Analysis of renal function in the immediate postoperative period after partial liver transplantation.

Although renal dysfunction is common after liver transplantation, postoperative renal function after split liver transplantation (SLT) has not been well studied. Renal function immediately after surgery was analyzed retrospectively in 16 patients that received a SLT (SLT group). The results were compared with corresponding data from 31 matched patients that received a full-size liver transplant (FSLT group) during the same period. Serum creatinine (SCr) was measured before surgery, and, after transplantation, daily during the first week and at days 14, 21, and 28. Renal dysfunction (RD) was defined as the requirement for renal replacement therapy (RRT) or a 100% increase in SCr if the basal value had been <1.0 mg/dL or a 50% increase in SCr if the basal value had been >1.0 mg/dL. SCr had to be at least 1.5 mg/dL for a diagnosis of RD to be considered. The classification of RD was: mild, SCr 1.5-2.4 mg/dL; moderate, SCr 2.5-4.0 mg/dL; or severe, SCr >4.0 mg/dL (the requirement for RRT). Both donor and recipient age and cold ischemia time were lower in the SLT group than in the FSLT group (P < 0.05). Length of surgery was longer in the SLT group (P < 0.05). There were no significant differences between groups with respect to Model for End-Stage Liver Disease scores, the need for transfusions, the length of admission to the intensive care unit (ICU), survival rate, individual severity index, or sepsis-related organ failure assessment scores at the time of diagnosing RD. Immunosuppression regimens were similar in both groups. RD developed in 82% of SLT patients, but in only 58% of FSLT patients (P = not significant [NS]). Among SLT patients, RD (23.0% mild, 15.5% moderate, and 61.5% severe) was more severe (P = 0.007) than in FSLT patients (63.1% mild, 15.8% moderate, and 24.1% severe). The requirement for RRT in the SLT group (43.7%) was significantly greater (P < 0.05) than that in the FSLT group (12.9%). This finding may be due to the different incidence of sepsis in the 2 groups (SLT 37.5% vs. FSLT 9.7%; P < 0.05). In conclusion, although the number of patients studied was small, our data suggest a higher incidence of RD and a greater requirement for RRT in patients that receive a split liver graft than in those that receive a full size liver graft.     

Effect of maternal and infant covariates on sibship correlation in birth weight

Birth weight on 12,644 singleton infants from 6,196 sibships born in Maryland between 1980 and 1984 were used to estimate the effects of nine maternal and infant covariates on the sibship correlation in birth weight. Assuming a homogeneous correlation across all families, the estimated intraclass correlation was 0.4664 (+/- 0.0099). This high sibship correlation makes it possible to predict, with reasonable accuracy, the birth weight of a child given information on previous sibs, as well as covariates on the mother and/or infant pertinent to a given pregnancy. The reduction in variance associated with incorporating information on the nine covariates used here was approximately equal to that obtained by conditioning on a single previous sib. Testing for heterogeneity in correlation among different groups of families showed that a crude measure of parity (first live birth vs. other), time between births, mother's marital status, and maternal age at the birth of the last child significantly influenced the sibship correlation in birth weight.     

Cross-cultural invariance of the Academic Expectations Stress Inventory: Adolescent samples from Canada and Singapore

We provide further evidence for the two-factor structure of the 9-item Academic Expectations Stress Inventory (AESI) using confirmatory factor analysis on a sample of 289 Canadian adolescents and 310 Singaporean adolescents. Examination of measurement invariance tests the assumption that the model underlying a set of scores is directly comparable across groups. This study also examined the cross-cultural validity of the AESI using multigroup confirmatory factor analysis across both the Canadian and Singaporean adolescent samples. The results suggested cross-cultural invariance of form, factor loadings, and factor variances and covariances of the AESI across both samples. Evidence of AESI's convergent and discriminant validity was also reported. Findings from t-tests revealed that Singaporean adolescents reported a significantly higher level of academic stress arising from self expectations, other expectations, and overall academic stress, compared to Canadian adolescents. Also, a larger cross-cultural effect was associated with academic stress arising from other expectations compared with academic stress arising from self expectations.     

上海市某区警察心理健康状况和生活质量的时点调查

目的调查警察心理健康状况和生命质量的基本流行学资料。方法采用梅奥心理服务问卷,主要内容为心理健康状况和生命质量测定等。在上海市某公安分局内进行截断面时点调查。结果1共调查警员1611人,男性91.5%,女性8.5%,年龄28.8±17.5岁。2GHQ的平均得分:1.5±2.31,存在可能心理障碍倾向者比例15.3%,可能存在重度心理障碍者比例2.9%。3SCL-90总分大于160分者比例17.2%;单项分大于2分比例最高的是强迫症状因子(19.5%),睡眠饮食因子次之(12.8%),躯体化症状因子(12.6%)第3位,敌对因子(12.4%)处于第4位。4健康变化、总体健康感、心理健康和生命活力得分是相对最低的维度。结论1在警察群体中存在心理障碍者比例远高于一般市民,生活质量一些维度相对较差;2建立长效机制是维护和保证警察心理健康和生活质量的有效手段。     

Comfort of fenestrated hydrogel lenses

A controlled, double-masked, randomized study was conducted on ten subjects to determine the effect of fenestration size on the initial comfort of hydrogel contact lenses. Four fenestrated lenses were tested, each lens containing four mid-peripheral fenestrations of the same size. The diameter of the fenestrations used in the four lenses ranged from 0.39 to 0.96 mm. An unfenestrated lens was also tested. All lenses were made of HEMA and were ordered with the following specifications: -3.00 D, 14.0 mm diameter, 8.4 mm back central optic radius and 0.06 mm centre thickness. There was a significant negative correlation between comfort and fenestration size, indicating that larger fenestrations are less comfortable. Even the lens with the smallest fenestrations (0.39 mm) was significantly less comfortable than the unfenestrated lens. The implication of this finding is that fenestrations may not be clinically efficacious in view of the poor comfort (and presumably increased mechanical effect of the fenestration edges on the tarsal conjunctiva) of fenestrated lenses.