Microalbuminuria as Predictor of Early Glomerular Injury in Children and Adolescents with Sickle Cell Anaemia at Muhimbili National Hospital Dar es Salaam, Tanzania 2012

Microalbuminuria (MA) is the earliest marker of various diseases affecting the renal system. Its relevance in children and adolescents with sickle cell anaemia (SCA), who are known to be prone to renal complications, has not been fully explored in our setting. Several studies have shown microalbuminuria to be prevalent among SCA children. It is now used extensively as a sensitive test of preclinical glomerular damage. Microalbuminuria in the early stages of sickle cell nephro¬pathy is a hallmark of future deterioration of renal function. It is important to detect this early with routine surveillance. Intervention at this stage may prevent or at least delay the end stage renal disease. To determine the prevalence of microalbuminuria and its clinical correlates in children and adolescents with SCA attending sickle cell clinic at Muhimbili National Hospital. This was a hospital based descriptive cross-sectional study. Children and adolescents aged 3 – 18 years attending sickle cell clinic were randomly selected. Urine sample of all eligible children and adolescent with SCA was screened for microalbuminuria by special Micral urine taste strips (Cliawaived Microlalbumin 2-1 Combo, USA),with sensitivity and specificity of 96.5% and 98.3 respectively. The resting blood pressure (BP) measurements, haemoglobin level, were obtained and clinical events associated with microalbuminuria were recorded. Data were analyzed using Statistical Package for Social Science (SPSS) version 17 statistical packages. Chi-square test was used for categorical variables, and student t test for independent sample means. Binary logistic regression was used to analyze potential effect modifiers of microalbuminuria. The study group was made up of 120 subjects aged 3 to 18 years (53% females). Microalbuminuria (MA) was found in 29/120 (24%). None of the clinical characteristics (painful crisis, blood transfusion, abnormal pressure) were significantly related with MA. Haemoglobin levels were significantly lower in subjects with MA than in those without MA (5.9±1.2 vs 7.4±1.0g/dL, respectively)p=0.001 . In multivariate logistic regression model of MA both Hb level and age remain in the final model as clinical correlates of MA. Higher Hb level showed a protective effect against MA (Odds ratio=0.55) p=0.001 while subjects with MA were more likely to have older age. (Odds ratio=1.7) p=0.001 MA is common among children and adolescents with SCA and directly related to age and inversely related to the haemoglobin levels. Urinary MA measurement is a simple and non-invasive screening biomarker which may be utilized as part of routine health care in children and adolescents with SCA. Screening for microalbuminuria seems prudent after age 6 to 7 years especially in those with severe anaemia. Longitudinal studies are essential to determine the significance of childhood microalbuminuria in the development of renal diseas

The best memories: Identity, narrative, and objects

Memory is everywhere in Blade Runner 2049. From the dead tree that serves as a memorial and a site of remembrance (“Who keeps a dead tree?”), to the ‘flashbulb’ memories individuals hold about the moment of the ‘blackout’, when all the electronic stores of data were irretrievably erased (“everyone remembers where they were at the blackout”). Indeed, the data wiped out in the blackout itself involves a loss of memory (“all our memory bearings from the time, they were all damaged in the blackout”). Memory, and lack of it, permeates place, where from the post-blackout Las Vegas Deckard remembers it as somewhere you could “forget your troubles.” Memory is a commodity, called upon and consumed by the Wallace Corporation, purchased from the memory-maker, Dr Ana Stelline, who constructs and implants “the best memories” in replicants so as to instil in them real human responses. Memory is ubiquitous in Blade Runner 2049, involving humans, replicants, objects, and machines. Even “God,” we are told, “remembered Rachael.” Nowhere, though, is the depiction of memory more important than in the attempt to solve a question of identity. Officer K has a memory of his past. Even though he knows it is an implant, it is a memory he is emotionally attached to, frequently narrating it to Joi, his digital girlfriend. But it is a memory that starts to puzzle and trouble him. When K discovers the remains of a dead replicant, a female NEXUS-7, he uncovers a secret—this replicant was pregnant and died during childbirth, a discovery that could “break the world.” K is charged with hunting down the child and making the problem disappear. Yet as K starts seeking answers to the question of the child’s identity he gets inextricably caught up in the mystery. Is he merely Officer K, or is he Joe, the miracle child of Rachael and Deckard? The answer to this question hinges on K’s memory. But is the memory genuine? Is the memory his? Blade Runner 2049 encourages us to think deeply about the nature of memory, identity, and the relation between them. Indeed, the film does not just serve as a starting point for thinking about philosophical issues related to memory and identity. Rather, as we show in this chapter, the film seems to offer a view on these philosophical issues. Blade Runner 2049 offers us a view of memory as spread out over people, objects, and the environment, and it shows us that memory’s role in questions of identity goes beyond merely accurately recalling one’s past. Identity depends not on memory per se, but partly on what we use memory for

The Methodology of Normative Policy Analysis

Policy analyses frequently clash. Their disagreements stem from many sources, including models, empirical estimates, and values such as who should have standing and how different criteria should be weighted. We provide a simple taxonomy of disagreement, identifying distinct categories within both the positive and values domains of normative policy analysis. Using disagreements in climate policy to illustrate, we demonstrate how illuminating the structure of disagreement helps to clarify the way forward. We conclude by suggesting a structure for policy analysis that can facilitate assessment, comparison, and debate by laying bare the most likely sources of disagreement.

Pathways and Mechanisms that Prevent Genome Instability in Saccharomyces cerevisiae.

Genome rearrangements result in mutations that underlie many human diseases, and ongoing genome instability likely contributes to the development of many cancers. The tools for studying genome instability in mammalian cells are limited, whereas model organisms such as Saccharomyces cerevisiae are more amenable to these studies. Here, we discuss the many genetic assays developed to measure the rate of occurrence of Gross Chromosomal Rearrangements (called GCRs) in S. cerevisiae These genetic assays have been used to identify many types of GCRs, including translocations, interstitial deletions, and broken chromosomes healed by de novo telomere addition, and have identified genes that act in the suppression and formation of GCRs. Insights from these studies have contributed to the understanding of pathways and mechanisms that suppress genome instability and how these pathways cooperate with each other. Integrated models for the formation and suppression of GCRs are discussed

Preventing Delinquency Through Improved Child Protection Services

Research indicates that the prevalence of child abuse or neglect among delinquent offenders is substantially greater than it is among the general population. Moreover, maltreated children are significantly more likely to become involved in delinquent behavior than their nonmaltreated peers, and delinquent youth with a history of abuse or neglect are more likely to continue their offending behavior than delinquents who have not suffered child abuse or neglect. Given the links between child maltreatment and juvenile offending, designing and implementing programs to reduce the incidence of child maltreatment as a means of preventing delinquency are a promising -- though often overlooked -- strategy.After reviewing what is known about the links between childhood maltreatment and juvenile and adult offending, the authors review OJJDP's Comprehensive Strategy for Serious, Violent, and Chronic Juvenile Offenders and examine the role that child protective services' prevention efforts can play in delinquency prevention and intervention

A study of spatial data management and analysis systems

The Earth Resources Laboratory of the NASA Stennis Space Center is a center of space related technology for Earth observations. It has assumed the task, in a joint effort with Jackson State University, to reach out to the science community and acquire information pertaining to characteristics of spatially oriented data processing

Interior maps in posterior pareital cortex

The posterior parietal cortex (PPC), historically believed to be a sensory structure, is now viewed as an area important for sensory-motor integration. Among its functions is the forming of intentions, that is, high-level cognitive plans for movement. There is a map of intentions within the PPC, with different subregions dedicated to the planning of eye movements, reaching movements, and grasping movements. These areas appear to be specialized for the multisensory integration and coordinate transformations required to convert sensory input to motor output. In several subregions of the PPC, these operations are facilitated by the use of a common distributed space representation that is independent of both sensory input and motor output. Attention and learning effects are also evident in the PPC. However, these effects may be general to cortex and operate in the PPC in the context of sensory-motor transformations

Cocoon viability and evidence for delayed hatching by the earthworm Lumbricus terrestris in a laboratory-based study.

Clitellate Lumbricus terrestris, obtained from 5 commercial suppliers (A-E) and also field collected (F) - grassland in Preston, Lancashire, UK, were kept under controlled environmental conditions (15 °C and 24 h darkness) in a sterilised loam soil and surface-fed with horse manure. Survival, biomass and cocoon production was monitored every 4 weeks over 1 y. Collected cocoons were maintained in water-filled Petri dishes on filter paper. Time to hatch and cocoon viability was recorded over a 2 y period. Cocoon production ranged from 15.1 – 32.2 ind.-1 y-1. Cocoon production was initially low followed by a period of high production (12-36 weeks) and then fell (36-52 weeks). Time for cocoon hatching ranged from 132-731 days. Hatching success after 2 years was 58–90% across treatments, with a total viability (including cocoons dissected after the 2 year period) of 88-94%. Evidence of 2 distinct hatching peaks was recorded, separated by a period of approximately 12 months in treatments of most of the commercially obtained earthworms. Cocoon incubation periods are in excess of those previously recorded under similar laboratory conditions (e.g. 90–280 days). Furthermore, viability is also higher than previously recorded (e.g. 67.9–83%). These differences are mainly attributable to the extended length of cocoon observation. Origin, age, unknown pre-treatment (in A-E) and experimental conditions (e.g. a constant temperature regime) may have influenced incubation times. However, it is suggested that asynchronous and delayed hatching within cohorts and ability for cocoons to remain viable for extended periods allows this K-selected species to maximise reproductive potential. This proposed “bet-hedging” strategy is worthy of further laboratory and field-based investigation