Troponins, Acute Coronary Syndrome and Renal Disease: From Acute Kidney Injury Through End-stage Kidney Disease

The diagnosis of acute coronary syndromes (ACS) is heavily dependent on cardiac biomarker assays, particularly cardiac troponins. ACS, particularly non-ST segment elevation MI, are more common in patients with acute kidney injury, chronic kidney disease (CKD) and end-stage kidney disease (ESKD), are associated with worse outcomes than in patients without kidney disease and are often difficult to diagnose and treat. Hence, early accurate diagnosis of ACS in kidney disease patients is important using easily available tools, such as cardiac troponins. However, the diagnostic reliability of cardiac troponins has been suboptimal in patients with kidney disease due to possible decreased clearance of troponin with acute and chronic kidney impairment and low levels of troponin secretion due to concomitant cardiac muscle injury related to left ventricular hypertrophy, inflammation and fibrosis. This article reviews the metabolism and utility of cardiac biomarkers in patients with acute and chronic kidney diseases. Cardiac troponins are small peptides that accumulate in both acute and chronic kidney diseases due to impaired excretion. Hence, troponin concentrations rise and fall with acute kidney injury and its recovery, limiting their use in the diagnosis of ACS. Troponin concentrations are chronically elevated in CKD and ESKD, are associated with poor prognosis and decrease the sensitivity and specificity for diagnosis of ACS. Yet, the evidence indicates that the use of high-sensitivity troponins can confirm or exclude a diagnosis of ACS in the emergency room in a significant proportion of kidney disease patients; those patients in whom the results are equivocal may need longer in-hospital assessment

Nondipole Resonant X-ray-Raman Spectroscopy: Polarized Inelastic Scattering at the K Edge of Cl2

Experimental and theoretical studies are reported on the inelastic (Raman) scattering of wavelength-selected polarized x rays from the K edge of gas-phase chlorine molecules. The polarized emission spectra exhibit prominent nondipole features consequent of phase variations of the incident and emitted radiation over molecular dimensions, as predicted by the Kramers-Heisenberg scattering formalism. Issues pursuant to the detection of core-hole localization by resonant Raman scattering from homonuclear diatomic molecules are critically examined. [S0031-9007(97)03486-8

Reply to Comment on ‘Nondipole Resonant X-ray-Raman Spectroscopy: Polarized Inelastic Scattering at the K Edge of Cl2,’

Mills et al. Reply: In their Comment on our Letter [1], Gel’mukhanov and Ågren [2] reiterate recent assertions [3] based on their earlier theoretical studies [4]. The primary purpose of their Comment is apparently to refute our stated conclusion that core-excited-state localization/ delocalization mechanisms are irrelevant to interpretations of reported Raman scattering experiments on homonuclear diatomic molecules

Sheila, Take a Bow

Professor Sheila Whiteley passed away on 6th of June, 2015. Sheila’s ground-breaking achievements in popular culture and gender studies, alongside her bright personal triumphs are celebrated by numerous obituaries from national and international media. Here, we present the tributes of Sheila’s students, colleagues and friends.Sheila Whiteley nous a quittés le 6 juin 2015. Ses recherches pionnières sur la culture populaire et le genre, en plus de ses grands succès personnels, furent célébrés dans de nombreux médias internationaux. Nous vous présentons ici une série d’hommages de ses étudiants, collègues et amis

Cross‐cultural assessment of HIV‐associated cognitive impairment using the Kaufman assessment battery for children: a systematic review

Introduction: Despite improved efficacy of, and access to, combination antiretroviral therapy (cART), HIV‐associated cognitive impairments remain prevalent in both children and adults. Neuropsychological tests that detect such impairment can help clinicians formulate effective treatment plans. The Kaufman Assessment Battery for Children (KABC), although developed and standardized in the United States, is used frequently in many different countries and cultural contexts to assess paediatric performance across various cognitive domains. This systematic review investigated the cross‐cultural utility of the original KABC, and its 2nd edition (KABC‐II), in detecting HIV‐associated cognitive impairment in children and adolescents.Methods: We entered relevant keywords and MeSH terms into the PubMed, PsycInfo, EBSCOHost, ProQuest, and Scopus databases, with search limits set from 1983–2017. Two independent reviewers evaluated the retrieved abstracts and manuscripts. Studies eligible for inclusion in the review were those that (a) used the KABC/KABC‐II to assess cognitive function in children/adolescents aged 2–18 years, (b) featured a definition of cognitive impairment (e.g. >2 SD below the mean) or compared the performance of HIV‐infected and uninfected control groups, and (c) used a sample excluded from population on which the instruments were normed.Results and discussion: We identified nine studies (eight conducted in African countries, and one in the United Kingdom) to comprise the review’s sample. All studies detected cognitive impairment in HIV‐infected children, including those who were cART‐naïve or who were cART treated and clinically stable. KABC/KABC‐II subtests assessing simultaneous processing appeared most sensitive. Evaluation of the methodological quality of the selected studies by two independent reviews suggested that shortcomings included reporting and selection biases.Conclusions: This systematic review provides evidence for the cross‐cultural utility of the KABC/KABC‐II, particularly the simultaneous processing subtests, in detecting cognitive impairment in HIV‐infected children (including those who are clinically stable). Although the current results suggest there is justification for using the KABC/KABC‐II primarily in East Africa, further investigation is required to explore the instrument’s utility in other HIV‐prevalent regions of the globe.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138351/1/jia21412.pd

Challenges and opportunities for improved understanding of regional climate dynamics

Dynamical processes in the atmosphere and ocean are central to determining the large-scale drivers of regional climate change, yet their predictive understanding is poor. Here, we identify three frontline challenges in climate dynamics where significant progress can be made to inform adaptation: response of storms, blocks and jet streams to external forcing; basin-to-basin and tropical–extratropical teleconnections; and the development of non-linear predictive theory. We highlight opportunities and techniques for making immediate progress in these areas, which critically involve the development of high-resolution coupled model simulations, partial coupling or pacemaker experiments, as well as the development and use of dynamical metrics and exploitation of hierarchies of models

Dark Sound: Feminine Voices in Sonic Shadow

Dark Sound is a concept bound to music that embodies 'dark' themes such as melancholy, death, desire, violence, loss and longing. This text interrogates the attraction to dark sound and its historical association with femininity through case studies such as Moor Mother, Anna Calvi, Chelsea Wolfe, concluding with the intensely political repertoire of Greek-American composer and singer Diamanda Galás