3,216 research outputs found
Prebiotic, Probiotic, and Synbiotic Supplementation in Chronic Kidney Disease: A Systematic Review and Meta-analysis
Gut dysbiosis has been implicated in the pathogenesis of chronic kidney disease (CKD). Restoring gut microbiota with prebiotic, probiotic, and synbiotic supplementation has emerged as a potential therapeutic intervention but has not been systematically evaluated in the CKD population.This is a systematic review. A structured search of MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and the International Clinical Trials Register Search Portal was conducted for articles published since inception until July 2017. Included studies were randomized controlled trials investigating the effects of prebiotic, probiotic, and/or synbiotic supplementation (>1\ua0week) on uremic toxins, microbiota profile, and clinical and patient-centered outcomes in adults and children with CKD.Sixteen studies investigating 645 adults met the inclusion criteria; 5 investigated prebiotics, 6 probiotics, and 5 synbiotics. The quality of the studies (Grades of Recommendation, Assessment, Development and Evaluation) ranged from moderate to very low. Prebiotic, probiotic, and synbiotic supplementation may have led to little or no difference in serum urea (9 studies, 345 participants: mean difference [MD] -0.30\ua0mmol/L, 95% confidence interval [CI] -2.20 to 1.61, P\ua0=\ua0.76, I\ua0=\ua053%), indoxyl sulfate (4 studies, 144 participants: MD -0.02\ua0mg/dL, 95% CI -0.09 to 0.05, P\ua0=\ua0.61, I\ua0=\ua00%), and p-cresyl sulfate (4 studies, 144 participants: MD -0.13\ua0mg/dL, 95% CI -0.41 to 0.15, P\ua0=\ua0.35, I\ua0=\ua00%). Prebiotic supplementation may have slightly reduced serum urea concentration (4 studies, 105 participants: MD -2.23\ua0mmol/L, 95% CI -3.83 to -0.64, P\ua0=\ua0.006, I\ua0=\ua011). Of the 2 studies investigating microbiota changes, synbiotic interventions significantly increased Bifidobacterium. Supplement effects on clinical outcomes were uncertain.There is limited evidence to support the use of prebiotics, probiotics, and/or synbiotics in CKD management
Telmisartan and cardioprotection
Cardiovascular risk reduction has been the target of several large clinical trials in the last decade. As the activation of the renin-angiotensin-aldosterone system (RAAS) plays a central role in the pathogenesis of atherosclerosis and cardiovascular disease, RAAS blockade has been suggested to be among the most efficient cardioprotective interventions, as revealed with the angiotensin converting enzyme (ACE) inhibitors trials. The angiotensin receptor blockersβ (ARBs) efficacy in lowering blood pressure has been very well established. Telmisartan is however the first ARB to show a promising role in reducing cardiovascular risk in high-risk patients. This article will highlight the role of telmisartan in cardioprotection, underlying specifically the results of two major randomized controlled trials: ONTARGET (ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized AssessmeNt Study in aCE-iNtolerant subjects with cardiovascular Disease)
The application of inelastic neutron scattering to investigate the interaction of methyl propanoate with silica
A modern industrial route for the manufacture of methyl methacrylate involves the reaction of methyl propanoate and formaldehyde over a silica-supported Cs catalyst. Although the process has been successfully commercialised, little is known about the surface interactions responsible for the forward chemistry. This work concentrates upon the interaction of methyl propanoate over a representative silica. A combination of infrared spectroscopy, inelastic neutron scattering, DFT calculations, X-ray diffraction and temperature-programmed desorption is used to deduce how the ester interacts with the silica surface
The relevance of aerosol optical depth to cumulus fraction changes: a five-year climatology at the ACRF SGP site
International audienceThe objective of this study is to investigate, by observational means, the magnitude and sign of the actively discussed relationship between cloud fraction N and aerosol optical depth ?a. Collocated and coincident ground-based measurements and Terra/Aqua satellite observations at the Atmospheric Radiation Measurement (ARM) Climate Research Facility (ACRF) Southern Great Plains (SGP) site form the basis of this study. The N??a relationship occurred in a specific 5-year dataset of fair-weather cumulus (FWC) clouds and mostly non-absorbing aerosols. To reduce possible contamination of the aerosols on the cloud properties estimation (and vice versa), we use independent datasets of ?a and N obtained from the Multi-filter Rotating Shadowband Radiometer (MFRSR) measurements and from the ARM Active Remotely Sensed Clouds Locations (ARSCL) value-added product, respectively. Optical depth of the FWC clouds ?cld and effective radius of cloud droplets re are obtained from the MODerate resolution Imaging Spectroradiometer (MODIS) data. We found that relationships between cloud properties (N,?cld, re) and aerosol optical depth are time-dependent (morning versus afternoon). Observed time-dependent changes of cloud properties, associated with aerosol loading, control the variability of surface radiative fluxes. In comparison with pristine clouds, the polluted clouds are more transparent in the afternoon due to smaller cloud fraction, smaller optical depth and larger droplets. As a result, the corresponding correlation between the surface radiative flux and ?a is positive (warming effect of aerosol). Also we found that relationship between cloud fraction and aerosol optical depth is cloud size dependent. The cloud fraction of large clouds (larger than 1 km) is relatively insensitive to the aerosol amount. In contrast, cloud fraction of small clouds (smaller than 1 km) is strongly positively correlated with ?a. This suggests that an ensemble of polluted clouds tends to be composed of smaller clouds than a similar one in a pristine environment. One should be aware of these time- and size-dependent features when qualitatively comparing N??a relationships obtained from the satellite observations, surface measurements, and model simulations
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Impact of data quality in real-time big data systems
Data Quality is one of the main challenges in any type of Big Data
System. Timeliness is one of the main factors in real-time Big Data. Limiting
data quality evaluations to data sources may be insufficient in Big Data Systems
with high Velocity and Variability. On the other hand, real-time Data Quality
evaluations throughout the Big Data Pipeline can be costly (i.e., latency introduced by Data Quality Evaluations). This paper identifies four categories β
embedded, parallel, in-line, and independentβ of approaches for Big Data
Quality Evaluation available in the literature. A real-time Big Data System
based on the SmartCambridge Real-Time Data Platform is deployed and used
as basis to implement a representative case for each one of the four categories
identified. An application for bus catching dynamic prediction is used as case
study to quantify the impact of these Data Quality Evaluations in the Real-Time
Data Platform in terms of latency introduced in the system. Results suggests
that the impact of Data Quality Evaluations differ depending on the type of
method used, and that the main factors are the data transfers between Data
Quality modules and the data processing algorithms, the synchronisation of
messages, and the complexity of the Data Quality algorithms
Antiepileptic drugs and bone metabolism
Anti-epileptic medications encompass a wide range of drugs including anticonvulsants, benzodiazepines, enzyme inducers or inhibitors, with a variety effects, including induction of cytochrome P450 and other enzyme, which may lead to catabolism of vitamin D and hypocalcemia and other effects that may significantly effect the risk for low bone mass and fractures. With the current estimates of 50 million people worldwide with epilepsy together with the rapid increase in utilization of these medications for other indications, bone disease associated with the use of anti-epileptic medications is emerging as a serious health threat for millions of people. Nevertheless, it usually goes unrecognized and untreated. In this review we discuss the pathophysiologic mechanisms of bone disease associated with anti-epileptic use, including effect of anti-epileptic agents on bone turnover and fracture risk, highlighting various strategies for prevention of bone loss and associated fractures a rapidly increasing vulnerable population
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