tissue. Conclusion Upregulation of miR-21 from normal ductal epithelial cells of the breast to FEA, DCIS and IDC parallels morphologically defined carcinogenesis. No clear relation was observed between the staining pattern of miR-21 and its previously reported target genes. PMID:19473551

Modulation of miR-21 signaling by MPS1 in human glioblastoma

PubMed Central

Maachani, Uday B.; Tandle, Anita; Shankavaram, Uma; Kramp, Tamalee; Camphausen, Kevin A.

2016-01-01

Monopolar spindle 1 (MPS1) is an essential spindle assembly checkpoint (SAC) kinase involved in determining spindle integrity. Beyond its mitotic functions, it has been implicated in several other signaling pathways. Our earlier studies have elaborated on role of MPS1 in glioblastoma (GBM) radiosensitization. In this study using reverse phase protein arrays (RPPAs), we assessed MPS1 mediated cell signaling pathways and demonstrated that inhibiting MPS1 could upregulate the expression of the tumor suppressor PDCD4 and MSH2 genes, by down regulating micro RNA-21 (miR-21). In GBMs miR-21 expression is significantly elevated and is associated with chemo and radioresistance. Both MPS1 and miR-21 depletion suppressed GBM cell proliferation, whereas, ectopic expression of miR-21 rescued GBM cell growth from MPS1 inhibition. Further, we demonstrate that MPS1 mediates phosphorylation of SMAD3 but not SMAD2 in GBM cells; A possible mechanism behind miR-21 modulation by MPS1. Collectively, our results shed light onto an important role of MPS1 in TGF-β/SMAD signaling via miR-21 regulation. We also, show the prognostic effect of miR-21, PDCD4 and MSH2 levels to patient survival across different GBM molecular subtypes. This scenario in which miR-21 is modulated by MPS1 inhibition may be exploited as a potential target for effective GBM therapy. PMID:25991676

Modulation of miR-21 signaling by MPS1 in human glioblastoma.

PubMed

Maachani, Uday B; Tandle, Anita; Shankavaram, Uma; Kramp, Tamalee; Camphausen, Kevin

2016-08-16

Monopolar spindle 1 (MPS1) is an essential spindle assembly checkpoint (SAC) kinase involved in determining spindle integrity. Beyond its mitotic functions, it has been implicated in several other signaling pathways. Our earlier studies have elaborated on role of MPS1 in glioblastoma (GBM) radiosensitization. In this study using reverse phase protein arrays (RPPAs), we assessed MPS1 mediated cell signaling pathways and demonstrated that inhibiting MPS1 could upregulate the expression of the tumor suppressor PDCD4 and MSH2 genes, by down regulating micro RNA-21 (miR-21). In GBMs miR-21 expression is significantly elevated and is associated with chemo and radioresistance. Both MPS1 and miR-21 depletion suppressed GBM cell proliferation, whereas, ectopic expression of miR-21 rescued GBM cell growth from MPS1 inhibition. Further, we demonstrate that MPS1 mediates phosphorylation of SMAD3 but not SMAD2 in GBM cells; A possible mechanism behind miR-21 modulation by MPS1. Collectively, our results shed light onto an important role of MPS1 in TGF-β/SMAD signaling via miR-21 regulation. We also, show the prognostic effect of miR-21, PDCD4 and MSH2 levels to patient survival across different GBM molecular subtypes. This scenario in which miR-21 is modulated by MPS1 inhibition may be exploited as a potential target for effective GBM therapy.

Role of cyclophilin D-dependent mitochondrial permeability transition in glutamate-induced calcium deregulation and excitotoxic neuronal death

PubMed Central

Li, Viacheslav; Brustovetsky, Tatiana; Brustovetsky, Nickolay

2009-01-01

In the present study we tested the hypothesis that the cyclophilin D-dependent (CyD) mitochondrial permeability transition (CyD-mPT) plays an important role in glutamate-triggered delayed calcium deregulation (DCD) and excitotoxic neuronal death. We used cultured cortical neurons from wild-type C57BL/6 and cyclophilin D knockout mice (Ppif-/-). Induction of the mPT was identified by following the rapid secondary acidification of mitochondrial matrices monitored with mitochondrially targeted pH-sensitive yellow fluorescent protein. Suppression of the CyD-mPT due to genetic CyD ablation deferred DCD and mitochondrial depolarization, and increased the survival rate after exposure of neurons to 10μM glutamate, but not to 100μM glutamate. Ca2+ influx into Ppif-/- neurons was not diminished in comparison with WT neurons judging by 45Ca accumulation. In both types of neurons, 100μM glutamate produced greater Ca2+ influx than 10μM glutamate. We hypothesize that greater Ca2+ influx produced by higher glutamate rapidly triggered the CyD-independent mPT in both WT and Ppif-/- neurons equalizing their responses to supra-physiologic excitotoxic insults. In neurons exposed to moderate but pathophysiologically-relevant glutamate concentrations, an induction of the CyD-mPT appears to play an important role in mitochondrial injury contributing to DCD and cell death. PMID:19236863

Solid solution partitioning of Sr2+, Ba2+, and Cd2+ to calcite

USGS Publications Warehouse

Tesoriero, A.J.; Pankow, J.F.

1996-01-01

Although solid solutions play important roles in controlling the concentrations of minor metal ions in natural waters, uncertainties regarding their compositions, thermodynamics, and kinetics usually prevent them from being considered. A range of precipitation rates was used here to study the nonequilibrium and equilibrium partitioning behaviors of Sr2+, Ba2+, and Cd2+ to calcite (CaCO3(s)). The distribution coefficient of a divalent metal ion Me2+ for partitioning from an aqueous solution into calcite is given by DMe = (XMeCO3(s)/[Me2+])/(XCaCO3(s)/[Ca 2+]). The X values are solid-phase mole fractions; the bracketed values are the aqueous molal concentrations. In agreement with prior work, at intermediate to high precipitation rates R (nmol/mg-min), DSr, DBa, and DCd were found to depend strongly on R. At low R, the values of DSr, DBa, and DCd became constant with R. At 25??C, the equilibrium values for DSr, DBa, and DCd for dilute solid solutions were estimated to be 0.021 ?? 0.003, 0.012 ?? 0.005, and 1240 ?? 300, respectively. Calculations using these values were made to illustrate the likely importance of partitioning of these ions to calcite in groundwater systems. Due to its large equilibrium DMe value, movement of Cd2+ will be strongly retarded in aquifers containing calcite; Sr2+ and Ba2+ will not be retarded nearly as much.

Understanding why an active video game intervention did not improve motor skill and physical activity in children with developmental coordination disorder: A quantity or quality issue?

PubMed

Howie, Erin K; Campbell, Amity C; Abbott, Rebecca A; Straker, Leon M

2017-01-01

Active video games (AVGs) have been identified as a novel strategy to improve motor skill and physical activity in clinical populations. A recent cross-over randomized trial found AVGs to be ineffective at improving motor skill and physical activity in the home-environment for children with or at-risk for developmental coordination disorder (DCD). The study purpose was to better understand why the intervention had been ineffective by examining the quantity and quality of AVG play during an AVG intervention for children with or at-risk for DCD. Participants (n=21, ages 9-12) completed the 16 week AVG intervention. Detailed quantitative and qualitative data were systematically triangulated to obtain the quantity of exposure (AVG exposure over time, patterns of exposure) and quality of use (game selection, facilitators and barriers to play). The median AVG dose (range 30-35min/day) remained relatively stable across the intervention and met the prescribed dose. Play quality was impacted by game selection, difficulty playing games, lack of time, illness, technical difficulties and boredom. The ineffectiveness of a home-based AVG intervention may be due to quality of play. Strategies to improve the quality of game play may help realize the potential benefits of AVGs as a clinical tool for children with DCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Exploring the Link between Visual Perception, Visual-Motor Integration, and Reading in Normal Developing and Impaired Children using DTVP-2.

PubMed

Bellocchi, Stéphanie; Muneaux, Mathilde; Huau, Andréa; Lévêque, Yohana; Jover, Marianne; Ducrot, Stéphanie

2017-08-01

Reading is known to be primarily a linguistic task. However, to successfully decode written words, children also need to develop good visual-perception skills. Furthermore, motor skills are implicated in letter recognition and reading acquisition. Three studies have been designed to determine the link between reading, visual perception, and visual-motor integration using the Developmental Test of Visual Perception version 2 (DTVP-2). Study 1 tests how visual perception and visual-motor integration in kindergarten predict reading outcomes in Grade 1, in typical developing children. Study 2 is aimed at finding out if these skills can be seen as clinical markers in dyslexic children (DD). Study 3 determines if visual-motor integration and motor-reduced visual perception can distinguish DD children according to whether they exhibit or not developmental coordination disorder (DCD). Results showed that phonological awareness and visual-motor integration predicted reading outcomes one year later. DTVP-2 demonstrated similarities and differences in visual-motor integration and motor-reduced visual perception between children with DD, DCD, and both of these deficits. DTVP-2 is a suitable tool to investigate links between visual perception, visual-motor integration and reading, and to differentiate cognitive profiles of children with developmental disabilities (i.e. DD, DCD, and comorbid children). Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

[Association between the characteristics of coordination development disorder and symptoms of attention deficit disorder with hyperactivity in children in the city of Manizales].

PubMed

Salamanca Duque, Luisa Matilde; Naranjo Aristizábal, María Mercedes; Castro Castro, Ángel Laban; Calle Jaramillo, Guillermo Andrés

2016-01-01

Developmental coordination disorder (DCD) in childhood is an important public health problem, which has important implications for different spheres of development: motor, cognitive, psychosocial and emotional. Therefore, the presence of comorbidity is common, along with other disorders in child development. This article presents a study that determines the association between DCD characteristics with attention deficit and hyperactivity disorder (ADHD) symptoms. To determine the association between DCD characteristics and ADHD symptoms in the city of Manizales, Colombia. Cross-sectional, descriptive and associative study, in a sample of 140 children aged 6-12, randomised in public and private institutions. A structured interview was conducted, along with the questionnaires MINIKID and Cuestionario para Trastorno del Desarrollo de la Coordinación (CTDC). A descriptive univariate analysis was performed on the the sociodemographic characteristics, as well as association tests with χ(2) test, and dependence level with φ coefficient. A statistically significant association was found between the CTDC characteristics with ADHD symptoms (φ=.452; P=.001). An association was found in the studied population between the CTDC characteristics and ADHD symptoms, indicating that children with difficulties in motor performance may also have attention difficulties and hyperactivity. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Effect of Feeding Palm Oil By-Products Based Diets on Total Bacteria, Cellulolytic Bacteria and Methanogenic Archaea in the Rumen of Goats

PubMed Central

Abubakr, Abdelrahim; Alimon, Abdul Razak; Yaakub, Halimatun; Abdullah, Norhani; Ivan, Michael

2014-01-01

Rumen microorganisms are responsible for digestion and utilization of dietary feeds by host ruminants. Unconventional feed resources could be used as alternatives in tropical areas where feed resources are insufficient in terms of quality and quantity. The objective of the present experiment was to evaluate the effect of diets based on palm oil (PO), decanter cake (DC) or palm kernel cake (PKC) on rumen total bacteria, selected cellulolytic bacteria, and methanogenic archaea. Four diets: control diet (CD), decanter cake diet (DCD), palm kernel cake diet (PKCD) and CD plus 5% PO diet (CPOD) were fed to rumen cannulated goats and rumen samples were collected at the start of the experimental diets (day 0) and on days 4, 6, 8, 12, 18, 24 and 30 post dietary treatments. Feeding DCD and PKCD resulted in significantly higher (P<0.05) DNA copy number of total bacteria, Fibrobacter succinogenes, Ruminococcus flavefeciens, and Ruminococcus albus. Rumen methanogenic archaea was significantly lower (P<0.05) in goats fed PKCD and CPOD and the trend showed a severe reduction on days 4 and 6 post experimental diets. In conclusion, results indicated that feeding DCD and PKC increased the populations of cellulolytic bacteria and decreased the density of methanogenic archaea in the rumen of goats. PMID:24756125

Ex Vivo Perfusion Characteristics of Donation After Cardiac Death Kidneys Predict Long-Term Graft Survival.

PubMed

Sevinc, M; Stamp, S; Ling, J; Carter, N; Talbot, D; Sheerin, N

2016-12-01

Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation. There were 155 kidney transplantations included in the final analysis. Demographic data, ischemia times, donor hypertension, graft function, survival and machine perfusion parameters after 3 hours were analyzed. Each perfusion parameter was divided into 3 groups as high, medium, and low. Estimated glomerular filtration rate was calculated at 12 months and then yearly after transplantation. There was a significant association between graft survival and PFI and GST (P values, .020 and .022, respectively). PFI was the only independent parameter to predict graft survival. A low PFI during ex vivo hypothermic perfusion is associated with inferior graft survival after DCD kidney transplantation. We propose that PFI is a measure of the health of the graft vasculature and that a low PFI indicates vascular disease and therefore predicts a worse long-term outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Integrated readout electronics for Belle II pixel detector

NASA Astrophysics Data System (ADS)

Blanco, R.; Leys, R.; Perić, I.

2018-03-01

This paper describes the readout components for Belle II that have been designed as integrated circuits. The ICs are connected to DEPFET sensor by bump bonding. Three types of ICs have been developed: SWITCHER for pixel matrix control, DCD for readout and digitizing of sensor signals and DHP for digital data processing. The ICs are radiation tolerant and use several novel features, such as the multiple-input differential amplifiers and the fast and radiation hard high-voltage drivers. SWITCHER and DCD have been developed at University of Heidelberg, Karlsruhe Institute of Technology (KIT) and DHP at Bonn University. The IC-development started in 2009 and was accomplished in 2016 with the submissions of final designs. The final ICs for Belle II pixel detector and the related measurement results will be presented in this contribution.

The movement assessment battery in Greek preschoolers: the impact of age, gender, birth order, and physical activity on motor outcome.

PubMed

Giagazoglou, Paraskevi; Kabitsis, Nikolaos; Kokaridas, Dimitrios; Zaragas, Charilaos; Katartzi, Ermioni; Kabitsis, Chris

2011-01-01

Early identification of possible risk factors that could impair the motor development is crucial, since poor motor performance may have long-term negative consequences for a child's overall development. The aim of the current study was the examination of disorders in motor coordination in Greek pre-school aged children and the detection of differences in motor performance with regards to age, gender, participation in sports and order of birth in the family. Performance profiles on the movement ABC were used to classify 412 Greek children aged 4-6 years old. It appears from the results that the occurrence rate of probable developmental coordination disorders (DCD) was 5.4%. Significant differences were observed in all independent variables except the order of birth in the family. The findings reinforce the need for the evaluation of motor performance in preschool-aged children, in order specific individual motor profiles to be established for optimizing and adapting early intervention programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

Training children aged 5-10 years in manual compliance control to improve drawing and handwriting.

PubMed

Bingham, Geoffrey P; Snapp-Childs, Winona

2018-04-12

A large proportion of school-aged children exhibit poor drawing and handwriting. This prevalence limits the availability of therapy. We developed an automated method for training improved manual compliance control and relatedly, prospective control of a stylus. The approach included a difficult training task, while providing parametrically modifiable support that enables the children to perform successfully while developing good compliance control. The task was to use a stylus to push a bead along a 3D wire path. Support was provided by making the wire magnetically attractive to the stylus. Support was progressively reduced as 3D tracing performance improved. We report studies that (1) compared performance of Typically Developing (TD) children and children with Developmental Coordination Disorder (DCD), (2) tested training with active versus passive movement, (3) tested progressively reduced versus constant or no support during training, (4) tested children of different ages, (5) tested the transfer of training to a drawing task, (6) tested the specificity of training in respect to the size, shape and dimensionality of figures, and (7) investigated the relevance of the training task to the Beery VMI, an inventory used to diagnose DCD. The findings were as follows. (1) Pre-training performance of TD and DCD children was the same and good with high support but distinct and poor with low support. Support yielded good self-efficacy that motivated training. Post training performance with no support was improved and the same for TD and DCD children. (2) Actively controlled movements were required for improved performance. (3) Progressively reduced support was required for good performance during and after training. (4) Age differences in performance during pre-training were eliminated post-training. (5) Improvements transferred to drawing. (6) There was no evidence of specificity of training in transfer. (7) Disparate Beery scores were reflected in pre-training but not post-training performance. We conclude that the method improves manual compliance control, and more generally, prospective control of movements used in drawing performance. Copyright © 2018. Published by Elsevier B.V.

Study on ATP concentration changes in cytosol of individual cultured neurons during glutamate-induced deregulation of calcium homeostasis.

PubMed

Surin, A M; Gorbacheva, L R; Savinkova, I G; Sharipov, R R; Khodorov, B I; Pinelis, V G

2014-02-01

For the first time, simultaneous monitoring of changes in the concentration of cytosolic ATP ([ATP]c), pH (pHc), and intracellular free Ca2+ concentration ([Ca2+]i) of the individual neurons challenged with toxic glutamate (Glu) concentrations was performed. To this end, the ATP-sensor AT1.03, which binds to ATP and therefore enhances the efficiency of resonance energy transfer between blue fluorescent protein (energy donor) and yellow-green fluorescent protein (energy acceptor), was expressed in cultured hippocampal neurons isolated from 1-2-day-old rat pups. Excitation of fluorescence in the acceptor protein allowed monitoring changes in pHc. Cells were loaded with fluorescent low-affinity Ca2+ indicators Fura-FF or X-rhod-FF to register [Ca2+]i. It was shown that Glu (20 µM, glycine 10 µM, Mg2+-free) produced a rapid acidification of the cytosol and decrease in [ATP]c. An approximately linear relationship (r(2) = 0.56) between the rate of [ATP]c decline and latency of glutamate-induced delayed calcium deregulation (DCD) was observed: higher rate of [ATP]c decrease corresponded to shorter DCD latency period. DCD began with a decrease in [ATP]c of as much as 15.9%. In the phase of high [Ca2+]i, the plateau of [ATP]c dropped to 10.4% compared to [ATP]c in resting neurons (100%). In the presence of the Na+/K+-ATPase inhibitor ouabain (0.5 mM), glutamate-induced reduction in [ATP]c in the phase of the high [Ca2+]i plateau was only 36.6%. Changes in [ATP]c, [Ca2+]i, mitochondrial potential, and pHc in calcium-free or sodium-free buffers, as well as in the presence of the inhibitor of Na+/K+-ATPase ouabain (0.5 mM), led us to suggest that in addition to increase in proton conductivity and decline in [ATP]c, one of the triggering factors of DCD might be a reversion of the neuronal plasma membrane Na+/Ca2+ exchange.

[Characteristics of ammonia volatilization and nitrous oxide emission from a paddy soil under continuous application of different slow/controlled release urea.

PubMed

Sun, Xiang Xin; Li, Dong Po; Wu, Zhi Jie; Cui, Ya Lan; Han, Mei; Li, Yong Hua; Yang, De Fu; Cui, Yong Kun

2016-06-01

The characteristics of ammonia volatilization and nitrous oxide emission from a paddy soil were examined under 9-year application of different slow/controlled release urea with the common large granule urea (U) as the control. The results showed that compared with the control, all slow/controlled release urea treatments, except 25.8% increase of ammonia volatilization under 1% 3,4-dimethylpyrazole phosphate (DMPP)+U, could decrease the ammonia volatilization. Polymer coated urea (PCU) dominated the highest reduction of 73.4% compared to U, followed by sulfur coated urea (SCU) (72.2%), 0.5% N-(N-butyl) thiophosphoric triamide (NBPT)+1% DMPP+U (71.9%), 1% hydroquinone (HQ)+3% dicyandiamide (DCD)+U (46.9%), 0.5% NBPT+U (43.2%), 1% HQ +U (40.2%), 3% DCD+U (25.5%), and the ammonia volatilization under different slow/controlled release urea treatments were statistically lower than that of U (P<0.05). 1% DMPP+U caused the lowest emission of N 2 O under different slow/controlled release urea treatments. The slow/controlled release urea also had a significant potential of N 2 O emission reduction: 1% DMPP+U showed the highest reduction of 74.9% compared to U, followed by PCU (62.1%), 1% HQ+3% DCD+U (54.7%), 0.5% NBPT+1% DMPP+U (42.2%), 3% DCD+U (35.9%), 1% HQ +U (28.9%), 0.5% NBPT+U (17.7%), SCU (14.5%), and N 2 O emissions under different slow/controlled release urea treatments were statistically lower than that of U (P<0.05). The comprehensive analysis showed that 0.5% NBPT+1% DMPP+U, SCU and PCU had similar effects on decreasing the ammonia volatilization and N 2 O emission and were remarkably better than the other treatments. The slow release urea with the combination of urease and nitrification inhibitors should be the first choice for reducing N loss and environmental pollution in paddy field, in view of the higher costs of coated urea fertilizers.

Regional perfusion by extracorporeal membrane oxygenation of abdominal organs from donors after circulatory death: a systematic review.

PubMed

Shapey, Iestyn M; Muiesan, Paolo

2013-12-01

Organs from donors after circulatory death (DCDs) are particularly susceptible to the effects of warm ischemia injury. Regional perfusion (RP) by extracorporeal membrane oxygenation (ECMO) is increasingly being advocated as a useful remedy to the effects of ischemia/reperfusion injury, and it has been reported to enable the transplantation of organs from donors previously deemed unsuitable. The MEDLINE, Embase, and Cochrane databases were searched, and articles published between 1997 and 2013 were obtained. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two hundred ten articles were identified, and 11 were eligible for inclusion. Four hundred eighty-two kidneys and 79 livers were transplanted from regional perfusion-supported donor after circulatory death (RP-DCD) sources. One-year graft survival was lower with uncontrolled RP-DCD liver transplantation, whereas 1-year patient survival was similar. Primary nonfunction and ischemic cholangiopathy were significantly more frequent with RP-DCDs versus donors after brain death (DBDs), but there was no difference in postoperative mortality between the 2 groups. The 1-year patient and graft survival rates for RP-DCD kidney transplantation were better than the rates with standard DCDs and were comparable to, if not better than, the rates with DBDs. At experienced centers, delayed graft function (DGF) for kidney transplantation from RP-DCDs was much less frequent in comparison with all other donor types. In conclusion, RP aids the recovery of DCD organs from ischemic injury and enables transplantation with acceptable survival. RP may help to increase the donor pool, but its benefits must still be balanced with the recognition of significantly higher rates of complications in liver transplantation. In kidney transplantation, significant reductions in DGF can be obtained with RP, and there are potentially important implications for long-term outcomes. Significant ethicolegal issues exist, and they are preventing a worldwide consensus on optimum RP protocols and an accurate appreciation of outcomes. © 2013 American Association for the Study of Liver Diseases.

Diverging diamond interchange performance evaluation (I-44 and Route 13)

DOT National Transportation Integrated Search

2011-02-01

Performance evaluation was conducted on the first diverging diamond interchange (DDI) or double : crossover interchange (DCD) constructed in the United States. This evaluation assessed traffic operations, safety and : public perceptions t...

Brief report: Response inhibition and processing speed in children with motor difficulties and developmental coordination disorder.

PubMed

Bernardi, Marialivia; Leonard, Hayley C; Hill, Elisabeth L; Henry, Lucy A

2016-01-01

A previous study reported that children with poor motor skills, classified as having motor difficulties (MD) or Developmental Coordination Disorder (DCD), produced more errors in a motor response inhibition task compared to typically developing (TD) children but did not differ in verbal inhibition errors. The present study investigated whether these groups differed in the length of time they took to respond in order to achieve these levels of accuracy, and whether any differences in response speed could be explained by generally slow information processing in children with poor motor skills. Timing data from the Verbal Inhibition Motor Inhibition test were analyzed to identify differences in performance between the groups on verbal and motor inhibition, as well as on processing speed measures from standardized batteries. Although children with MD and DCD produced more errors in the motor inhibition task than TD children, the current analyses found that they did not take longer to complete the task. Children with DCD were slower at inhibiting verbal responses than TD children, while the MD group seemed to perform at an intermediate level between the other groups in terms of verbal inhibition speed. Slow processing speed did not account for these group differences. Results extended previous research into response inhibition in children with poor motor skills by explicitly comparing motor and verbal responses, and suggesting that slow performance, even when accurate, may be attributable to an inefficient way of inhibiting responses, rather than slow information processing speed per se.

Rapid label-free identification of Klebsiella pneumoniae antibiotic resistant strains by the drop-coating deposition surface-enhanced Raman scattering method

NASA Astrophysics Data System (ADS)

Cheong, Youjin; Kim, Young Jin; Kang, Heeyoon; Choi, Samjin; Lee, Hee Joo

2017-08-01

Although many methodologies have been developed to identify unknown bacteria, bacterial identification in clinical microbiology remains a complex and time-consuming procedure. To address this problem, we developed a label-free method for rapidly identifying clinically relevant multilocus sequencing typing-verified quinolone-resistant Klebsiella pneumoniae strains. We also applied the method to identify three strains from colony samples, ATCC70063 (control), ST11 and ST15; these are the prevalent quinolone-resistant K. pneumoniae strains in East Asia. The colonies were identified using a drop-coating deposition surface-enhanced Raman scattering (DCD-SERS) procedure coupled with a multivariate statistical method. Our workflow exhibited an enhancement factor of 11.3 × 106 to Raman intensities, high reproducibility (relative standard deviation of 7.4%), and a sensitive limit of detection (100 pM rhodamine 6G), with a correlation coefficient of 0.98. All quinolone-resistant K. pneumoniae strains showed similar spectral Raman shifts (high correlations) regardless of bacterial type, as well as different Raman vibrational modes compared to Escherichia coli strains. Our proposed DCD-SERS procedure coupled with the multivariate statistics-based identification method achieved excellent performance in discriminating similar microbes from one another and also in subtyping of K. pneumoniae strains. Therefore, our label-free DCD-SERS procedure coupled with the computational decision supporting method is a potentially useful method for the rapid identification of clinically relevant K. pneumoniae strains.

Cross-cultural adaptation, reliability and predictive validity of the Italian version of Developmental Coordination Disorder Questionnaire (DCDQ).

PubMed

Caravale, Barbara; Baldi, Silvia; Gasparini, Corinna; Wilson, Brenda N

2014-05-01

Developmental coordination disorder (DCD) is a motor disorder of unclear etiology that severely interferes with a child's ability to perform daily motor tasks. As a useful alternative to a time-consuming motor test and specialist evaluation, parents or teachers can complete motor questionnaires. A tool used worldwide to screen motor performance in 4- to 14-year-old children is the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). To describe how we translated the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) and adapted it to the Italian population and to test its preliminary psychometric properties in Italian children. Parents of a clinical group of 26 children (5-11 years old) with a diagnosis of DCD and 52 matched controls completed the DCDQ translated into Italian and adapted for cross-cultural purposes according to current guidelines. Twenty-four parents of typically developing children randomly selected completed the questionnaire twice to examine test-retest reliability. The internal consistency value (Cronbach alpha) for the Italian DCDQ was 0.94. The Italian DCDQ achieved moderate-to-high test-retest reliability (ICC) for 14/15 items and a good diagnostic performance for identifying children with DCD (sensitivity 88% and specificity 96%). The Italian DCDQ is a valid screening tool for assessing motor performance in 5- to 11-year-old children that merits research in a larger sample. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Outcome of organs procured from donors on extracorporeal membrane oxygenation support: an analysis of kidney and liver allograft data.

PubMed

Carter, Timothy; Bodzin, Adam S; Hirose, Hitoshi; West, Sharon; Hasz, Richard; Maley, Warren R; Cavarocchi, Nicholas C

2014-07-01

Extracorporeal membrane oxygenation has become rescue therapy for adults with overwhelming cardiac and/or respiratory failure. Not all patients are saved, creating a new cohort of potential organ donors. This study examines the outcomes of liver and kidney allografts procured from donors on extracorporeal membrane oxygenation (ECMO). A retrospective review was conducted through the local organ procurement organization. Donors on ECMO prior to notification were classified into donation after brain death (DBD) and donation after cardiac death (DCD). We compared short-term outcome data against published standards. Between 1995 and 2012, 97 organs were procured from 41 donors supported on ECMO. There were 68 kidneys donated, 51 were transplanted and 17 discarded. Excluding extended criteria donors, 29 DBD and 13 DCD kidneys were transplanted from donors supported on ECMO. Delayed graft function occurred in 34% of DBD kidneys and 38% of DCD kidneys. Kidney allograft survival at one yr was 93%. Twenty-four livers were procured, nine discarded, and 15 transplanted. Ninety-three percent of liver transplant recipients were alive with graft function at one yr. Donation after brain death kidneys procured from donors on ECMO perform similarly to non-ECMO organs with regard to delayed graft function (DGF), one-yr graft survival and function. Livers from ECMO donors have a higher discard rate than non-ECMO donors, but function similarly at six months and one yr. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Programmed cell death 6 interacting protein (PDCD6IP) and Rabenosyn-5 (ZFYVE20) are potential urinary biomarkers for upper gastrointestinal cancer.

PubMed

Husi, Holger; Skipworth, Richard J E; Cronshaw, Andrew; Stephens, Nathan A; Wackerhage, Henning; Greig, Carolyn; Fearon, Kenneth C H; Ross, James A

2015-06-01

Cancer of the upper digestive tract (uGI) is a major contributor to cancer-related death worldwide. Due to a rise in occurrence, together with poor survival rates and a lack of diagnostic or prognostic clinical assays, there is a clear need to establish molecular biomarkers. Initial assessment was performed on urine samples from 60 control and 60 uGI cancer patients using MS to establish a peak pattern or fingerprint model, which was validated by a further set of 59 samples. We detected 86 cluster peaks by MS above frequency and detection thresholds. Statistical testing and model building resulted in a peak profiling model of five relevant peaks with 88% overall sensitivity and 91% specificity, and overall correctness of 90%. High-resolution MS of 40 samples in the 2-10 kDa range resulted in 646 identified proteins, and pattern matching identified four of the five model peaks within significant parameters, namely programmed cell death 6 interacting protein (PDCD6IP/Alix/AIP1), Rabenosyn-5 (ZFYVE20), protein S100A8, and protein S100A9, of which the first two were validated by Western blotting. We demonstrate that MS analysis of human urine can identify lead biomarker candidates in uGI cancers, which makes this technique potentially useful in defining and consolidating biomarker patterns for uGI cancer screening. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Omega-6 Fatty Acids

MedlinePlus

... not coordination or movement in children with DCD. Laser eye surgery. Early research suggests that taking a tablet that ... improve tear production and improve eye healing after laser eye surgery. Improving mental development or growth in infants.Adding ...

Organ donation in adults: a critical care perspective.

PubMed

Citerio, Giuseppe; Cypel, Marcelo; Dobb, Geoff J; Dominguez-Gil, Beatriz; Frontera, Jennifer A; Greer, David M; Manara, Alex R; Shemie, Sam D; Smith, Martin; Valenza, Franco; Wijdicks, Eelco F M

2016-03-01

The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

Handwriting in children with ADHD.

PubMed

Langmaid, Rebecca A; Papadopoulos, Nicole; Johnson, Beth P; Phillips, James G; Rinehart, Nicole J

2014-08-01

Children with ADHD-combined type (ADHD-CT) display fine and gross motor problems, often expressed as handwriting difficulties. This study aimed to kinematically characterize the handwriting of children with ADHD using a cursive letter l's task. In all, 28 boys (7-12 years), 14 ADHD-CT and 14 typically developing (TD), without developmental coordination disorder (DCD) or comorbid autism, wrote a series of four cursive letter l's using a graphics tablet and stylus. Children with ADHD-CT had more inconsistent writing size than did TD controls. In addition, ADHD-CT symptom severity, specifically inattention, predicted poorer handwriting outcomes. In a sample of children with ADHD-CT who do not have DCD or autism, subtle handwriting differences were evident. It was concluded that handwriting might be impaired in children with ADHD in a manner dependent on symptom severity. This may reflect reports of underlying motor impairment in ADHD. © 2011 SAGE Publications.

Is heart transplantation after circulatory death compatible with the dead donor rule?

PubMed

Nair-Collins, Michael; Miller, Franklin G

2016-05-01

Dalle Ave et al (2016) provide a valuable overview of several protocols for heart transplantation after circulatory death. However, their analysis of the compatibility of heart donation after circulatory death (DCD) with the dead donor rule (DDR) is flawed. Their permanence-based criteria for death, which depart substantially from established law and bioethics, are ad hoc and unfounded. Furthermore, their analysis is self-defeating, because it undercuts the central motivation for DDR as both a legal and a moral constraint, rendering the DDR vacuous and trivial. Rather than devise new and ad hoc criteria for death for the purpose of rendering DCD nominally consistent with DDR, we contend that the best approach is to explicitly abandon DDR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Donation after circulatory death: burying the dead donor rule.

PubMed

Rodríguez-Arias, David; Smith, Maxwell J; Lazar, Neil M

2011-08-01

Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death.

The importance of parent and child opinion in detecting change in movement capabilities.

PubMed

Green, Dido; Wilson, Brenda N

2008-10-01

Children and parents can make valid judgments about movement difficulties, which aids in the screening and assessment of Developmental Coordination Disorder (DCD). When considering therapy outcomes, child and family-centred practice supports the inclusion of parent and child perspectives to reflect progress made in meaningful daily contexts. This paper describes an evaluation of the use of questionnaires for parents and children to measure change in motor performance. Questionnaires were administered to 43 children with DCD and their parents five times over two-anda-quarter years in conjunction with other clinical measures. Parent report, using the Developmental Coordination Disorder Questionnaire, correlated significantly with clinical measures of motor skill, whilst parent and child perceptions differed. Children's confidence and resilience may influence their opinions of their ability. These results raise questions of whose perspective of progress is most valid and relevant - the therapist's, child's or parent's?

Developmental dyspraxia by any other name: are they all just clumsy children?

PubMed

Missiuna, C; Polatajko, H

1995-01-01

The recent introduction of the diagnostic category developmental coordination disorder (DCD) (American Psychiatric Association [APA], 1987, 1994), has generated confusion among researchers and clinicians in many fields, including occupational therapy. Although the diagnostic criteria appear to be similar to those used to define clumsy children, children with developmental dyspraxia, or children with sensory integrative dysfunction, we are left with the question: Are children who receive the diagnosis of DCD the same as those who receive the other diagnoses, a subgroup, or an entirely distinct group of children? This article will examine the theoretical and empirical literature and use the results to support the thesis that these terms are not interchangeable and yet are not being used in the literature in a way that clearly defines each subgroup of children. Clear definitions and characteristic features need to be identified and associated with each term to guide occupational therapy assessment and intervention and clinical research.

Preparation, characterization and dissolution of passive oxide film on the 400 series stainless steel surfaces

NASA Astrophysics Data System (ADS)

Sathyaseelan, V. S.; Rufus, A. L.; Chandramohan, P.; Subramanian, H.; Velmurugan, S.

2015-12-01

Full system decontamination of Primary Heat Transport (PHT) system of Pressurised Heavy Water Reactors (PHWRs) resulted in low decontamination factors (DF) on stainless steel (SS) surfaces. Hence, studies were carried out with 403 SS and 410 SS that are the material of construction of "End-Fitting body" and "End-Fitting Liner tubes". Three formulations were evaluated for the dissolution of passive films formed over these alloys viz., i) Two-step process consisting of oxidation and reduction reactions, ii) Dilute Chemical Decontamination (DCD) and iii) High Temperature Process. The two-step and high temperature processes could dissolve the oxide completely while the DCD process could remove only 60%. Various techniques like XRD, Raman spectroscopy and SEM-EDX were used for assessing the dissolution process. The two-step process is time consuming, laborious while the high temperature process is less time consuming and is recommended for SS decontamination.

Organ donation after medical assistance in dying or cessation of life-sustaining treatment requested by conscious patients: the Canadian context.

PubMed

Allard, Julie; Fortin, Marie-Chantal

2017-09-01

In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death. The donation is subsequent to the decision to withdraw life-sustaining treatment (LST). Cases where patients are conscious prior to the withdrawal of LST are unusual, and have raised doubts as to the acceptability of removing organs from individuals who are not neurologically impaired and who have voluntarily chosen to die. These cases can be compared with likely scenarios in which patients will request both MAID and organ donation. In both instances, patients will be conscious and competent. Organ donation in such contexts raises ethical issues regarding respect for autonomy, societal pressure, conscientious objections and the dead-donor rule. In this article, we look at relevant policies in other countries and examine the ethical issues associated with cDCD in conscious patients who choose to die. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A Novel Balance Training Program for Children With Developmental Coordination Disorder

PubMed Central

Fong, Shirley S.M.; Guo, X.; Cheng, Yoyo T.Y.; Liu, Karen P.Y.; Tsang, William W.N.; Yam, Timothy T.T.; Chung, Louisa M.Y.; Macfarlane, Duncan J.

2016-01-01

Abstract This study aimed to compare the effectiveness of a specific functional movement–power training (FMPT) program, a functional movement training (FMT) program and no training in the improvement of balance strategies, and neuromuscular performance in children with developmental coordination disorder (DCD). It was a randomized, single-blinded, parallel group controlled trial. Methods: 161 children with DCD (age: 6–10 years) were randomly assigned to the FMPT, FMT, or control groups. The 2 intervention groups received FMPT or FMT twice a week for 3 months. Measurements were taken before, after, and 3 months after the end of the intervention period. The primary outcomes were the composite score and strategy scores on the sensory organization test as measured by a computerized dynamic posturography machine. Secondary outcomes included the knee muscle peak force and the time taken to reach the peak force. The balance strategies adopted in sensory challenging environments of the FMPT participants showed greater improvement from baseline to posttest than those of the FMT participants (7.10 points; 95% confidence interval, 1.51–12.69; P = 0.008) and the control participants (7.59 points; 95% confidence interval, 1.81–13.38; P = 0.005). The FMPT participants also exhibited greater improvement from baseline to the posttest in the knee extensor peak force and time to peak force in the knee flexors. The FMPT program was more effective than the conventional FMT program in the enhancement of balance strategies and neuromuscular performance in children with DCD. PMID:27100457

Influence of titanium implant surface characteristics on bone regeneration in dehiscence-type defects: an experimental study in dogs.

PubMed

Schwarz, Frank; Sager, Martin; Kadelka, Ines; Ferrari, Daniel; Becker, Jürgen

2010-05-01

The aim of the present study was to compare bone regeneration in dehiscence-type defects at titanium implants with chemically modified sandblasted/acid-etched (modSLA) or dual acid-etched surfaces with a calcium phosphate nanometre particle modification (DCD/CaP). Buccal dehiscence-type defects were surgically created following implant site preparation in both the upper and the lower jaws of 12 fox hounds. Both types of implants were randomly allocated in a split-mouth design and left to heal in a submerged position for 2 and 8 weeks. Dissected blocks were processed for histomorphometrical analysis [e.g. new bone height (NBH), percentage of bone-to-implant contact (BIC), area of new bone fill (BF), and area of mineralized tissue (MT) within BF]. At 2 and 8 weeks, both groups revealed comparable mean BF (2.3+/-0.6 to 2.5+/-0.6 mm(2)versus 2.0+/-0.6 to 1.4+/-0.5 mm(2)) and MT (31.1+/-14.3-83.2+/-8.2%versus 38.9+/-15.9-84.4+/-6.3%) values. However, modSLA implants revealed significantly higher mean NBH (2.4+/-0.8 to 3.6+/-0.3 mm versus 0.9+/-0.8 to 1.8+/-1.4 mm) and BIC (53.3+/-11.3-79.5+/-6.6%versus 19.3+/-16.4-47.2+/-30.7%) values than DCD/CaP implants. ModSLA implants may have a higher potential to support osseointegration in dehiscence-type defects than DCD/CaP implants.

A narrative meta-review of a series of systematic and meta-analytic reviews on the intervention outcome for children with developmental co-ordination disorder.

PubMed

Miyahara, M; Lagisz, M; Nakagawa, S; Henderson, S E

2017-09-01

Systematic reviews and meta-analyses are considered to be the 'gold standards' for synthesizing research evidence in particular areas of enquiry. However, such reviews are only useful if they themselves are conducted to a sufficiently high standard. The aim of this study was to conduct a narrative meta-review of existing analyses of the effectiveness of interventions designed for children with developmental co-ordination disorder (DCD). A narrative meta-review of systematic and meta-analytic reviews aimed at evaluating the effectiveness of intervention for children with DCD was conducted on studies published between 1950 and 2014. We identified suitable reviews, using a modification of the Population, Intervention, Comparison, Outcome (PICO) system and evaluated their methodological quality using the Assessment of Multiple Systematic Reviews (AMSTAR). In addition, the consistency of the quality of evidence and classification of intervention approaches was assessed independently by two assessors. The literature search yielded a total of four appropriate reviews published in the selected time span. The Assessment of Multiple Systematic Reviews percentage quality scores assigned to each review ranged from 0% (low quality) to 55% (medium quality). Evaluation of the quality of evidence and classification of intervention approaches yielded a discrepancy rate of 25%. All reviews concluded that some kind of intervention was better than none at all. Although the quality of the reviews progressively improved over the years, the shortcomings identified need to be addressed before concrete evidence regarding the best approach to intervention for children with DCD can be specified. © 2016 John Wiley & Sons Ltd.

Early allograft dysfunction in liver transplantation with donation after cardiac death donors results in inferior survival.

PubMed

Lee, David D; Singh, Amandeep; Burns, Justin M; Perry, Dana K; Nguyen, Justin H; Taner, C Burcin

2014-12-01

Donation after cardiac death (DCD) liver allografts have been associated with increased morbidity from primary nonfunction, biliary complications, early allograft failure, cost, and mortality. Early allograft dysfunction (EAD) after liver transplantation has been found to be associated with inferior patient and graft survival. In a cohort of 205 consecutive liver-only transplant patients with allografts from DCD donors at a single center, the incidence of EAD was found to be 39.5%. The patient survival rates for those with no EAD and those with EAD at 1, 3, and 5 years were 97% and 89%, 79% and 79%, and 61% and 54%, respectively (P = 0.009). Allograft survival rates for recipients with no EAD and those with EAD at 1, 3, and 5 years were 90% and 75%, 72% and 64%, and 53% and 43%, respectively (P = 0.003). A multivariate analysis demonstrated a significant association between the development of EAD and the cold ischemia time [odds ratio (OR) = 1.26, 95% confidence interval (CI) = 1.01-1.56, P = 0.037] and hepatocellular cancer as a secondary diagnosis in recipients (OR = 2.26, 95% CI = 1.11-4.58, P = 0.025). There was no correlation between EAD and the development of ischemic cholangiopathy. In conclusion, EAD results in inferior patient and graft survival in recipients of DCD liver allografts. Understanding the events that cause EAD and developing preventive or early therapeutic approaches should be the focus of future investigations. © 2014 American Association for the Study of Liver Diseases.

Early bone anchorage to micro- and nano-topographically complex implant surfaces in hyperglycemia.

PubMed

Ajami, Elnaz; Bell, Spencer; Liddell, Robert S; Davies, John E

2016-07-15

The aim of this work was to investigate the effect of implant surface design on early bone anchorage in the presence of hyperglycemia. 108 Wistar rats were separated into euglycemic (EG) controls and STZ-treated hyperglycemic (HG) groups, and received bilateral femoral custom rectangular implants of two surface topographies: grit blasted (GB) and grit-blast with a superimposed calcium phosphate nanotopography (GB-DCD). The peri-implant bone was subjected to a tensile disruption test 5, 7, and 9days post-operatively (n=28/time point); the force was measured; and the residual peri-implant bone was observed by scanning electron microscopy (SEM). Disruption forces at 5days were not significantly different from zero for the GB implants (p=0.24) in either metabolic group; but were for GB+DCD implants in both metabolic groups (p<0.001). Contact osteogenesis was greater on GB-DCD than the GB surface. The nano-and micro-surfaced implants showed significantly different disruption forces at all time points (e.g. >15N and <5N respectively at 9days). Such differences were not seen within the GB implants, as all values were very low (<5N). Even in hyperglycemia the GB-DCD surface outperformed the GB surfaces in both metabolic groups. Significantly, SEM of peri-implant bone showed compromised intra-fibrillar collagen mineralization in hyperglycemia, while inter-fibrillar and cement line mineralization remained unaffected. Enhanced bone anchorage to the implant surfaces was observed on the nanotopographically complex surface independent of metabolic group. The compromised intra-fibrillar mineralization observed provides a mechanism by which early bone mineralization is affected in hyperglycemia. It is generally accepted that the hyperglycemia associated with diabetes mellitus compromises bone quality, although the mechanism by which this occurs is unknown. Uncontrolled hyperglycemia is therefore a contra-indication for bone implant placement. It is also known that nano-topographically complex implant surfaces accelerate early peri-implant healing. In this report we show that, in our experimental model, nano-topographically complex surfaces can mitigate the compromised bone healing seen in hyperglycemia. Importantly, we also provide a mechanistic explanation for compromised bone quality in hyperglycemia. We show that intra-fibrillar collagen mineralization is compromised in hyperglycemia, but that interfibrillar and cement line mineralization, remain unaffected. Copyright © 2016 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Application effects of coated urea and urease and nitrification inhibitors on ammonia and greenhouse gas emissions from a subtropical cotton field of the Mississippi delta region.

PubMed

Tian, Zhou; Wang, Jim J; Liu, Shuai; Zhang, Zengqiang; Dodla, Syam K; Myers, Gerald

2015-11-15

Nitrogen (N) fertilization affects both ammonia (NH3) and greenhouse gas (GHG) emissions that have implications in air quality and global warming potential. Different cropping systems practice varying N fertilizations. The aim of this study was to investigate the effects of applications of polymer-coated urea and urea treated with N process inhibitors: NBPT [N-(n-butyl)thiophosphoric triamide], urease inhibitor, and DCD [Dicyandiamide], nitrification inhibitor, on NH3 and GHG emissions from a cotton production system in the Mississippi delta region. A two-year field experiment consisting of five treatments including the Check (unfertilized), urea, polymer-coated urea (ESN), urea+NBPT, and urea+DCD was conducted over 2013 and 2014 in a Cancienne loam (Fine-silty, mixed, superactive, nonacid, hyperthermic Fluvaquentic Epiaquepts). Ammonia and GHG samples were collected using active and passive chamber methods, respectively, and characterized. The results showed that the N loss to the atmosphere following urea-N application was dominated by a significantly higher emission of N2O-N than NH3-N and the most N2O-N and NH3-N emissions were during the first 30-50 days. Among different N treatments compared to regular urea, NBPT was the most effective in reducing NH3-N volatilization (by 58-63%), whereas DCD the most significant in mitigating N2O-N emissions (by 75%). Polymer-coated urea (ESN) and NBPT also significantly reduced N2O-N losses (both by 52%) over urea. The emission factors (EFs) for urea, ESN, urea-NBPT, urea+DCD were 1.9%, 1.0%, 0.2%, 0.8% for NH3-N, and 8.3%, 3.4%, 3.9%, 1.0% for N2O-N, respectively. There were no significant effects of different N treatments on CO2-C and CH4-C fluxes. Overall both of these N stabilizers and polymer-coated urea could be used as a mitigation strategy for reducing N2O emission while urease inhibitor NBPT for reducing NH3 emission in the subtropical cotton production system of the Mississippi delta region. Copyright © 2015 Elsevier B.V. All rights reserved.

Evaluation of miRNA-196a2 and apoptosis-related target genes: ANXA1, DFFA and PDCD4 expression in gastrointestinal cancer patients: A pilot study

PubMed Central

Toraih, Eman A.; Ibrahiem, Afaf; Abdeldayem, Hala; Mohamed, Amany O.; Abdel-Daim, Mohamed M.

2017-01-01

Previous reports have suggested the significant association of miRNAs aberrant expression with tumor initiation, progression and metastasis in cancer, including gastrointestinal (GI) cancers. The current preliminary study aimed to evaluate the relative expression levels of miR-196a2 and three of its selected apoptosis-related targets; ANXA1, DFFA and PDCD4 in a sample of GI cancer patients. Quantitative real-time PCR for miR-196a2 and its selected mRNA targets, as well as immunohistochemical assay for annexin A1 protein expression were detected in 58 tissues with different GI cancer samples. In addition, correlation with the clinicopathological features and in silico network analysis of the selected molecular markers were analyzed. Stratified analyses by cancer site revealed elevated levels of miR-196a2 and low expression of the selected target genes. Annexin protein expression was positively correlated with its gene expression profile. In colorectal cancer, miR-196a over-expression was negatively correlated with annexin A1 protein expression (r = -0.738, p < 0.001), and both were indicators of unfavorable prognosis in terms of poor differentiation, larger tumor size, and advanced clinical stage. Taken together, aberrant expression of miR-196a2 and the selected apoptosis-related biomarkers might be involved in GI cancer development and progression and could have potential diagnostic and prognostic roles in these types of cancer; particularly colorectal cancer, provided the results experimentally validated and confirmed in larger multi-center studies. PMID:29091952

Promoter methylation of the immune checkpoint receptor PD-1 (PDCD1) is an independent prognostic biomarker for biochemical recurrence-free survival in prostate cancer patients following radical prostatectomy.

PubMed

Goltz, Diane; Gevensleben, Heidrun; Dietrich, Jörn; Ellinger, Jörg; Landsberg, Jennifer; Kristiansen, Glen; Dietrich, Dimo

2016-01-01

Biomarkers that facilitate the prediction of disease recurrence in prostate cancer (PCa) may enable physicians to personalize treatment for individual patients. In the current study, PD-1 ( PDCD1 ) promoter methylation was assessed in a cohort of 498 PCa patients included in The Cancer Genome Atlas (TCGA) and a second cohort of 300 PCa cases treated at the University Hospital of Bonn. In the TCGA cohort, the PD-1 promoter was significantly hypermethylated in carcinomas versus normal prostatic epithelium (55.5% vs. 38.2%, p < 0.001) and PD-1 methylation ( mPD-1 ) inversely correlated with PD-1 mRNA expression in PCa (Spearman's ρ = -0.415, p < 0.001). In both cohorts, mPD-1 significantly correlated with preoperative prostate specific antigen (PSA). In univariate Cox Proportional Hazard analysis, mPD-1 served as a significant prognostic factor for biochemical recurrence (BCR)-free survival (Hazard ratio: HR = 2.35 [1.35-4.10], p = 0.003, n = 410) in the TCGA cohort. In multivariate analysis, mPD-1 was shown to add significant independent prognostic information adjunct to pathologic tumor category (pT) and Gleason grading group (HR = 2.08 [1.16-3.74], p = 0.014, n = 350). PD-1 promoter methylation analyses could thus potentially aid the identification of patients which might benefit from adjuvant treatment after radical prostatectomy. Moreover, our data suggest an intrinsic role of PD-1 in PCa carcinogenesis and disease progression, which needs to be addressed in future studies.

76 FR 44377 - Advisory Committee on Reactor Safeguards (ACRS), Meeting of the ACRS Subcommittee on AP1000...

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2011-07-25

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2010-06-18

... search (advanced search) engine or the ADAMS ``Find'' tool in Citrix. The Westinghouse AP1000 DCD, which... local residents at the South Dade Regional Library and the Homestead Branch Library. To search for...

Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis.

PubMed

Smits-Engelsman, Bouwien; Vinçon, Sabine; Blank, Rainer; Quadrado, Virgínia H; Polatajko, Helene; Wilson, Peter H

2018-03-01

As part of the process of creating an update of the clinical practice guidelines for developmental coordination disorder (DCD) (Blank, Smits-Engelsman, Polatajko, & Wilson, 2012), a systematic review of intervention studies, published since the last guidelines statement was conducted. The aim of this study was to 1) systematically review the evidence published from January 2012 to February 2017 regarding the effectiveness of motor based interventions in individuals with DCD, 2) quantify treatment effects using a meta-analysis, 3) examine the available information on different aspects of delivery including use of group intervention, duration and frequency of therapy, and 4) identify gaps in the literature and make recommendations for future intervention research. An electronic search of 5 databases (PubMed, Embase, Pedro, Scopus and Cochrane) was conducted for studies that evaluated motor-based interventions to improve performance for individuals with DCD. Thirty studies covering 25 datasets were included, 19 of which provided outcomes on standardized measures of motor performance. The overall effect size (Cohen's d) across intervention studies was large (1.06), but the range was wide: for 11 interventions, the observed effect was large (>0.80), in eight studies moderate (>0.50), and in five it was small or negligible (<0.50). Positive benefits were evident for activity-oriented approaches, body function-oriented combined with activities, active video games, and small group programs. Results showed that activity-oriented and body function oriented interventions can have a positive effect on motor function and skills. However, given the varied methodological quality and the large confidence intervals of some studies, the results should be interpreted with caution. Copyright © 2018 Elsevier Ltd. All rights reserved.

Donor-derived infections among Chinese donation after cardiac death liver recipients

PubMed Central

Ye, Qi-Fa; Zhou, Wei; Wan, Qi-Quan

2017-01-01

AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. METHODS We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors’ and patients’ characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections. RESULTS Head trauma was the most common origin of death among our 67 DCD donors (46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria (70.6%). Only three (4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections, with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donor-derived infections showed relation to higher crude mortality and graft loss rates (33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections (9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy. CONCLUSION Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given. PMID:28883707

Kinematic performance of fine motor control in attention-deficit/hyperactivity disorder: the effects of comorbid developmental coordination disorder and core symptoms.

PubMed

Lee, I-Ching; Chen, Yung-Jung; Tsai, Chin-Liang

2013-02-01

The aims of this study were: (i) to determine whether differences exist in the fine motor fluency and flexibility of three groups (children with attention-deficit/hyperactivity disorder [ADHD], children in whom ADHD is comorbid with developmental coordination disorder [DCD] [denoted as ADHD+DCD], and a typically developing control group); and (ii) to clarify whether the degree of severity of core symptoms affects performance. The Peabody Picture Vocabulary Test-Revised, the Beery-Buktenica Development Test of Visual-Motor Integration and the Movement Assessment Battery for Children were used as prescreening tests. The Integrated Visual and Auditory+Plus test was utilized to assess subjects' attention. The redesigned fine motor tracking and pursuit tasks were administered to evaluate subjects' fine motor performance. No significant difference was found when comparing the performance of the Children with ADHD and the typically developing group. Significant differences existed between children in whom ADHD is comorbid with DCD and typically developing children. Children with ADHD demonstrated proper fine motor fluency and flexibility, and deficient performance occurred when ADHD was comorbid with developmental coordination disorder. Children with ADHD had more difficulty implementing closed-loop movements that required higher levels of cognitive processing than those of their typically developing peers. Also, deficits in fine motor control were more pronounced when ADHD was combined with movement coordination problems. The severity of core symptoms had a greater effect on children with ADHD's fine motor flexibility than did fluency performance. In children with pure ADHD, unsmooth movement performance was highly related to the severity of core symptoms. © 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society.

Combining Restricted Grazing and Nitrification Inhibitors to Reduce Nitrogen Leaching on New Zealand Dairy Farms.

PubMed

Romera, Alvaro J; Cichota, Rogerio; Beukes, Pierre C; Gregorini, Pablo; Snow, Val O; Vogeler, Iris

2017-01-01

Intensification of pastoral dairy systems often means more nitrogen (N) leaching. A number of mitigation strategies have been proposed to reduce or reverse this trend. The main strategies focus on reducing the urinary N load onto pastures or reducing the rate of nitrification once the urine has been deposited. Restricted grazing is an example of the former and the use of nitrification inhibitors an example of the latter. A relevant concern is the cost effectiveness of these strategies, independently and jointly. To address this concern, we employed a modeling approach to estimate N leaching with and without the use of these mitigation options from a typical grazing dairy farm in New Zealand. Three restricted grazing options were modeled with and without a nitrification inhibitor (dicyandiamide, DCD) and the results were compared with a baseline farm (no restricted grazing, no inhibitor). Applying DCD twice a year, closely following the cows after an autumn and winter grazing round, has the potential to reduce annualized and farm-scale N leaching by ∼12%, whereas restricted grazing had leaching reductions ranging from 23 to 32%, depending on the timing of restricted grazing. Combining the two strategies resulted in leaching reductions of 31 to 40%. The abatement cost per kilogram of N leaching reduction was NZ$50 with DCD, NZ$32 to 37 for restricted grazing, and NZ$40 to 46 when the two were combined. For the range analyzed, all treatments indicated similar cost per percentage unit of mitigated N leaching, demonstrating that restricted grazing and nitrification inhibitors can be effective when used concurrently. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Developmental coordination disorder in children - experimental work and data annotation.

PubMed

Vareka, Lukáš; Bruha, Petr; Moucek, Roman; Mautner, Pavel; Cepicka, Ladislav; Holecková, Irena

2017-04-01

Developmental coordination disorder (DCD) is described as a motor skill disorder characterized by a marked impairment in the development of motor coordination abilities that significantly interferes with performance of daily activities and/or academic achievement. Since some electrophysiological studies suggest differences between children with/without motor development problems, we prepared an experimental protocol and performed electrophysiological experiments with the aim of making a step toward a possible diagnosis of this disorder using the event-related potentials (ERP) technique. The second aim is to properly annotate the obtained raw data with relevant metadata and promote their long-term sustainability. The data from 32 school children (16 with possible DCD and 16 in the control group) were collected. Each dataset contains raw electroencephalography (EEG) data in the BrainVision format and provides sufficient metadata (such as age, gender, results of the motor test, and hearing thresholds) to allow other researchers to perform analysis. For each experiment, the percentage of ERP trials damaged by blinking artifacts was estimated. Furthermore, ERP trials were averaged across different participants and conditions, and the resulting plots are included in the manuscript. This should help researchers to estimate the usability of individual datasets for analysis. The aim of the whole project is to find out if it is possible to make any conclusions about DCD from EEG data obtained. For the purpose of further analysis, the data were collected and annotated respecting the current outcomes of the International Neuroinformatics Coordinating Facility Program on Standards for Data Sharing, the Task Force on Electrophysiology, and the group developing the Ontology for Experimental Neurophysiology. The data with metadata are stored in the EEG/ERP Portal. © The Authors 2017. Published by Oxford University Press.

The effect of nitrification inhibitors on nitrous oxide emissions from cattle urine depositions to grassland under summer conditions in the UK.

PubMed

Barneze, A S; Minet, E P; Cerri, C C; Misselbrook, T

2015-01-01

Nitrous oxide (N2O) has become the prime ozone depleting atmospheric emission and the third most important anthropogenic greenhouse gas, with a global warming potential approximately 300 times higher than CO2. Nitrification and denitrification are processes responsible for N2O emission from the soil after nitrogen input. The application of a nitrification inhibitor can reduce N2O emissions from these processes. The objective of this study was to assess the effect of two different nitrification inhibitors (dicyandiamide (DCD) and a commercial formulation containing two pyrazole derivatives (PD), 1H-1,2,4-triazole and 3-methylpyrazole) on N2O emissions from cattle urine applications for summer grazing conditions in the UK. Experiments were conducted under controlled conditions in a laboratory incubator and under field conditions on a grassland soil. The N2O emissions showed similar temporal dynamics in both experiments. DCD concentration in the soil showed an exponential degradation during the experiment, with a half-life of the order of only 10d (air temperature c. 15 °C). DCD (10 kg ha(-1)) and PD at the highest application rate (3.76 kg ha(-1)) reduced N2O emissions by 13% and 29% in the incubation experiment and by 33% and 6% in the field experiment, respectively, although these reductions were not statistically significant (P>0.05). Under UK summer grazing conditions, these nitrification inhibitors appear to be less effective at reducing N2O emissions than reported for other conditions elsewhere in the literature, presumably due to the higher soil temperature. Copyright © 2014 Elsevier Ltd. All rights reserved.

An active video game intervention does not improve physical activity and sedentary time of children at-risk for developmental coordination disorder: a crossover randomized trial.

PubMed

Howie, E K; Campbell, A C; Straker, L M

2016-03-01

Children with developmental coordination disorder (DCD) are highly inactive and sedentary. The purpose of this study was to assess the impact of a home-based active video game intervention on objectively measured physical activity and sedentary behaviour in children at risk for DCD. In a crossover randomized clinical trial, 21 children (mean age 11.0, SD 1.0; n = 11 girls) in Perth, Western Australia participated in two 16-week periods: no active video games (AVGs) control period and AVGs intervention period. Two active input consoles were provided to participants along with a selection of non-violent AVGs for participants to play at home. Participants wore accelerometers at baseline and following each period to determine minutes of sedentary, light, moderate and vigorous times in addition to self-reported types of activities in a diary. Linear mixed models, adjusted for the order of periods, compared physical activity and sedentary time during the last week of each period. There were no significant differences between the intervention and control periods in time spent in sedentary (decrease of -1.0 min/day during the intervention period, 95%CI -12.1, 10.1), light (increase of 2.2 min/day, 95%CI -8.8, 13.2), moderate (decrease of 0.7 min/day, 95%CI -4.6, 3.3) or vigorous (decrease of -0.6 min/day, 95%CI -1.6, 0.4). Among children at risk for DCD, participating in this AVG intervention did not improve objectively measured physical activity and sedentary time. © 2015 John Wiley & Sons Ltd.

An Oxygenated and Transportable Machine Perfusion System Fully Rescues Liver Grafts Exposed to Lethal Ischemic Damage in a Pig Model of DCD Liver Transplantation.

PubMed

Compagnon, Philippe; Levesque, Eric; Hentati, Hassen; Disabato, Mara; Calderaro, Julien; Feray, Cyrille; Corlu, Anne; Cohen, José Laurent; Ben Mosbah, Ismail; Azoulay, Daniel

2017-07-01

Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. Cardiac arrest was induced in female large white pigs by intravenous injection of potassium chloride. After 60 minutes of WI, livers were flushed in situ with histidine-tryptophan-ketoglutarate and subsequently preserved either by simple cold storage (WI-SCS group) or HMP (WI-HMP group) using Belzer-MPS solution. Liver grafts procured from heart-beating donors and preserved by SCS served as controls. After 4 hours of preservation, all livers were transplanted. All recipients in WI-SCS group died within 6 hours after transplantation. In contrast, the HMP device fully protected the liver against lethal ischemia/reperfusion injury, allowing 100% survival rate. A postreperfusion syndrome was observed in all animals of the WI-SCS group but none of the control or WI-HMP groups. After reperfusion, HMP-preserved livers functioned better and showed less hepatocellular and endothelial cell injury, in agreement with better-preserved liver histology relative to WI-SCS group. In addition to improved energy metabolism, this protective effect was associated with an attenuation of inflammatory response, oxidative load, endoplasmic reticulum stress, mitochondrial damage, and apoptosis. This study demonstrates for the first time the efficacy of the HMP Airdrive system to protect liver grafts from lethal ischemic damage before transplantation in a clinically relevant DCD model.

Donor-derived infections among Chinese donation after cardiac death liver recipients.

PubMed

Ye, Qi-Fa; Zhou, Wei; Wan, Qi-Quan

2017-08-21

To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections. Head trauma was the most common origin of death among our 67 DCD donors (46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria (70.6%). Only three (4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections, with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donor-derived infections showed relation to higher crude mortality and graft loss rates (33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections (9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy. Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.

Graft reconditioning with nitric oxide gas in rat liver transplantation from cardiac death donors.

PubMed

Kageyama, Shoichi; Yagi, Shintaro; Tanaka, Hirokazu; Saito, Shunichi; Nagai, Kazuyuki; Hata, Koichiro; Fujimoto, Yasuhiro; Ogura, Yasuhiro; Tolba, Rene; Shinji, Uemoto

2014-03-27

Liver transplant outcomes using grafts donated after cardiac death (DCD) remain poor. We investigated the effects of ex vivo reconditioning of DCD grafts with venous systemic oxygen persufflation using nitric oxide gas (VSOP-NO) in rat liver transplants. Orthotopic liver transplants were performed in Lewis rats, using DCD grafts prepared using static cold storage alone (group-control) or reconditioning using VSOP-NO during cold storage (group-VSOP-NO). Experiment I: In a 30-min warm ischemia model, graft damage and hepatic expression of inflammatory cytokines, endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and endothelin-1 (ET-1) were examined, and histologic analysis was performed 2, 6, 24, and 72 hr after transplantation. Experiment II: In a 60-min warm ischemia model, grafts were evaluated 2 hr after transplantation (6 rats/group), and survival was assessed (7 rats/group). Experiment I: Group-VSOP-NO had lower alanine aminotransferase (ALT) (P<0.001), hyaluronic acid (P<0.05), and malondialdehyde (MDA) (P<0.001), hepatic interleukin-6 expression (IL-6) (P<0.05), and hepatic tumor necrosis factor-alpha (TNF-α) expression (P<0.001). Hepatic eNOS expression (P<0.001) was upregulated, whereas hepatic iNOS (P<0.01) and ET-1 (P<0.001) expressions were downregulated. The damage of hepatocyte and sinusoidal endothelial cells (SECs) were lower in group-VSOP-NO.Experiment II: VSOP-NO decreased ET-1 and 8-hydroxy-2'deoxyguanosine (8-OHdG) expression and improved survival after transplantation by 71.4% (P<0.01). These results suggest that VSOP-NO effectively reconditions warm ischemia-damaged grafts, presumably by decreasing ET-1 upregulation and oxidative damage.

Responses of Nitrogen Utilization and Apparent Nitrogen Loss to Different Control Measures in the Wheat and Maize Rotation System

PubMed Central

Peng, Zhengping; Liu, Yanan; Li, Yingchun; Abawi, Yahya; Wang, Yanqun; Men, Mingxin; An-Vo, Duc-Anh

2017-01-01

Nitrogen (N) is an essential macronutrient for plant growth and excessive application rates can decrease crop yield and increase N loss into the environment. Field experiments were carried out to understand the effects of N fertilizers on N utilization, crop yield and net income in wheat and maize rotation system of the North China Plain (NCP). Compared to farmers’ N rate (FN), the yield of wheat and maize in reduction N rate by 21–24% based on FN (RN) was improved by 451 kg ha-1, N uptakes improved by 17 kg ha-1 and net income increased by 1671 CNY ha-1, while apparent N loss was reduced by 156 kg ha-1. The controlled-release fertilizer with a 20% reduction of RN (CRF80%), a 20% reduction of RN together with dicyandiamide (RN80%+DCD) and a 20% reduction of RN added with nano-carbon (RN80%+NC) all resulted in an improvement in crop yield and decreased the apparent N losses compared to RN. Contrasted with RN80%+NC, the total crop yield in RN80%+DCD improved by 1185 kg ha-1, N uptake enhanced by 9 kg ha-1 and net income increased by 3929 CNY ha-1, while apparent N loss was similar. Therefore, a 37–39% overall decrease in N rate compared to farmers plus the nitrification inhibitor, DCD, was effective N control measure that increased crop yields, enhanced N efficiencies, and improved economic benefits, while mitigating apparent N loss. There is considerable scope for improved N use effieincy in the intensive wheat -maize rotation of the NCP. PMID:28228772

Protection of pulmonary graft from thrombosis in donation after cardiac death: effect of warm ischaemia versus cold ischaemia.

PubMed

Pierre, Leif; Lindstedt, Sandra; Ingemansson, Richard

2016-11-01

The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation. The animals were then exposed to either 1 h of cold ischaemia (insertion of drain and installation of cold fluid in the pleuras) or warm ischaemia (body temperature). After 1 h, the pulmonary artery was opened and the pulmonary arterial branches were then macroscopically studied for thrombotic material. After 60 min, the temperature was 36.6 ± 0.0°C in the warm ischaemic group and 14.6 ± 0.1°C in the cold ischaemic group (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the pulmonary artery in the animals examined and in the cold ischaemic group 6.8 ± 0.2 ml thrombotic material was found in the pulmonary artery (P < 0.001). In the warm ischaemic group, no thrombotic material could be found in the arterial branches of the pulmonary artery and in the cold ischaemic group 2.3 ± 0.1 ml thrombotic material was found in the arterial branches of the pulmonary artery (P < 0.001). Warm ischaemia rather than cold ischaemia seems to protect the pulmonary graft from thrombosis in uncontrolled non-heparinized DCD pigs. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Early Outcomes of the New UK Deceased Donor Kidney Fast-Track Offering Scheme.

PubMed

Callaghan, Chris J; Mumford, Lisa; Pankhurst, Laura; Baker, Richard J; Bradley, J Andrew; Watson, Christopher J E

2017-12-01

The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012 to identify kidneys at high risk of discard and to rapidly facilitate transplantation. A retrospective analysis of kidneys transplanted through the KFTS was undertaken. UK Transplant Registry data were collected on deceased donor kidneys implanted between November 1, 2012, and April 30, 2015, (donation after brain death [DBD] donors) and March 1, 2013, and April 30, 2015 (donation after circulatory death [DCD] donors). Posttransplant outcomes included 1-year estimated glomerular filtration rate and death-censored graft survival (DCGS). Over the study period, 523 deceased donor kidneys were transplanted through the KFTS and 4174 via the standard National Kidney Allocation Scheme (NKAS). Kidneys in the KFTS were more likely to be from older diabetic donors, had a higher frequency of poor ex vivo perfusion, had longer cold ischemic times, and were transplanted into older recipients. One-year DCGS of KFTS and NKAS DBD donor kidneys was similar (94% vs 95%; P = 0.70), but for DCD donor kidneys, DCGS was lower in those allocated via the KFTS (91% versus 95%; P = 0.04). Median 1-year estimated glomerular filtration rate for DBD donor kidneys was lower in those allocated via the KFTS (49 vs 52 mL/min per 1.73 m; P = 0.01), but for DCD kidneys, there was no difference (45 vs 48 mL/min per 1.73 m; P = 0.10). Although KFTS kidneys have less favorable donor, graft, and recipient risk factors than NKAS kidneys, short-term graft and patient outcomes are acceptable. National schemes that identify and rapidly offer kidneys at high risk of discard may contribute to minimizing the unnecessary discard of organs.

78 FR 24441 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on Evolutionary...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... Reactor (U.S. EPR) will hold a meeting on May 8-9, 2013, Room T-2B1, 11545 Rockville Pike, Rockville... License Application (COLA) associated with the U.S. EPR Design Control Document (DCD). The Subcommittee...

76 FR 22935 - Advisory Committee on Reactor Safeguards (ACRS); Meeting of the ACRS Subcommittee on U.S...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-25

... Power Reactor (U.S. EPR) will hold a meeting on May 11, 2011, Room T-2B1, 11545 Rockville Pike.... EPR Design Control Document (DCD). The Subcommittee will hear presentations by and hold discussions...

Efficacy of a task-based training approach in the rehabilitation of three children with poor handwriting quality: a pilot study.

PubMed

Baldi, Silvia; Nunzi, Michela; Brina, Carlo Di

2015-02-01

Evidence suggests that task-based training approaches can improve the performance of children with handwriting difficulties. The present case study tests the efficacy of the Handwriting Task Program (HTP). Three male children (9-10 yr. old) with poor handwriting skills and different developmental disorders participated in the HTP, twice per week, for 13 wk. Handwriting legibility was assessed through the Concise Evaluation Scale for Children's Handwriting, and fine motor performance and handwriting speed were evaluated at pre- and post-treatment with the Visual Motor Integration Test and the Battery for the assessment of writing skills of children from 7 to 13 yr. old. The results showed that motor efficiency and global handwriting quality improved in all the children, although some handwriting difficulties still persisted in one child with Developmental Coordination Disorder (DCD). Further study may confirm on a larger sample that a visual-spatially based training may improve the handwriting legibility of children with DCD.

Physical Fitness in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Schott, Nadja; Alof, Verena; Hultsch, Daniela; Meermann, Dagmar

2007-01-01

The protective effects of physical activity and fitness on cardiovascular health have clearly been shown among normally developed children. However, data are currently lacking pertaining to children with developmental coordination disorder (DCD). The purpose of this study was to examine differences in fitness measures, body composition, and…

50 CFR 300.117 - Prohibitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... provisions of the Convention or in violation of a conservation measure in force with respect to the United... have known, was harvested in violation of a conservation measure in force with respect to the United... subpart. (s) Import Dissostichus spp. with a Specially Validated DCD. (t) Import shipments of frozen...

Motor Skill Learning in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Bo, Jin; Lee, Chi-Mei

2013-01-01

Children with Developmental Coordination Disorder (DCD) are characterized as having motor difficulties and learning impairment that may last well into adolescence and adulthood. Although behavioral deficits have been identified in many domains such as visuo-spatial processing, kinesthetic perception, and cross-modal sensory integration, recent…

ALG2 regulates glioblastoma cell proliferation, migration and tumorigenicity

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Dunke; Wang, Feng; Pang, Yi

Apoptosis-linked gene-2 (ALG-2), also known as programmed cell death 6 (PDCD6), has recently been reported to be aberrantly expressed in various tumors and required for tumor cell viability. The aim of the present study was to investigate whether ALG-2 plays a crucial role in tumor cell proliferation, migration and tumorigenicity. In this study, we examined the expression of PDCD6 in glioblastoma cell lines and found that ALG-2 was generally expressed in glioblastoma cell lines. We also performed an analysis of an online database and found that high expression of ALG-2 was associated with poor prognosis (p = 0.039). We found that over-expressionmore » of ALG2 in glioblastoma could inhibit cell proliferation and, conversely, that down-regulation of ALG2 could promote cell proliferation. Further studies showed that over-expression of ALG2 inhibited the migration of tumor cells, whereas down-regulation of ALG2 promoted tumor cell migration. Finally, in vitro and in vivo studies showed that over-expression of ALG2 inhibited the tumorigenic ability of tumor cells, while down-regulation of ALG2 promoted tumor cell tumorigenic ability. In conclusion, ALG2 has a tumor suppressive role in glioblastoma and might be a potential target for the treatment of glioblastoma. - Highlights: • Low ALG2 expression is indicative of poor prognosis in glioblastoma patients. • ALG2 is required for cell proliferation in GBM cells. • ALG2 is involved in GBM cell migration. • ALG2 is involved in GBM cell self-renewal and tumorigenesis in vitro and in vivo.« less

Promoter methylation of the immune checkpoint receptor PD-1 (PDCD1) is an independent prognostic biomarker for biochemical recurrence-free survival in prostate cancer patients following radical prostatectomy

PubMed Central

Goltz, Diane; Gevensleben, Heidrun; Dietrich, Jörn; Ellinger, Jörg; Landsberg, Jennifer; Kristiansen, Glen; Dietrich, Dimo

2016-01-01

ABSTRACT Biomarkers that facilitate the prediction of disease recurrence in prostate cancer (PCa) may enable physicians to personalize treatment for individual patients. In the current study, PD-1 (PDCD1) promoter methylation was assessed in a cohort of 498 PCa patients included in The Cancer Genome Atlas (TCGA) and a second cohort of 300 PCa cases treated at the University Hospital of Bonn. In the TCGA cohort, the PD-1 promoter was significantly hypermethylated in carcinomas versus normal prostatic epithelium (55.5% vs. 38.2%, p < 0.001) and PD-1 methylation (mPD-1) inversely correlated with PD-1 mRNA expression in PCa (Spearman's ρ = −0.415, p < 0.001). In both cohorts, mPD-1 significantly correlated with preoperative prostate specific antigen (PSA). In univariate Cox Proportional Hazard analysis, mPD-1 served as a significant prognostic factor for biochemical recurrence (BCR)-free survival (Hazard ratio: HR = 2.35 [1.35–4.10], p = 0.003, n = 410) in the TCGA cohort. In multivariate analysis, mPD-1 was shown to add significant independent prognostic information adjunct to pathologic tumor category (pT) and Gleason grading group (HR = 2.08 [1.16–3.74], p = 0.014, n = 350). PD-1 promoter methylation analyses could thus potentially aid the identification of patients which might benefit from adjuvant treatment after radical prostatectomy. Moreover, our data suggest an intrinsic role of PD-1 in PCa carcinogenesis and disease progression, which needs to be addressed in future studies. PMID:27853645

76 FR 82079 - AP1000 Design Certification Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-30

... reference Revision 15 of the design control document (DCD) (ADAMS Accession No. ML053460400), which... to DAC in the areas of piping design (Chapter 3), instrumentation and control (I&C) systems (Chapter... Systems Manual, as described in the AP1000 Design Control Document, Revision 17, meets the criteria of...

50 CFR 300.101 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... returns to port and at all points in between. Real-time means as soon as possible, but at least every 4... paragraph (1) of this definition. Centralized Vessel Monitoring System (C-VMS) means a system that uses... weight, at any time, of the catch on board the vessel. Dissostichus catch document (DCD) means the...

50 CFR 300.101 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... returns to port and at all points in between. Real-time means as soon as possible, but at least every 4... paragraph (1) of this definition. Centralized Vessel Monitoring System (C-VMS) means a system that uses... weight, at any time, of the catch on board the vessel. Dissostichus catch document (DCD) means the...

Design Report for Low Power Acoustic Detector

DTIC Science & Technology

2013-08-01

high speed integrated circuit (VHSIC) hardware description language ( VHDL ) implementation of both the HED and DCD detectors. Figures 4 and 5 show the...the hardware design, target detection algorithm design in both MATLAB and VHDL , and typical performance results. 15. SUBJECT TERMS Acoustic low...5 2.4 Algorithm Implementation ..............................................................................................6 3. Testing

Statistically Characterizing Intra- and Inter-Individual Variability in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

King, Bradley R.; Harring, Jeffrey R.; Oliveira, Marcio A.; Clark, Jane E.

2011-01-01

Previous research investigating children with Developmental Coordination Disorder (DCD) has consistently reported increased intra- and inter-individual variability during motor skill performance. Statistically characterizing this variability is not only critical for the analysis and interpretation of behavioral data, but also may facilitate our…

Developmental Coordination Disorder and Reported Enjoyment of Physical Education in Children

ERIC Educational Resources Information Center

Cairney, John; Hay, John; Mandigo, James; Wade, Terrance; Faught, Brent E.; Flouris, Andreas

2007-01-01

Children with developmental coordination disorder (DCD) are less likely to enjoy participating in physical education (PE) than children without motor coordination difficulties. However, no studies have attempted to quantify this relationship or examine potentially modifiable mediating variables. Using a large sample (N = 590) of children (aged 9…

Self-Concept of Boys with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Cocks, Neralie; Barton, Belinda; Donelly, Michelle

2009-01-01

Children with Developmental Coordination Disorder (DCD) experience difficulties in motor coordination. During the last decade there has been increasing interest in the psychosocial aspects of children with motor coordination difficulties. To date, the majority of studies have focused on the perceived competence and global self-worth of children…

Pulmonary Function in Children with Development Coordination Disorder

ERIC Educational Resources Information Center

Wu, Sheng K.; Cairney, John; Lin, Hsiao-Hui; Li, Yao-Chuen; Song, Tai-Fen

2011-01-01

The purpose of this study was to compare pulmonary function in children with developmental coordination disorder (DCD) with children who are typically developing (TD), and also analyze possible gender differences in pulmonary function between these groups. The Movement ABC test was used to identify the movement coordination ability of children.…

Roadside Judgments in Children with Developmental Co-ordination Disorder

ERIC Educational Resources Information Center

Purcell, Catherine; Wann, John P.; Wilmut, Kate; Poulter, Damian

2011-01-01

As pedestrians, the perceptual ability to accurately judge the relative rate of approaching vehicles and select a suitable crossing gap requires sensitivity to looming. It also requires that crossing judgments are synchronized with motoric capabilities. Previous research has suggested that children with Developmental Co-ordination Disorder (DCD)…

50 CFR 300.101 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... returns to port and at all points in between. Real-time means as soon as possible, but at least every 4... paragraph (1) of this definition. Centralized Vessel Monitoring System (C-VMS) means a system that uses... weight, at any time, of the catch on board the vessel. Dissostichus catch document (DCD) means the...

Working Memory, Reading, and Mathematical Skills in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Alloway, Tracy Packiam

2007-01-01

The aim of the present study was investigate the relationship between working memory and reading and mathematical skills in 55 children diagnosed with developmental coordination disorder (DCD). The findings indicate a pervasive memory deficit in all memory measures. In particular, deficits observed in visuospatial short-term and working memory…

Motor Assessment in Developmental Coordination Disorder: From Identification to Intervention

ERIC Educational Resources Information Center

Barnett, Anna L.

2008-01-01

A description of Developmental Coordination Disorder (DCD) is included in the "Diagnostic Manual of the American Psychiatric Association" fourth edition ("DSM-IV-TR"). The major feature of this condition is impairment in motor skill, which has a negative impact on the performance of everyday life tasks. The present review outlines major issues…

Neural Underpinnings of Impaired Predictive Motor Timing in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Debrabant, Julie; Gheysen, Freja; Caeyenberghs, Karen; Van Waelvelde, Hilde; Vingerhoets, Guy

2013-01-01

A dysfunction in predictive motor timing is put forward to underlie DCD-related motor problems. Predictive timing allows for the pre-selection of motor programmes (except "program" in computers) in order to decrease processing load and facilitate reactions. Using functional magnetic resonance imaging (fMRI), this study investigated the neural…

Parameterization of Movement Execution in Children with Developmental Coordination Disorder

ERIC Educational Resources Information Center

Van Waelvelde, Hilde; De Weerdt, Willy; De Cock, Paul; Janssens, Luc; Feys, Hilde; Engelsman, Bouwien C. M. Smits

2006-01-01

The Rhythmic Movement Test (RMT) evaluates temporal and amplitude parameterization and fluency of movement execution in a series of rhythmic arm movements under different sensory conditions. The RMT was used in combination with a jumping and a drawing task, to evaluate 36 children with Developmental Coordination Disorder (DCD) and a matched…

Center for Advanced Power and Energy Research (CAPEC)

DTIC Science & Technology

2015-01-01

discharge (DCD). A glow discharge at a low ambient density becomes Corona discharge at the elevated ambient pressure condition. The thermal plasma actuator...Elisson and Kogelschlatz [9] has identified that the discharge consists of two distinct positive Corona streamers and diffusion modes. Enloe et al...4 2.3 Physics-Base Discharge Modeling

A Test of Motor (Not Executive) Planning in Developmental Coordination Disorder and Autism

ERIC Educational Resources Information Center

van Swieten, Lisa M.; van Bergen, Elsje; Williams, Justin H. G.; Wilson, Andrew D.; Plumb, Mandy S.; Kent, Samuel W.; Mon-Williams, Mark A.

2010-01-01

Grip selection tasks have been used to test "planning" in both autism and developmental coordination disorder (DCD). We differentiate between "motor" and "executive" planning and present a modified motor planning task. Participants grasped a cylinder in 1 of 2 orientations before turning it clockwise or anticlockwise.…

Emerging Adulthood in Developmental Co-Ordination Disorder: Parent and Young Adult Perspectives

ERIC Educational Resources Information Center

Kirby, A.; Edwards, L.; Sugden, D.

2011-01-01

Recent research widely acknowledges that developmental co-ordination disorder (DCD) is a pervasive and enduring disorder, which persists into adolescence and adulthood ([Cousins and Smyth, 2003] and [Kirby et al., 2008]). However, few studies have given detailed consideration to the range and level of functioning difficulties in emerging adults…

Physical Activity and Fitness in Children with Developmental Coordination Disorder: A Systematic Review

ERIC Educational Resources Information Center

Rivilis, Irina; Hay, John; Cairney, John; Klentrou, Panagiota; Liu, Jian; Faught, Brent E.

2011-01-01

Developmental coordination disorder (DCD) is a neurodevelopmental condition characterized by poor motor proficiency that interferes with a child's activities of daily living. Activities that most young children engage in such as running, walking, and jumping are important for the proper development of fitness and overall health. However, children…

Motor Coordination and Social-Emotional Behaviour in Preschool-Aged Children

ERIC Educational Resources Information Center

Piek, Jan P.; Bradbury, Greer S.; Elsley, Sharon C.; Tate, Lucinda

2008-01-01

School-age children with movement problems such as Developmental Coordination Disorder (DCD) are known to have social and emotional difficulties. However, little research has investigated younger children to determine whether these problems emerge at school age or are present earlier. The aim of the current study was to investigate the…