Evaluation of cystatin C for the detection of chronic kidney disease in cats

BackgroundSerum cystatin C (sCysC) and urinary cystatin C (uCysC) are potential biomarkers for early detection of chronic kidney disease (CKD) in cats. An in-depth clinical validation is required. ObjectivesTo evaluate CysC as a marker for CKD in cats and to compare assay performance of the turbidimetric assay (PETIA) with the previously validated nephelometric assay (PENIA). AnimalsNinety cats were included: 49 CKD and 41 healthy cats. MethodsSerum CysC and uCysC concentrations were prospectively evaluated in cats with CKD and healthy cats. Based on plasma exo-iohexol clearance test (PexICT), sCysC was evaluated to distinguish normal, borderline, and low GFR. Sensitivity and specificity to detect PexICT<1.7mL/min/kg were calculated. Serum CysC results of PENIA and PETIA were correlated with GFR. Statistical analysis was performed using general linear modeling. ResultsCats with CKD had significantly higher meanSD sCysC (1.4 +/- 0.5mg/L) (P<.001) and uCysC/urinary creatinine (uCr) (291 +/- 411mg/mol) (P<.001) compared to healthy cats (sCysC 1.0 +/- 0.3 and uCysC/uCr 0.32 +/- 0.97). UCysC was detected in 35/49 CKD cats. R-2 values between GFR and sCysC or sCr were 0.39 and 0.71, respectively (sCysC or sCr=+GFR+epsilon). Sensitivity and specificity were 22 and 100% for sCysC and 83 and 93% for sCr. Serum CysC could not distinguish healthy from CKD cats, nor normal from borderline or low GFR, in contrast with sCr. ConclusionSerum CysC is not a reliable marker of reduced GFR in cats and uCysC could not be detected in all CKD cats

Hypergraphic LP Relaxations for Steiner Trees

We investigate hypergraphic LP relaxations for the Steiner tree problem, primarily the partition LP relaxation introduced by Koenemann et al. [Math. Programming, 2009]. Specifically, we are interested in proving upper bounds on the integrality gap of this LP, and studying its relation to other linear relaxations. Our results are the following. Structural results: We extend the technique of uncrossing, usually applied to families of sets, to families of partitions. As a consequence we show that any basic feasible solution to the partition LP formulation has sparse support. Although the number of variables could be exponential, the number of positive variables is at most the number of terminals. Relations with other relaxations: We show the equivalence of the partition LP relaxation with other known hypergraphic relaxations. We also show that these hypergraphic relaxations are equivalent to the well studied bidirected cut relaxation, if the instance is quasibipartite. Integrality gap upper bounds: We show an upper bound of sqrt(3) ~ 1.729 on the integrality gap of these hypergraph relaxations in general graphs. In the special case of uniformly quasibipartite instances, we show an improved upper bound of 73/60 ~ 1.216. By our equivalence theorem, the latter result implies an improved upper bound for the bidirected cut relaxation as well.Comment: Revised full version; a shorter version will appear at IPCO 2010

Cardiovascular-renal axis disorders in the domestic dog and cat: a veterinary consensus statement

OBJECTIVES There is a growing understanding of the complexity of interplay between renal and cardiovascular systems in both health and disease. The medical profession has adopted the term "cardiorenal syndrome" (CRS) to describe the pathophysiological relationship between the kidney and heart in disease. CRS has yet to be formally defined and described by the veterinary profession and its existence and importance in dogs and cats warrant investigation. The CRS Consensus Group, comprising nine veterinary cardiologists and seven nephrologists from Europe and North America, sought to achieve consensus around the definition, pathophysiology, diagnosis and management of dogs and cats with "cardiovascular-renal disorders" (CvRD). To this end, the Delphi formal methodology for defining/building consensus and defining guidelines was utilised. METHODS Following a literature review, 13 candidate statements regarding CvRD in dogs and cats were tested for consensus, using a modified Delphi method. As a new area of interest, well-designed studies, specific to CRS/CvRD, are lacking, particularly in dogs and cats. Hence, while scientific justification of all the recommendations was sought and used when available, recommendations were largely reliant on theory, expert opinion, small clinical studies and extrapolation from data derived from other species. RESULTS Of the 13 statements, 11 achieved consensus and 2 did not. The modified Delphi approach worked well to achieve consensus in an objective manner and to develop initial guidelines for CvRD. DISCUSSION The resultant manuscript describes consensus statements for the definition, classification, diagnosis and management strategies for veterinary patients with CvRD, with an emphasis on the pathological interplay between the two organ systems. By formulating consensus statements regarding CvRD in veterinary medicine, the authors hope to stimulate interest in and advancement of the understanding and management of CvRD in dogs and cats. The use of a formalised method for consensus and guideline development should be considered for other topics in veterinary medicine

A review of phosphorus homeostasis and the impact of different types and amounts of dietary phosphate on metabolism and renal health in cats

Elevated concentrations of serum phosphate are linked with progression and increased case fatality rate in animals and humans with chronic kidney disease. Elevated concentrations of serum phosphate can be a risk factor for development of renal and cardiovascular diseases or osteoporosis in previously healthy people. In rodents, an excess intake of dietary phosphorus combined with an inverse dietary calcium : phosphorus ratio (<1 : 1) contributes to renal calcification. Renal injury also has occured in cats fed experimental diets supplemented with highly soluble phosphate salts, especially in diets with inverse calcium : phosphorus ratios. However, not all phosphorus sources contribute similarly to this effect. This review, which focuses on cats, summarizes the published evidence regarding phosphorus metabolism and homeostasis, including the relative impact of different dietary phosphorus sources, and their impact on the kidneys. No data currently shows that commercial cat foods induce renal injury. However, some diets contain high amounts of phosphorus relative to recommendations and some have inverse Ca : P ratios and so could increase the risk for development of kidney disease. While limiting the use of highly soluble phosphates appears to be important, there are insufficient data to support a specific upper limit for phosphate intake. This review also proposes areas where additional research is needed in order to strengthen conclusions and recommendations regarding dietary phosphorus for cats

Surface stress and lattice dynamics in oxide ultrathin films

The lattice misfit between the substrate and an epitaxial film leads in general to static forces, which define the interface stress, and dynamic responses that modify the thin-film lattice dynamics. Although these are both fundamental concepts that are important for film growth and thin-film properties, they have not been investigated in a combined way so far. Therefore, herein, surface stress experiments in combination with surface phonon studies for three different, cubic oxide ultrathin film systems are reviewed. Within the class of binary oxides, NiO(001) grown on Ag(001) is chosen, which exhibits a -2.2% lattice mismatch, and BaO(001) on Pt(001), a system with a negligible lattice mismatch. For the ternary oxides, perovskite thin films of BaTiO3 grown epitaxially on Pt(001) with a lattice mismatch of -2.3% are focused upon. The surface stress experiments are conducted with an optical two-beam curvature technique under in situ growth conditions. Surface and thin-film phonons are determined by high-resolution electron energy loss spectroscopy. Surface stress and lattice dynamics are discussed in the range from the oxide monolayer to thin films of about 20 unit cell in thickness

Energy spectra of the ocean's internal wave field: theory and observations

The high-frequency limit of the Garrett and Munk spectrum of internal waves in the ocean and the observed deviations from it are shown to form a pattern consistent with the predictions of wave turbulence theory. In particular, the high frequency limit of the Garrett and Munk spectrum constitutes an {\it exact} steady state solution of the corresponding kinetic equation.Comment: 4 pages, one color figur

Modification of turbulent dissipation rates by a deep Southern Ocean eddy

The impact of a mesoscale eddy on the magnitude and spatial distribution of diapycnal ocean mixing is investigated using a set of hydrographic and microstructure measurements collected in the Southern Ocean. These data sampled a baroclinic, mid-depth eddy formed during the disintegration of a deep boundary current. Turbulent dissipation is suppressed within the eddy, but is elevated by up to an order of magnitude along the upper and lower eddy boundaries. A ray-tracing approximation is employed asa heuristic device to elucidate how the internal wave field evolves in the ambient velocity and stratification conditions accompanying the eddy. These calculations are consistent with the observations, suggesting reflection of internal wave energy from the eddy center and enhanced breaking through critical layer processes along the eddy boundaries. These results have important implications for understanding where and how internal wave energy is dissipated in the presence of energetic deep geostrophic flows