Glomerular filtration rate estimates decrease during high altitude expedition but increase with Lake Louise acute mountain sickness scores

AIM: Acute mountain sickness (AMS) can result in pulmonary and cerebral oedema with overperfusion of microvascular beds, elevated hydrostatic capillary pressure, capillary leakage and consequent oedema as pathogenetic mechanisms. Data on changes in glomerular filtration rate (GFR) at altitudes above 5000 m are very limited. METHODS: Thirty-four healthy mountaineers, who were randomized to two acclimatization protocols, undertook an expedition on Muztagh Ata Mountain (7549 m) in China. Tests were performed at five altitudes: Zurich pre-expedition (PE, 450 m), base camp (BC, 4497 m), Camp 1 (C1, 5533 m), Camp 2 (C2, 6265 m) and Camp 3 (C3, 6865 m). Cystatin C- and creatinine-based (Mayo Clinic quadratic equation) GFR estimates (eGFR) were assessed together with Lake Louise AMS score and other tests. RESULTS: eGFR significantly decreased from PE to BC (P < 0.01). However, when analysing at changes between BC and C3, only cystatin C-based estimates indicated a significant decrease in GFR (P = 0.02). There was a linear decrease in eGFR from PE to C3, with a decrease of approx. 3.1 mL min(-1) 1.73 m(-2) per 1000 m increase in altitude. No differences between eGFR of the two groups with different acclimatization protocols could be observed. There was a significant association between eGFR and haematocrit (P = 0.01), whereas no significant association between eGFR and aldosterone, renin and brain natriuretic peptide could be observed. Finally, higher AMS scores were significantly associated with higher eGFR (P = 0.01). CONCLUSIONS: Renal function declines when ascending from low to high altitude. Cystatin C-based eGFR decreases during ascent in high altitude expedition but increases with AMS scores. For individuals with eGFR <40 mL min(-1) 1.73 m(-2), caution may be necessary when planning trips to high altitude above 4500 m above sea level

The replication problem and its implications for policy studies

In this article we re-examine the epistemological basis for claims to ‘best evidence’ and ‘best practice’ in policy studies by tracing these to a Popperian model of theory development and testing. This model outlines how only scientific explanations that survive repeated testing count as good theory. Yet repeated testing (replication) is scarce across the social sciences – this is the ‘replication problem’. More specifically, the lack of replications in policy studies undermines the epistemological basis for policy transfer based on ‘best practice’ and ‘best evidence’. To resolve this, we offer an innovative explanation of the replication problem drawing on Foucault's concept of Episteme. In doing so, we outline two respectively different accounts of replication: ‘scientific project,’ and ‘aesthetic object.’ The latter offers alternative bases from which to pursue ‘best practice’ and ‘best evidence’

Measurement of ψ\psi(2S) production as a function of charged-particle pseudorapidity density in pp collisions at s\sqrt{s} = 13 TeV and p-Pb collisions at sNN\sqrt{s_{\rm NN}} = 8.16 TeV with ALICE at the LHC

International audienceProduction of inclusive charmonia in pp collisions at center-of-mass energy of $\sqrt{s}$ = 13 TeV and p–Pb collisions at center-of-mass energy per nucleon pair of $\sqrt{s_{\textrm{NN}}}$ = 8.16 TeV is studied as a function of charged-particle pseudorapidity density with ALICE. Ground and excited charmonium states (J/ψ, ψ(2S)) are measured from their dimuon decays in the interval of rapidity in the center-of-mass frame 2.5 < y$_{cms}$< 4.0 for pp collisions, and 2.03 < y$_{cms}$< 3.53 and −4.46 < y$_{cms}$< −2.96 for p–Pb collisions. The charged-particle pseudorapidity density is measured around midrapidity (|η| < 1.0). In pp collisions, the measured charged-particle multiplicity extends to about six times the average value, while in p-Pb collisions at forward (backward) rapidity a multiplicity corresponding to about three (four) times the average is reached. The ψ(2S) yield increases with the charged-particle pseudorapidity density. The ratio of ψ(2S) over J/ψ yield does not show a significant multiplicity dependence in either colliding system, suggesting a similar behavior of J/ψ and ψ(2S) yields with respect to charged-particle pseudorapidity density. Results for the ψ(2S) yield and its ratio with respect to J/ψ agree with available model calculations.[graphic not available: see fulltext