Adherence to the Kidney Disease: Improving Global Outcomes CKD Guideline in Nephrology Practice Across Countries.

The uptake of the Kidney Disease: Improving Global Outcomes (KDIGO) 2012 chronic kidney disease (CKD) Guideline is not fully described in real-world nephrology practice across the world. We used baseline data from the CKD Outcomes and Practice Patterns Study (2013-2017), a 4-country cohort of patients with estimated glomerular filtration rate <60 ml/min per 1.73 m recruited from national samples of nephrology clinics, to describe adherence to measures for monitoring and delaying CKD progression. Data were collected as in clinical practice, except laboratory measures per protocol in France. The mean age ranged from 65 years in Brazil to 72 years in Germany. Albuminuria (mostly proteinuria) was measured routinely in 36% to 43% of patients in Brazil, Germany, and the United States. Blood pressure control (≤140/90 mm Hg) ranged from 49% in France to 76% in Brazil; <40% of patients had blood pressure ≤130/80 mm Hg everywhere but Brazil (52%). More than 40% of nephrologists in Brazil reported a systolic blood pressure target ≤130 mm Hg for nondiabetic patients without proteinuria, but only 19% to 24% elsewhere. Prescription of renin-angiotensin aldosterone system inhibitors ranged from 52% in the United States to 81% in Germany. Dietary advice was more frequent for salt than protein intake; dietitian visits were uncommon. In nondiabetic patients, achievement of all 3 targets including blood pressure ≤130/80 mm Hg, renin-angiotensin aldosterone system inhibition, and dietary advice, ranged from 10% in the United States to 32% in Brazil; in treated diabetic patients, this ranged from 6% to 11% after including hemoglobin A1c target. Adherence to recommendations to slow CKD progression is low in typical practice settings, and substantial variation among countries for some indicates opportunities for improvement

Nano-coating protects biofunctional materials

The demand to develop convergent technology platforms, such as bio-functionalized medical devices, is rapidly increasing. However, the loss of biological function of the effector molecules during sterilization represents a significant and general problem. Therefore, we have developed and characterized a nano-coating (NC) formulation capable of maintaining the functionality of proteins on biological-device combination products. As a proof of concept, the NC preserved the structural and functional integrity of an otherwise highly fragile antibody immobilized on polyurethane during deleterious sterilizing irradiation (≥ 25 kGy). The NC procedure enables straight-forward terminal sterilization of bio-functionalized materials while preserving optimal conditioning of the bioactive surface.© Elsevier Ltd 201

Pater optime: Vergilian Allusion in Obrecht's Mille quingentis

Efforts to uncover biographical data in the text of Jacob Obrecht's motet Mille quingentis have led scholars to minimize the significance of the poem's figurative language. Written in response to the death of the composer's father, the text is a hybrid of different poetic styles, a reflection of the rich web of literary and cultural practices that lies behind it. Allusions to the poetry of Vergil figure more prominently in the motet than has been previously recognized. Other examples of the kinds of allusions found in Mille quingentis, drawn from a wide range of works, demonstrate that Obrecht was here participating in a more general commemorative practice, wherein the assimilation of well-known classical texts served to express private sentiments using a "public" language newly charged with meaning. A consideration of texts that possibly mediated his use of Vergilian language and themes (among them a treatise of Johannes Tinctoris) suggests that the motet's biographical significance lies principally in what it can tell us about Obrecht's intellectual background and tendencies, as well as his engagement with the humanistic literary environment he would have encountered during his first stay at the Ferrarese court