Determinants of the creatinine clearance to glomerular filtration rate ratio in patients with chronic kidney disease: a cross-sectional study

BACKGROUND: Creatinine secretion, as quantified by the ratio of creatinine clearance (CrCl) to glomerular filtration rate (GFR), may introduce another source of error when using serum creatinine concentration to estimate GFR. Few studies have examined determinants of the CrCl/GFR ratio. We sought to study whether higher levels of albuminuria would be associated with higher, and being non-Hispanic black with lower, CrCl/GFR ratio. METHODS: We did a cross-sectional analysis of 1342 patients with chronic kidney disease from the Chronic Renal Insufficiency Cohort (CRIC) who had baseline measure of iothalamate GFR (iGFR) and 24-hour urine collections. Our predictors included urine albumin as determined from 24-hour urine collections (categorized as: <30, 30-299, 300-2999 and ≥3000 mg), and race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic). Our outcome was CrCl/iGFR ratio, a measure of creatinine secretion. RESULTS: Mean iGFR was 48.0 ± 19.9 mL/min/1.73 m(2), median albuminuria was 84 mg per day, and 36.8% of the study participants were non-Hispanic black. Mean CrCl/iGFR ratio was 1.19 ± 0.48. There was no association between the CrCl/iGFR ratio and urine albumin (coefficient 0.11 [95% CI−0.01-0.22] for higest verus lowest levels of albuminuria, p = 0.07). Also, there was no association between race/ethnicity and CrCl/iGFR ratio (coefficient for non-Hispanic blacks was−0.03 [95% CI−0.09-0.03] compared with whites, p = 0.38). CONCLUSIONS: Contrary to what had been suggested by prior smaller studies, CrCl/GFR ratio does not vary with degree of proteinuria or race/ethnicity. The ratio is also closer to 1.0 than reported by several frequently cited reports in the literature

Semi-automatic tool to identify heterogeneity zones in lge-cmr and incorporate the result into a 3d model of the left ventricle

Fatal scar-related arrhythmias are caused by an abnormal electrical wave propagation around non conductive scarred tissue and through viable channels of reduced conductivity. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is the gold-standard procedure used to differentiate the scarred tissue from the healthy, highlighting the dead cells. The border regions responsible for creating the feeble channels are visible as gray zones. Identifying and monitoring (as they may evolve) these areas may predict the risk of arrhythmias that may lead to cardiac arrest. The main goal of this project is the development of a system able to aid the user in the extraction of geometrical and physiological information from LGE images and the replication of myocardial heterogeneities onto a three-dimensional (3D) structure, built by the methods described by our team in another publication, able to undergo electro-physiologic simulations. The system components were developed in MATLAB R2019b the first is a semi-automatic tool, to identify and segment the myocardial scars and gray zones in every two-dimensional (2D) slice of a LGE CMR dataset. The second component takes these results and assembles different sections while setting different conductivity values for each. At this point, the resulting parts are incorporated into the functional 3D model of the left ventricle, and therefore the chosen values and regions can be validated and redefined until a satisfactory result is obtained. As preliminary results we present the first steps of building one functional Left ventricle (LV) model with scarred zones.authorsversionpublishe

Atomic Physics: Neutral atoms put in charge

An elegant experiment shows that atoms subjected to a pair of laser beams can behave like electrons in a magnetic field, as demonstrated by the appearance of quantized vortices in a neutral superfluid

Prioritized Sweeping Neural DynaQ with Multiple Predecessors, and Hippocampal Replays

During sleep and awake rest, the hippocampus replays sequences of place cells that have been activated during prior experiences. These have been interpreted as a memory consolidation process, but recent results suggest a possible interpretation in terms of reinforcement learning. The Dyna reinforcement learning algorithms use off-line replays to improve learning. Under limited replay budget, a prioritized sweeping approach, which requires a model of the transitions to the predecessors, can be used to improve performance. We investigate whether such algorithms can explain the experimentally observed replays. We propose a neural network version of prioritized sweeping Q-learning, for which we developed a growing multiple expert algorithm, able to cope with multiple predecessors. The resulting architecture is able to improve the learning of simulated agents confronted to a navigation task. We predict that, in animals, learning the world model should occur during rest periods, and that the corresponding replays should be shuffled.Comment: Living Machines 2018 (Paris, France

C-terminal truncated hepatitis B virus X protein promotes hepatocellular carcinogenesis through induction of cancer and stem cell-like properties

published_or_final_versio

Integrated model for flood forecasting and river inundation in Taiwan

This is the author accepted manuscriptRoyal Societ

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation: We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions: Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery

Flood impact assessment under climate change scenarios in central Taipei area, Taiwan

Providing effective information regarding flood control for responding climate change is essential to future flood risk management for cities. This study simulated and assessed the impacts of flooding for future climate change scenarios in Taipei city, Taiwan. We modelled rainfall events, generated by general circulation models, with different return periods. The flood extents and damage in the Central Taipei Area for the A1B climate change scenarios were compared to the ones, caused by the rainfall events with same return periods, without climate change (baseline scenario). The proposed approach provides potential flooding maps and flood damage assessment for climate change scenarios as useful information for flood risk management in urban areas.The work is supported by the National Science Council, Taiwan (NSC 99-2915-I-002-120) and the CORFU project, funded by the European Commission through Framework Programme 7, Grant Number 244047