Mechanism of Action and Clinical Attributes of Auryxia® (Ferric Citrate).

Chronic kidney disease (CKD) is a major cause of morbidity and premature mortality and represents a significant global public health issue. Underlying this burden are the many complications of CKD, including mineral and bone disorders, anemia, and accelerated cardiovascular disease. Hyperphosphatemia and elevated levels of fibroblast growth factor 23 (FGF23) have been identified as key independent risk factors for the adverse cardiovascular outcomes that frequently occur in patients with CKD. Auryxia® (ferric citrate; Keryx Biopharmaceuticals, Inc., Boston, MA, USA) is an iron-based compound with distinctive chemical characteristics and a mechanism of action that render it dually effective as a therapy in patients with CKD; it has been approved as a phosphate binder for the control of serum phosphate levels in adult CKD patients treated with dialysis and as an iron replacement product for the treatment of iron deficiency anemia in adult CKD patients not treated with dialysis. This review focuses on Auryxia, its mechanism of action, and the clinical attributes that differentiate it from other, non-pharmaceutical-grade, commercially available forms of ferric citrate and from other commonly used phosphate binder and iron supplement therapies for patients with CKD. Consistent with the chemistry and mechanism of action of Auryxia, multiple clinical studies have demonstrated its efficacy in both lowering serum phosphate levels and improving iron parameters in patients with CKD. Levels of FGF23 decrease significantly with Auryxia treatment, but the effects associated with the cardiovascular system remain to be evaluated in longer-term studies

Mars Science Laboratory Drill

The Drill for the Mars Science Laboratory mission is a rotary-percussive sample acquisition device with an emphasis on toughness and robustness to handle the harsh environment on Mars. The unique challenges associated with autonomous drilling from a mobile robot are addressed. A highly compressed development schedule dictated a modular design architecture that satisfies the functional and load requirements while allowing independent development and testing of the Drill subassemblies. The Drill consists of four actuated mechanisms: a spindle that rotates the bit, a chuck that releases and engages bits, a novel voice-coil-based percussion mechanism that hammers the bit, and a linear translation mechanism. The Drill has three passive mechanisms: a replaceable bit assembly that acquires and collects sample, a contact sensor / stabilizer mechanism, and, lastly a flex harness service loop. This paper describes the various mechanisms that makeup the Drill and discusses the solutions to their unique design and development challenges

The effects of greater occipital nerve block and trigger point injection on brush allodynia and pain in migraine

Objective: To evaluate the effect of GONB, with or without trigger point injection (TPI), on dynamical mechanical (brush) allodynia (BA) and on head pain in migraine. Background: Patients with migraine often have cutaneous allodynia, which is related to sensitization of central pain neurons. Greater occipital nerve block (GONB) is an effective treatment for migraine headache, however its effect on cutaneous allodynia in migraine is unknown. Methods: We studied patients with migraine and BA who were treated with GONB with or without TPI. Demographic data, migraine history and headache features were documented. Allodynia was evaluated using a structured questionnaire and by applying a 4x4-inch gauze pad to skin areas in the trigeminal and cervical dermatomes. Degree of allodynia (the allodynia score) was measured on a 100 mm visual analog scale (VAS) before treatment and 10 and 20 minutes thereafter. Headache levels were assessed using an 11-point verbal scale. Allodynia scores, as well as headache levels, before and after treatment were compared. Results: Nineteen patients were studied. Mean age was 43.6 ± 11.8 years. Twenty minutes after treatment, headache was reduced in 17 patients (89.5%) and did not change in two (10.5%). The average headache level was 6.53 before treatment and 3.47 twenty minutes after it. The average allodynia score decreased after 20 minutes in all patients. Average allodynia score per site was reduced by 18.69 mm and 13.74 mm in the trigeminal and cervical areas, respectively. There was a positive correlation between allodynia index, obtained through the questionnaire, and allodynia score, obtained by examination. Conclusion: GONB, with or without TPI, reduced both head pain and brush allodynia in this migraine patient group

Dynamic mechanical (brush) allodynia in cluster headache

Cutaneous allodynia is the perception of pain when a non-noxious stimulus is applied to normal skin. It has been described in patients with migraine. Cutaneous allodynia is caused by sensitization of central nervous system neurons that receive convergent sensory input from both skin and intracranial structures. This phenomenon has not been previously described in patients with cluster headache. Although migraine and cluster headache (CH) may share some clinical features, the pathogenesis of these two primary headaches is different. The aim of this study was to examine the occurrence of dynamic mechanical (brush) allodynia (BA) in patients with CH

Self-Consistent Field Theory of Brushes of Neutral Water-Soluble Polymers

The Self-Consistent Field theory of brushes of neutral water-soluble polymers described by two-state models is formulated in terms of the effective Flory interaction parameter $\chi_{eff}(T,\phi)$ that depends on both temperature, T and the monomer volume fraction, $\phi$. The concentration profiles, distribution of free ends and compression force profiles are obtained in the presence and in the absence of a vertical phase separation. A vertical phase separation within the layer leads to a distinctive compression force profile and a minimum in the plot of the moments of the concentration profile vs. the grafting density. The analysis is applied explicitly to the Karalstrom model. The relevance to brushes of Poly(N-isopropylacrylamide)(PNIPAM) is discussed.Comment: Accepted for publication in the Journal of Chemical Physic

Recharging Metode Pembelajaran Kewirausahaan Berbasis Multimedia untuk Guru SD di Desa Tieng Wonosobo

Perkembangan ilmu dan teknologi semakin mendorong USAha-USAha ke arah pembaharuan dalam memanfaatkan hasil-hasil teknologi dalam pelaksanaan pembelajaran. Guru (pengajar) dalam mengikuti perkembangan teknologi ini diharapkan dapat menggunakan alat atau bahan pendukung proses pembelajaran, dari alat yang sederhana sampai alat yang canggih (sesuai dengan perkembangan dan tuntutan jaman). Pengabdian ini dilaksanakan dengan peserta pelatihan yaitu guru di SD Ma'arif dan Muhammadiyah Tieng. Materi pelatihan adalah konsep kewirausahaan yang dibuat dalam aplikasi video multimedia. Analisis situasi menunjukkan pembelajaran kewirausahaan bisa diterapkan di hamper semua bidang studi. Muatan dan konsep kewirausaan dapat diterapkan pada mata pelajaran yang menjadi kurikulum di SD Ma'arif dan Muhammadiyah. Namun demikian metode pembelajaran yang digunakan masih sederhana. Dengan pelatihan ini peserta diajarkan membuat media ajar yang menggunakan video multimedia dengan aplikasi Software Pinacle. Peserta pelatihan menunjukkan respon antusias dan hasil pelatihan menunjukkan hasil beberapa peserta pelatihan mampu menagkap dan mengaplikasikannya

Referred cutaneous allodynia in a migraine patient without simultaneous headache

Cutaneous allodynia is defined as the perception of pain when a non-noxious stimulus is applied to normal skin. This phenomenon has been demonstrated in migraine patients during an acute attack. It is thought to result from central sensitization of neurons in the trigemino-vascular system and may spread to areas beyond that of the referred head pain. In a recent study, migraine patients demonstrated increased temporal summation to painful mechanical stimuli in their referred head pain area between attacks. This suggests that changes in physiologic properties of nociceptive neurons may occur in migraine patients between attacks. We describe a migraine patient with interictal cutaneous allodynia contralateral to her usual head pain

Strategi Pengembangan USAhatani Kedelai di Kabupaten Grobogan dengan Pendekatan Analysis Hierarchy Process (Ahp)

Soybean is one of the agricultural commodity Grobogan. Soybean commodity is widely cultivated by farmers because the topography is consistent with the characteristics of the soil in Grobogan. In 2010 soybean production Grobogan is most widely in Central Java. However, Indonesia is still dependent on imported soybeans, especially in times of shortages of soybeans. This is partly also due to soybean production in soybean-producing region is very volatile while soybean demand in the market tends to increase. So, we need a strategy development of soybean farming in Grobogan. The goals to be achieved from the preparation of this study was to analyze the condition of soybean farming in Grobogan and obtain soybean farming development strategy in Grobogan based approach Analysis of Hierarchy Process. Alternative measures a priority to develop soybean are: Provision of continuous production factors and affordable, production factor subsidies, assistance to farmers, extension and education on effective post-harvest handling, Counseling institutional strengthening of farmer groups, and technical assistance (equipment, factors of production, training) to farmers. sedagkan least priority are: Incentives for active farmer organizations, cooperatives Revitalization and extension services and farmer partnerships with major employer

Occipital nerve block rapidly eliminates allodynia far from the site of headache: A case report

Seventy to 80% of persons with migraine develop allodynia during the course of a severe attack. During a migraine attack, allodynia spreads topographically to extratrigeminal territory. Dynamic mechanical allodynia, otherwise known as brush allodynia (BA), is a subtype of allodynia that is easily tested. Ashkenazi & Young recently reported on the immediate benefits of greater occipital nerve (GON) block on brush allodynia and pain in migraine and in cluster headache. In these studies, testing was performed at fixed sites in the trigeminal and cervical distributions. Allodynia in thoracic dermatomes was not studied