Impaired Fasting Glucose Is Associated With Renal Hyperfiltration in the General Population

Increased glomerular filtration rate (GFR), also called hyperfiltration, is a proposed mechanism for renal injury in diabetes. The causes of hyperfiltration in individuals without diabetes are largely unknown, including the possible role of borderline hyperglycemia. We assessed whether impaired fasting glucose (IFG; 5.6–6.9 mmol/L), elevated HbA1c, or hyperinsulinemia are associated with hyperfiltration in the general middle-aged population. A total of 1,560 individuals, aged 50–62 years without diabetes, were included in the Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6). GFR was measured as single-sample plasma iohexol clearance. Hyperfiltration was defined as GFR >90th percentile, adjusted for sex, age, weight, height, and use of renin-angiotensin system inhibitors. Participants with IFG had a multivariable-adjusted odds ratio of 1.56 (95% CI 1.07–2.25) for hyperfiltration compared with individuals with normal fasting glucose. Odds ratios (95% CI) of hyperfiltration calculated for a 1-unit increase in fasting plasma glucose (FPG) and HbA1c, after multivariable-adjustment, were 1.97 (1.36–2.85) and 2.23 (1.30–3.86). There was no association between fasting insulin levels and hyperfiltration. A nonlinear association between FPG and GFR was observed (df = 3, P < 0.0001). GFR increased with higher glucose levels, with a steeper slope beginning at FPG ≥5.4 mmol/L. Borderline hyperglycemia was associated with hyperfiltration, whereas hyperinsulinemia was not. Longitudinal studies are needed to investigate whether the hyperfiltration associated with IFG is a risk factor for renal injury in the general population

The Values of Tangible User Interfaces: How to discover, assess and evaluate them?

Since the introduction of Tangible User Interfaces, in the beginning of the 90s, a generation grew up interacting with computers. At the same time the context of computing changed dramatically: from a device used almost exclusively by specialists, it evolved to a general device that plays a dominant role in our societies. But where does this leave TUI? In many respects, the idea of tangibility plays a marginal role in Human Computer Interaction. It makes sense to re-evaluate the intrinsic values of TUI design. This paper proposes to research the appropriate metrics to do so

Factors affecting glomerular filtration rate, as measured by iohexol disappearance, in men with or at risk for HIV infection

Objective: Formulae used to estimate glomerular filtration rate (GFR) underestimate higher GFRs and have not been well-studied in HIV-infected (HIV(+)) people; we evaluated the relationships of HIV infection and known or potential risk factors for kidney disease with directly measured GFR and the presence of chronic kidney disease (CKD). Design: Cross-sectional measurement of iohexol-based GFR (iGFR) in HIV(+) men (n = 455) receiving antiretroviral therapy, and HIV-uninfected (HIV(-)) men (n = 258) in the Multicenter AIDS Cohort Study. Methods: iGFR was calculated from disappearance of infused iohexol from plasma. Determinants of GFR and the presence of CKD were compared using iGFR and GFR estimated by the CKD-Epi equation (eGFR). Results: Median iGFR was higher among HIV(+) than HIV(-) men (109 vs. 106 ml/min/1.73 m2, respectively, p = .046), and was 7 ml/min higher than median eGFR. Mean iGFR was lower in men who were older, had chronic hepatitis C virus (HCV) infection, or had a history of AIDS. Low iGFR (≤90 ml/min/1.73 m2) was associated with these factors and with black race. Other than age, factors associated with low iGFR were not observed with low eGFR. CKD was more common in HIV(+) than HIV(-) men; predictors of CKD were similar using iGFR and eGFR. Conclusions: iGFR was higher than eGFR in this population of HIV-infected and -uninfected men who have sex with men. Presence of CKD was predicted equally well by iGFR and eGFR, but associations of chronic HCV infection and history of clinically-defined AIDS with mildly decreased GFR were seen only with iGFR. © 2014 Margolick et al

Association of HLA-B*5801 allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis

Background: Despite some studies suggesting a possible association between human leukocyte antigen, HLA-B*5801 and allopurinol induced Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), the evidence of association and its magnitude remain inconclusive. This study aims to systematically review and meta-analyze the association between HLA-B*5801 allele and allopurinol-induced SJS/TEN.Methods: A comprehensive search was performed in databases including MEDLINE, Pre-MEDLINE, Cochrane Library, EMBASE, International Pharmaceutical Abstracts (IPA), CINAHL, PsychInfo, the WHO International, Clinical Trial Registry, and ClinicalTrial.gov from their inceptions to June 2011. Only studies investigating association between HLA-B*5801 with allopurinol-induced SJS/TEN were included. All studies were extracted by two independent authors. The primary analysis was the carrier frequency of HLA-B*5801 comparison between allopurinol-induced SJS/TEN cases and each comparative group. The pooled odds ratios were calculated using a random effect model.Results: A total of 4 studies with 55 SJS/TEN cases and 678 matched-controls (allopurinol-tolerant control) was identified, while 5 studies with 69 SJS/TEN cases and 3378 population-controls (general population) were found. SJS/TEN cases were found to be significantly associated with HLA-B*5801 allele in both groups of studies with matched-control (OR 96.60, 95%CI 24.49-381.00, p < 0.001) and population-control (OR 79.28, 95%CI 41.51-151.35, p < 0.001). Subgroup analysis for Asian and Non-Asian population yielded similar findings.Conclusion: We found a strong and significant association between HLA-B*5801 and allopurinol-induced SJS/TEN. Therefore, HLA-B*5801 allele screening may be considered in patients who will be treated with allopurinol

Importance of density-compensated temperature change for deep North Atlantic Ocean heat uptake

The efficiency with which the oceans take up heat has a significant influence on the rate of global warming. Warming of the ocean above 700 m over the past few decades has been well documented. However, most of the ocean lies below 700 m. Here we analyse observations of heat uptake into the deep North Atlantic. We find that the extratropical North Atlantic as a whole warmed by 1.45±0.5×1022 J between 1955 and 2005, but Lower North Atlantic Deep Water cooled, most likely as an adjustment from an early twentieth-century warm period. In contrast, the heat content of Upper North Atlantic Deep Water exhibited strong decadal variability. We demonstrate and quantify the importance of density-compensated temperature anomalies for long-term heat uptake into the deep North Atlantic. These anomalies form in the subpolar gyre and propagate equatorwards. High salinity in the subpolar gyre is a key requirement for this mechanism. In the past 50 years, suitable conditions have occurred only twice: first during the 1960s and again during the past decade. We conclude that heat uptake through density-compensated temperature anomalies will contribute to deep ocean heat uptake in the near term. In the longer term, the importance of this mechanism will be determined by competition between the multiple processes that influence subpolar gyre salinity in a changing climate

Detection of the Fast Kelvin Wave Teleconnection Due to El Niño‐Southern Oscillation

Previous analyses of the ocean state along the western American coast have often indicated unexpectedly slow and limited propagation of coastally trapped Kelvin waves associated with the El Niño‐Southern Oscillation. In contrast, theoretical and numerical ocean models demonstrate that these Kelvin waves are a rapid and long‐range teleconnection between the low‐ and high‐latitude Pacific Ocean, strongly impacting both the surface coastal currents and nutrient upwelling. Sea level variations along the western coast of North America are reexamined under the assumption that tropically forced Kelvin waves are produced in bursts of several months duration. A cross‐correlation analysis, restricted to mid‐1982 to mid‐1983, is performed between Galapagos Island and stations along western Central and North America. A coastally trapped Kelvin wave is revealed to propagate at a speed of 2–3 m s−1 from the tropical Pacific to the Aleutian Island Chain. The observed phase speed agrees with the estimated speed of a Kelvin wave based on the average density profile of the ocean near the coast. Weaker El Niño events in 1986/1987 and 1991/1992 appear to contain a combination of this remote signal and local wind forcing. The wave propagation speed calculated from the spectral phase is shown to be sensitive to the presence of other (noise) processes in the observations. This is demonstrated through an analysis of a synthetic sea level data set that contains many of the essential features of the real sea level data. A relatively small level of red noise can give a 100% expected error in the estimated propagation speed. This suggests a new explanation for this important inconsistency within dynamical oceanography

Asthma and indoor environment in Nepal

BACKGROUND—The development of asthma seems to be influenced by the adoption of a Western lifestyle. A study was undertaken to assess the importance of indoor environmental factors in Nepal where the lifestyle and home environment differ from that in the West.
METHODS—The home environment of 121 schoolchildren with asthma and 126 controls aged 11-17 years was studied. The homes of all participants were investigated and the children and their mothers were interviewed using a standardised questionnaire. Cases and controls were identified from an ISAAC (International Study of Asthma and Allergy in Childhood) based population study of 2330 schoolchildren in Kathmandu, Nepal.
RESULTS—Keeping cattle inside the house during the night was related to a lower risk for having asthma (adjusted odds ratio (OR) 0.2(95% CI 0.1 to 0.5)) while there was no association between asthma and cattle kept outside. Asthma was associated with cigarette smoking by two or more family members (OR 1.9 (95% CI 1.0 to 3.9)) and with the domestic use of smoky fuels (OR 2.2 (95% CI 1.0 to 4.5)). In analyses stratified by sex, passive smoking and the use of smoky fuels were significantly associated with asthma only in boys.
CONCLUSIONS—The risk of asthma in Nepalese children was lower in subjects exposed to cattle kept inside the house and higher in subjects exposed to passive smoking and indoor use of smoky fuels. Childhood exposure to microorganisms or allergens from cattle may protect against the development of atopic disease.