Consequences and therapy of the metabolic acidosis of chronic kidney disease

Metabolic acidosis is common in patients with chronic kidney disease (CKD), particularly once the glomerular filtration rate (GFR) falls below 25 ml/min/1.73 m2. It is usually mild to moderate in magnitude with the serum bicarbonate concentration ([HCO3−]) ranging from 12 to 23 mEq/l. Even so, it can have substantial adverse effects, including development or exacerbation of bone disease, growth retardation in children, increased muscle degradation with muscle wasting, reduced albumin synthesis with a predisposition to hypoalbuminemia, resistance to the effects of insulin with impaired glucose tolerance, acceleration of the progression of CKD, stimulation of inflammation, and augmentation of β2-microglobulin production. Also, its presence is associated with increased mortality. The administration of base to patients prior to or after initiation of dialysis leads to improvement in many of these adverse effects. The present recommendation by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) is to raise serum [HCO3−] to ≥22 mEq/l, whereas Caring for Australians with Renal Impairment (CARI) recommends raising serum [HCO3−] to >22 mEq/l. Base administration can potentially contribute to volume overload and exacerbation of hypertension as well as to metastatic calcium precipitation in tissues. However, sodium retention is less when given as sodium bicarbonate and sodium chloride intake is concomitantly restricted. Results from various studies suggest that enhanced metastatic calcification is unlikely with the pH values achieved during conservative base administration, but the clinician should be careful not to raise serum [HCO3−] to values outside the normal range

Matching People And Groups: Recruitment And Selection In Online Games

Massively multiplayer online games (MMOGs) have great potential as sites for research within the social and behavioral sciences and human-computer interaction. This is because “guilds” — semi-persistent groups in online games — are much like groups in real organizations. In this paper, we examine how groups and individuals find appropriate matches and whether appropriate matches lead newcomers to stay longer in their groups in an online game environment. Results from archival data, observation, and survey in the game World of Warcraft (WoW) indicate that different selection methods lead to person-group fit for social and task-oriented characteristics and good fit leads recruits to stay longer in their group. In particular, recruitment of new members to task-oriented guilds was most successful when brief interactions were used whereas recruitment to social-oriented guilds was most successful when probationary periods and referrals were used

Trust Across Borders: Buyer-Supplier Trust in Global Business-to-Business E-Commerce

This study focuses on trust formation and development in global buyer-supplier relationships. Trust affects all business relationships, especially global business-to-business (B2B) transactions due to the distances between buyers and suppliers. We use information signaling theory to examine how information indices and signals affect buyers’ trust in suppliers in global B2B commerce. Specifically, we examine how buyers’ trust is affected by (1) their perceptions of the national integrity and legal structure of suppliers’ country, and (2) third-party verifications of suppliers on B2B exchanges. Because buyer-supplier relationships usually evolve over time, we study how the effects of indices and signals change as the number of transactions between the partners increases. A survey of global organizational buyers finds that perceptions of national integrity, legal structure, and supplier verifications are all positively related to buyers’ trust. However, the number of prior transactions between buyers and suppliers moderates the impact of perceived legal structure on buyers’ trust

All Who Wander: On the Prevalence and Characteristics of Multi-community Engagement

Although analyzing user behavior within individual communities is an active and rich research domain, people usually interact with multiple communities both on- and off-line. How do users act in such multi-community environments? Although there are a host of intriguing aspects to this question, it has received much less attention in the research community in comparison to the intra-community case. In this paper, we examine three aspects of multi-community engagement: the sequence of communities that users post to, the language that users employ in those communities, and the feedback that users receive, using longitudinal posting behavior on Reddit as our main data source, and DBLP for auxiliary experiments. We also demonstrate the effectiveness of features drawn from these aspects in predicting users' future level of activity. One might expect that a user's trajectory mimics the "settling-down" process in real life: an initial exploration of sub-communities before settling down into a few niches. However, we find that the users in our data continually post in new communities; moreover, as time goes on, they post increasingly evenly among a more diverse set of smaller communities. Interestingly, it seems that users that eventually leave the community are "destined" to do so from the very beginning, in the sense of showing significantly different "wandering" patterns very early on in their trajectories; this finding has potentially important design implications for community maintainers. Our multi-community perspective also allows us to investigate the "situation vs. personality" debate from language usage across different communities.Comment: 11 pages, data available at https://chenhaot.com/pages/multi-community.html, Proceedings of WWW 2015 (updated references

Virtuality in human supervisory control: Assessing the effects of psychological and social remoteness

Virtuality would seem to offer certain advantages for human supervisory control. First, it could provide a physical analogue of the 'real world' environment. Second, it does not require control room engineers to be in the same place as each other. In order to investigate these issues, a low-fidelity simulation of an energy distribution network was developed. The main aims of the research were to assess some of the psychological concerns associated with virtual environments. First, it may result in the social isolation of the people, and it may have dramatic effects upon the nature of the work. Second, a direct physical correspondence with the 'real world' may not best support human supervisory control activities. Experimental teams were asked to control an energy distribution network. Measures of team performance, group identity and core job characteristics were taken. In general terms, the results showed that teams working in the same location performed better than team who were remote from one another

A field study of team working in a new human supervisory control system

This paper presents a case study of an investigation into team behaviour in an energy distribution company. The main aim was to investigate the impact of major changes in the company on system performance, comprising human and technical elements. A socio-technical systems approach was adopted. There were main differences between the teams investigated in the study: the time of year each control room was studied (i.e. summer or winter),the stage of development each team was in (i.e. 10 months), and the team structure (i.e. hierarchical or heterarchical). In all other respects the control rooms were the same: employing the same technology and within the same organization. The main findings were: the teams studied in the winter months were engaged in more `planning’ and `awareness’ type of activities than those studies in the summer months. Newer teams seem to be engaged in more sharing of information than older teams, which maybe indicative of the development process. One of the hierarchical teams was engaged in more `system-driven’ activities than the heterarchical team studied at the same time of year. Finally, in general, the heterarchical team perceived a greater degree of team working culture than its hierarchical counterparts. This applied research project confirms findings from laboratory research and emphasizes the importance of involving ergonomics in the design of team working in human supervisory control

The unacknowledged legacy

This paper presents a critical discussion of the treatment of mimetic art, and particularly poetry and the theatre, in the work of the Athenian philosopher Plato (427-347 BC). It centres on Plato's discussion of the corrupting powers of the arts in the Republic, and the implications that his fierce attack on poetry and theatre have for his construction of the ideal polity. The legacy of Platonic ideas in later elaborations of the corrupting power of the arts is discussed. Furthermore, the paper investigates the relationship between current debates on cultural policy and the Platonic idea that the transformative powers of the arts ought to be harnessed by the state to promote a just society. The conclusion thus reached is that “instrumental cultural policy”, rather then being a modern invention, was in fact first theorized precisely in Plato's Republic