The Pancreas Can Take the Cold: Lower Waitlist Times Through Importation.

BACKGROUND: Our center has used a strategy of pancreas importation owing to long regional waitlist times. Here we assess the clinical outcomes and financial considerations of this strategy. METHODS: This was a retrospective observational cohort study of patients who received a pancreas transplant at Montefiore Medical Center (MMC) from 2014 to 2017 (n = 28). Clinical parameters, including hemoglobin A1c and complications, were analyzed. The cohort was compared with United Network for Organ Sharing (UNOS) Region 9 with the use of the UNOS/Organ Procurement and Transplantation Network database. Cost analysis of length of stay (LOS), standard acquisition (SAC) fees, and transportation was performed with the use of internal financial data. RESULTS: Pancreas importation resulted in significantly shorter simultaneous pancreas kidney transplant waitlist times compared with Region 9: 518 days vs 1001 days (P = .038). In addition, postoperative complications and 1-year HbA1c did not differ between groups: local 6.30% vs import 6.17% (P = .87). Patients receiving local pancreata stayed an average of 9.2 days compared with 11 days for the import group (P = .36). As such, pancreas importation was associated with higher mean charges ($445,968) compared with local pancreas recipients ($325,470). CONCLUSIONS: Long waitlist times in Region 9 have encouraged our center's adoption of pancreas importation to address the needs of our patient population. This practice has resulted in a reduction of waitlist times by an average of 483 days. Understandably, centers have long been wary of importation owing to perceived risk in clinical outcomes. In our single-center experience, we have demonstrated equivalent postoperative glucose control and graft survival. Importantly, there does appear to be increased costs associated with importation, which are mainly driven by LOS. Curiously, importation from regions with lower SAC fees has the potential to offset costs related to transportation expenses. Notwithstanding these findings, pancreas importation does have the potential to lessen the financial societal burden through reduction in waitlist times.

Understanding and managing enhancements: why fisheries scientists should care.

Fisheries enhancements are a set of management approaches involving the use of aquaculture technologies to enhance or restore fisheries in natural ecosystems. Enhancements are widely used in inland and coastal fisheries, but have received limited attention from fisheries scientists. This paper sets out 10 reasons why fisheries scientists should care about understanding and managing enhancements. (1) Enhancements happen, driven mostly by resource users and managers rather than scientists. (2) Enhancements create complex fisheries systems that encompass and integrate everything fisheries stakeholders can practically manage. (3) Enhancements emerge in fisheries where the scope for technical and governance control is high, and they synergistically reinforce both. (4) Successful enhancements expand management options and achievable outcomes. (5) Many enhancements fail or do ecological harm but persist regardless. (6) Effective science engagement is crucial to developing beneficial enhancements and preventing harmful ones. (7) Good scientific guidance is available to aid development or reform of enhancements but is not widely applied. (8) Enhancement research advances, integrates and unifies the fisheries sciences. (9) Enhancements provide unique opportunities for learning about natural fish populations and fisheries. (10) Needs, opportunities and incentives for enhancements are bound to increase.

Stock enhancement to address multiple recreational fisheries objectives: an integrated model applied to red drum Sciaenops ocellatus in Florida.

An integrated socioecological model was developed to evaluate the potential for stock enhancement with hatchery fishes to achieve socioeconomic and conservation objectives in recreational fisheries. As a case study, this model was applied to the red drum Sciaenops ocellatus recreational fishery in the Tampa Bay estuary, Florida, U.S.A. The results suggest that stocking of juvenile fish larger than the size at which the strongest density dependence in mortality occurs can help increase angler satisfaction and total fishing effort (socioeconomic objectives) but are likely to result in decreases to the abundance of wild fishes (a conservation objective). Stocking of small juveniles that are susceptible to density-dependent mortality after release does not achieve socioeconomic objectives (or only at excessive cost) but still leads to a reduction of wild fish abundance. The intensity and type of socioeconomic gains depended on assumptions of dynamic angler-effort responses and importance of catch-related satisfaction, with greatest gains possible if aggregate effort is responsive to increases in abundance and satisfaction that are greatly related to catch rates. These results emphasize the view of stock enhancement, not as a panacea but rather as a management tool with inherent costs that is best applied to recreational fisheries under certain conditions.

Effects of hatchery rearing on Florida largemouth bass Micropterus floridanus resource allocation and performance under semi-natural conditions.

This study examined the growth, activity, metabolism and post-release survival of three groups of Florida largemouth bass Micropterus floridanus: wild-caught fish, hatchery fish reared according to standard practice (hatchery standard) and hatchery fish reared under reduced and unpredictable food provisioning (hatchery manipulated). Hatchery-standard fish differed from wild-caught fish in all measured variables, including survival in semi-natural ponds. Hatchery-standard and hatchery-manipulated fish showed higher activity levels, faster growth and lower standard metabolic rates than wild-caught fish in the hatchery. Fish reared under the manipulated feeding regime showed increased metabolic rates and increased post-release growth, similar to wild-caught fish. Their activity levels and post-release survival, however, remained similar to those of hatchery-standard fish. Activity was negatively correlated with post-release survival and failure of the feed manipulation to reduce activity may have contributed to its failure to improve post-release survival. Activity and post-release survival may be influenced by characteristics of the rearing environment other than the feeding regime, such as stock density or water flow rates.

Comparison of dry ice-baited centers for disease control and New Jersey light traps for measuring mosquito abundance in California.

Mosquito catch in New Jersy light traps (NJLTs) has been declining in recent years, compromising the sensitivity of the California mosquito monitoring program. Centers for Disease Control traps (CDCTs) operated without light and augmented with dry ice have been considered for replacement or augmentation. To provide information on comparative sensitivity and ability to measure abundance over time and space, catch of mosquitoes in NJLTs was compared to catch in CDCTs operated concurrently at 8-10 sites within the Coachella Valley, Kern, San Joaquin County, and Sacramento-Yolo Mosquito and Vector Control Districts. The CDCTs always collected more female mosquitoes than did NJLTs; however, differences in sensitivity varied markedly over time and space precluding the calculation of a universal conversion factor. Regressions of the catch of female Culex tarsalis in CDCTs as a function of catch in NJLTs within districts indicated that the slopes varied markedly, again precluding the derivation of a universal function. Therefore, we recommend that mosquito surveillance programs replace or supplement NJLTs with systematically operated CDCTs to enhance sampling sensitivity for females of most mosquito species. However, both trap types should be operated concurrently at several sites within each district to derive regression functions to convert historical relative abundance data from NJLTs to equivalent counts in CDCTs for retrospective analyses.

Real-time PCR-analysis of the cytochrome P450 1B1 codon 432-polymorphism.

The aim of the present study was to develop and validate a rapid assay for genotyping of CYP1B1 codon 432-polymorphism. The described method is a single tube assay and combines both rapid-cycle polymerase chain reaction (PCR) with real-time monitoring by amplification and generation of the melting profiles of an allele-specific fluorescent probe. With this method 300 samples were analysed from healthy, unrelated Germans. Genotype frequency determined for the mutated allele CYP1B1*2 was 0.40. The results show that genotyping of CYP1B1 codon 432-polymorphism with a real-time fluorescence PCR method is a rapid and reliable assay for the analysis of large numbers of samples.

The distribution of species of the Aedes increpitus complex in the western United States.

Maps of the California and Oregon distribution of members of the Aedes increpitus complex (Aedes clivis Lanzaro and Eldridge, Aedes increpitus Dyar, and Aedes washinoi Lanzaro and Eldridge) are presented that are based on collections reported by Lanzaro and Eldridge (1992) and new collections from various sites, many in the Central Valley of California. Analysis of individually reared specimens by polyacrylamide gel electrophoresis and conventional morphological methods confirmed the diagnostic value of isozymes for these species and of larval head hairs for distinguishing Ae. clivis from other members of the complex. Other larval characters and pupal hairs did not appear to have diagnostic value. An additional site was discovered where apparent hybrids between Ae. washinoi and Ae. increpitus occur, and a single possible hybrid between Ae. washinoi and Ae. clivis was found at a site where these species had previously been reported to occur sympatrically.

Five new bioactive sesquiterpenes from the fungus Radulomyces confluens (Fr.) Christ.

The three protoilludanes radulone A (1), radulone B (2) and radudiol (3), the illudalane radulactone (4) and the illudane radulol (5) were isolated from the extracts of the culture fluids of the basidiomycete Radulomyces confluens. The structures of the five new compounds were determined by spectroscopic techniques. Radulone A (1) is a potent inhibitor of human and bovine platelet aggregation stimulated by different agonists, inhibiting preferentially the aggregation of human platelets induced by ADP with an IC50 value of 2 microM. In addition 1 exhibits cytotoxic and antimicrobial activities. The other four compounds exhibited weak antimicrobial and cytotoxic activity.

11-Hydroxy-4-methyl-2,4,6-dodecatrienoic acid from fermentations of a Mucor species.

11-Hydroxy-4-methyl-2,4,6-dodecatrienoic acid was isolated from fermentations of the Mucor species, strain KL 94-92 aq. The compound exhibits cytotoxic activity and the structural elucidation, as well as the biological properties of the new compound, are described.

5-hydroxy-3-vinyl-2(5H)-furanone--a new inhibitor of human synovial phospholipase A2 and platelet aggregation from fermentations of a Calyptella species (basidiomycetes).

5-Hydroxy-3-vinyl-2(5H)-furanone, a potent and selective inhibitor of human synovial phospholipase A2 was isolated from fermentations of a Calyptella species. Its structure as identified by spectroscopic methods is identical to PA 147, an antibiotic previously isolated from a streptomycete. 5-hydroxy-3-vinyl-2(5H)-furanone inhibits the aggregation of human and bovine platelets stimulated by different inducers and exhibits weak antimicrobial activities.

Kuehneromycins A and B, two new biological active compounds from a Tasmanian Kuehneromyces sp. (Strophariaceae, Basidiomycetes).

In a search for new inhibitors of RNA-directed DNA-polymerases kuehneromycin A (1) was isolated from fermentations of a Tasmanian Kuehneromyces species. Its structure was elucidated by spectroscopic methods. Kuehneromycin A (1) is a non-competitive inhibitor of avian myeloblastosis virus (Ki 200 microM) and moloney murine leukemia virus (Ki 40 microM) reverse transcriptases. The second compound, kuehneromycin B (2) is a strong inhibitor of platelet aggregation stimulated with different inducers. In addition, both compounds exhibit cytotoxic and antimicrobial activities.

14-epidihydrocochlioquinone B and 14-epicochlioquinone B, antibiotics from fermentations of the ascomycete Neobulgaria pura: structure elucidation and effects on platelet aggregation.

14-Epicochlioquinone B (1) and 14-epidihydrocochlioquinone B (2) were isolated from submerged cultures of Neobulgaria pura (Pers. ex Fr.) Petrak. 14-Epicochlioquinone B is a potent inhibitor of human and bovine platelet aggregation stimulated by different inducers. 14-Epidihydrocochlioquinone B does not inhibit the aggregation of platelets. In addition, both 1 and 2 exhibited cytotoxic and antimicrobial activities.

Two inhibitors of platelet aggregation from a Panus species (Basidiomycetes).

Two inhibitors of platelet aggregation were isolated from fermentations of Panus sp. 9096. One inhibitor proved to be identical to naematolon (2), an antibiotic previously isolated by S. Backens et al. from several Hypholoma species. The other metabolite, panudial (1), is a new nordrimane (cis-annelation of the bicyclus) lacking the carbon atom in position 10 of the drimane skeleton. Panudial is a potent inhibitor of bovine and human platelet aggregation stimulated by different inducers.

Tc-99m-labeled red blood cells for the measurement of red cell mass in newborn infants: concise communication.

In vitro and in vivo investigations were performed to examine the binding of Tc-99m to neonatal red blood cells (RBC). Labeling efficiency was about 90%, and unbound Tc-99m less than 3% after one washing, in premature and full-term newborns and in children. Thus presence of high percentages of fetal hemoglobin (Hb F) did not influence the labeling of RBCs with Tc-99m. RBCs of 11 newborns were hemolysed and the distribution of Tc-99m on RBC components was analyzed. Although Hb F percentage averaged (60.0 +/- 8.1)% (s.d.), only (11.9 +/- 3.7)% of Tc-99m was bound by Hb F, whereas (45.0 +/- 6.1)% was associated with Hb A. RBC membranes bound (13.7 +/- 4.3)% and (29.3 +/- 4.0)% were found unbound in hemolysates. These results indicate that Tc-99m preferentially binds to beta chains. In vivo equilibration of Tc-99m RBCs and of albumin labeled with Evans blue was investigated in five newborn infants. Tc-99m RBCs were stable in each case during the first hour after injection. Elution of Tc-99m from RBCs was (3.4 +/- 1.5)% per hour. Body-to-venous hematocrit ratio averaged 0.86 +/- 0.03.