Low parathyroid hormone status induced by high dialysate calcium is an independent risk factor for cardiovascular death in hemodialysis patients

Here we studied a possible association between low parathyroid hormone (PTH) status and mortality in incident patients undergoing hemodialysis . A total of 1983 patients were included at baseline and prospectively followed for 24 months. Patients were classified according to their Kidney Disease: Improving Global Outcomes PTH status at baseline and at 12 months, and mortality evaluated at 12 to 24 months using adjusted Cox analysis. Factors potentially involved in PTH status variability between baseline and 12 months were analyzed. A decrease in serum PTH from normal or high to low values between baseline and 12 months was associated with significantly increased cardiovascular mortality at 12 to 24 months (hazard ratio, 2.03; 95% confidence interval, 1.22–3.36). For patients with high or normal baseline PTH levels, the main independent factor at 6 months for a decrease to low PTH levels at 12 months was high dialysate calcium (1.75 mmol/L), whereas prescription of non–calcium-based phosphate binders was associated with a lower risk of PTH decrease. In the high cardiovascular (CV) mortality risk subgroup of patients who acquired a low PTH status at 12 months, the main independent factor at 12 months associated with significant 12- to 24-month CV mortality was high dialysate calcium (odds ratio, 5.44; 95% CI, 2.52–11.75). Thus, patients with a serum PTH decrease to low values after 1 year of hemodialysis treatment are at high risk of short-term CV death. High dialysate calcium was an important contributor to PTH oversuppression, and continued use was associated with increased CV mortality

The Swiss Pathogen Surveillance Platform - towards a nation-wide One Health data exchange platform for bacterial, viral and fungal genomics and associated metadata

The Swiss Pathogen Surveillance Platform (SPSP) is a shared secure surveillance platform between human and veterinary medicine, to also include environmental and foodborne isolates. It enables rapid and detailed transmission monitoring and outbreak surveillance of pathogens using whole genome sequencing data and associated metadata. It features controlled data access, complex dynamic queries, dedicated dashboards and automated data sharing with international repositories, providing actionable results for public health and the vision to improve societal well-being and health

Exploring Cosmic Origins with CORE: Cosmological Parameters

We forecast the main cosmological parameter constraints achievable with theCORE space mission which is dedicated to mapping the polarisation of the CosmicMicrowave Background (CMB). CORE was recently submitted in response to ESA'sfifth call for medium-sized mission proposals (M5). Here we report the resultsfrom our pre-submission study of the impact of various instrumental options, inparticular the telescope size and sensitivity level, and review the great,transformative potential of the mission as proposed. Specifically, we assessthe impact on a broad range of fundamental parameters of our Universe as afunction of the expected CMB characteristics, with other papers in the seriesfocusing on controlling astrophysical and instrumental residual systematics. Inthis paper, we assume that only a few central CORE frequency channels areusable for our purpose, all others being devoted to the cleaning ofastrophysical contaminants. On the theoretical side, we assume LCDM as ourgeneral framework and quantify the improvement provided by CORE over thecurrent constraints from the Planck 2015 release. We also study the jointsensitivity of CORE and of future Baryon Acoustic Oscillation and Large ScaleStructure experiments like DESI and Euclid. Specific constraints on the physicsof inflation are presented in another paper of the series. In addition to thesix parameters of the base LCDM, which describe the matter content of aspatially flat universe with adiabatic and scalar primordial fluctuations frominflation, we derive the precision achievable on parameters like thosedescribing curvature, neutrino physics, extra light relics, primordial heliumabundance, dark matter annihilation, recombination physics, variation offundamental constants, dark energy, modified gravity, reionization and cosmicbirefringence. (ABRIDGED

Gender differences in the use of cardiovascular interventions in HIV-positive persons; the D:A:D Study

Peer reviewe

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Les feuilles d'or de placage des casques celtiques d'Amfreville et d'Agris

With the help of scanning electron microscopy (SEM) we are now able to distinguish between the various ancient methods of sheet gold hammering. A primitive or "vertical" hammering used from the beginning of gold jewellery has little by little been replaced by a more elaborate "progressive" hammering during the first millenium B.C. The plated gold leaves of the Amfreville and Agris helmets (4th century B.C.) were made with the first method which was virtually abandoned during the same period in the Mediterranean basin. Many other observations of this kind would be very useful to know the extension of the process in the Celtic world.Le microscope électronique à balayage (MEB) permet de mieux percevoir les différentes méthodes de fabrication de la feuille d'or dans l'Antiquité. On peut ainsi distinguer une frappe primitive ou «verticale» et une frappe «progressive» plus élaborée. Les feuilles de placage des casques d'Amfreville et d'Agris sont issues de la première méthode, pratiquement abandonnée dans le domaine méditerranéen à leur époque (IV s. avant J.- C). Des observations au MEB plus nombreuses nous renseigneraient utilement sur l'extension du procédé dans le monde celte.Nicolini Gérard, Bouchet Bernard. Les feuilles d'or de placage des casques celtiques d'Amfreville et d'Agris. In: Gallia, tome 47, 1990. pp. 67-77

Effets sur les écosystèmes aquatiques lentiques des émissions de polluants provenant de différents modes de valorisation/élimination de déchets - Application à des mâchefers d'IUOM et à des boues de dragage de canaux

La valorisation des déchets a été favorisée par la loi du 13 juillet 1992 et la définition de la notion de déchets ultimes. L'impact de deux scénarios d'études ont été évalués vis-à-vis des écosystèmes lentiques : valorisation de mâchefers d'incinération d'ordures ménagères (MIOM) en technique routière et immersion de sédiments de dragage en gravière. Ces travaux devaient apar ailleurs permettre de compléter la méthodologie d'évaluation de l'écocompatibilité des déchets, mise au point par l'ADEME. Le potentiel toxique des matrices a été évalué à l'aide d'eeais en microcosmes. Cinq sédiments de dragage ont été étudiés : (i) en condition statiques, (ii) pour 3 rapports eau/sédiment et (iii) 3 conditions de renouvellement de la colonne d'eau. Les percolats de MIOM, obtenus à l'aide d'un lysimètre, ont été évalués à l'aide de 4 essais monospécifiques, d'essais en microcosmes de 2 litres en conditions statiques et d'un essai en microcosmes de 100 litres. Les 5 sédiments des dragage ont été classés au vu de leur potentiel toxique. Quatre des sédiments présentent un potentiel toxique élévé dont des risques d'eutrophisation du milieu récepteur. Les critères d'effets mesurés ont été classés, la survie de Hyalella azteca étant le plus sensible. Les risques liés à l'immersion des sédiments sous eau ne sont pas acceptables pour ces 5 sédiments. Des recommandations quant au volume de sédiement à immerger et aux conditions de ces dépôts ont été émises. L'impact ds percolats de MIOM est avéré pour l'ensemble des espèces tests. Le cuivre semble être à l'origine des effets mesurés. Il apparaît comme un contaminant majeur des percolats de MIOM. Les risques liés à ce scénario de valorisation des MIOM ne sont pas négligeables pour l'écosystème lentique récepteur. Des recommandations pour une mise en oeuvre dans les meilleures conditions possibles ont été émises. Cette étude a enfi souligné l'intéret d'utiliser les essais en microcosmes pour évaluer l'impact de matrices contaminées vis-à-vis d'écosystèmes lentiques. Certains aspects du protocole restent, à ce jour, à optimiser afin d'optenir, notamment, des niveaux de variabilité acceptables pour l'ensemble des paramètres suivis.Waste reused has been promoted by the definition of final wastes (law of the 13/07/92). The impact of two scenarios against lentic ecosystems was studied : one deals with municipal solid waste incineration bottom ashes (MSWIBA) reused in road embankment, the other with under water deposition of dredged materials in a gravel pit. One of the purpose of yhis study was to complete the methodology for the assessment of waste ecocompatibility, focused by ADEME.The toxic potential of these materials have been distinguished and ordered according to their toxic potential. Four of the dredged materials were characterized by a high toxic potential and presented risks of lentic ecosystem eutrophisation. Risks of this storage scenario are not acceptable for these sediments. Recommendations have been made for the sediment amount to be submerged and for the constraints around thsese deposits. MSWIBA leachates impact was demonstrated whatever the methodology used. Copper seems to be responsible of the effects measured on species. It can be considered as a major pollutant of MSWIBA leachates. Risks of this reused scenario are not acceptable for lentic ecosystems. Recommendations have been made for MSWIBA reused as road embankment. With this study, the interest of microcosm assays have been emphasized. Yhis kind of approach was convenient for the evaluation of contaminated matrix impact against lentic ecosystems. Some aspects of this protocol have to be optimised in order to obtain acceptable variability levels for each parameter.CHAMBERY -BU Bourget (730512101) / SudocSudocFranceF

Mam , la mère et le fils, roman

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A Solid-State Potentiometric Sensor Based on Polybenzimidazole for Hydrogen Determination in Air

International audienceA solid-state electrochemical sensor for hydrogen determination in air is described. The device incorporates a protonic conductor based on polybenzimidazole doped with phosphoric acid as the electrolyte and a Ag-AgCl, KCl electrode as the reference electrode. Pt grid or Pt supported on carbon are tested as the sensitive electrode. The performance characteristics of both types of sensor including either the Pt grid or the carbon-supported Pt electrode are reported

Mixed potential type hydrogen sensor

International audienceThe principle of potentiometric hydrogen sensors based on protonic conductors is reviewed. The origin of the potentiometric response in inert gas (Nernst potential) and in air (mixed potential) is discussed. It is shown that the nature of the sensing electrode as well as the morphology influence the mixed potential response. The properties of the solid-state internal reference electrode are also examined and discussed. A H+ reversible electrode based on quinhydrone is described. Then, an example of solid-state potentiometric hydrogen sensor is presented. The device incorporates a protonic polymer electrolyte based on polybenzimidazole, a Pt gas diffusion electrode or a Pt grid as sensing electrode and a reference electrode based on Ag-AgCl. The sensing characteristics in nitrogen and dry air are reported