Biomarkers - FGF-23 and α-Klotho in hemodialysis patients with secondary hyperparathyroidism

Chronic kidney disease has been shown to impair the metabolism of a number of minerals, resulting in bone damage, vascular wall calculations, functional disorders and significant mortality.Renal osteodystrophy in this disease is characterized by histological bone abnormalities and altered rate of bone transformation (increased in fibrous osteitis or decreased in adynamic bone disease), pathological mineralization (osteomalacia) and bone loss. Secondary hyperparathyroidism is associated with fibrosis osteitis, early build-up of phosphorus (responsible for excess production of FGF23 by the bone tissue), decreased production of calcitriol by the kidneys and hypocalcemia. Other bone debilitating factors include acidosis, chronic inflammation, food deficiency, and iatrogenic complications.It has been proven  that with the progression of CKD and the reduction of glomerular filtration, the activity of FGF-23 is increased, which leads to inhibition of alpha-1 hydroxylase and to decrease levels of 1,25 dihydroxyvitamin D. /1/FGF-23 comes predominantly from the bones, while αKlotho - from the kidneys, and together they play different important roles to maintain mineral metabolism. Chronic kidney disease is associated with significant increases in FGF-23 concentrations and inhibition of αKlotho.Hyperphosphatemia, which correlates with endothelial dysfunction and elevated FGF-23, in an untimely treatment, results in pruritus, bone pain, anemia, cardiovascular complications, disability, and reduced survival rate.The association between protein-related uremic toxins and fibroblast growth factor-23  / FGF-23  is a challenge motivating the study and study of bone biomarkers.

Sound Record Producers\u27 Rights and the Problem of Sound Recording Piracy

This paper will describe some current issues and developments that are of relevance to sound recordings protection, as they are experienced and debated in industry and among customers, as well as policy making bodies. The paper’s focus is on the historical development of sound recordings protection under United States Copyright law. In Part II, this paper will explore early federal and state law protections for sound recordings, including the Copyright Act of 1909, common law protections, and state statutes. This section also will trace the development of proposals for a federal statute granting express copyright protection for sound recordings. In Part III, this paper will examine the 1971 Sound Recording Amendment, particularly the scope of protection afforded for sound recordings. In Part IV, the paper will review some recent forms of sound recording piracy that occur over the Internet with the development of digital technologies, recent litigation, and alternative solutions technology can offer against piracy. Finally, in Part V it will examine the available remedies in federal law against sound recording piracy

Očuvanje okoliša u području grada Bankyje

The town of Bankya is a balneological resort (spa) situated in a picturesque valley 17 km west from Sofia. It is a place suitable for the treatment of cardiovascular diseases and certain functional diseases of the nervous system. As a national resort, it applies stricter environmental regulations for activities that might endanger the environment, including road transport. The aim of this study was to establish the health status of Bankya townspeople before the pending construction of a highway. The morbidity of the population of Bankya and neighbouring towns and villages was compared to that of the capital Sofia for the period between 1997 and 1999. The data were statistically processed using the non–parametric, chi–square analysis. The results showed similar morbidity in children from Bankya and neighbouring towns and villages, but it was significantly lower than in children from Sofia. The results for adults were also in favour of Bankya – lower morbidity than in the neighbouring towns and villages, and less than 50% of disease cases recorded for Sofia.Grad Bankya nalazi se u kupališnome području smještenom u slikovitoj dolini 17 km zapadno od Sofije. To je mjesto pogodno za liječenje kardiovaskularnih bolesti i nekih funkcionalnih poremećaja živčanog sustava. Budući da se radi o zaštićenome području, ekološki zahtjevi za razvoj proizvodnje koja bi mogla ugroziti okoliš su stroži, a to se odnosi i na povećanje cestovnog prometa. Cilj je ovog istraživanja bio ispitati zdravstveno stanje stanovništva grada Bankyje prije izgradnje autoceste Lyulin. U razdoblju od 1997. do 1999. godine analizirano je pobolijevanje stanovnika grada Bankyje i okolnih gradova i sela i uspoređeno s pobolijevanjem stanovnika Sofije. Dobiveni rezultati statistički su obrađeni neparametrijskom analizom – kriterij χ2. Nađeno je da je pobolijevanje djece u gradu Bankyji slično kao u susjednim gradovima i selima, no da je značajno niže negoli u Sofiji (3379,17‰). Rezultati istraživanja u odrasloj populaciji govore u prilog nižem pobolijevanju u gradu Bankyji u usporedbi sa susjednim gradovima i selima. Štoviše, u usporedbi sa Sofijom pobolijevanje je bilo dva puta manje

A Model of Digital Payment Infrastructure Formation and Development: The EU Regulator´s Perspective

The payment field is being rapidly transformed. New players have emerged and are threatening the well-established positions of the incumbents. This process is driven by technology change and market forces, and it is shaped by the increasing role of the regulator. When considering the change in the regulatory environment and combining it with the disruptive and innovative nature of the mobile phone, the result is a market that is rapidly transforming from well-established structure into a state of flux. We build a model to understand and explain this transformation of the digital payment infrastructure. The model captures the formation and development of the digital payment infrastructure with a particular emphasis on the regulator´s and innovator’s perspective. It consists of four stages characterized by slow incremental change which are followed by short and rapid bursts of discontinuity. Each stage is portrayed by its evolutionary dynamics, the nature of the payment platform, the legal implications, the level of competition, and what drives the discontinuity. Keywords: digital payments, multi-sided platform, EU payment regulation, digital infrastructures

VERTICAL FARMS

The urbanized population is increasing year by year, leaving fewer and fewer inhabitants in the province. This inevitably leads to increased energy and resource consumption, leading to environmental problems. All this, combined with climate change, calls for a more holistic approach to the provision of raw materials and resources in future cities, both in the main aspects of sustainable development, social, environmental and economic. From this point of view, vertical farms can be an instrument that addresses these aspects.The urbanized population is increasing year by year, leaving fewer and fewer inhabitants in the province. This inevitably leads to increased energy and resource consumption, leading to environmental problems. All this, combined with climate change, calls for a more holistic approach to the provision of raw materials and resources in future cities, both in the main aspects of sustainable development, social, environmental and economic. From this point of view, vertical farms can be an instrument that addresses these aspects

Tracing and comparing serum, specific, bone biomarkers in patients with secondary hyperparathyroidism

Bone and mineral disorders (BMDs) in chronic kidney disease (CKD) are increasingly being studied, and prophylaxis and treatment are conducted, but they still remain one of the most severe systemic illnesses in patients with CKD.In patients with end-stage CKD and secondary hyperparathyroidism, accompanying metabolic disorders of calcium and phosphorus homeostasis may lead to pathological changes in bone and blood vessels, which increase the risk of bone fractures and cardiovascular (CV) events. High levels of parathyroid hormone (PTH), calcium and phosphorus are associated with increased morbidity and mortality in dialysis patients.Dialysis treatment is a renal replacement method that continues the life of patients with CKD, temporarily improving existing bone pathology, but it more often accelerates its progression. Therefore, the symptoms, developmental and complications of BMD-CKD are demonstrated and manifested in patients with extracorporeal treatment.Treatment of BMD requires constant monitoring of Ca-P exchange, PTH, serum of Vitamin D levels and the protein bone markers - osteocalcin, bone alkaline phosphatase.Despite the systemic use of active metabolites of vitamin D, phosphate binders and calcimimetics, in many patients with secondary hyperparathyroidsm, inadequate biochemical control has been observed.In the Dialysis Clinic at St. Marina University Hospital, Varna, two groups of patients on hemodialysis (HD) and with CKD - 2/3 stage with secondary hyperparathyroidism, were followed and had their serum biomarker levels compared - PTH, bone alkaline phosphatase (BAP), osteocalcin, and vitamin D. The results showed statistically significant differences between the two groups in the investigated serum levels of the indicators

Therapeutic Strategies for the Prevention of Catheter-Associated Complications in Hemodialysis Patients

A reliable and well-functioning vascular access is pivotal for effective hemodialysis, ensuring an optimal quality of life for individuals with end-stage chronic kidney disease. Patients undergoing chronic dialysis treatment have three permanent vascular access options: arteriovenous fistula (AVF), arteriovenous graft (AVG), and tunneled central venous catheter (CVC). In recent years, the prevalence of patients utilizing permanent vascular catheters for HD treatment has been rising, necessitating a focus on reducing complications and prolonging their functional duration.Common complications associated with central catheters encompass intra- or pericatheter thrombosis and catheter-associated infection (CAI). Varied CVC locking solutions are used to prevent infection and thrombosis. Regardless of the chosen locking solution type, utilizing thrombolytic agents for prophylaxis from catheter insertion onward is recommended to reduce the risk of thrombotic complications.Taurolidine- and citrate-based locking solutions have demonstrated greater effectiveness compared to heparin-based locking solutions in addressing CVC-related infections, and they show similar efficiency in averting catheter-related thrombosis. However, studies directly comparing the efficacy of taurolidine- and citrate-based solutions are limited. Definitive conclusions regarding the superiority of CVC occlusion medications are yet to be established. Authoritative, randomized clinical trials are necessary to validate these initial findings

Introducing Platform Interactions Model for Studying Multi-Sided Platforms

Multi-Sided Platforms (MSPs) function as socio-technical entities that facilitate direct interactions between various affiliated to them constituencies through developing and managing IT architecture. In this paper, we aim to explain the nature of the platform interactions as key characteristic of any MSP. To this end, we propose the Platform Interaction Model (PIM), built upon Activity Theory and Business Action Theory. We then test its explanatory capability by applying it to four cases. Based on our analysis, we argue that MSPs enable various types of interactions, which has implications for the initial adoption, competitiveness, and subsequent expansion of particular MSP

Pentraxin 3 – A Novel Prognostic Biomarker For Endothelial Dysfunction In Esrd Patients

Endothelial dysfunction is a common feature in the uremic environment that develops relatively early in the pathogenesis of CKD. It is associated with chronic inflammation, and predicts both cardiovascular events and adverse patient outcomes.The aim of this review is to present Pentraxin 3 (PTX3) as a new prognostic biomarker with plasma levels that exhibit notably enhanced accuracy in outcome prediction. It demonstrates a consistent correlation with other inflammatory markers, disorders of lipid metabolism, and adipokines, and functions independently as a risk factor for unfavorable outcomes, malnutrition, and cardiovascular risks in patients undergoing hemodialysis (HD).ESRD patients exhibit notably elevated PTX3 levels, aligned with heightened vascular resistance and accelerated atherosclerosis, effectively aligning with well-established markers of endothelial dysfunction. In HD patients, PTX3 levels display more variation compared to CRP, and their sustained elevation over three months associates with an augmented risk of cardiovascular mortality. Paradoxically, heightened PTX3 levels, despite increased RNA expression in adipose tissue, coincide with poorer nutritional status and malnutrition. Notably, dialysis procedures themselves stimulate additional PTX3 production, prompting inquiries into the enhanced biocompatibility of HD membranes and exploring the effects of highflux HD and online hemodiafiltration on plasma PTX3 levels. Furthermore, negative correlations between PTX3, albuminuria in diabetics at various stages of diabetic nephropathy, and PTX3 and GFR in early CKD stages challenge its predictive role and relevance in disease onset and progression.In conclusion, the highlighted unresolved issues, along with the persistently elevated mortality rate within the rapidly growing ESRD patient population, position PTX3 as a promising marker capable of altering prognoses in the early stages. Therefore, it is necessary to conduct more complex studies and develop a strategic approach, considering its potential therapeutic implications