The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study.

BackgroundChronic kidney disease (CKD) may be common among individuals living in sub-Saharan Africa due to the confluence of CKD risk factors and genetic predisposition.MethodsWe ascertained the prevalence of CKD and its risk factors among a sample of 3,686 participants of a population-based HIV trial in rural Uganda and Kenya. Prevalent CKD was defined as a serum creatinine-based estimated glomerular filtration rate <60 mL/min/1.73m2 or proteinuria (urine dipstick ≥1+). We used inverse-weighting to estimate the population prevalence of CKD, and multivariable log-link Poisson models to assess the associations of potential risk factors with CKD.ResultsThe estimated CKD prevalence was 6.8% (95% CI 5.7-8.1%) overall and varied by region, being 12.5% (10.1-15.4%) in eastern Uganda, 3.9% (2.2-6.8%) in southwestern Uganda and 3.7% (2.7-5.1%) in western Kenya. Risk factors associated with greater CKD prevalence included age ≥60 years (adjusted prevalence ratio [aPR] 3.5 [95% CI 1.9-6.5] compared with age 18-29 years), HIV infection (aPR 1.6 [1.1-2.2]), and residence in eastern Uganda (aPR 3.9 [2.6-5.9]). However, two-thirds of individuals with CKD did not have HIV, diabetes, or hypertension as risk factors. Furthermore, we noted many individuals who did not have proteinuria had dipstick positive leukocyturia or hematuria.ConclusionThe prevalence of CKD is appreciable in rural East Africa and there are considerable regional differences. Conventional risk factors appear to only explain a minority of cases, and leukocyturia and hematuria were common, highlighting the need for further research into understanding the nature of CKD in sub-Saharan Africa

First order Mott transition at zero temperature in two dimensions: Variational plaquette study

The nature of the metal-insulator Mott transition at zero temperature has been discussed for a number of years. Whether it occurs through a quantum critical point or through a first order transition is expected to profoundly influence the nature of the finite temperature phase diagram. In this paper, we study the zero temperature Mott transition in the two-dimensional Hubbard model on the square lattice with the variational cluster approximation. This takes into account the influence of antiferromagnetic short-range correlations. By contrast to single-site dynamical mean-field theory, the transition turns out to be first order even at zero temperature.Comment: 6 pages, 5 figures, version 2 with additional results for 8 bath site

Lesion-symptom mapping corroborates lateralization of verbal and nonverbal memory processes and identifies distributed brain networks responsible for memory dysfunction

Memory disorders are a common consequence of cerebrovascular accident (CVA). However, uncertainties remain about the exact anatomical correlates of memory impairment and the material-specific lateralization of memory function in the brain. We used lesion-symptom mapping (LSM) in patients with first-time CVA to identify which brain structures are pivotal for verbal and nonverbal memory and to re-examine whether verbal and nonverbal memory functions are lateralized processes in the brain. The cognitive performance of a relatively large cohort of 114 patients in five classic episodic memory tests was analysed with factor analysis. Two factors were extracted that distinguished the verbal and nonverbal components of these memory tests, and their scores were subsequently tested for anatomical correlates by combining univariate and multivariate LSM. LSM analysis revealed for the verbal factor exclusively left-hemispheric insular, subcortical and adjacent white matter regions and for the nonverbal factor exclusively right-hemispheric temporal, occipital, insular, subcortical and adjacent white matter structures. These results corroborate the long-standing hypothesis of a material-specific lateralization of memory function in the brain and confirm a robust association between right temporal lobe lesions and nonverbal memory dysfunction. The right-hemispheric correlates for the nonverbal aspects of episodic memory include not only classic memory structures in the medial temporal lobe but also a more distributed network that includes cortical and subcortical structures also known for implicit memory processes

The Nucleon Anapole Moment and Parity-Violating ep Scattering

Parity-violating (PV) interactions among quarks in the nucleon induce a PV $\gamma NN$ coupling, or anapole moment (AM). We compute electroweak gauge-independent contributions to the AM through {\cal O}(1/\lamchis) in chiral perturbation theory. We estimate short-distance PV effects using resonance saturation. The AM contributions to PV electron-proton scattering slightly enhance the axial vector radiative corrections, R_A^p, over the scale implied by the Standard Model when weak quark-quark interactions are neglected. We estimate the theoretical uncertainty associated with the AM contributions to R_A^p to be large, and discuss the implications for the interpretation PV of ep scattering.Comment: RevTex 29 pages + 8 PS figures, references and discussions added, to appear in Phys. Rev.

Introduction to Configuration Path Integral Monte Carlo

In low-temperature high-density plasmas quantum effects of the electrons are becoming increasingly important. This requires the development of new theoretical and computational tools. Quantum Monte Carlo methods are among the most successful approaches to first-principle simulations of many-body quantum systems. In this chapter we present a recently developed method---the configuration path integral Monte Carlo (CPIMC) method for moderately coupled, highly degenerate fermions at finite temperatures. It is based on the second quantization representation of the $N$-particle density operator in a basis of (anti-)symmetrized $N$-particle states (configurations of occupation numbers) and allows to tread arbitrary pair interactions in a continuous space. We give a detailed description of the method and discuss the application to electrons or, more generally, Coulomb-interacting fermions. As a test case we consider a few quantum particles in a one-dimensional harmonic trap. Depending on the coupling parameter (ratio of the interaction energy to kinetic energy), the method strongly reduces the sign problem as compared to direct path integral Monte Carlo (DPIMC) simulations in the regime of strong degeneracy which is of particular importance for dense matter in laser plasmas or compact stars. In order to provide a self-contained introduction, the chapter includes a short introduction to Metropolis Monte Carlo methods and the second quantization of quantum mechanics.Comment: chapter in book "Introduction to Complex Plasmas: Scientific Challenges and Technological Opportunities", Michael Bonitz, K. Becker, J. Lopez and H. Thomsen (Eds.) Springer Series "Atomic, Optical and Plasma Physics", vol. 82, Springer 2014, pp. 153-194 ISBN: 978-3-319-05436-0 (Print) 978-3-319-05437-7 (Online

Cytokines as potential novel therapeutic targets in severe inflammatory cardiomyopathy

BACKGROUND: Despite currently available state-of-the art therapies, a substantial proportion of patients with inflammatory cardiomyopathy progresses to advanced heart failure. There is an urgent need for novel therapies to improve outcomes. We hypothesized that elevated cyto-kine levels in inflammatory cardiomyopathy may lead to cardiac injury and that specific cyto-kines are associated with severely decreased left ventricular function consequently, thereby suggesting their potential as therapeutic targets. METHODS AND RESULTS: Blood samples collected from 529 patients at 2 registries were inves-tigated. First, in a derivation cohort of inflammatory cardiomyopathy from our medical center (n=63), we discovered cytokines that correlate inversely with severely decreased left ventricu-lar ejection fraction (LVEF). We confirmed reproducibility of our results in an independent cohort from a national registry (n=425) and to some degree generalizability in a small cohort of idiopathic dilated cardiomyopathy (IDCM, n=41). In total, we identified 82 cytokines asso-ciated with severely decreased LVEF (FDR < 0.05); a small portion had been previously pro-posed as therapeutic targets, while others emerged as novel discoveries. Finally, real-world data from electronic medical records further indicated the potential of inhibitors targeting cy-tokines of interest to confer a cardioprotective effect. CONCLUSIONS: We identified 82 cytokines associated with severe inflammatory cardiomyopa-thy. Our data were highly significant, reproducible, and generalizable to IDCM. The fact that some of the cytokines had been suggested as potential targets in prior literature supports va-lidity and plausibility of our data. Given that inhibition of cytokines is technically feasible, the identified proteins are compelling potential novel therapeutic targets

FHIR-DHP: A standardized clinical data harmonisation pipeline for scalable AI application deployment

Background Increasing digitalisation in the medical domain gives rise to large amounts of healthcare data which has the potential to expand clinical knowledge and transform patient care if leveraged through artificial intelligence (AI). Yet, big data and AI oftentimes cannot unlock their full potential at scale, owing to non-standardised data formats, lack of technical and semantic data interoperability, and limited cooperation between stakeholders in the healthcare system. Despite the existence of standardised data formats for the medical domain, such as Fast Healthcare Interoperability Resources (FHIR), their prevalence and usability for AI remains limited.Objective We developed a data harmonisation pipeline (DHP) for clinical data sets relying on the common FHIR data standard.Methods We validated the performance and usability of our FHIR-DHP with data from the MIMIC IV database including > 40,000 patients admitted to an intensive care unit.Results We present the FHIR-DHP workflow in respect of transformation of “raw” hospital records into a harmonised, AI-friendly data representation. The pipeline consists of five key preprocessing steps: querying of data from hospital database, FHIR mapping, syntactic validation, transfer of harmonised data into the patient-model database and export of data in an AI-friendly format for further medical applications. A detailed example of FHIR-DHP execution was presented for clinical diagnoses records.Conclusions Our approach enables scalable and needs-driven data modelling of large and heterogenous clinical data sets. The FHIR-DHP is a pivotal step towards increasing cooperation, interoperability and quality of patient care in the clinical routine and for medical research

Studies of Bunch-bunch Interactions in the ANKA Storage Ring with Coherent Synchrotron Radiation using an Ultra-fast Terahertz Detection System

In the low-alpha operation mode of the ANKA synchrotron light source, coherent synchrotron radiation (CSR) is emitted from short electron bunches. Depending on the bunch current, the radiation shows bursts of high intensity. These bursts of high intensity THz radiation display a time evolution which can be observed only on long time scales with respect to the revolution period. In addition, long range wake fields can introduce a correlation between the bunches within a bunch train and thus modify the observed behaviour. A novel detection system consisting of an ultra-fast superconducting THz detector and data acquisition system was used to investigate correlations visible on the bursting pattern and to study the interactions of very short pulses in the ANKA storage ring

Nuclear Anapole Moments

Nuclear anapole moments are parity-odd, time-reversal-even E1 moments of the electromagnetic current operator. Although the existence of this moment was recognized theoretically soon after the discovery of parity nonconservation (PNC), its experimental isolation was achieved only recently, when a new level of precision was reached in a measurement of the hyperfine dependence of atomic PNC in 133Cs. An important anapole moment bound in 205Tl also exists. In this paper, we present the details of the first calculation of these anapole moments in the framework commonly used in other studies of hadronic PNC, a meson exchange potential that includes long-range pion exchange and enough degrees of freedom to describe the five independent $S-P$ amplitudes induced by short-range interactions. The resulting contributions of pi-, rho-, and omega-exchange to the single-nucleon anapole moment, to parity admixtures in the nuclear ground state, and to PNC exchange currents are evaluated, using configuration-mixed shell-model wave functions. The experimental anapole moment constraints on the PNC meson-nucleon coupling constants are derived and compared with those from other tests of the hadronic weak interaction. While the bounds obtained from the anapole moment results are consistent with the broad ``reasonable ranges'' defined by theory, they are not in good agreement with the constraints from the other experiments. We explore possible explanations for the discrepancy and comment on the potential importance of new experiments.Comment: 53 pages; 10 figures; revtex; submitted to Phys Rev