Sirolimus and kidney growth in autosomal dominant polycystic kidney disease

BACKGROUND: In autosomal dominant polycystic kidney disease (ADPKD), aberrant activation of the mammalian target of rapamycin (mTOR) pathway is associated with progressive kidney enlargement. The drug sirolimus suppresses mTOR signaling. METHODS: In this 18-month, open-label, randomized, controlled trial, we sought to determine whether sirolimus halts the growth in kidney volume among patients with ADPKD. We randomly assigned 100 patients between the ages of 18 and 40 years to receive either sirolimus (target dose, 2 mg daily) or standard care. All patients had an estimated creatinine clearance of at least 70 ml per minute. Serial magnetic resonance imaging was performed to measure the volume of polycystic kidneys. The primary outcome was total kidney volume at 18 months on blinded assessment. Secondary outcomes were the glomerular filtration rate and urinary albumin excretion rate at 18 months. RESULTS: At randomization, the median total kidney volume was 907 cm(3) (interquartile range, 577 to 1330) in the sirolimus group and 1003 cm(3) (interquartile range, 574 to 1422) in the control group. The median increase over the 18-month period was 99 cm(3) (interquartile range, 43 to 173) in the sirolimus group and 97 cm(3) (interquartile range, 37 to 181) in the control group. At 18 months, the median total kidney volume in the sirolimus group was 102% of that in the control group (95% confidence interval, 99 to 105; P=0.26). The glomerular filtration rate did not differ significantly between the two groups; however, the urinary albumin excretion rate was higher in the sirolimus group. CONCLUSIONS: In adults with ADPKD and early chronic kidney disease, 18 months of treatment with sirolimus did not halt polycystic kidney growth. (ClinicalTrials.gov number, NCT00346918.

K+N charge-exchange scattering at 1.94 GeV/c

Experimental results are presented on the reaction K+n→K0p at 2 GeV/c. As required by strong ρ-A2 exchange degeneracy, the dσ/dt distribution shows no structure at t~-0.6 (GeV/c)^2. The dσ/du distribution for backward charge-exchange scattering does not agree with proposed I=0 baryon-exchange models

Sailing into the wind : new disciplines in Australian higher education

Much is made of the potential of lifelong learning for individuals and organisations. In this article we tend to make much less of it, certainly with respect to its use in universities to discipline academics. Nevertheless, we argue that academics now need to re-learn the positions they occupy and the stances they take in response to the marketisation of Australian universities. In particular, we suggest that the position of (pure) critique no longer commands attention in Australian contexts of higher education, although the paper does not suggest a disregard for a critical stance purely for the sake of participation. It is in understanding the interconnections between position and stance , and how they might be strategically performed during the everyday practices of academics, that a more promising way of engaging with the venalities of the market is envisaged; a strategy that could be described as \u27sailing into the wind\u27. In discussing these matters, the paper draws on semi-structured interviews with academics located in university faculties/departments/schools of education along Australia\u27s eastern seaboard

Does the source migration pathway of HBCDs to household dust influence their bioaccessibility?

A study was conducted to assess the human bioaccessibility of dust contaminated with hexabromocyclododecane (HBCD) via two migration pathways a) volatilisation with subsequent partitioning to dust particles, and b) abrasion of treated textile fibres directly to the dust. This was achieved using previously developed experimental chamber designs to generate dust samples contaminated with HBCDs emit-ted from a HBCD treated textile curtain. The generated dust samples were exposed to an in vitro colon extended physiologically based extraction test (CE-PBET). The bioaccessibility of the HBCDs which were incorporated within dust as a result of volatilisation from the curtain material with subsequent partitioning to dust was higher than in dusts contaminated with HBCDs via abrasion of the curtain (35% and 15% respectively). We propose this occurs due to a stronger binding of HBCDs to treated fabric fibres than that experienced following volatilisation and sorption of HBCDs to dust particles