Duration of temporary catheter use for hemodialysis: an observational, prospective evaluation of renal units in Brazil

<p>Abstract</p> <p>Background</p> <p>For chronic hemodialysis, the ideal permanent vascular access is the arteriovenous fistula (AVF). Temporary catheters should be reserved for acute dialysis needs. The AVF is associated with lower infection rates, better clinical results, and a higher quality of life and survival when compared to temporary catheters. In Brazil, the proportion of patients with temporary catheters for more than 3 months from the beginning of therapy is used as an evaluation of the quality of renal units. The aim of this study is to evaluate factors associated with the time between the beginning of hemodialysis with temporary catheters and the placement of the first arteriovenous fistula in Brazil.</p> <p>Methods</p> <p>This is an observational, prospective non-concurrent study using national administrative registries of all patients financed by the public health system who began renal replacement therapy (RRT) between 2000 and 2004 in Brazil. Incident patients were eligible who had hemodialysis for the first time. Patients were excluded who: had hemodialysis reportedly started after the date of death (inconsistent database); were younger than 18 years old; had HIV; had no record of the first dialysis unit; and were dialyzed in units with less than twenty patients. To evaluate individual and renal unit factors associated with the event of interest, the frailty model was used (N = 55,589).</p> <p>Results</p> <p>Among the 23,824 patients (42.9%) who underwent fistula placement in the period of the study, 18.2% maintained the temporary catheter for more than three months until the fistula creation. The analysis identified five statistically significant factors associated with longer time until first fistula: higher age (Hazard-risk - HR 0.99, 95% CI 0.99-1.00); having hypertension and cardiovascular diseases (HR 0.94, 95% CI 0.9-0.98) as the cause of chronic renal disease; residing in capitals cities (HR 0.92, 95% CI 0.9-0.95) and certain regions in Brazil - South (HR 0.83, 95% CI 0.8-0.87), Midwest (HR 0.88, 95% CI 0.83-0.94), Northeast (HR 0.91, 95% CI 0.88-0.94), or North (HR 0.88, 95% CI 0.83-0.94) and the type of renal unit (public or private).</p> <p>Conclusion</p> <p>Monitoring the provision of arteriovenous fistulas in renal units could improve the care given to patients with end stage renal disease.</p

Leaf photosynthesis and respiration of three bioenergy crops in relation to temperature and leaf nitrogen: how conserved are biochemical model parameters among crop species?

Given the need for parallel increases in food and energy production from crops in the context of global change, crop simulation models and data sets to feed these models with photosynthesis and respiration parameters are increasingly important. This study provides information on photosynthesis and respiration for three energy crops (sunflower, kenaf, and cynara), reviews relevant information for five other crops (wheat, barley, cotton, tobacco, and grape), and assesses how conserved photosynthesis parameters are among crops. Using large data sets and optimization techniques, the C3 leaf photosynthesis model of Farquhar, von Caemmerer, and Berry (FvCB) and an empirical night respiration model for tested energy crops accounting for effects of temperature and leaf nitrogen were parameterized. Instead of the common approach of using information on net photosynthesis response to CO2 at the stomatal cavity (An–Ci), the model was parameterized by analysing the photosynthesis response to incident light intensity (An–Iinc). Convincing evidence is provided that the maximum Rubisco carboxylation rate or the maximum electron transport rate was very similar whether derived from An–Ci or from An–Iinc data sets. Parameters characterizing Rubisco limitation, electron transport limitation, the degree to which light inhibits leaf respiration, night respiration, and the minimum leaf nitrogen required for photosynthesis were then determined. Model predictions were validated against independent sets. Only a few FvCB parameters were conserved among crop species, thus species-specific FvCB model parameters are needed for crop modelling. Therefore, information from readily available but underexplored An–Iinc data should be re-analysed, thereby expanding the potential of combining classical photosynthetic data and the biochemical model

Identification of Potent EGFR Inhibitors from TCM Database@Taiwan

Overexpression of epidermal growth factor receptor (EGFR) has been associated with cancer. Targeted inhibition of the EGFR pathway has been shown to limit proliferation of cancerous cells. Hence, we employed Traditional Chinese Medicine Database (TCM Database@Taiwan) (http://tcm.cmu.edu.tw) to identify potential EGFR inhibitor. Multiple Linear Regression (MLR), Support Vector Machine (SVM), Comparative Molecular Field Analysis (CoMFA), and Comparative Molecular Similarities Indices Analysis (CoMSIA) models were generated using a training set of EGFR ligands of known inhibitory activities. The top four TCM candidates based on DockScore were 2-O-caffeoyl tartaric acid, Emitine, Rosmaricine, and 2-O-feruloyl tartaric acid, and all had higher binding affinities than the control Iressa®. The TCM candidates had interactions with Asp855, Lys716, and Lys728, all which are residues of the protein kinase binding site. Validated MLR (r² = 0.7858) and SVM (r² = 0.8754) models predicted good bioactivity for the TCM candidates. In addition, the TCM candidates contoured well to the 3D-Quantitative Structure-Activity Relationship (3D-QSAR) map derived from the CoMFA (q² = 0.721, r² = 0.986) and CoMSIA (q² = 0.662, r² = 0.988) models. The steric field, hydrophobic field, and H-bond of the 3D-QSAR map were well matched by each TCM candidate. Molecular docking indicated that all TCM candidates formed H-bonds within the EGFR protein kinase domain. Based on the different structures, H-bonds were formed at either Asp855 or Lys716/Lys728. The compounds remained stable throughout molecular dynamics (MD) simulation. Based on the results of this study, 2-O-caffeoyl tartaric acid, Emitine, Rosmaricine, and 2-O-feruloyl tartaric acid are suggested to be potential EGFR inhibitors.National Science Council of Taiwan (NSC 99-2221-E-039-013-)Committee on Chinese Medicine and Pharmacy (CCMP100-RD-030)China Medical University (CMU98-TCM)China Medical University (CMU99-TCM)China Medical University (CMU99-S-02)China Medical University (CMU99-ASIA-25)China Medical University (CMU99-ASIA-26)China Medical University (CMU99-ASIA-27)China Medical University (CMU99-ASIA-28)Asia UniversityTaiwan Department of Health. Clinical Trial and Research Center of Excellence (DOH100-TD-B-111-004)Taiwan Department of Health. Cancer Research Center of Excellence (DOH100-TD-C-111-005

A Multi-family Water Conservation Study in Chatham County, Georgia

Proceedings of the 1999 Georgia Water Resources Conference, March 30 and 31, Athens, Georgia.Due to saltwater intrusion into the Floridan Aquifer and State Environmental Protection Division (EPD) requirements to reduce Floridan Aquifer water usage by 10 million gallons a day (mgd) by the year 2005, Chatham County must implement water conservation programs which have measurable results. Conserving water, in effect, creates an additional source of water which will decrease dependence on developing additional surface and ground water resources. This multi-family water conservation study demonstrates that by installing ultra low-flow toilets which use 1.6 gallons per flush (gpf) in 54 multi-family housing complexes, water usage in Chatham County can be reduced by 260,000 gallons per day (gpd). This measurable water reduction is one step towards reaching the 10 mgd reduction mandated by EPD. Water efficient methods are solutions whereby Chatham County citizens can reduce water withdrawal from both ground and surface water sources. The EPD required reduction of 10 mgd can be partially achieved by implementing water efficient programs such as the multifamily retrofitting method outlined in this report.Sponsored and Organized by: U.S. Geological Survey, Georgia Department of Natural Resources, The University of Georgia, Georgia State University, Georgia Institute of TechnologyThis book was published by the Institute of Ecology, The University of Georgia, Athens, Georgia 30602-2202 with partial funding provided by the U.S. Department of Interior, geological Survey, through the Georgia Water Research Insttitute as authorized by the Water Research Institutes Authorization Act of 1990 (P.L. 101-397). The views and statements advanced in this publication are solely those of the authors and do not represent official views or policies of the University of Georgia or the U.S. Geological Survey or the conference sponsors

PROTECTION AND REAL REWARDS: SOME ANTINOMIES

This paper develops a model with an increasing returns to scale sector and complementarities in production. It is shown that under a particular protectionist regime, the factor specific to the unprotected sector(s) might gain, along with the factor specific to the protected sector. Under such a regime the mobile factor is most severely hurt. Under another protectionist regime, it is shown that both the specific factors (even the factor specific to the protected sector(s)) might lose and the mobile factor gains unambiguously. Both these cases are in stark conflict with the conventional wisdom associated with the specific factors model. Copyright 2009 The Author. Journal compilation 2009 Blackwell Publishing Asia Pty Ltd

data for NtrC

movie [http://bioinfo.mbb.yale.edu/molmovdb; W. G. Krebs, M. Gerstein, Nucleic Acids Res. 28, 1665 (2000)] is also available at www.sciencemag. org/cgi/content/full/291/5512/2429/DC1. 27. An aromatic residue is highly conserved at this position among the receiver domain family (35), and its reorientation has been discussed to be an important element in CheY activation. However the correlation between function and the rotameric state of this conserved aromatic side chain is controversial (18, 19). Our structural and dynamic data on NtrC functional states reveal that Y101 is mobile in both the &quot;on&quot; and &quot;off &quot; state in NtrC which may explain the inconsistent results from the various CheY and Spo0F crystal structures. Crystallization may trap one of the accessible states, depending on the equilibrium and on the solution conditions. The presence of two modes of motion in NtrC shows that the simplest two-state model is not strictly accurate. The equilibrium constants between I an