Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison

Hypertension in obese children may require a different diagnostic and treatment approach from that for children with secondary hypertension, yet there is neither consensus nor a clear guideline. The aim of this study was to assess how obese children with hypertension are currently diagnosed and treated by paediatric nephrologists, what obstacles exist and what can be improved. In the period May–November 2014, an online questionnaire was sent to all members of the European Society for Paediatric Nephrology (n = 2148). Questions focused on current practices and obstacles regarding screening, diagnosis and treatment of hypertension in obese children. A total of 214 paediatric nephrologists responded. Although nearly 100 % agreed that screening of obese children for hypertension is indicated, it was current practice in only 56 % of participating countries; 88 % of respondents diagnosed hypertension with 24-h ambulatory blood pressure measurement. Diagnostics used to rule out causes or consequences of hypertension varied among the respondents; they included, in particular, the use of serum renin/aldosterone, urine sodium/potassium, and dimercaptosuccinic acid scan. Concerning treatment, 45 % of respondents preferred to start treatment with a lifestyle program, 2 % with antihypertensive medication, and 40 % with both. For 73 % of respondents, angiotensin-converting enzyme-inhibitors or angiotensin receptor blockers were the drugs of first choice. The findings of this study emphasize the urgent need for an international guideline for screening, diagnosis and treatment of hypertension in obese children

The Marine Engineer in a Literature published in the Meiji Era

Nephrolog

Visualizing order in dispersions and solid state morphology with CryoTEM and electron tomography: P3HT:PCBM organic solar cells

Building blocks for organic solar cells are made from P3HT in a P3HT:PCBM solution in toluene and used to tune the morphology of the photoactive layer. The approach presented here decouples the structure and morphology formation, providing precise control over both the structures in solution and the morphology of the photoactive layer. For the characterization of the nanostructures in the organic casting solutions, cryo-TEM was successfully employed, and reveals the P3HT crystals and even the 1.7 nm lamellar stacking, which in combination with cryogenic low dose electron diffraction clearly proves the high crystallinity of P3HT aggregates realized. The photoactive layers made from pre-crystallized solutions show a morphology that is closely related to the structures in solution. A clear trend of decreasing open circuit voltage and increasing short circuit current with increasing order in the casting solutions and the devices was observed, which correlates with the evolution of the morphology from very intermixed with small fibrillar structures to phase-separated with large polymer crystals, as evaluated from representative devices, characterized in 3D with electron tomography

Low-dose (S)TEM elemental analysis of water and oxygen uptake in beam sensitive materials

The performance stability of organic photovoltaics (OPVs) is largely determined by their nanoscale morphology and composition and is highly dependent on the interaction with oxygen and water from air. Low-dose cryo-(S)TEM techniques, in combination with OPV donor-acceptor model systems, can be used to assess oxygen- and water-uptake in the donor, acceptor and their interface. By determining a materials dependent critical electron dose from the decay of the oxygen K-edge intensity in Electron Energy Loss Spectra, we reliably measured oxygen- and water-uptake minimizing and correcting electron beam effects. With measurements below the dose limit the capability of STEM-EDX, EFTEM and STEM-EELS techniques are compared to qualitatively and quantitatively measure oxygen and water uptake in these OPV model systems. Here we demonstrate that oxygen and water is mainly taken up in acceptor-rich regions, and that specific oxygen uptake at the donor-acceptor interphase does not occur. STEM-EELS is shown to be the best suitable technique, enabling quantification of the local oxygen concentration in OPV model systems

Suspended crystalline films of protein hydrophobin I (HFBI)

Protein interfaces play an essential role in both natural and man-made materials as stabilizers,sensors, catalysts, and selective channels for ions and small molecules. Probing the molecular arrangement within such interfaces is of prime importance to understand the relation between structure and functionality. Here we report on the preparation and characterization of large area suspended crystalline films of class II hydrophobin HFBI. This small, amphiphilic globular protein readily self-assembles at the air–water interface into a 2D hexagonal lattice which can be transferred onto a holey carbon electron microscopy grid yielding large areas of hundreds of square micrometers intact hydrophobin film spun across micronsized holes. Fourier transform analysis of low-dose electron microscopy images and selected area electron diffraction profiles reveal a unit cell dimension a = 5.6 ± 0.1 nm, in agreement with reported atomic force microscopy studies on solid substrates and grazing incidence X-ray scattering experiments at the air–water interface. These findings constitute the first step towards the utilization of large-area suspended crystalline hydrophobin films as membranes for ultrapurification and chiral separation or as biological substrates for ultrafast electron diffraction

Triplet exciton generation in bulk-heterojunction solar cells based on endohedral fullerenes

Organic bulk-heterojunctions (BHJ) and solar cells containing the trimetallic nitride endohedral fullerene 1-[3-(2-ethyl)hexoxy carbonyl]propyl-1-phenyl-Lu3N@C80 (Lu3N@C80-PCBEH) show an open circuit voltage (VOC) 0.3 V higher than similar devices with [6,6]-phenyl-C[61]-butyric acid methyl ester (PC61BM). To fully exploit the potential of this acceptor molecule with respect to the power conversion efficiency (PCE) of solar cells, the short circuit current (JSC) should be improved to become competitive with the state of the art solar cells. Here, we address factors influencing the JSC in blends containing the high voltage absorber Lu3N@C80-PCBEH in view of both photogeneration but also transport and extraction of charge carriers. We apply optical, charge carrier extraction, morphology, and spin-sensitive techniques. In blends containing Lu3N@C80-PCBEH, we found 2 times weaker photoluminescence quenching, remainders of interchain excitons, and, most remarkably, triplet excitons formed on the polymer chain, which were absent in the reference P3HT:PC61BM blends. We show that electron back transfer to the triplet state along with the lower exciton dissociation yield due to intramolecular charge transfer in Lu3N@C80-PCBEH are responsible for the reduced photocurrent

Nano-morphology characterization of organic bulk heterojunctions based on mono and bis-adduct fullerenes

We have studied organic bulk heterojunction photovoltaic devices based on a bridged-bithiophene donor-acceptor type low-band gap polymer blended with PCBM and bis-PCBM. The impact of the molecular arrangement is discussed in terms of the correlation between the solar-cell performance and the degree of crystallization. Differential scanning calorimetry (DSC) and grazing-incidence X-ray diffraction (GIXRD) prove that films with bis-PCBM typically result in more amorphous blends than comparable films with PCBM. Electron tomography (ET) is used to visualize the three dimensional morphology of photoactive layers, confirming the presence of nanofibers, formed in different scales through the thickness in the blended films with mono and bis-fullerenes. (C) 2012 Elsevier B.V. All rights reserve

Is there an association between cortisol and hypertension in overweight or obese children?

Objective: The precise mechanisms behind the development of hypertension in overweight or obese children are not yet completely understood. Alterations in hypothalamic-pituitary-adrenal axis activity may play a role. We aimed to investigate the association between cortisol parameters and hypertension in overweight or obese children. Methods: Random urine (n=180) and early-morning saliva samples (n=126) for assessment of cortisol and cortisone were collected from 1) hypertensive overweight children (n=50), 2) normotensive overweight children (n=145), and 3) normotensive non-overweight children (n=75). Results: The age of participants was 10.4±3.3 years and 53% were boys. The urinary cortisol-to-cortisone ratio [β 1.11, 95% confidence interval (CI) 1.05-1.19] as well as urinary cortisol/creatinine (β 1.38, 95% CI 1.09-1.54), and cortisone/creatinine ratios (β 1.26, 95% CI 1.17-1.36) were significantly higher in overweight or obese than in non-overweight children. After adjusting for body mass index-standard deviation score and urinary cortisone/creatinine ratio, but not cortisol/creatinine ratio, was significantly associated with presence of hypertension (β 1.12, 95% CI 1.02-1.23). Salivary cortisol and cortisone levels were significantly lower in overweight or obese than in non-overweight children (β -4.67, 95% CI -8.19- -1.15, and β 0.89, 95% CI 0.80-0.97 respectively). There were no significant differences in cortisol parameters between hypertensive and normotensive overweight or obese children. Conclusion: This study provided further evidence for an increased cortisol production rate with decreased renal 11β-hydroxysteroid dehydrogenase 2 activity and flattening of early-morning peak cortisol and cortisone in overweight or obese children. However, there were no significant differences in cortisol parameters between hypertensive and normotensive overweight and obese children