It behoves to identify risk factors At 14 Spanish centers, data

It behoves to identify risk factors. At 14 Spanish centers, data on 1062 adult patients with HT (age 59.2 +/- 12.3 yr, 82.5% men) were collected at GSK923295 routine follow-up examinations. Glomerular filtration rate, GFR, was estimated using the four-variable MDRD equation, and moderate-or-severe renal dysfunction (MSRD) was defined as K/DOQI stage 3 CKD or worse. Time since transplant ranged from one month to 22 yr (mean 6.7 yr). At assessment, 26.6% of patients were diabetic and 63.9% hypertensive; 53.9% were taking cyclosporine and 33.1% tacrolimus; and 61.4% had MSRD. Among patients on cyclosporine or tacrolimus at assessment, multivariate logistic regression

identified male sex (OR 0.44), pre- and post-HT creatinine (2.73 and 3.13 per mg/dL), age at transplant C59 (1.06 per yr), time since transplant (1.05 per yr), and tacrolimus

(0.65) as independent positive or negative predictors of MSRD. It is concluded that female sex, pre- and one-month post-HT serum creatinine, age at transplant, time since transplant, and immunosuppression with cyclosporine rather than tacrolimus may all be risk factors for development of CKD >= stage 3 by patients with HT.”
“This paper investigates the application of multivariable PID (MPID) controllers to wastewater treatment plants (WWTPs) with pre-denitrifying process. WWTPs have usually a number of interacting control loops. The controller’s parameters are often left unchanged since the plant commissioning and hence poor performance Buparlisib ic50 is often observed due to inevitable

changes in the plant and its influent characteristics. The model-based MPID tuning methods are complicated, cumbersome and expensive, and require a high level of control expertise to design, and implement. In this paper, a simple and novel tuning method is proposed along with three existing methods, which require only step or frequency response tests. The performance of these methods is compared and the parameters are tuned using a proposed optimisation technique to meet standard quality effluent at a minimum cost. This is achieved using a nonlinear ASM1 model to determine the optimal values of the controller parameters. The results Show that by effective and proper tuning of the MPID controllers, the closed-loop performance of WWTP improves and it could potentially lead to energy saving and improvement in the removal of nitrogen. (C) 2009 Elsevier B.V. All rights reserved.”
“The role of Fe as an acceptor and Nb as a donor in [0.94-x](Bi1/2Na1/2)TiO3-0.06BaTiO(3)-x (K0.5Na0.5)NbO3 (100xKNN) (x=0.02 and 0.03) lead-free piezoceramics was investigated. X-ray diffraction analyses show that all the profiles are best-fitted with a cubic symmetry where Fe doping tends to induce a lattice expansion, while Nb doping does the opposite. The strain and polarization characteristics are enhanced and suppressed by the acceptor and donor dopants, respectively.

Conclusions: Results suggest that Internet-based tools should be

Conclusions: Results suggest that Internet-based tools should be developed to become an easy access door to sexual health services for young men. Wherever they consult and for whatever problem, sexual health must be on the agenda.”
“Epitaxial magnetoelectric (ME) Pb(Zr0.53Ti0.47)O-3(PZT)/CoFe2O4(CFO) multilayer nanocomposite thin films with up to 11 alternative layers are grown on Nb doped SrTiO3 (STO) substrates by pulsed-laser deposition. X-ray diffraction

BMS202 in vivo and high resolution transmission electron microscopy studies reveal a good epitaxial relationship between the PZT and CFO layers without interfacial reaction at their interfaces. These epitaxial composite films exhibit strong ferroelectric and magnetic responses simultaneously at room temperature, and the interfacial-coupling-modulated dielectric behavior, Q VD Oph polarization, and magnetic properties are observed and analyzed systematically.

These results suggest that the magnetic, electric, and ME coupling effect may be tuned by the “”strain engineering”" in ferroelectric/ magnetic or other multiferroic superlattice. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3386510]“
“Capillary hemangiomas are hamartomatous proliferation of vascular endothelial cells, usually presenting in infancy or are age-related (senile). These tend to affect the head and neck regions. Herein, we report a rare cause of hand nodules: post-traumatic capillary hemangioma.”
“Purpose To measure quality of life (QOL) and utilities for prostate cancer (PC) patients and determine their predictors.

Methods A population-based, community-dwelling, geographically diverse sample of long-term PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physician. Consenting patients completed questionnaires by mail: Health Utilities Index (HUI 2/3), Patient Oriented Prostate Utility Scale PORPUS-U (utility), learn more PORPUS-P (health profile), Functional Assessment of Cancer Therapy-Prostate (FACT-P), and Prostate Cancer Index (PCI). Clinical data were obtained from chart reviews. Regression

models determined the effects of a series of variables on QOL and utility.

Results We received questionnaires and reviewed charts for 585 patients (mean age 72.6, 2-13 years postdiagnosis). Mean utility scores were as follows: PORPUS-U = 0.92, HUI2 = 0.85, and HUI3 = 0.78. Mean health profile scores were as follows: PORPUS-P = 71.7, PCI sexual, urinary, and bowel function = 23.7, 79.1, and 84.6, respectively (0 = worst, 100 = best), and FACT-P = 125.1 (0 = worst, 156 = best). In multiple regression analyses, comorbidity and PCI urinary, sexual, and bowel function were significant predictors of other QOL measures. With all variables, 32-50 % of the variance in utilities was explained.

Conclusions Many variables affect global QOL of PC survivors; only prostate symptoms and comorbidity have independent effects.

Efficacy

Efficacy https://www.selleckchem.com/products/q-vd-oph.html of the vaccine against clinical malaria under different transmission settings, the evolution of efficacy over time and the potential benefit of a booster will be evaluated. In addition, the effect of RTS, S/AS01 vaccination on growth, and the safety and immunogenicity in HIV-infected and malnourished children will be assessed. Safety of the primary course of immunization and the booster dose will be documented

in both age categories.

Conclusions: This pivotal phase III study of the RTS, S/AS01 candidate malaria vaccine in African children was designed and implemented by the Clinical Trials Partnership Committee. The study will provide efficacy and safety data to fulfil regulatory requirements, together with data on a broad range of endpoints that will facilitate the evaluation of the public health impact of the vaccine and will aid policy and implementation decisions.”
“Influence of heat treatment and fillers on the heat distortion

temperature (HDT) of poly(lactic acid) hybrid biocomposites was intensively studied through HDT testing, polarizing microscope (POM), differential scanning calorimetry (DSC), and dynamic mechanical analysis (DMA). With loading 20 wt % BF or 20 wt % talc, improvement of HDT in PLA composite was about 10 degrees C comparing with neat PLA after heat treatment. Moreover, there was a great improvement (above 45 degrees C) of HDT in PLA composites with loading 20 wt % BF and 20 wt % talc simultaneously after heat treatment. Transcrystallization was observed during heat treatment Proteasome inhibitor and isothermal crystallization of PLA composites with loading BF and talc simultaneously. There was no similar phenomenon in other PLA composite with loading only one filler. The possible mechanism of forming transcrystallization was proposed. DSC and DMA were also used to clarify the variation in HDT before and after heat treatment,

and the results suggest that the crystallinity, modulus and glass transition changed, especially formation of transcrystallization played a key role in improvement of HDT in PLA composites. (c) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 123:2828-2836, 2012″
“Background: CH5183284 molecular weight Homozygosity for the variant 677T allele in the methylenetetrahydrofolate reductase (MTHFR) gene increases the requirement for folate and may alter the metabolic use of choline. The choline adequate intake is 550 mg/d for men, although the metabolic consequences of consuming extra choline are unclear.

Objective: Deuterium-labeled choline (d9-choline) as tracer was used to determine the differential effects of the MTHFR C677T genotype and the effect of various choline intakes on the isotopic enrichment of choline derivatives in folate-compromised men.

Design: Mexican American men with the MTHFR 677CC or 677TT genotype consumed a diet providing 300 mg choline/d plus supplemental choline chloride for total choline intakes of 550 (n = 11; 4 with 677CC and 7 with 677TT) or 1100 (n = 12; 4 with 677CC and 8 with 677TT) mg/d for 12 wk.

In these studies, the average r-hFSH dose per patient was 230 29

In these studies, the average r-hFSH dose per patient was 230.29 IU less with administration of follitropin alfa FbM compared with FbIU, and the number of days of treatment was reduced by 0.48. In addition, a significantly greater number of oocytes (0.84) were extracted, more embryos (0.88) were obtained, and a higher peak level of estradiol (613.08 pmol/L) was achieved in the patients undergoing ovarian stimulation with follitropin alfa FbM. However, no statistically significant differences were observed in the number of follicles >14mm, clinical pregnancies, or OHSS

cases.

Conclusion: Follitropin alfa FbM, a technologically modified formulation of r-hFSH, is as safe as follitropin alfa FbIU but requires a smaller dose over a shorter period to produce more oocytes and final embryos.”
“Aim: As the primary relevant tissue NSC23766 supplier (brain) for psychiatric disorders is commonly not available, we aimed to investigate whether blood can be used as a proxy in methylation studies on the basis of two models. In the ‘signature’ model methylation-disease associations occur because

a disease-causing factor affected methylation in the blood. In the ‘mirror-site’ model the methylation status in the blood is correlated with the corresponding disease-causing site in the brain. Materials, methods & results: Methyl-binding domain enrichment and next-generation sequencing of the blood, C188-9 clinical trial cortex and hippocampus from four haloperidol-treated and ten untreated C57BL/6 mice revealed high levels

of correlation in methylation across tissues. Despite the treatment inducing a large number of methylation changes, this correlation remains high. Conclusion: Our results show that, consistent with the signature model, factors that affect brain processes (i.e., haloperidol) leave biomarker signatures in the blood and, consistent with the mirror-site model, Autophagy high throughput screening the methylation status of many sites in the blood mirror those in the brain.”
“Purpose To describe anterior segment fluorescein angiography (ASFA) of the normal feline eye using a digital single-lens reflex (dSLR) camera adaptor. Animals Ten cats free of ocular and systemic disease were evaluated. Methods All cats received maropitant citrate (1.0mg/kg SQ) and diphenhydramine (2.0mg/kg SQ) 20min prior to anesthesia using propofol (4mg/kg IV bolus, 0.2mg/kg/min CRI). Standard color and red-free images were obtained prior to the administration of 10% sodium fluorescein (20mg/kg IV). Imaging was performed using a dSLR camera (Canon 7D), dSLR camera adaptor, camera lens (Canon EF-S 60mm f/2.8macro), and an accessory flash (Canon 580EXII). Imaging occurred at a rate of 1/second immediately following IV bolus of sodium fluorescein for a total of 30s, then at 1, 2, 3, 4, 5, and 10min. Results Ten cats with an average age of 3.7 +/- 0.9years and various iris colors were imaged. Arterial, capillary, and venous phases occurred 4.6, 7.8, and 8.9s postinjection, respectively.

The network captures the detailed dynamics of human behavior duri

The network captures the detailed dynamics of human behavior during dual-task-performance, including both mean RTs and RT distributions, and establishes concrete predictions on neuronal dynamics during dual-task experiments in humans and non-human primates.”
“Metamaterials support optically excitable dark-plasmon modes Tubastatin A datasheet featured by antisymmetric surface current oscillations, which can be explained by Fano-type resonance and can be

tailored by controlling the embedded structural geometry. In this article, we numerically investigate the Fano-type resonance in complex metamaterials, and demonstrate the presence of Fano-Feshbach resonances due to the interaction between two Fano-type resonances in the overlapping region, implemented by breaking and tuning the symmetric properties of the resonant metallic element. Features of the resonance are discussed. This work shows that the domain of dark-plasmon mode based metamaterial system supports rich physics and can lead to various potential applications. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3528208]“
“Matrix metalloproteinases (MMPs) play an essential role in tissue repair, cell death, and morphogenesis. The aim of the present

study was to investigate potential involvement of find more selected MMPs in the pathogenesis of neuronal apoptosis induced by the NMDA antagonist MK-801 (dizocilpine) or the GABA(A) agonist phenobarbital in infant rats, Epacadostat supplier transgenic rats overexpressing MMP-9 and MMP-9 knockout mice. Seven-day-old rats or knockout mice received intraperitoneal injections of MK-801, 1 mg/kg, or phenobarbital, 50 mg/kg. At different survival intervals following administration of the compounds (1-72 h), pups were sacrificed, tissue from different brain regions was isolated, and the expression and activity of MMP-2 and MMP-9 were analyzed by real-time PCR, western blot, and zymography. In addition, brains were fixed and processed for TUNEL staining.

In all the brain regions analyzed, we found an increased number of TUNEL-positive cells 24 h after administration of MK-801. After treatment, we detected no significant increase in MMP-2 or MMP-9 mRNA expression in cortical areas. No changes in the MMP-9 protein expression or gelatinolytic activity of MMP-2 were observed in conjunction with MK-801 or phenobarbital-induced neuroapoptosis in any brain region analyzed. The extent of neurodegeneration induced by MK-801 or phenobarbital was not altered in MMP-9 transgenic rats and was increased in MMP-9 knockout mice compared to wild-type rats and mice. Treatment with the panmetalloproteinase inhibitor GM6001 did not confer protection against MK-801-induced apoptotic cell death in the developing rat brain.

Results: For GSTP1 313 A -> G polymorphism,

statistica

Results: For GSTP1 313 A -> G polymorphism,

statistically significant differences were observed between the DLBCL and control groups for the AA, AG, and GG genotypes, as well as the G allele. For CYP1A1 4889 A -> G (M2) polymorphism, statistically significant differences were observed for the AA and AG genotypes and the G allele. The relationship of smoking status to susceptibility to DLBCL in the presence of these genetic polymorphisms revealed that smoking status had no effect.

Conclusion: GSTP1 313 A -> Nec-1s G polymorphism is associated with a decreased risk of lymphoma, whereas CYP1A1 4889 A -> G (M2) polymorphism is associated with an increased risk of lymphoma regardless of smoking status.”
“The spectrum of

pulmonary pathology in the Middle East is as versatile as its civilizations and cultures. In this review, we outline the key challenges confronting LOXO-101 order pulmonologists in the Middle East. We shed light on the diverse conditions commonly encountered in the region, from the centuries-old illnesses of tuberculosis, to contemporary problems such as lung complications from chemical warfare. We specifically highlighted unique aspects related to respiratory illnesses in the Middle East, for example, climate factors in the desert region, cultural habits, for example, water-pipe smoking and disorders unique to the region, such as Behet’s disease. Pulmonologists are also faced with the consequences of modernization, including large immigrant population and associated social and health issues, rising incidence of obesity and sleep apnoea, and drug-resistant tuberculosis. Tackling these health issues will require

an integrated approach involving public health, primary care as well as specialist pulmonology input, taking into consideration HSP990 the unique cultural and environmental factors to ensure effective management and compliance to medical care.”
“Background: A recent out-of-hospital cardiac arrest (OHCA) clinical trial showed improved survival to hospital discharge (HD) with favorable neurologic function for patients with cardiac arrest of cardiac origin treated with active compression decompression cardiopulmonary resuscitation (CPR) plus an impedance threshold device (ACD + ICD) versus standard (S) CPR. The current analysis examined whether treatment with ACD + ITD is more effective than standard (S-CPR) for all cardiac arrests of non-traumatic origin, regardless of the etiology.

Methods: This is a secondary analysis of data from a randomized, prospective, multicenter, intention-to-treat, OHCA clinical trial. Adults with presumed non-traumatic cardiac arrest were enrolled and followed for one year post arrest. The primary endpoint was survival to hospital discharge (HD) with favorable neurologic function (Modified Rankin Scale score <= 3).

Recent findings

The shedding of prostate cancer cells

Recent findings

The shedding of prostate cancer cells by the primary tumor into Dehydrogenase inhibitor the circulation can occur very early in the disease process but the detection of CTC at the time

of initial presentation is not necessarily a poor prognostic. Furthermore, some patients who have undergone a radical prostatectomy and have no evidence of disease for 5 years still have detectable tumor cells in their bone marrow. In some cases these dormant tumor cells can eventually be activated and form a metastasis. In other situations the shed cells might contain aggressive stem-like cells. Overall, a pattern of an evolving genomic and molecular profile appears to be apparent over the course of initial dissemination to development of overt metastases. Clinically, several studies suggest that the enumeration of CTC prior to and during chemotherapy is predictive of the overall therapeutic response. Additionally, the absolute count or CTC threshold could be patient specific and not universal, suggesting the change in CTC count on a case-by-case basis may be more significant for patient management.

Summary

CTC are clinically significant in the management of prostate cancer. However, to determine the true efficacy

of selleckchem CTC detection in the active clinical arena, coordinated multi-institutional studies with a standardized detection methodology need to be undertaken.”
“Background: Traumatic pneumomediastinum secondary to blunt chest injury in children Geneticin nmr is concerning for potential life-threatening tracheobronchial, esophageal, or vascular thoracic injuries. These patients often undergo extensive radiologic

evaluation and invasive testing due to the unclear risk of traumatic pneumomediastinum.

Methods: This was a retrospective cohort study in two phases. First, we reviewed the National Trauma Database from 2002 to 2005 for patients younger than 19 years with blunt traumatic pneumomediastinum to describe the epidemiology, clinical course, and associated life-threatening thoracic injuries. Patients with isolated pneumomediastinum were compared with those with pneumomediastinum and other thoracic injuries (complicated pneumomediastinum). Second, we conducted a retrospective case series from our Level I Pediatric Trauma Center from 1995 to 2009 to delineate the clinical course and the utility of diagnostic studies beyond chest X-ray (CXR).

Results: In the National Trauma Database, 8 of 193 patients (4.1%; 95% CI, 1.3-7.0) had life-threatening tracheobronchial, esophageal, or vascular thoracic injuries; all had other organ system injuries and additional thoracic injuries, which would have been visible on CXR. Complicated pneumomediastinum was more highly associated with abnormal vital signs (p = 0.02). The retrospective institutional case series identified 18 patients, none with life-threatening thoracic injuries.

08; 95% confidence interval, 1 01-1 16; P for trend=0 02) Improv

08; 95% confidence interval, 1.01-1.16; P for trend=0.02). Improvement in survival was driven largely by an improvement in acute resuscitation survival (risk-adjusted rates: 42.9% in 2000, 81.2% in 2009; adjusted rate ratio AS1842856 purchase per year: 1.04; 95% confidence interval, 1.01-1.08; P for trend=0.006). Moreover, survival trends were not accompanied by higher rates of neurological disability among survivors over time (unadjusted P for trend=0.32), suggesting an overall increase in the number of survivors without neurological

disability over time.

Conclusions-Rates of survival to hospital discharge in children with in-hospital cardiac arrests have improved over the past decade without higher rates of neurological disability among survivors. (Circ Cardiovasc Qual Outcomes. 2013; 6: 42-49.)”
“Hemophagocytosis may be encountered in association with a variety of underlying conditions, MK-2206 including primary or familial disorders, and secondary forms induced by infections, malignancy, and metabolic disorders. It is usually observed in organs such as the spleen, lymph nodes, bone marrow, and central nervous system, but rarely in the skin. When hemophagocytosis

coexists with a sepsis-like systemic disorder it is termed hemophagocytic syndrome or hemophagocytic lymphohistiocytosis. Recently, 2 cases with evidence of perivascular hemophagocytosis in skin biopsy specimens of patients without additional findings of hemophagocytic lymphohistiocytosis have been reported. We report 2 additional cases of patients with cutaneous lesions suggestive of leukocytoclastic vasculitis whose skin biopsies showed a

perivascular and interstitial infiltrate of neutrophils with nuclear dust and extravasated erythrocytes, and the presence of histiocytes with phagocytized red blood cells and nuclear fragments. There was also evidence of fibrin in the walls of the venules. One patient presented with a sepsis-like clinical scenario, but an extensive work-up failed to demonstrate any underlying disease or infection. The second patient was asymptomatic at the time of presentation, but further work-up revealed an underlying B-cell lymphoma. Whether these histologic findings represent late lesions of leukocytoclastic vasculitis or an incomplete presentation as part of a hemophagocytic syndrome is debatable, because both are associated selleck with activated immunity and cytokine release, which could account for the presence of hemophagocytosis. Although the histopathologic finding alone of hemophagocytosis is insufficient to label as a syndrome, it should incite the clinician for further systemic evaluation.”
“Background: Quality of care provided by the outpatient hypertension unit of a general hospital was measured using quality indicators (QIs) derived from guidelines.

Methods: We enrolled 1206 patients with hypertension, 626 men and 580 women, with a mean age of 55.33 +/- 12.08 years.

Here we review the growing body of basic research on the role of

Here we review the growing body of basic research on the role of PI3K signaling in the heart and give an overview of the different therapeutic strategies being developed for cancer using PI3K inhibitors, including pan and isoform-selective inhibitors, combination PI3K/mammalian target of rapamycin inhibitors and the use

of PI3K inhibitors in combination therapies with other anticancer therapies. We focus on the clinical implications for treating patients with preexisting cardiac risk factors or comorbidities with PI3K inhibitors.

Conclusions: PI3K inhibitors are novel cancer drugs that are likely to lead to considerable toxicity to the cardiovascular

system, especially in elderly buy PFTα patients and those with preexisting cardiovascular disease. (J Cardiac Fail 2013;19:268-282)”
“Purpose:

To GF120918 order determine changes in regional airflow obstruction over time in the lungs of patients with asthma, as demonstrated with hyperpolarized helium 3 (He-3) magnetic resonance (MR) imaging, and to assess correlations with disease severity and use of asthma medications.

Materials and Methods:

Institutional review board approval and written informed consent were obtained for this HIPAA-compliant study. Use of He-3 was approved by the U. S. Food and Drug Administration. Forty-three patients underwent 103 MR imaging studies in total; 26 were imaged twice within 42-82 minutes (same day), and 17 were imaged on 3 days between 1 and 476 days (multiday). Each day, spirometry was performed, disease severity was determined, and the use of asthma medications was recorded. Images were reviewed in a pairwise fashion

to determine total ventilation defect number, defects in same location between imaging studies, and size. Parametric and nonparametric statistical methods were used.

Results:

For the same-day examinations, the mean number of defects per image section was similar at baseline Epoxomicin in vivo and repeat imaging (1.8 +/- 1.9 [standard deviation] vs 1.6 +/- 1.9, respectively; P = .15), with 75% of defects remaining in the same location and 71% of these not changing size. For the multiday examinations, the mean number of defects per section was higher for study 2 (2.4 +/- 1.5) than study 1 (1.7 +/- 0.9, P = .02), was lower for study 3 (1.5 +/- 1.1) than for study 2 (P < .01), and was similar for studies 1 and 3 (P = .56). Time between examinations was not associated with change in mean number of defects per section (median intrasubject correlation [r(m)] = 0.01, P = .64) or change in spirometric values (range of r(m) values: -0.56 to -0.31; range of P values: .09-.71). Defects in the same location decreased with time (r(m) = -0.83, P < .

HUI-III-based health utilities display convergent validity with t

HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies.”
“The method of preparation, determination of foaming parameters, selleckchem and methods for the determination of physicochemical properties of polyurethane-polyisocyanurate (PUR-PIR) foams prepared

with the use of N,N’-di(methyleneoxy-2-hydroxyethyl)urea and boric acid derivatives are presented in this paper. It was found that application of the borate as a polyol component and simultaneously as a flame retardant in the recipe for production of PUR-PIR foams was very favorable. The foams prepared were characterized by reduced brittleness, higher compressive strength and content of closed cells, as well as considerably lower flammability in comparison with standard foam. The results show that the new polyol prepared on the basis of N,N’-di(methyleneoxy-2-hydroxyethyl)urea

and boric acid can be applied for production of rigid PUR-PIR foams, and it improves their physicochemical properties. (C) 2010 Wiley Periodicals, Inc. I Appl Polym Sci 118: 2250-2256, 2010″
“Travel to procure deceased donor organs is associated with risk to transplant personnel. In many instances, multiple teams are present for a given operation. We studied our statewide Saracatinib price experience to determine how much excess travel this redundancy entails, and generated alternate models for organ recovery. We reviewed our organ procurement organization’s experience with deceased donor operations between 2002 and 2008. Travel was expressed as cumulative person-miles YM155 between procurement team origin and donor hospital. A model of minimal travel was created, using thoracic and abdominal teams from the closest in-state center. A second model involved transporting donors to a dedicated procurement

facility. Travel distance was recalculated using these models, and mode and cost of travel extrapolated from current practices. In 654 thoracic and 1469 abdominal donors studied, the mean travel for thoracic teams was 1066 person-miles and for abdominal teams was 550 person-miles. The mean distance traveled by thoracic and abdominal organs was 223 miles and 142 miles, respectively. Both hypothetical models showed reductions in team travel and reliance on air transport, with favorable costs and organ transport times compared to historical data. In summary, we found significant inefficiency in current practice, which may be alleviated using new paradigms for donor procurement.