Estimation of Muscle Mass in the Integrated Assessment of Patients on Hemodialysis

Assessment of muscle mass (MM) or its proxies, lean tissue mass (LTM) or fat-free mass (FFM), is an integral part of the diagnosis of protein-energy wasting (PEW) and sarcopenia in patients on hemodialysis (HD). Both sarcopenia and PEW are related to a loss of functionality and also increased morbidity and mortality in this patient population. However, loss of MM is a part of a wider spectrum, including inflammation and fluid overload. As both sarcopenia and PEW are amendable to treatment, estimation of MM regularly is therefore of major clinical relevance. Whereas, computer-assisted tomography (CT) or dual-energy X-ray absorptiometry (DXA) is considered a reference method, it is unsuitable as a method for routine clinical monitoring. In this review, different bedside methods to estimate MM or its proxies in patients on HD will be discussed, with emphasis on biochemical methods, simplified creatinine index (SCI), bioimpedance spectroscopy (BIS), and muscle ultrasound (US). Body composition parameters of all methods are related to the outcome and appear relevant in clinical practice. The US is the only parameter by which muscle dimensions are measured. BIS and SCI are also dependent on either theoretical assumptions or the use of population-specific regression equations. Potential caveats of the methods are that SCI can be influenced by residual renal function, BIS can be influenced by fluid overload, although the latter may be circumvented by the use of a three-compartment model, and that muscle US reflects regional and not whole body MM. In conclusion, both SCI and BIS as well as muscle US are all valuable methods that can be applied for bedside nutritional assessment in patients on HD and appear suitable for routine follow-up. The choice for either method depends on local preferences. However, estimation of MM or its proxies should always be part of a multidimensional assessment of the patient followed by a personalized treatment strategy

Determinants of above-ground carbon stocks and productivity in secondary forests along a 3000-m elevation gradient in the Ecuadorian Andes

Background: Secondary montane forests, covering 30% of forested lands in the Andes, play a crucial role in mitigating the impact of carbon release. However, the mechanisms responsible for carbon sequestration in the above-ground biomass of these forests are not well quantified. Aims: Understanding the determinants of above-ground carbon (AGC) dynamics in secondary forests along a 3000-m elevational gradient in the Andes to assess their mitigation potential. Methods: We assessed how abiotic and biotic conditions and past human disturbances were related to forest structure and composition, AGC stocks and productivity within sixteen 0.36-ha plots established in secondary forest stands of 30–35 years of age. Results: Structural equation models revealed that changes in temperature conditions along the elevation gradient shaped leaf functional composition, which in turn controlled AGC dynamics. Productivity and temperature decreased with increasing elevation and decreased tree community leaf area. Disturbance legacy (Tree mortality) increased with competitive thinning and low soil fertility. Conclusions: We show that temperature drives AGC dynamics by changing the functional trait composition. This highlights the importance of preserving these forests along elevation gradients and implies potentially strong future changes due to global warming.</p

THE VLT LEGA-C spectroscopic survey:the physics of galaxies at a lookback time of 7 Gyr

The Large Early Galaxy Census (LEGA-C) is a Public Spectroscopic Survey of ~3200 K-band selected galaxies at redshifts z = 0.6 − 1.0 with stellar masses ${M}_{*}\gt {10}^{10}\quad {M}_{\odot }$, conducted with VIMOS on ESO's Very Large Telescope. The survey is embedded in the COSMOS field (R.A. = 10h00; $\mathrm{decl}.\;=\;+2\;\mathrm{deg}$). The 20 hr long integrations produce high-signal-to-noise ratio continuum spectra that reveal ages, metallicities and velocity dispersions of the stellar populations. LEGA-C's unique combination of sample size and depth will enable us for the first time to map the stellar content at large lookback time, across galaxies of different types and star formation activity. Observations started in 2014 December and are planned to be completed by mid 2018, with early data releases of the spectra and value-added products. In this paper we present the science case, the observing strategy, an overview of the data reduction process and data products, and a first look at the relationship between galaxy structure and spectral properties, as it existed 7 Gyr ago

Tightly coupled morpho-kinematic evolution for massive star-forming and quiescent galaxies across 7Gyr of cosmic time

We use the Fundamental Plane (FP) to measure the redshift evolution of the dynamical mass-to-light ratio (Mdyn/L) and the dynamical-to-stellar mass ratio (Mdyn/M*). Although conventionally used to study the properties of early-type galaxies, we here obtain stellar kinematic measurements from the Large Early Galaxy Astrophysics Census span a wide (LEGA-C range ) in Survey star formation for a sample activity. of ∼ In 1400 line massive with previous (log(M studies, * M) > we 10.5 find ) galaxies a strong at evolution 0.6 < z in < M 1.0dynthat /Lg with redshift. In contrast, we find only a weak dependence of the mean value of Mdyn/M* on the specific star formation rate, and a redshift evolution that likely is explained by systematics. Therefore, we demonstrate that star-forming and quiescent galaxies lie on the same, stable mass FP across 0 < z < 1, and that the decrease in Mdyn/Lg toward high redshift can be attributed entirely to evolution of the stellar populations. Moreover, we show that the growth of galaxies in size and mass is constrained to occur within the mass FP. Our results imply either minimal structural evolution in massive galaxies since z ∼ 1, or a tight coupling in the evolution of their morphological and dynamical properties, and establish the mass FP as a tool for studying galaxy evolution with low impact from progenitor bias

Effects of acute variation of dialysate calcium concentrations on arterial stiffness and aortic pressure waveform

Background. Abnormal mineral metabolism in chronic kidney disease plays a critical role in vascular calcification and arterial stiffness. The impact of presently used dialysis calcium concentration (DCa) on arterial stiffness and aortic pressure waveform has never been studied. The aim of the present study is to evaluate, in haemodialysis (HD) patients, the impact of acute modification of DCa on arterial stiffness and central pulse wave profile (cPWP)

Host Genetic Factors and Vaccine-Induced Immunity to HBV Infection: Haplotype Analysis

Hepatitis B virus (HBV) infection remains a significant health burden world-wide, although vaccines help decrease this problem. We previously identified associations of single nucleotide polymorphisms in several candidate genes with vaccine-induced peak antibody level (anti-HBs), which is predictive of long-term vaccine efficacy and protection against infection and persistent carriage; here we report on a haplotype-based analysis. A total of 688 SNPs from 117 genes were examined for a two, three and four sliding window haplotype analysis in a Gambian cohort. Analysis was performed on 197 unrelated individuals, 454 individuals from 174 families, and the combined sample (N = 651). Global and individual haplotype association tests were carried out (adjusted for covariates), employing peak anti-HBs level as outcome. Five genes (CD44, CD58, CDC42, IL19 and IL1R1) had at least one significant haplotype in the unrelated or family analysis as well as the combined analysis. Previous single locus results were confirmed for CD44 (combined global p = 9.1×10−5 for rs353644-rs353630-rs7937602) and CD58 (combined global p = 0.008 for rs1414275-rs11588376-rs1016140). Haplotypes in CDC42, IL19 and IL1R1 also associated with peak anti-HBs level. We have identified strong haplotype effects on HBV vaccine-induced antibody level in five genes, three of which, CDC42, IL19 and IL1R1, did not show evidence of association in a single SNP analyses and corroborated the majority of these effects in two datasets. The haplotype analysis identified associations with HBV vaccine-induced immunity in several new genes