The usefulness of a free self-test for screening albuminuria in the general population: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>In this study we evaluated the usefulness of a free self-test for screening albuminuria in the general population.</p> <p>Methods</p> <p>Dutch adults were invited by the Dutch Kidney Foundation to order a free albuminuria self-test, consisting of three semi quantitative dipstick tests, via the Internet. Results were classified in negative, low-positive and high-positive. In case of a positive test result, the tester was recommended to visit a GP for supplementary examination and/or treatment. Participants of the programme were sent a questionnaire for evaluation by e-mail eight weeks after receiving the self-test.</p> <p>Results</p> <p>During the first 30 days of the self-test programme, 996,927 self-tests were ordered. In total, 71,714 participants completed the questionnaire: 79% had a negative test result and 21% had a positive test result (20% low-positive and 1% high-positive). Of the positive testers, 25% visited a GP after testing for albuminuria. Among the 3,983 participants who visited a GP, 193 new diseases were detected: 25 chronic renal failure, 152 hypertension and 31 diabetes mellitus.</p> <p>Conclusion</p> <p>Using a free self-test for screening albuminuria in the general population resulted in a large response and a number of newly detected diseases. However, we found a very high percentage of positive testers of which probably a large part is false positive. Furthermore, only a small part of the positive testers visited a GP for additional examination and/or treatment. The efficiency of such a campaign could be increased by embedding the testing in health care to reduce the number of false-positive results and to ensure follow-up and treatment in case of a positive test result.</p

Building capacity of small-medium cities’ local authorities to implement MaaS and other innovative transport schemes

Sustainable development requirements in combination with extreme technological evolution have changed the way mobility is considered, creating challenges to Local Authorities (L?s) both in planning and implementation phases of mobility solutions. This paper focuses on the capacity building of LAs to deliver Mobility-as-a-Service (MaaS) and other innovative transport schemes as part of Sustainable Urban Mobility Plans (SUMPs). It presents a methodological approach for the design and employment of an integrated learning tool that intends to increase the adoption rates of measures’ packages through LAs knowledge strengthening. The learning tool consists of a detailed facilitator guide to run an one-day classroom course along with the conceptual background and necessary training material. The methodological approach consists of a multilevel and multicriteria process that integrates the results/outcomes of the assessment of the cities capacity to implement SUMP through an evaluation framework. The classroom course has been structured in order to clarify the value of MaaS and other innovative measures for small-medium cities, analyze successful case studies under the spectrum of overcoming challenges efficiently, present tools and guidelines supporting collaboration between team members. The results of this work have been validated through the pilot application to six LAs. The overall evaluation of the pilots showed that content’s accuracy and achievement of workshop’s objectives was more than satisfactory (more than 50% of the participants gave the highest rate) and participants became more engaged with SUMP measures implementation.info:eu-repo/semantics/acceptedVersio

Golimumab induction and maintenance for moderate to severe ulcerative colitis: results from GO-COLITIS (Golimumab: a Phase 4, UK, open label, single arm study on its utilization and impact in ulcerative Colitis)

Objective GO-COLITIS aimed to measure the effectiveness of subcutaneous golimumab in tumour necrosis factor-α antagonist–naive patients with moderate to severe ulcerative colitis (UC) despite conventional treatment. Design GO-COLITIS was an open label, single arm, phase 4 study with a pragmatic design which reflected UK clinical practice. Adult patients were eligible if diagnosed with UC ≥3 months, partial Mayo score (PMS) 4–9. Patients received subcutaneous golimumab induction (200 mg initially and 100 mg at week 2) followed at week 6 by 50 mg or 100 mg (depending on weight) every 4 weeks until week 54 with a 12-week follow-up. Efficacy was measured by PMS at baseline, week 6, 30, 54 and 66. Health-related quality of life (HRQoL; Inflammatory Bowel Disease Questionnaire (IBDQ) and EuroQol Group 5 Dimensions Health Questionnaire (EQ-5D)) was assessed at baseline, week 6 and week 54. All safety adverse events (AEs) were recorded. Results 207 patients were enrolled and 205 received golimumab (full analysis set (FAS)205). At week 6, 68.8% (95% CI 62.0% to 75.1%) and 38.5% (95% CI 31.8% to 45.6%) of patients were in response and remission, respectively, using PMS. At the end of the induction phase, 140/141 patients in clinical response continued into the maintenance phase (Maintenance FAS). Sustained clinical response through week 54 was achieved in 51/205 (24.9%) of the FAS205 population and 51/140 (36.4%) of the Maintenance FAS population. Statistically significant improvements from baseline to week 6 were observed for the IBDQ total score and for each IBDQ domain score (bowel symptoms, emotional function, systemic symptoms and social function), as well as the EQ-5D index score and associated visual analogue scale score (p<0.0001). Improvement of HRQoL was sustained through week 54. Serious AEs leading to treatment discontinuation occurred in 8.8% of patients. Conclusion In this study measuring patient-reported outcomes in patients with moderate to severe UC, golimumab induced and maintained response as measured by PMS and significantly improved quality of life measures. Trial registration number NCT02092285; 2013-004583-56

Experimental Evaluation of Locally Synthesized Biodiesel Drilling Fluid

Diesel oil has been the preferred base fluid for the formulation of oil-based drilling mud. Diesel oil has negative effects on the environment and there is a growing need for more environmentally sustainable alternatives that can be technically compared to diesel base oil. In recent times, the use of vegetable oils as drilling fluid base oil has been of interest. In this study, 1378 kg/m3 of palm kernel oil-based mud (PKOBM) and palm kernel oil biodiesel based mud (BDBM) were experimentally formulated. BDBM was synthesized by the transesterification of vegetable (palm kernel) oil. The performance of PKOBM and BDBM was then evaluated against conventional diesel oil-based mud (DOBM). The evaluation performed was based on the rheological, filtration and wall building properties, emulsion and thermal stabilities, and acute toxicity of the formulated drilling fluid systems. The results obtained from the study reveal that the mud systems (PKOBM and BDBM) show a typical Herschel-Bulkley (modified power-law) drilling mud rheological pattern at temperatures of 49°C, 66°C and 80°C. BDBM showed comparable rheological properties with better hole cleaning capacity as indicated by a lower flow index. For the filtrate loss test, BDBM exhibited a slightly lower filtrate loss compared to DOBM, whereas PKOBM had a higher fluid loss of 4.4 ml. For the filter cake and thermal stability test, there were no significant changes between DOBM and BDBM, whereas PKOBM had the least desirable performance. BDBM exhibited the most stable emulsion of 1274 volts breaking voltage and PKOBM, the least with 739 volts compared to 1169 volts breaking voltage of DOBM. This study concludes that BDBM could be used as an environmentally sustainable substitute for diesel oil-based mud (DOBM).Sažetak: Kao bazni fluid za pripremu isplake na bazi ulja najčešće se upotrebljava dizelsko ulje. Dizelsko ulje ima negativan utjecaj na okoliš i sve je veća potreba za ekološki održivijim alternativama koje se s tehničkoga aspekta mogu usporediti s dizelskim baznim uljem. U novije se vrijeme istražuje mogućnost upotrebe biljnih ulja kao baznoga ulja u isplakama. U ovome istraživanju eksperimentalno su pripremljene isplaka (gustoće 1378 kg/m3) na bazi palmina ulja (ulje iz palminih koštica) (PKOBM) i isplaka na bazi biodizela dobivenoga iz palmina ulja (BDBM). BDBM je dobiven transesterifikacijom biljnoga (palmina) ulja. Zatim je napravljena usporedba karakteristika PKOBM-a i BDBM-a i konvencionalne isplake na bazi dizelskoga ulja (DOBM). Isplake su uspoređene na temelju reoloških i filtracijskih svojstava, sposobnosti stvaranja isplačnoga obloga, stabilnosti emulzije, toplinske stabilnosti te akutne toksičnosti. Rezultati dobiveni istraživanjem upućuju na to da isplake PKOBM i BDBM pokazuju tipično Herschel-Bulkley (modificirani eksponencijalni (power-law) model) reološko ponašanje pri temperaturama od 49 °C, 66 °C i 80 °C. BDBM je pokazao usporediva reološka svojstva uz bolji kapacitet iznošenja krhotina nego što bi na to upućivao niži indeks protoka. U testu gubitka filtrata isplake BDBM je pokazao nešto manji gubitak filtrata u odnosu na DOBM, dok je PKOBM imao veći gubitak filtrata, koji je iznosio 4,4 ml. Ispitivanja isplačne obloge (filter cake) i termičke stabilnosti nisu pokazala znatnije razlike između DOBM-a i BDBMa, dok je PKOBM imao najmanje poželjne performanse. U usporedbi stabilnosti emulzija BDBM je pokazao najstabilniju emulziju (destabilizacija emulzije pri naponu od 1274 V), a PKOBM najmanje stabilnu emulziju (destabilizacija pri 739 V), dok u slučaju DOBM-a do destabilizacije emulzije dolazi pri naponu od 1169 V. Temeljem provedenih istraživanja zaključeno je da bi se BDBM mogao koristiti kao ekološki održiva zamjena za isplaku na bazi dizelskoga ulja (DOBM)

The thalamic mGluR1-PLC??4 pathway is critical in sleep architecture

The transition from wakefulness to a nonrapid eye movement (NREM) sleep state at the onset of sleep involves a transition from low-voltage, high-frequency irregular electroencephalography (EEG) waveforms to large-amplitude, low-frequency EEG waveforms accompanying synchronized oscillatory activity in the thalamocortical circuit. The thalamocortical circuit consists of reciprocal connections between the thalamus and cortex. The cortex sends strong excitatory feedback to the thalamus, however the function of which is unclear. In this study, we investigated the role of the thalamic metabotropic glutamate receptor 1 (mGluR1)-phospholipase C ??4 (PLC??4) pathway in sleep control in PLC??4-deficient (PLC??4-/-) mice. The thalamic mGluR1-PLC??4 pathway contains synapses that receive corticothalamic inputs. In PLC??4-/- mice, the transition from wakefulness to the NREM sleep state was stimulated, and the NREM sleep state was stabilized, which resulted in increased NREM sleep. The power density of delta (??) waves increased in parallel with the increased NREM sleep. These sleep phenotypes in PLC??4-/- mice were consistent in TC-restricted PLC??4 knockdown mice. Moreover, in vitro intrathalamic oscillations were greatly enhanced in the PLC??4-/- slices. The results of our study showed that thalamic mGluR1-PLC??4 pathway was critical in controlling sleep architecture.ope

A meta-analysis and critical review of prospective memory in autism spectrum disorder

Prospective memory (PM) is the ability to remember to carry out a planned intention at an appropriate moment in the future. Research on PM in ASD has produced mixed results. We aimed to establish the extent to which two types of PM (event-based/time-based) are impaired in ASD. In part 1, a meta-analysis of all existing studies indicates a large impairment of time-based, but only a small impairment of event-based, PM in ASD. In Part 2, a critical review concludes that time-based PM appears diminished in ASD, in line with the meta-analysis, but that caution should be taken when interpreting event-based PM findings, given potential methodological limitations of several studies. Clinical implications and directions for future research are discussed

Clostridium difficile infection.

Infection of the colon with the Gram-positive bacterium Clostridium difficile is potentially life threatening, especially in elderly people and in patients who have dysbiosis of the gut microbiota following antimicrobial drug exposure. C. difficile is the leading cause of health-care-associated infective diarrhoea. The life cycle of C. difficile is influenced by antimicrobial agents, the host immune system, and the host microbiota and its associated metabolites. The primary mediators of inflammation in C. difficile infection (CDI) are large clostridial toxins, toxin A (TcdA) and toxin B (TcdB), and, in some bacterial strains, the binary toxin CDT. The toxins trigger a complex cascade of host cellular responses to cause diarrhoea, inflammation and tissue necrosis - the major symptoms of CDI. The factors responsible for the epidemic of some C. difficile strains are poorly understood. Recurrent infections are common and can be debilitating. Toxin detection for diagnosis is important for accurate epidemiological study, and for optimal management and prevention strategies. Infections are commonly treated with specific antimicrobial agents, but faecal microbiota transplants have shown promise for recurrent infections. Future biotherapies for C. difficile infections are likely to involve defined combinations of key gut microbiota

Angular dependence of spin-orbit spin-transfer torques

In ferromagnet/heavy-metal bilayers, an in-plane current gives rise to spin-orbit spin-transfer torque, which is usually decomposed into fieldlike and dampinglike torques. For two-dimensional free-electron and tight-binding models with Rashba spin-orbit coupling, the fieldlike torque acquires nontrivial dependence on the magnetization direction when the Rashba spin-orbit coupling becomes comparable to the exchange interaction. This nontrivial angular dependence of the fieldlike torque is related to the Fermi surface distortion, determined by the ratio of the Rashba spin-orbit coupling to the exchange interaction. On the other hand, the dampinglike torque acquires nontrivial angular dependence when the Rashba spin-orbit coupling is comparable to or stronger than the exchange interaction. It is related to the combined effects of the Fermi surface distortion and the Fermi sea contribution. The angular dependence is consistent with experimental observations and can be important to understand magnetization dynamics induced by spin-orbit spin-transfer torques.open113534sciescopu