In vitro efficacy and safety of a system for sorbent-assisted peritoneal dialysis

In vitro efficacy and safety of a system for sorbent-assisted peritoneal dialysis. Am J Physiol Renal Physiol 319: F162-F170, 2020. First published June 1, 2020; doi:10.1152/ajprenal. 00079.2020.-A system for sorbent-assisted peritoneal dialysis (SAPD) was designed to continuously recirculate dialysate via a tidal mode using a single lumen peritoneal catheter with regeneration of spent dialysate by means of sorbent technology. We hypothesize that SAPD treatment will maintain a high plasma-to-dialysate concentration gradient and increase the mass transfer area coefficient of solutes. Thereby, the SAPD system may enhance clearance while reducing the number of exchanges. Application is envisaged at night as a bedside device (12 kg, nighttime system). A wearable system (2.0 kg, daytime system) may further enhance clearance during the day. Urea, creatinine, and phosphate removal were studied with the daytime and nighttime system (n = 3 per system) by recirculating 2 liters of spent peritoneal dialysate via a tidal mode (mean flow rate: 50 and 100 mL/min, respectively) for 8 h in vitro. Time-averaged plasma clearance over 24 h was modeled assuming one 2 liter exchange/day, an increase in mass transfer area coefficient, and 0.9 liters ultrafiltration/day. Urea, creatinine, and phosphate removal was 33.2 ± 4.1, 5.3 ± 0.5, and 6.2 ± 1.8 mmol, respectively, with the daytime system and 204 ± 28, 10.3 ± 2.4, and 11.4 ± 2.1 mmol, respectively, with the nighttime system. Time-averaged plasma clearances of urea, creatinine and phosphate were 9.6 ± 1.1, 9.6 ± 1.7, and 7.0 ± 0.9 mL/min, respectively, with the nighttime system and 10.8 ± 1.1, 13.4 ± 1.8, and 9.7 ± 1.6 mL/min, respectively, with the daytime and nighttime system. SAPD treatment may improve removal of uremic toxins compared with conventional peritoneal dialysis, provided that peritoneal mass transport will increase

Transverse phase-locking in fully frustrated Josephson junction arrays: a new type of fractional giant steps

We study, analytically and numerically, phase locking of driven vortex lattices in fully-frustrated Josephson junction arrays at zero temperature. We consider the case when an ac current is applied {\it perpendicular} to a dc current. We observe phase locking, steps in the current-voltage characteristics, with a dependence on external ac-drive amplitude and frequency qualitatively different from the Shapiro steps, observed when the ac and dc currents are applied in parallel. Further, the critical current increases with increasing transverse ac-drive amplitude, while it decreases for longitudinal ac-drive. The critical current and the phase-locked current step width, increase quadratically with (small) amplitudes of the ac-drive. For larger amplitudes of the transverse ac-signal, we find windows where the critical current is hysteretic, and windows where phase locking is suppressed due to dynamical instabilities. We characterize the dynamical states around the phase-locking interference condition in the $IV$ curve with voltage noise, Lyapunov exponents and Poincar\'e sections. We find that zero temperature phase-locking behavior in large fully frustrated arrays is well described by an effective four plaquette model.Comment: 12 pages, 11 figure

Diagnostic Performance of PET or PET/CT Using ¹⁸F-FDG Labeled White Blood Cells in Infectious Diseases: A Systematic Review and a Bivariate Meta-Analysis.

Diagnostic performance of positron emission tomography using white blood cells labeled with fluorine-18-fluorodeoxyglucose ( <sup>18</sup> F-FDG-WBC PET or PET/CT) in patients with suspicious infectious diseases has been evaluated in several studies; however, there is no consensus about the diagnostic accuracy of this method. Therefore, a systematic review and meta-analysis was carried out on this topic. A comprehensive computer literature search screening PubMed/MEDLINE, Embase and Cochrane library databases through March 2019 was performed. Pooled sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), and diagnostic odds ratio (DOR) of <sup>18</sup> F-FDG-WBC PET or PET/CT in patients with infectious diseases were calculated. Eight studies on the use of <sup>18</sup> F-FDG-WBC PET or PET/CT in suspicious infectious diseases were discussed in the systematic review. The meta-analysis of seven studies (236 patients) provided these pooled results on a per patient-based analysis: sensitivity was 86.3% [95% confidence interval (95%CI) 75-92.9%], specificity 92% (95%CI 79.8-97.1%), LR+ 6.6 (95%CI: 3.1-14.1), LR- 0.2 (95%CI: 0.12-0.33), DOR 43.5 (95%CI: 12.2-155). A statistically significant heterogeneity was not detected. Despite limited literature data, <sup>18</sup> F-FDG-WBC PET or PET/CT demonstrated a good diagnostic accuracy for the diagnosis of infectious diseases; nevertheless, larger studies are needed