Fibroblast growth factor-23 and cardiovascular disease among prevalent hemodialysis patients focusing on residual kidney function

BackgroundIn patients undergoing incident hemodialysis, increased fibroblast growth factor-23 (FGF-23) levels are associated with the development of cardiovascular disease (CVD), but the influence of residual kidney function (RFK) on this association is unclear. This study aimed to investigate the association between FGF-23 levels, RKF, and CVD in patients undergoing prevalent hemodialysis.MethodsThis cross-sectional and longitudinal observational study included 296 patients undergoing maintenance hemodialysis for at least three months who were followed up for a median of 44 months. RKF was defined as 24-h urine output >200 mL, left ventricular (LV) diastolic dysfunction as E/E’ >15 on echocardiographic parameters. CVD was defined as hospitalization or emergency room visits due to cardiovascular causes, such as angina, myocardial infarction, or congestive heart failure.ResultsThe median intact FGF-23 (iFGF-23) level was 423.8 pg/mL (interquartile range, 171–1,443). Patients with an FGF-23 level > 423.8 pg/mL significantly had a lower proportion of RKF (39.2% vs. 60.1%, P < 0.001) and a higher proportion of LV diastolic dysfunction (54. 1% vs. 29.1%, P < 0.001) than those with an iFGF-23 level ≤ 423.8 pg/mL. The odds ratio (OR) for LV diastolic dysfunction was significantly higher in patients with RFK (OR per one-unit increase in the natural log-transformed iFGF-23 levels, 1.80; 95% confidence interval [CI]: 1.11–2.93) than in patients without RKF (OR per one-unit increase in the natural log-transformed iFGF-23 levels: 1.42; 95% CI: 1.01–1.99) in multivariate analysis (p < 0.001). During the follow-up period, 55 patients experienced CVD. The hazard ratio (HR) for CVD development was also significantly higher in patients with RKF (HR per one-unit increase in the natural log-transformed iFGF-23 levels, 2.64; 95% CI: 1.29–5.40) than those without RKF (HR per one-unit increase in the natural log-transformed iFGF-23 levels: 1.44; 95% CI: 1.04–1.99) in multivariate analysis (p = 0.05).ConclusionsIncreased iFGF-23 levels were associated with LV diastolic dysfunction and CVD development in patients undergoing prevalent hemodialysis; however, the loss of RKF attenuated the magnitude of these associations. Therefore, in these patients, RKF strongly influenced the detrimental role of iFGF-23 in the development of CVD

The Effect of Competitive Advantage and Human Advantage on Industrial Competitive Strategy (Case Study: Smis in Gorontalo Province)

Small and Medium Industries (SMIs) have a strategic role in the Indonesian economy, as they earn 61.9 percent of the foreign exchange which goes to make up the nation\u27s Gross Domestic Product, and nationally they are able to absorb 97 percent of the workforce. The Global Competitiveness Report also notes that SMIs serve as the business units that affect every nation\u27s competitiveness. Considering this strategic role, the selection of a competitive strategy for these SMIs is absolutely necessary. Through an in-depth literature review, this study aims to explore what variables influence the competitive strategy of industries, particularly the SMIs. By using a Systematic Literature Review (SLR) with a total of 31 main literature (articles, papers and books), this study has found two dominant factors that influence industrial competitive strategy: Competitive advantage and human advantage, which are subsequently developed into six independent variables (construct variables), i.e. cost, delivery, product quality, product variety, know-how and innovativeness, with a total of 44 indicators. The results of measurements of the sample of SMIs in Gorontalo Province, using Structural Equation Modeling, found that both competitive advantage and human advantage jointly influence 40.2 percent of the industrial competitive strategies. These results indicate that competitive strategies, such as creating products with unique features, on-time delivery, flexibility in production, and employee involvement in the innovations, are indispensable to SMIs in order for them to produce quality products and be able to maintain their advantage

Loss of Heterozygosity on Chromosomes 3p, 8p, 9p and 17p in the Progression of Squamous Cell Carcinoma of the Larynx

Previous molecular genetic studies of laryngeal squamous cell carcinoma (SCC)have shown certain chromosomal regions with recurring alterations. But studies of sequential molecular alterations and genetic progression model of laryngeal SCC have not been clearly defined. To identify the chromosomal alterations associated with the carcinogenesis of laryngeal SCC, we analyzed genomic DNA from microdissected squamous metaplasia, squamous dysplasia, invasive SCC, and metastatic carcinoma samples from 22 laryngeal SCC patients for loss of heterozygosity (LOH) at microsatellite loci. Ten microsatellite markers on chromosome 3p, 8p, 9p, and 17p were used. LOH at 9p21 was observed in the all stages including squamous metaplasia, squamous dysplasia, invasive SCC and metastatic carcinoma. LOH at 17p13.1, 3p25 and 3p14.2 was observed from the squamous dysplasia, invasive SCC and metastatic carcinoma. LOH at 8p21.3-p22 was observed mainly from the invasive SCC and metastatic carcinoma. The results suggest that 9p21 in the early event, 17p13.1, 3p25 and 3p14.2 in the intermediate event and 8p21.3-p22 in the late event may be involved in the laryngeal carcinogenesis

d’Aérosols Organiques.

A mathematical model for the computation of the phase equilibrium related to atmospheric organic aerosols is proposed. The equilibrium is given by the minimum of the Gibbs free energy and is characterized using the notion of phase simplex of its convex hull. A primal-dual interior-point method solving the Karush-Kuhn-Tucker conditions is detailed. Numerical results show the efficiency of our algorithm