Development of an Integrated Modeling Tool to Evaluate Revisions to Water Control Structure Operations Needed to Support Kissimmee River Restoration Requirements

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchiv

CMB-S4

We describe the stage 4 cosmic microwave background ground-based experiment CMB-S4

Influence of low-glucose peritoneal dialysis on serum lipids and apolipoproteins in the IMPENDIA/EDEN trials

BACKGROUND: Glucose, the conventional osmotic agent in peritoneal dialysis (PD) solutions, may contribute to atherogenic dyslipoproteinemia and increased cardiovascular risk. OBJECTIVE: To determine whether a low-glucose PD regimen may improve the serum lipid and lipoprotein profile in patients with diabetes. METHODS: A prospective, open-label, parallel group, multinational, randomized, controlled trial with a 6-month follow-up, comprising 251 patients with diabetes receiving PD. Patients were randomized to a low-glucose PD regimen (dextrose-based PD solution plus icodextrin, a starch polymer, and amino acids) or a conventional PD regimen (dextrose PD solutions). Serum lipid and apolipoprotein profiles were determined at baseline and 3 and 6 months. RESULTS: Serum triglycerides, very low-density-lipoprotein cholesterol, and apolipoprotein B (apoB) decreased significantly in the intervention group at both 3 and 6 months compared with baseline (serum triglycerides: median change at 3 months -0.5 mmol/L, P \u3c .001, at 6 months -0.3 mmol/L, P \u3c .001; very low-density-lipoprotein cholesterol: -0.3 mg/dL, P \u3c .001; -0.3 mg/dL, P \u3c .001; and apoB: -8.5 mg/dL, P \u3c .001; -3.6 mg/dL, P = .043, respectively) and also compared with the control group. In contrast, apoB levels increased significantly in the control group at 3 and 6 months compared with baseline (5.3 mg/dL, P = .041; 5.2 mg/dL, P = .007, respectively). Percentage of patients on lipid-lowering medications at baseline and intensity of therapy was equivalent in each group. The apoB decrease was not affected by lipid-lowering medications in the intervention group. CONCLUSION: A low glucose-PD regimen significantly improved the atherogenic lipoprotein phenotype compared with PD patients treated with a conventional glucose regimen

Ethical Leadership: Lessons from Africa for International Management

Scholarship at the interface of ethics, leadership and organizations in Sub-Saharan Africa (SSA) is still scarce. We draw from literature about leadership in Africa to identify three research streams (functional, cultural, and critical) and use these streams to make sense of research on ethics, organizations and leadership in SSA, as well as to analyze opportunities for research. We propose four interpretative approaches allowing the advancement of research in the field of ethical leadership in SSA. More diverse research on SSA is important for it allows the development of textured theories on the context and opens possibilities for revitalizing organization theory.Recherche sur l’interface entre l’éthique, le leadership et les organisations en Afrique sub-saharienne (ASS) sont encore rares. Nous nous appuyons sur la littérature relative au leadership en Afrique pour identifier trois courants de recherche (fonctionnel, culturel et critique) et utilisons ces courants pour donner un sens à la recherche sur l’éthique, les organisations et le leadership en ASS, ainsi que pour analyser les opportunités de recherche. Nous proposons quatre approches interprétatives permettant l’avancement de la recherche dans le domaine du leadership éthique en ASS. Une recherche plus diversifiée sur l’ASS est importante car elle permet le développement de théories texturées sur le contexte et ouvre des possibilités de revitalisation de la théorie des organisations.Los estudios sobre la interfaz de la ética, el liderazgo y las organizaciones en el África subsahariana (ASS) siguen siendo escasos. Nos basamos en la literatura sobre el liderazgo en África para identificar tres corrientes de investigación (funcional, cultural y crítica) y utilizamos estas corrientes para dar sentido a la investigación sobre la ética, las organizaciones y el liderazgo en el ASS, así como para analizar las oportunidades de investigación. Proponemos cuatro enfoques interpretativos que permiten el avance de la investigación en el campo del liderazgo ético en el ASS. Una investigación más diversa sobre el ASS es importante porque permite el desarrollo de teorías texturizadas sobre el contexto y abre posibilidades para revitalizar la teoría de la organización

Ethical leadership: African lessons for international management

Scholarship on ethical leadership is vast. However, scholarship at the interface of ethics, leadership and organizations in Sub-Saharan Africa (SSA) is still scarce. We draw from literature about leadership in Africa to (a) identify three research streams (functional, cultural, and critical) and (b) use these streams to make sense of research on ethics, organizations and leadership in SSA, as well as to analyze opportunities for future research. We do so by proposing four interpretative modes or approaches that allow the advancement of research in the field of ethical leadership in SSA. We argue that more paradigmatically diverse research on SSA is extremely important as it can allow for the development of textured theories on the context as well as open possibilities for revitalizing organization theory. The study of leadership and ethics in SSA may be an interesting arena to explore a number of tensions and paradoxes that are pervasive in organization theory. If paradox theory is crystallizing prematurely around a number of tensions, the SSA context may contribute to the release of the study of paradox from the straightjacket of convergence and reveal a number of tensions permeating the practice of international management

Impact of Age on Peritonitis Risk in Peritoneal Dialysis Patients: An Era Effect

Background and objectives: Despite reductions in the frequency of peritoneal dialysis (PD)-related infectious complications over time, peritonitis and catheter infection remain important causes of morbidity and mortality. Given the increasing number of elderly patients reaching end-stage renal disease, making informed decisions about PD utilization is contingent on an understanding of the infectious complications of PD in this population. We therefore studied the impact of age on infection rates, organisms and outcomes

The benefit of a glucose-sparing PD therapy on glycemic control measured by serum fructosamine in diabetic patients in a randomized, controlled trial (IMPENDIA)

Background/Aims: Poor glycemic control can lead to increased morbidity and mortality in peritoneal dialysis (PD) patients. Serum fructosamine may be a more reliable marker of glycemic control than HbA1c in dialysis patients. Methods: We evaluated the effects of a glucose-sparing PD regimen on serum fructosamine. In the multicenter, controlled IMPENDIA trial, eligible diabetic PD patients were randomized (1:1) to a 24-hour combination of a glucose sparing regimen (n = 89) or a glucose-based therapy (n = 91). Serum fructosamine and HbA1c were measured at baseline, 3 months and 6 months; fructosamine measurements were corrected for serum albumin (AlbF). Results: Serum fructosamine decreased from 297 to 253 μmol/l in the glucose-sparing group (95% confidence interval [CI] for the difference, -26 to -68, p < 0.001), and increased from 311 to 314 μmol/l in the glucose-only group (95% CI for the difference, -23 to +19, p = 0.87). The mean difference in change of fructosamine levels between groups at 6 months was 64 μmol/l (95% CI 29-99, p < 0.001). HbA1c decreased versus baseline in both groups (treatment difference 0.3%, p = 0.07). The correlation between AlbF and baseline fasting serum glucose was stronger than that seen between HbA1c and baseline fasting serum glucose (r = 0.47, p < 0.0001 and r = 0.31, p < 0.0001, respectively). Conclusion: A glucose-sparing regimen (P-E-N) improved glycemic control as measured by serum fructosamine. Further studies are needed to establish fructosamine targets that will reduce the morbidity risk related to hyperglycemia in PD patients

Randomized, controlled trial of glucose-sparing peritoneal dialysis in diabetic patients

Glucose-containing peritoneal dialysis solutions may exacerbate metabolic abnormalities and increase cardiovascular risk in diabetic patients. Here, we examined whether a low-glucose regimen improves metabolic control in diabetic patients undergoing peritoneal dialysis. Eligible patients were randomly assigned in a 1:1 manner to the control group (dextrose solutions only) or to the low-glucose intervention group (IMPENDIA trial: combination of dextrose-based solution, icodextrin and amino acids; EDEN trial: a different dextrose-based solution, icodextrin andamino acids) and followed for 6 months. Combiningboth studies, 251 patients were allocated to control (n=127) or intervention (n=124) across 11 countries. The primary endpoint was change in glycated hemoglobin from baseline. Mean glycated hemoglobin at baseline was similar in both groups. In the intention-to-treat population, the mean glycated hemoglobin profile improved in the intervention group but remained unchanged in the control group (0.5% difference between groups; 95% confidence interval, 0.1% to 0.8%; P=0.006). Serum triglyceride, very-low-density lipoprotein, and apolipoprotein B levels also improved in the intervention group. Deaths and serious adverse events, including several related to extracellular fluid volume expansion, increased in the intervention group, however. These data suggest that a low-glucose dialysis regimen improves metabolic indices in diabetic patients receiving peritoneal dialysis but may be associated with an increased risk of extracellular fluid volume expansion. Thus, use of glucose-sparing regimens in peritoneal dialysis patients should be accompanied by close monitoring of fluid volume status. Copyrigh