Less Efficient Neural Processing Related to Irregular Sleep and Less Sustained Attention in Toddlers

The current study used event-related potentials to examine a candidate process through which sleep difficulties affect attentional processing in toddlers. Fifteen toddlers participated in an auditory Oddball task while neurophysiological data were collected. Sleep deficits were assessed using actigraphs, and attention was examined with a sustained attention task. A P3-like component was elicited from the toddlers, and longer target P3 latencies were associated with poorer sustained attention and irregular sleep. Findings suggest that irregular sleep is associated with less efficient attentional processing as reflected by the P3 component, and that longer target P3 latencies are associated with poorer sustained attention.     

Repeat liver resection for recurrent colorectal metastases: a single-centre, 13-year experience

Objectives: Isolated intrahepatic recurrence is noted in up to 40% of patients following curative liver resection for colorectal liver metastases (CLM). The aims of this study were to analyse the outcomes of repeat hepatectomy for recurrent CLM and to identify factors predicting survival.Methods: Data for all liver resections for CLM carried out at one centre between 1998 and 2011 were analysed.Results: A total of 1027 liver resections were performed for CLM. Of these, 58 were repeat liver resections performed in 53 patients. Median time intervals were 10.5 months between the primary resection and first hepatectomy, and 15.4 months between the first and repeat hepatectomies. The median tumour size was 3.0 cm and the median number of tumours was one. Six patients had a positive margin (R1) resection following first hepatectomy. There were no perioperative deaths. Significant complications included transient liver dysfunction in one and bile leak in two patients. Rates of 1-, 3-and 5-year overall survival following repeat liver resection were 85%, 61% and 52%, respectively, at a median follow-up of 23 months. R1 resection at first hepatectomy (P = 0.002), a shorter time interval between the first and second hepatectomies (P = 0.02) and the presence of extrahepatic disease (P = 0.02) were associated with significantly worse overall survival.Conclusions: Repeat resection of CLM is safe and can achieve longterm survival in carefully selected patients. A preoperative knowledge of poor prognostic factors helps to facilitate better patient selection.     

How severe is diabetes after total pancreatectomy? A case-matched analysis

Objectives

Total pancreatectomy (TP) is associated with significant morbidity and mortality. The severity of postoperative diabetes and existence of ‘brittle diabetes’ are unclear. This study sought to identify quality of life (QoL) and diabetes-specific outcomes after TP.

Methods

Patients who underwent TP were matched for age, sex and duration of diabetes with patients with type 1 diabetes. General QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) core quality of life questionnaire QLQ-C30 and the PAN26 tool. Diabetes-specific outcomes were assessed using the Problem Areas in Diabetes (PAID) tool and an assessment of diabetes-specific complications and outcomes.

Results

A total of 123 patients underwent TP; 88 died (none of diabetic complications) and two were lost to follow-up. Of the remaining 33 patients, 28 returned questionnaires. Fourteen general and pancreas-specific QoL measurements were all significantly worse amongst the TP cohort (QLQ-C30 + PAN26). However, when diabetes-specific outcomes were compared using the PAID tool, only one of 20 was significantly worse. HbA1c values were comparable (P = 0.299), as were diabetes-related complications such as hypoglycaemic attacks and organ dysfunction.

Conclusions

Total pancreatectomy is associated with impaired QoL on general measures compared with that in type 1 diabetes patients. Importantly, however, there was almost no significant difference in diabetes-specific outcomes as assessed by a diabetes-specific questionnaire, or in diabetes control. This study does not support the existence of ‘brittle diabetes’ after TP.     

Preimplant Histologic Acute Tubular Necrosis and Allograft Outcomes

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.     

THE RELATION BETWEEN RISK AND PROTECTIVE FACTORS FOR PROBLEM BEHAVIORS AND DEPRESSIVE SYMPTOMS,ANTISOCIAL BEHAVIOR,AND ALCOHOL USE IN ADOLESCENCE

Both externalizing and internalizing psychopathology increase throughout adolescence and a similar set of risk and protective factors may underlie depressive symptoms, antisocial behavior, and alcohol use. Analyses test how risk and protective factors for externalizing behavior in community, school, family, peer, and individual domains are related to depressive symptoms, antisocial behavior, and alcohol use concurrently and longitudinally in a sample of 2,002 students assessed in 8^th and 10^th grades (52% male; 58% Caucasian). Findings indicate that risk and protective factors for antisocial behavior and alcohol use are also associated with depressive symptoms, both concurrently and longitudinally. Prevention approaches that target risk and protective factors for externalizing problems may have crossover effects on depressive symptoms during adolescence.     

Acridine-based thiosemicarbazones as novel inhibitors of mild steel corrosion in 1 M HCl: synthesis,electrochemical, DFT and Monte Carlo simulation studies

Electrochemical, surface morphology, density functional theory and Monte Carlo simulation methods were employed in investigating the effects of (2E,2′E)-2,2′-(3,3,6,6-tetramethyl-9-phenyl-3,4,6,7-tetrahydroacridine-1,8(2H,5H,9H,10H)-diylidene)bis(N-phenylhydrazinecarbothioamide) (IAB-NP), (2E,2′E)-2,2′-(3,3,6,6-tetramethyl-9-phenyl-3,4,6,7-tetrahydroacridine-1,8(2H,5H,9H,10H)-diylidene)bis(N-(2,4-difluorophenyl)hydrazinecarbothioamide)IAB-ND) and (2E,2′E)-2,2′-(3,3,6,6-tetramethyl-9-phenyl-3,4,6,7-tetrahydroacridine-1,8(2H,5H,9H,10H)-diylidene)bis(N-(2-fluorophenyl) hydrazinecarbothioamide) (IAB-NF) on mild steel corrosion in 1 M HCl solution. From the studies, compounds IAB-NP, IAB-ND and IAB-NF inhibit mild steel corrosion in the acid and the protection efficiencies were found to increase with the increase in concentration of each compound. At the optimum inhibitor concentration of 1.5 × 10⁻⁴ M, the inhibition efficiencies (%) of the compounds are in the order IAB-NF (90.48) > IAB-ND (87.48) > IAB-NP (85.28). Potentiodynamic polarization measurements revealed that all the compounds acted as mixed-type corrosion inhibitors. Experimental data for the adsorption of the studied molecules on a mild steel surface in 1 M HCl fitted into the Langmuir adsorption isotherm and the standard free energies of adsorption (ΔG^o_ads) suggested both physisorption and chemisorption mechanisms. Scanning electron microscopy analyses confirmed the formation of a protective film on the mild steel surface by the inhibitor molecules, resulting in protection of the metal from corrosive electrolyte ions. The experimental findings were corroborated by both theoretical density functional theory and Monte Carlo simulation studies.

Three novel acridine-based thiosemicarbazones were investigated for their corrosion inhibition potentials on mild steel in 1 M HCl using combined electrochemical, DFT and Monte Carlo simulation techniques.