Tubular secretion of creatinine and kidney function: an observational study.

BackgroundPrior papers have been inconsistent regarding how much creatinine clearance (CrCl) overestimates glomerular filtration rate (GFR). A recent cross-sectional study suggested that measurement error alone could entirely account for the longstanding observation that CrCl/GFR ratio is larger when GFR is lower among patients with chronic kidney disease (CKD); but there have been no validation of this in other cohorts.MethodsTo fill these gaps in knowledge regarding the relation between CrCl and GFR, we conducted cross-sectional and longitudinal analysis of the Modification of Diet in Renal Disease study (MDRD) and African American Study of Kidney Disease and Hypertension (AASK); and cross-sectional analysis of a clinical dataset from the Mayo Clinic of four different patient populations (CKD patients, kidney transplant recipients, post kidney donation subgroup and potential kidney donors). In the cross-sectional analyses (MDRD, AASK and Mayo Clinic cohort), we examined the relation between the CrCl/iothalamate GFR (iGFR) ratio at different categories of iGFR or different levels of CrCl. In the MDRD and AASK longitudinal analyses, we studied how the CrCl/iGFR ratio changed with those who had improvement in iGFR (CrCl) over time versus those who had worsening of iGFR (CrCl) over time.ResultsObserved CrCl/iGFR ratios were generally on the lower end of the range reported in the literature for CKD (median 1.24 in MDRD, 1.13 in AASK and 1.25 in Mayo Clinic cohort). Among CKD patients in whom CrCl and iGFR were measured using different timed urine collections, CrCl/iGFR ratio were higher with lower iGFR categories but lower with lower CrCl categories. However, among CKD patients in whom CrCl and iGFR were measured using the same timed urine collections (which reduces dis-concordant measurement error), CrCl/iGFR ratio were higher with both lower iGFR categories and lower CrCl categories.ConclusionsThese data refute the recent suggestion that measurement error alone could entirely account for the longstanding observation that CrCl/GFR ratio increases as GFR decreases in CKD patients. They also highlight the lack of certainty in our knowledge with regard to how much CrCl actually overestimates GFR

Dilemmas and Challenges in the Marketing of Hybrid Organizations: A Theoretical Exploration of Dutch Sheltered Work Companies

__Abstract__ This article explores the dilemmas and challenges that hybrid organizations face when developing marketi

The case for inclusive area profiling applied in geographic information systems

This paper introduces the history and role of consultation processes of contemporary planning and, after presenting the popularity and criticisms of different practices including communities in urban decision making, it explores how rational planning tools like the geographic information system (GIS) could be exploited to reshape consultation and formally include subjective data in traditional area profiling. Focusing on the popular consultation tool of community mapping, primary and secondary research methods (a literature review, seven interviews to planners and two observational studies) identified seven different problems with contemporary community mapping: spatial and temporal scale, generalisation, integration, representativeness, accessibility, relatedness and visualisation. The conceptualisation, physical modelling and testing of a new community mapping procedure ‘Submap’ is then used to address these problems and discuss (a) the strengths and limitations of formalising community mapping activities for area profiling in GIS and (b) the role of pragmatic research in promoting inclusive practices in contemporary planning

Night sky brightness at sites from DMSP-OLS satellite measurements

We apply the sky brightness modelling technique introduced and developed by Roy Garstang to high-resolution DMSP-OLS satellite measurements of upward artificial light flux and to GTOPO30 digital elevation data in order to predict the brightness distribution of the night sky at a given site in the primary astronomical photometric bands for a range of atmospheric aerosol contents. This method, based on global data and accounting for elevation, Earth curvature and mountain screening, allows the evaluation of sky glow conditions over the entire sky for any site in the World, to evaluate its evolution, to disentangle the contribution of individual sources in the surrounding territory, and to identify main contributing sources. Sky brightness, naked eye stellar visibility and telescope limiting magnitude are produced as 3-dimensional arrays whose axes are the position on the sky and the atmospheric clarity. We compared our results to available measurements.Comment: 14 pages, 12 figures, accepted for publication in MNRAS, 17 june 200

The theory of canonical perturbations applied to attitude dynamics and to the Earth rotation. Osculating and nonosculating Andoyer variables

The Hamiltonian theory of Earth rotation, known as the Kinoshita-Souchay theory, operates with nonosculating Andoyer elements. This situation parallels a similar phenomenon that often happens (but seldom gets noticed) in orbital dynamics, when the standard Lagrange-type or Delaunay-type planetary equations unexpectedly render nonosculating orbital elements. In orbital mechanics, osculation loss happens when a velocity-dependent perturbation is plugged into the standard planetary equations. In attitude mechanics, osculation is lost when an angular-velocity-dependent disturbance is plugged in the standard dynamical equations for the Andoyer elements. We encounter exactly this situation in the theory of Earth rotation, because this theory contains an angular-velocity-dependent perturbation (the switch from an inertial frame to that associated with the precessing ecliptic of date). While the osculation loss does not influence the predictions for the figure axis of the planet, it considerably alters the predictions for the instantaneous spin-axis' orientation. We explore this issue in great detail

Astrometry and geodesy with radio interferometry: experiments, models, results

Summarizes current status of radio interferometry at radio frequencies between Earth-based receivers, for astrometric and geodetic applications. Emphasizes theoretical models of VLBI observables that are required to extract results at the present accuracy levels of 1 cm and 1 nanoradian. Highlights the achievements of VLBI during the past two decades in reference frames, Earth orientation, atmospheric effects on microwave propagation, and relativity.Comment: 83 pages, 19 Postscript figures. To be published in Rev. Mod. Phys., Vol. 70, Oct. 199

Lorentz Covariant Theory of Light Propagation in Gravitational Fields of Arbitrary-Moving Bodies

The Lorentz covariant theory of propagation of light in the (weak) gravitational fields of N-body systems consisting of arbitrarily moving point-like bodies with constant masses is constructed. The theory is based on the Lienard-Wiechert presentation of the metric tensor. A new approach for integrating the equations of motion of light particles depending on the retarded time argument is applied. In an approximation which is linear with respect to the universal gravitational constant, G, the equations of light propagation are integrated by quadratures and, moreover, an expression for the tangent vector to the perturbed trajectory of light ray is found in terms of instanteneous functions of the retarded time. General expressions for the relativistic time delay, the angle of light deflection, and gravitational red shift are derived. They generalize previously known results for the case of static or uniformly moving bodies. The most important applications of the theory are given. They include a discussion of the velocity dependent terms in the gravitational lens equation, the Shapiro time delay in binary pulsars, and a precise theoretical formulation of the general relativistic algorithm of data processing of radio and optical astrometric measurements in the non-stationary gravitational field of the solar system. Finally, proposals for future theoretical work being important for astrophysical applications are formulated.Comment: 77 pages, 7 figures, list of references is updated, to be published in Phys. Rev. D6

Metabolic diagnosis and medical prevention of calcium nephrolithiasis and its systemic manifestations: a consensus statement

Background: Recently published guidelines on the medical management of renal stone disease did not address relevant topics in the field of idiopathic calcium nephrolithiasis, which are important also for clinical research. Design: A steering committee identified 27 questions, which were proposed to a faculty of 44 experts in nephrolithiasis and allied fields. A systematic review of the literature was conducted and 5216 potentially relevant articles were selected; from these, 407 articles were deemed to provide useful scientific information. The Faculty, divided into working groups, analysed the relevant literature. Preliminary statements developed by each group were exhaustively discussed in plenary sessions and approved. Results: Statements were developed to inform clinicians on the identification of secondary forms of calcium nephrolithiasis and systemic complications; on the definition of idiopathic calcium nephrolithiasis; on the use of urinary tests of crystallization and of surgical observations during stone treatment in the management of these patients; on the identification of patients warranting preventive measures; on the role of fluid and nutritional measures and of drugs to prevent recurrent episodes of stones; and finally, on the cooperation between the urologist and nephrologist in the renal stone patients. Conclusions: This document has addressed idiopathic calcium nephrolithiasis from the perspective of a disease that can associate with systemic disorders, emphasizing the interplay needed between urologists and nephrologists. It is complementary to the American Urological Association and European Association of Urology guidelines. Future areas for research are identified

Studies on CrO_x/La₂O₃/ZrO₂ catalysts modified by Mg

Lanthana–zirconia supported chromium oxide and magnesium chromium mixed oxide catalysts were studied in the dehydrocyclization of n-octane and characterized by temperature-programmed desorption of NH3, temperature-programmed reduction, XPS and DRIFTS. The Mg-free catalyst shows the highest activity, but suffers from rapid deactivation due to coke formation. The addition of Mg decreases the initial activity of the supported chromium oxide and retards its deactivation. The characterization results reveal that the deactivation retarding effect of Mg species not only consists in the deletion of strong acid sites but also in the decoration and/or dilution of Cr3+ oxide cluster, supposedly due to the formation of Mg–Cr surface compounds and, thus, in preventing the formation of coke