Comparison of sodium removal in peritoneal dialysis patients treated by continuous ambulatory and automated peritoneal dialysis

BACKGROUND: Optimal fluid balance for peritoneal dialysis (PD) patients requires both water and sodium removal. Previous studies have variously reported that continuous ambulatory peritoneal dialysis (CAPD) removes more or equivalent amounts of sodium than automated PD (APD) cyclers. We therefore wished to determine peritoneal dialysate losses with different PD treatments. METHODS: Peritoneal and urinary sodium losses were measured in 24-h collections of urine and PD effluent in patients attending for their first assessment of peritoneal membrane function. We adjusted fluid and sodium losses for CAPD patients for the flush before fill technique. RESULTS: We reviewed the results from 659 patients, mean age 57 ± 16 years, 56.3% male, 38.9% diabetic, 24.0% treated by CAPD, 22.5% by APD and 53.5% APD with a day-time exchange, with icodextrin prescribed to 72.8% and 22.7 g/L glucose to 31.7%. Ultrafiltration was greatest for CAPD 650 (300-1100) vs 337 (103-598) APD p < 0.001, vs 474 (171-830) mL/day for APD with a day exchange. CAPD removed most sodium 79 (33-132) vs 23 (- 2 to 51) APD p < 0.001, and 51 (9-91) for APD with a day exchange, and after adjustment for the CAPD flush before fill 57 (20-113), p < 0.001 vs APD. APD patients with a day exchanged used more hypertonic glucose dialysates [0 (0-5) vs CAPD 0 (0-1) L], p < 0.001. CONCLUSION: CAPD provides greater ultrafiltration and sodium removal than APD cyclers, even after adjusting for the flush-before fill, despite greater hypertonic usage by APD cyclers. Ultrafiltration volume and sodium removal were similar between CAPD and APD with a day fill

An Analytical Model of a Thermally Excited Microcantilever Vibrating Laterally in a Viscous Fluid

To achieve higher quality factors (Q) for microcantilevers used in liquid-phase sensing applications, recent studies have explored the use of the lateral (in-plane) flexural mode. In particular, we have recently shown that this mode may be excited electrothermally using integrated heating resistors near the micro cantilever support, and that the resulting increase in Q helps to make low-ppb limits of detection a possibility in liquids. However, because the use of electrothermally excited, liquid-phase, microcantilever-based sensors in lateral flexure is relatively new, theoretical models are lacking. Therefore, we present here a new analytical model for predicting the vibratory response of these devices. The model is also used to successfully confirm the validity of our previously derived Q formula, which was based on a single-degree-of-freedom (SDOF) model and a harmonic tip force. Comparisons with experimental data show that the present model and, thus, the analytical formula provide excellent Q estimates for sufficiently thin beams vibrating laterally in water and reasonable upper-bound estimates for thicker beams

Traditional Healers and Mental Health in Nepal: A Scoping Review.

Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. We focused on the following clinically based research question, "What are the processes by which Nepali traditional healers address mental well-being?" We adopted a scoping review methodology to maximize the available literature base and conducted a modified thematic analysis rooted in grounded theory, ethnography, and phenomenology. We searched five databases using terms related to traditional healers and mental health. We contacted key authors and reviewed references for additional literature. Our scoping review yielded 86 eligible studies, 65 of which relied solely on classical qualitative study designs. The reviewed literature suggests that traditional healers use a wide range of interventions that utilize magico-religious explanatory models to invoke symbolic transference, manipulation of local illness narratives, roles, and relationships, cognitive restructuring, meaning-making, and catharsis. Traditional healers' perceived impact appears greatest for mild to moderate forms of psychological distress. However, the methodological and sample heterogeneity preclude uniform conclusions about traditional healing. Further research should employ methods which are both empirically sound and culturally adapted to explore the role of traditional healers in mental health

Staged cost optimization of urban storm drainage systems based on hydraulic performance in a changing environment

International audienceUrban flooding causes large economic losses, property damage and loss of lives. The impact of environmental changes mainly, the urbanization and the climatic change leads to increased runoff and increased peak flows which the drainage system must be able to cope with to overcome possible damage and inconveniences caused by the induced flooding. Allowing for detention storage to compliment the capacity of the drainage system network is one of the approaches to reduce urban floods. The traditional practice was to design systems against stationary environmental forcings ? including design rainfall, landuse, etc. Due to the rapid change in climate-environment, this approach is no longer economically viable and safe, and explicit consideration of changes that gradually take place during the life-time of the drainage system is warranted. In this paper, a staged cost optimization tool based on the hydraulic performance of the drainage system is presented. A one dimensional hydraulic model is used for hydraulic evaluation of the network together with a genetic algorithm based optimization tool to determine optimal intervention timings and amounts throughout the lifespan of the drainage network. The model was applied in a case study area in the city of Porto Alegre, Brazil. It was concluded that considerable financial savings and/or additional level of flood-safety can be achieved by approaching the design problem as a staged plan rather than one-off scheme

The effect of self-awareness on the ability to recognize personal motion

The purpose of this study was to examine the abilities of athletes with specific gait training (i.e., runners) discriminating personal gait from point-light videos were compared to athletes for whom gait is not a trained aspect of the sport (i.e., swimmers), and that of a control. It was hypothesized that runners would discriminate their gait among different individuals with greater accuracy than the other two groups and that runners would also devote more attention to the lower extremities for recognition indications. Results showed that runners group recognized themselves more often than the other two groups (p = .048, η 2 = 0.18), and that runners allotted more visual attention to the lower extremities (p < .05, ηp 2 = 0.16) when viewing the point-light videos than the other groups. The findings were consistent with other investigations with point-light video representations of movement and suggest that experience and training lead to movement self-awareness that is both recognizable and accessible by a performer.The project was supported by a grant from the Research Council at Western Illinois University for the purchase of the Gazepoint eye tracking equipment

Corn Response to Nitrogen Management under Fully-Irrigated vs. Water-Stressed Conditions

Characterizing corn (Zea mays L.) grain yield (GY) response to N is critical for maximizing profits, increasing N use efficiency and minimizing environmental impacts. Although a large database of GY response to N exists for highly productive soils, few data exist for less productive soils. While changes in precipitation are expected in the future, few studies have compared GY response to varying N management practices under conditions of varying water availability. We measured GY and basal stalk nitrate nitrogen (BSN) at harvest using split-applied urea at eight N rates under fully-irrigated (FI) and water-stressed (WS) conditions in a loamy sand over 2 yr (2009 and 2010). We also measured GY and BSN using single, pre-plant applications of urea, polymer-coated urea (PCU) and urea amended with urease and nitrification inhibitors (IU) at one or two N rates. The results showed that economic optimum nitrogen rate (EONR) and agronomic optimum nitrogen rate (AONR) did not vary by water management, in spite of significant increases in GY (up to 48%) under FI compared to WS. Modification of N fertilizer timing or N source was effective for increasing GY (by 18–41%) with FI, but did not affect GY under WS conditions. Averaged across years, BSN was greater with WS compared to FI at most N rates; however, BSN corresponding to AONR was within the optimal range for both water regimes. These findings may have important implications in areas where changes in irrigation practices or water availability are expected under future climate conditions

Equity implications of rice fortification: a modelling study from Nepal.

OBJECTIVE: To model the potential impact and equity impact of fortifying rice on nutritional adequacy of different subpopulations in Nepal. DESIGN: Using 24-h dietary recall data and a household consumption survey, we estimated: rice intakes; probability of adequacy (PA) of eight micronutrients commonly fortified in rice (vitamin A, niacin (B3), pyridoxine (B6), cobalamin (B12), thiamin (B1), folate (B9), Fe and Zn) plus riboflavin (B2), vitamin C and Ca and mean probability of adequacy (MPA) of these micronutrients. We modelled: no fortification; fortification of purchased rice, averaged across all households and in rice-buying households only. We compared adequacy increases between population subgroups. SETTING: (i) Dhanusha and Mahottari districts of Nepal (24-h recall) and (ii) all agro-ecological zones of Nepal (consumption data). PARTICIPANTS: (i) Pregnant women (n 128), mothers-in-law and male household heads; (ii) households (n 4360). RESULTS: Unfortified diets were especially inadequate in vitamins B12, A, B9, Zn and Fe. Fortification of purchased rice in rice-purchasing households increased PA > 0·9 for thiamin, niacin, B6, folate and Zn, but B12 and Fe remained inadequate even after fortification (PA range 0·3-0·9). Pregnant women's increases exceeded men's for thiamin, niacin, B6, folate and MPA; men had larger gains in vitamin A, B12 and Zn. Adequacy improved more in the hills (coefficient 0·08 (95 % CI 0·05, 0·10)) and mountains (coefficient 0·07 (95 % CI 0·01, 0·14)) but less in rural areas (coefficient -0·05 (95 % CI -0·09, -0·01)). CONCLUSIONS: Consumption of purchased fortified rice improves adequacy and gender equity of nutrient intake, especially in non-rice-growing areas

Consumption of rice, acceptability and sensory qualities of fortified rice amongst consumers of social safety net rice in Nepal

INTRODUCTION: Micronutrient deficiencies are prevalent in Nepal where starchy foods constitute a large proportion of diets and consumption of micronutrient-rich foods is inadequate. We conducted a study to determine whether rice would be an appropriate vehicle for micronutrient fortification in Nepal. MATERIALS AND METHODS: In Bajura in remote rural Nepal, we conducted a household survey to characterize rice intakes in 195 households, and a double-blinded acceptability test with 177 social safety net rice consumers ≥18 years of age. Of these, 168 tasted fortified and unfortified rice to assess whether respondents could differentiate between fortified and non-fortified rice and their sensory properties. Rice was fortified by blending hot extruded kernels containing 6 micronutrients together with non-fortified rice at a 1:99 ratio. We used binomial tests to assess whether participants could correctly differentiate fortified rice, from non-fortified rice and paired t-tests to compare scores for sensory qualities of cooked fortified and non-fortified rice. We used multiple regression to test associations between per capita consumption and age, gender, wealth and food security. RESULTS: Per capita consumption of rice (median 216g/day, IQR 144.0, 288.0) did not vary by wealth but was +52.08g, (95% CI 10.43, 93.72) higher amongst moderately to severely food insecure households compared with food secure / mildly food insecure. Most respondents could not differentiate fortified rice from non-fortified rice: 37.5% identified uncooked fortified rice and 39.3% cooked rice, which was not different from the 33% expected by chance (p = 0.22 and p = 0.09 respectively). The sensory qualities of fortified rice were acceptable (scoring 3.9 out of 5) and did not differ from non-fortified rice (p>0.05). CONCLUSION: A rice fortification programme implemented through the Nepal Food Corporation's social safety nets has potential because purchase and consumption of rice is high and fortified rice is acceptable among consumers in remote food insecure areas of Nepal