Effect of renin-angiotensin-aldosterone system blockade in adults with diabetes mellitus and advanced chronic kidney disease not on dialysis : a systematic review and meta-analysis

The presumed superiority of renin-angiotensin-aldosterone system (RAAS)-blocking agents over other antihypertensive agents in patients with diabetes to delay development of end-stage kidney disease (ESKD) has recently been challenged. In addition, there is ongoing uncertainty whether RAAS-blocking agents reduce mortality and/or delay ESKD in patients with diabetes and chronic kidney disease (CKD) stages 3-5. In this subgroup, there might be an expedited need for renal replacement therapy (RRT) when RAAS-blocking agents are used. We conducted a meta-analysis of randomized controlled trials (RCTs) of at least 6-months duration in adult patients with diabetes who also have non-dialysis CKD stages 3-5. RCTs comparing single RAAS-blocking agents to placebo or alternative antihypertensive agents were included. Outcomes of interest were allcause mortality, cardiovascular morbidity, progression of renal function, ESKD and adverse events. A total of nine trials (n = 9797 participants with CKD stages 3-5) fit our inclusion criteria. There was no difference between the RAAS group and control group regarding all-cause mortality {relative risk [RR] = 0.97 [95% confidence interval (CI) 0.85-1.10]}, cardiovascular mortality [RR = 1.03 (95% CI 0.75-1.41)] and adverse events [RR = 1.05 (95% CI 0.89-1.25)]. There was a trend for a favourable effect for non-fatal cardiovascular events [RR = 0.90 (95% CI 0.81-1.00)] and a lower risk of the composite endpoint need for RRT/doubling of serum creatinine [RR = 0.81 (95% CI 0.70-0.92)] in the RAAS-blocking agents group versus the control group. We found evidence that in patients with diabetes mellitus and CKD stages 3-5, treatment with RAAS-blocking agents did not result in a clear survival advantage. The effect on renal outcomes did depend on the selected outcome measure. However, we did not find evidence that the use of RAAS-blocking agents expedited the need for RRT in patients with CKD stages 3-5

OPEN STOMATA3 - an ABC transporter implicated in ABA signalling, drought and light response

Mutants sensitive to progressive water deficit are characterized by excessive transpiration due to the failure of stomatal closure and can therefore be detected as cold plants (Fig. 1 blue) by remote infrared imaging (Merlot et al., 2002). Among the signalling mutants, three are collectively named open stomata (ost). The corresponding OST1 and OST2 genes encode an ABA-activated kinase and a P-type H+-ATPase, respectively (Mustilli et al., 2002; Merlot et al., 2007). The current work deals with OST3 which encodes an ATP-binding cassette (ABC) transporter. There are over 120 members of the ABC protein in the superfamily of Arabidopsis thaliana. Most of them are membrane-bound proteins that transport a diverse range of substances across the phospholipid bilayer. Characterisation of the mutant phenotype confirmed that ost3 transpires excessively (Fig. 1, 2). We have also shown that the ost3 mutations reduce seed dormancy (Fig. 3) but seed sensitivity to exogenous ABA seems unaffected (data not shown). The guard cells of ost3 are impaired in responses to ABA and light (Fig. 4), but are normal with respect to low level of CO2 which stimulates stomatal opening (data not shown). OST3 is expressed mainly in leaves, particularly in guard cells (Fig. 5), but it is low in root tissues. Transgenic expression of the OST3 protein fused to GFP in the ost3 mutant can rescue the phenotype and moreover, the fusion protein is targeted exclusively to the plasma membrane (Fig. 6) suggesting that it has a role in intercellular transport required for ABA signal perception. We found that OST3 interacts with OST2 (Fig. 8) and OST1 (Fig. 8 + 9). The last observation is also consistent with the fact that OST3 can be phosphorylated by OST1 in vitro (Fig. 7). Therefore we suggest that the trio of proteins identified by our genetic screen may function in the same signalling complex in mediating stomatal response

Les compétences des sages-femmes selon la loi

Deutsch: Seit Anfang Jahr ist das Gesundheitsberufegesetz in Kraft und definiert die Kom­petenzen von Hebammen und sechs weiteren Berufsgruppen. Ein Gesetz regelt nicht nur Pflichten, es beinhaltet auch Rechte und bietet Schutz. Entstanden ist es in mehrjähriger, intensiver Zusammenarbeit von Behörden und Vertreterinnen aus der Berufskonferenz sowie unter Einbezug von Hebammen aus verschiedenen Bereichen der Praxis und der Lehre. Sie haben mit grosser Umsicht und Sorgfalt die grund­legenden Formulierungen erarbeitet und in den Vernehmlassungen verteidigt Français: La loi sur les professions de la santé est en vigueur depuis le début de l’année et définit les compétences des sages-femmes et de six autres professions. Une telle loi règle non seulement les devoirs mais aussi les droits et offre une protection. Elle a été créée après plusieurs années de coopération intensive entre les autorités et les représentants de la Conférence professionnelle ainsi qu'avec la participation de sages-femmes de divers domaines de la pratique et de l'enseignement. Celles-ci ont élaboré les formulations de base avec grand soin et diligence et les ont défendues lors des consultations

Intranasal Delivery of MVA Vector Vaccine Induces Effective Pulmonary Immunity Against SARS-CoV-2 in Rodents

Antigen-specific tissue-resident memory T cells (Trms) and neutralizing IgA antibodies provide the most effective protection of the lungs from viral infections. To induce those essential components of lung immunity against SARS-CoV-2, we tested various immunization protocols involving intranasal delivery of a novel Modified Vaccinia virus Ankara (MVA)-SARS-2-spike vaccine candidate. We show that a single intranasal MVA-SARS-CoV-2-S application in mice strongly induced pulmonary spike-specific CD8+ T cells, albeit restricted production of neutralizing antibodies. In prime-boost protocols, intranasal booster vaccine delivery proved to be crucial for a massive expansion of systemic and lung tissue-resident spike-specific CD8+ T cells and the development of Th1 - but not Th2 - CD4+ T cells. Likewise, very high titers of IgG and IgA anti-spike antibodies were present in serum and broncho-alveolar lavages that possessed high virus neutralization capacities to all current SARS-CoV-2 variants of concern. Importantly, the MVA-SARS-2-spike vaccine applied in intramuscular priming and intranasal boosting treatment regimen completely protected hamsters from developing SARS-CoV-2 lung infection and pathology. Together, these results identify intramuscular priming followed by respiratory tract boosting with MVA-SARS-2-S as a promising approach for the induction of local, respiratory as well as systemic immune responses suited to protect from SARS-CoV-2 infections

On the Determinants of Currency Crises: The Role of Model Uncertainty

We tackle explicitly the issue of model uncertainty in the framework of binary variable models of currency crises. Using Bayesian model averaging techniques, we assess the robustness of the explanatory variables proposed in the recent literature for both static and dynamic models. Our results indicate that the variables belonging to the set of macroeconomic fundamentals proposed by the literature are very fragile determinants of the occurrence of currency crises. The results improve if the crisis index identifies a crisis period (defined as the period up to a year before a crisis) instead of a crisis occurrence. In this setting, the extent of real exchange rate misalignment and financial market indicators appear as robust determinants of crisis periods

A Service of zbw Leibniz-Informationszentrum Wirtschaft Leibniz Information Centre for Economics Working Papers in Economics and Statistics Trust in cooperation or ability? An experimental study on gender differences

Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Matthias Sutter Terms of use: Documents in EconStor may University of Innsbruck and University of Göteborg Abstract: We examine gender differences in trust in another party's cooperation (CC) or its ability (AC). While men and women do not differ concerning trust in cooperation, gender has a strong influence when trust in another subject's ability is required. JEL-classification: C72, C9