Renal replacement modality and stroke risk in end-stage renal disease—a national registry study

Background: The risk of stroke in end-stage renal disease (ESRD) on renal replacement therapy (RRT) is up to 10-fold greater than the general population. However, whether this increased risk differs by RRT modality is unclear. Methods: We used data contained in the Scottish Renal Registry and the Scottish Stroke Care Audit to identify stroke in all adult patients who commenced RRT for ESRD from 2005 to 2013. Incidence rate was calculated and regression analyses were performed to identify variables associated with stroke. We explored the effect of RRT modality at initiation and cumulative dialysis exposure by time-dependent regression analysis, using transplant recipients as the reference group. Results: A total of 4957 patients commenced RRT for ESRD. Median age was 64.5 years, 41.5% were female and 277 patients suffered a stroke (incidence rate was 18.6/1000 patient-years). Patients who had stroke were older, had higher blood pressure and were more likely to be female and have diabetes. On multivariable regression older age, female sex, diabetes and higher serum phosphate were associated with risk of stroke. RRT modality at initiation was not. On time-dependent analysis, haemodialysis (HD) exposure was independently associated with increased risk of stroke. Conclusions: In patients with ESRD who initiate RRT, HD use independently increases risk of stroke compared with transplantation. Use of peritoneal dialysis did not increase risk on adjusted analysis

Development of Data Processing Skills of Physics Students in Intermediate Laboratory Course

Peer reviewe

Monte Carlo study of the two-dimensional dipolar ising model

The two-dimensional Ising model with a dipolar and superexchange interaction will be examined. This model will be studied using Monte Carlo simulations. The results of this study will be discussed in two ways. First, the results will he analysed treating the system as a possible model for the rare earth ordering in the compounds REBa₂Cu₃O₇, where RE one of the Kramers rare earth ions. A comparison between the Néel temperature of a pure dipolar system and the experimental Néel temperature of these compounds will be done. As well, the results will be analysed in terms of what may be learned about dipolar systems in general. In particular, the Néel temperature and the static critical exponents will be discussed

Reorientation transition of ultrathin ferromagnetic films

We demonstrate that the reorientation transition from out-of-plane to in-plane magnetization with decreasing temperature as observed experimentally in Ni-films on Cu(001) can be explained on a microscopic basis. Using a combination of mean field theory and perturbation theory, we derive an analytic expression for the temperature dependent anisotropy. The reduced magnetization in the film surface at finite temperatures plays a crucial role for this transition as with increasing temperature the influence of the uniaxial anisotropies is reduced at the surface and is enhanced inside the film.Comment: 4 pages(RevTeX), 3 figures (EPS

Metric Features of a Dipolar Model

The lattice spin model, with nearest neighbor ferromagnetic exchange and long range dipolar interaction, is studied by the method of time series for observables based on cluster configurations and associated partitions, such as Shannon entropy, Hamming and Rohlin distances. Previous results based on the two peaks shape of the specific heat, suggested the existence of two possible transitions. By the analysis of the Shannon entropy we are able to prove that the first one is a true phase transition corresponding to a particular melting process of oriented domains, where colored noise is present almost independently of true fractality. The second one is not a real transition and it may be ascribed to a smooth balancing between two geometrical effects: a progressive fragmentation of the big clusters (possibly creating fractals), and the slow onset of a small clusters chaotic phase. Comparison with the nearest neighbor Ising ferromagnetic system points out a substantial difference in the cluster geometrical properties of the two models and in their critical behavior.Comment: 20 pages, 15 figures, submitted to JPhys

The association of atrial fibrillation and ischaemic stroke in patients on haemodialysis: a competing risk analysis

Background: Stroke is common in patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) and associated with high mortality rate. In the general population, atrial fibrillation (AF) is a major risk factor for stroke and therapeutic anticoagulation is associated with risk reduction, whereas in ESRD the relationship is less clear. Objective: The purpose of this study is to demonstrate the influence of AF on stroke rates and probability in those on HD following competing risk analyses. Design: A national record linkage cohort study. Setting: All renal and stroke units in Scotland, UK. Patients: All patients with ESRD receiving HD within Scotland from 2005 to 2013 (follow-up to 2015). Measurements: Demographic, clinical, and laboratory data were linked between the Scottish Renal Registry, Scottish Stroke Care Audit, and hospital discharge data. Stroke was defined as a fatal or nonfatal event and mortality derived from national records. Methods: Associations for stroke were determined using competing risk models: the cause-specific hazards model and the Fine and Gray subdistribution hazards model accounting for the competing risk of death in models of all stroke, ischemic stroke, and first-ever stroke. Results: Of 5502 patients treated with HD with 12 348.6-year follow-up, 363 (6.6%) experienced stroke. The stroke incidence rate was 26.7 per 1000 patient-years. Multivariable regression on the cause-specific hazard for stroke demonstrated age, hazard ratio (HR) (95% confidence interval [CI]) = 1.04 (1.03-1.05); AF, HR (95% CI) = 1.88 (1.25-2.83); prior stroke, HR (95% CI) = 2.29 (1.48-3.54), and diabetes, HR (95% CI) = 1.92 (1.45-2.53); serum phosphate, HR (95% CI) = 2.15 (1.56-2.99); lower body weight, HR (95% CI) = 0.99 (0.98-1.00); lower hemoglobin, HR (95% CI) = 0.88 (0.77-0.99); and systolic blood pressure (BP), HR (95% CI) = 1.01 (1.00-1.02), to be associated with an increased stroke rate. In contrast, the subdistribution HRs obtained following Fine and Gray regression demonstrated that AF, weight, and hemoglobin were not associated with stroke risk. In both models, AF was significantly associated with nonstroke death. Limitations: Our analyses derive from retrospective data sets and thus can only describe association not causation. Data on anticoagulant use are not available. Conclusions: The incidence of stroke in HD patients is high. The competing risk of “prestroke” mortality affects the relationship between AF and risk of future stroke. Trial designs for interventions to reduce stroke risk in HD patients, such as anticoagulation for AF, should take account of competing risks affecting associations between risk factors and outcomes

Aging in a Two-Dimensional Ising Model with Dipolar Interactions

Aging in a two-dimensional Ising spin model with both ferromagnetic exchange and antiferromagnetic dipolar interactions is established and investigated via Monte Carlo simulations. The behaviour of the autocorrelation function $C(t,t_w)$ is analyzed for different values of the temperature, the waiting time $t_w$ and the quotient $\delta=J_0/J_d$, $J_0$ and $J_d$ being the strength of exchange and dipolar interactions respectively. Different behaviours are encountered for $C(t,t_w)$ at low temperatures as $\delta$ is varied. Our results show that, depending on the value of $\delta$, the dynamics of this non-disordered model is consistent either with a slow domain dynamics characteristic of ferromagnets or with an activated scenario, like that proposed for spin glasses.Comment: 4 pages, RevTex, 5 postscript figures; acknowledgment added and some grammatical corrections in caption

Ferromagnetism and Temperature-Driven Reorientation Transition in Thin Itinerant-Electron Films

The temperature-driven reorientation transition which, up to now, has been studied by use of Heisenberg-type models only, is investigated within an itinerant-electron model. We consider the Hubbard model for a thin fcc(100) film together with the dipole interaction and a layer-dependent anisotropy field. The isotropic part of the model is treated by use of a generalization of the spectral-density approach to the film geometry. The magnetic properties of the film are investigated as a function of temperature and film thickness and are analyzed in detail with help of the spin- and layer-dependent quasiparticle density of states. By calculating the temperature dependence of the second-order anisotropy constants we find that both types of reorientation transitions, from out-of-plane to in-plane (``Fe-type'') and from in-plane to out-of-plane (``Ni-type'') magnetization are possible within our model. In the latter case the inclusion of a positive volume anisotropy is vital. The reorientation transition is mediated by a strong reduction of the surface magnetization with respect to the inner layers as a function of temperature and is found to depend significantly on the total band occupation.Comment: 10 pages, 8 figures included (eps), Phys Rev B in pres

Dipolar interaction between two-dimensional magnetic particles

We determine the effective dipolar interaction between single domain two-dimensional ferromagnetic particles (islands or dots), taking into account their finite size. The first correction term decays as 1/D^5, where D is the distance between particles. If the particles are arranged in a regular two-dimensional array and are magnetized in plane, we show that the correction term reinforces the antiferromagnetic character of the ground state in a square lattice, and the ferromagnetic one in a triangular lattice. We also determine the dipolar spin-wave spectrum and evaluate how the Curie temperature of an ensemble of magnetic particles scales with the parameters defining the particle array: height and size of each particle, and interparticle distance. Our results show that dipolar coupling between particles might induce ferromagnetic long range order at experimentally relevant temperatures. However, depending on the size of the particles, such a collective phenomenon may be disguised by superparamagnetism.Comment: 11 pages, 5 figure

Inequality in Care and Differences in Outcome Following Stroke in People With ESRD

Acknowledgments: MF is funded by a Kidney Research UK Training Fellowship and is supported by a grant from Darlinda’s Charity for Renal Research.Peer reviewedPublisher PD