This work presents novel colorless polyimides (PIs) derived from 1R,2S,4S,5R‐cyclohexanetetracarboxylic dianhydride (H″‐PMDA). Isomer effects were also discussed by comparing with PI systems derived from conventional hydrogenated pyromellitic dianhydride, that is, 1S,2R,4S,5R‐cyclohexanetetracarboxylic dianhydride (H‐PMDA). H″‐PMDA was much more reactive with various diamines than H‐PMDA, and the former led to PI precursors with much higher molecular weights. The results can be explained from the quite different steric structures of these isomers. The thermally imidized H″‐PMDA‐based films were colorless regardless of diamines because of inhibited charge‐transfer interaction. In particular, the H″‐PMDA/4,4′‐oxydianiline system simultaneously achieved a very high Tg exceeding 300 °C, high toughness (elongation at break > 70%), and good solution processability. In contrast, the H‐PMDA‐based counterparts were essentially insoluble. The outstanding solubility of the former probably results from disturbed chain stacking by its nonplanar steric structure. An advantage of chemical imidization process is also proposed. In some cases, a copolymerization approach with an aromatic tetracarboxylic dianhydride was effective to improve the thermal expansion property. The results suggest that the H″‐PMDA‐based PI systems can be promising candidates for novel high‐temperature plastic substrate materials in electronic paper displays. A potential application as optical compensation film materials in liquid crystal displays (LCD) is also proposed in this work. © 2012 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2013
IMPORTANCECow's milk formula (CMF) is used to supplement breastfeeding (BF) at birth without clear clinical evidence to support the practice.OBJECTIVE To determine whether avoiding supplementation with CMF at birth can decrease risks of sensitization to cow's milk protein and/or clinical food allergy, including cow's milk allergy (CMA), overall and in subgroups stratified by 25-hydroxyvitamin D (25[OH]D) levels. DESIGN, SETTING, AND PARTICIPANTSThe Atopy Induced by Breastfeeding or Cow's Milk Formula (ABC) trial, a randomized, nonblinded clinical trial, began enrollment October 1, 2013, and completed follow-up May 31, 2018, at a single university hospital in Japan. Participants included 330 newborns at risk for atopy; of these, 312 were included in the analysis. Data were analyzed from September 1 through October 31, 2018.INTERVENTIONS Immediately after birth, newborns were randomized (1:1 ratio) to BF with or without amino acid-based elemental formula (EF) for at least the first 3 days of life (BF/EF group) or BF supplemented with CMF (Ն5 mL/d) from the first day of life to 5 months of age (BF plus CMF group). MAIN OUTCOMES AND MEASURESThe primary outcome was sensitization to cow's milk (IgE level, Ն0.35 allergen units [U A ]/mL) at the infant's second birthday. Secondary outcomes were immediate and anaphylactic types of food allergy, including CMA, diagnosed by oral food challenge test or triggered by food ingestion, with food-specific IgE levels of at least 0.35 U A /mL. Subgroup analysis was prespecified by tertiles of serum 25(OH)D levels at 5 months of age. RESULTSOf the 312 infants included in the analysis (160 female [51.3%] and 152 male [48.7%]), 151 of 156 (96.8%) in the BF/EF and BF plus CMF groups were followed up until their second birthday. The primary outcome occurred in 24 infants (16.8%) in the BF/EF group, which was significantly fewer than the 46 infants (32.2%) in the BF plus CMF group (relative risk [RR], 0.52; 95% CI, 0.34-0.81). The middle tertile of the 25(OH)D subgroup, but not the low and high tertiles, had a significant interaction with the intervention (RR, 0.19; 95% CI, 0.07-0.50; P = .02). The prevalence of food allergy at the second birthday was significantly lower in the BF/EF than in the BF plus CMF groups for immediate (4 [2.6%] vs 20 [13.2%]; RR, 0.20; 95% CI, 0.07-0.57) and anaphylactic (1 [0.7%] vs 13 [8.6%]; RR, 0.08; 95% CI, 0.01-0.58) types. CONCLUSIONS AND RELEVANCEThe evidence suggests that sensitization to cow's milk and food allergy, including CMA and anaphylaxis, are primarily preventable by avoiding CMF supplementation for at least the first 3 days of life.TRIAL REGISTRATION http://umin.ac.jp Identifier: UMIN000011577
Rituximab (RTX) has been successfully used as a rescue therapy in children with steroid-dependent nephrotic syndrome (SDNS). However, little is known regarding maintenance therapy after a successful response to RTX in such patients. The efficacy and safety of a single RTX infusion (375 mg/m(2)) were assessed in ten patients who had persistent SDNS associated with minimal-change disease (MCD) despite the long-term use of cyclosporine (CsA). The mean follow-up after RTX infusion was 17 months. Applying RTX resulted in a significant reduction in the mean prednisolone (PSL) dose from 0.39 +/-0.18 to 0.15 +/- 0.14 mg/kg per day. The mean 12-month relapse rates significantly decreased from 4.1 +/- 1.7 to 0.6 +/- 0.6. All but one patient who had continued CsA as maintenance therapy after a single RTX infusion were able to withdraw from PSL without any relapses during the study period, whereas the remaining five patients who discontinued CsA experienced relapses after CD19 cells re-emerged, leading to the reintroduction of CsA or an additional RTX infusion. Infusion reactions occurred in five of ten patients. These data indicate that a single RTX infusion may improve response to CsA in patients with persistent SDNS due to the phenomenon of secondary resistance to CsA.
Background: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. Methods: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013. Patients were followed up for 2 years. AKI was defined according to the pRIFLE criteria as ≥25% decrease in estimated creatinine clearance. Results: AKI developed postoperatively in 104 cases (24.9%). Approximately 80% belonged to the “Risk” category according to the pRIFLE criteria, and only 21 cases (5%) required renal replacement therapy (peritoneal dialysis in all cases). Multivariate analysis revealed 3 independent risk factors for onset of AKI: young age (<1 year), surgery in Risk Adjustment in Congenital Heart Surgery (RACHS-1) category ≥4, and long cardiopulmonary bypass (CPB) time (≥90 min). Twenty-three patients (22%) with AKI died during the 2-year follow-up. In multivariate cox hazard regression analysis, the most significant contributor to risk of mortality was AKI. Conclusions: Postoperative AKI was strongly associated with young age, high RACHS-1 category, and prolonged CPB time. In addition, mortality rate was higher in patients who survived after recovery from AKI than in those without AKI, even among the lower pRIFLE categories.
Both birth weight and gestational age were strongly associated with childhood-onset CKD in this study.
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