The impact of nocturnal hemodialysis on sexual function

BACKGROUND: Sexual dysfunction is common in patients with end stage renal disease (ESRD) and treatment options are limited. Observational studies suggest that nocturnal hemodialysis may improve sexual function. We compared sexual activity and responses to sexual related questions in the Kidney Disease Quality of Life Short Form questionnaire among patients randomized to frequent nocturnal or thrice weekly conventional hemodialysis. METHODS: We performed a secondary analysis of data from an RCT which enrolled 51 patients comparing frequent nocturnal and conventional thrice weekly hemodialysis. Sexual activity and responses to sexual related questions were assessed at baseline and six months using relevant questions from the Kidney Disease Quality of Life Short Form questionnaire. RESULTS: Overall, there was no difference in sexual activity, or the extent to which people were bothered by the impact of kidney disease on their sex life between the two groups between randomization and 6 months. However, women and patients age < 60 who were randomized to frequent nocturnal hemodialysis were less bothered by the impact of kidney disease on their sex life at 6 months, compared with patients allocated to conventional hemodialysis (p = 0.005 and p = 0.024 respectively). CONCLUSIONS: Our results suggest that frequent nocturnal hemodialysis is not associated with an improvement in sexual activity in all patients but might have an effect on the burden of kidney disease on sex life in women and patients less than 60 years of age. The validity of these subgroup findings require confirmation in future RCTs

Cavidades de uso funerario durante el Neolítico final/Calcolítico en el territorio valenciano: trabajos arqueológicos en Avenc Dels Dos Forats o Cova del Monedero (Carcaixent, Valencia)

Presentamos en este trabajo los resultados de la intervención arqueológica de urgencia efectuada en la cavidad de Avenc dels Dos Forats o Cova del Monedero (Carcaixent, Valencia) a finales del verano de 2008. Noticias preliminares informaban de la existencia de restos humanos y elementos de ajuar que indicaban un uso funerario de este espacio al menos desde el Neolítico final/Calcolítico. Con la presente actuación hemos podido dilucidar el grado de conservación del depósito arqueológico a la vez que esbozar la diacronía, características y orientación funcional de las ocupaciones prehistóricas e históricas

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Objectives: Left ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants. Methods: Between 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF. Results: There were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival. Conclusions: Without radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF

Schizophrenia, recovery and the self: An introduction to the special issue on metacognition

In this special issue, work is presented linking metacognition among persons with schizophrenia with a range of psychosocial outcomes including vocational functioning, empathy, motivation, self-evaluation, and other cognitive functions. This overview will highlight how these works allow for the quantitative study of processes which underpin alterations in self-experience in schizophrenia, which in turn allows self-experience to be studied as part of a larger set of brain-based and social phenomena whose interaction influences the trajectory of one's life and illness. We explore the hypothesis that metacognitive capacity, as a node in a larger biopsychosocial network, may be accessible by psychosocial treatment and, if successfully targeted, may disrupt the processes which perpetuate disability. Limitations and directions for future research are also discussed

Closely related fungi employ diverse enzymatic strategies to degrade plant biomass

Background Plant biomass is the major substrate for the production of biofuels and biochemicals, as well as food, textiles and other products. It is also the major carbon source for many fungi and enzymes of these fungi are essential for the depolymerization of plant polysaccharides in industrial processes. This is a highly complex process that involves a large number of extracellular enzymes as well as non-hydrolytic proteins, whose production in fungi is controlled by a set of transcriptional regulators. Aspergillus species form one of the best studied fungal genera in this field, and several species are used for the production of commercial enzyme cocktails. Results It is often assumed that related fungi use similar enzymatic approaches to degrade plant polysaccharides. In this study we have compared the genomic content and the enzymes produced by eight Aspergilli for the degradation of plant biomass. All tested Aspergilli have a similar genomic potential to degrade plant biomass, with the exception of A. clavatus that has a strongly reduced pectinolytic ability. Despite this similar genomic potential their approaches to degrade plant biomass differ markedly in the overall activities as well as the specific enzymes they employ. While many of the genes have orthologs in (nearly) all tested species, only very few of the corresponding enzymes are produced by all species during growth on wheat bran or sugar beet pulp. In addition, significant differences were observed between the enzyme sets produced on these feedstocks, largely correlating with their polysaccharide composition. Conclusions These data demonstrate that Aspergillus species and possibly also other related fungi employ significantly different approaches to degrade plant biomass. This makes sense from an ecological perspective where mixed populations of fungi together degrade plant biomass. The results of this study indicate that combining the approaches from different species could result in improved enzyme mixtures for industrial applications, in particular saccharification of plant biomass for biofuel production. Such an approach may result in a much better improvement of saccharification efficiency than adding specific enzymes to the mixture of a single fungus, which is currently the most common approach used in biotechnology.Peer reviewe

Micromechanical Properties of Injection-Molded Starch–Wood Particle Composites

The micromechanical properties of injection molded starch–wood particle composites were investigated as a function of particle content and humidity conditions. The composite materials were characterized by scanning electron microscopy and X-ray diffraction methods. The microhardness of the composites was shown to increase notably with the concentration of the wood particles. In addition,creep behavior under the indenter and temperature dependence were evaluated in terms of the independent contribution of the starch matrix and the wood microparticles to the hardness value. The influence of drying time on the density and weight uptake of the injection-molded composites was highlighted. The results revealed the role of the mechanism of water evaporation, showing that the dependence of water uptake and temperature was greater for the starch–wood composites than for the pure starch sample. Experiments performed during the drying process at 70°C indicated that the wood in the starch composites did not prevent water loss from the samples.Peer reviewe

Wildfire and Abrupt Ecosystem Disruption on California\u27s Northern Channel Islands at the Allerod-Younger Dryas Boundary (13.0-12.9 ka)

Sedimentary records from California\u27s Northern Channel Islands and the adjacent Santa Barbara Basin (SBB) indicate intense regional biomass burning (wildfire) at the Ållerød–Younger Dryas boundary (~13.0–12.9 ka) (All age ranges in this paper are expressed in thousands of calendar years before present [ka]. Radiocarbon ages will be identified and clearly marked “14C years”.). Multiproxy records in SBB Ocean Drilling Project (ODP) Site 893 indicate that these wildfires coincided with the onset of regional cooling and an abrupt vegetational shift from closed montane forest to more open habitats. Abrupt ecosystem disruption is evident on the Northern Channel Islands at the Ållerød–Younger Dryas boundary with the onset of biomass burning and resulting mass sediment wasting of the landscape. These wildfires coincide with the extinction of Mammuthus exilis [pygmy mammoth]. The earliest evidence for human presence on these islands at 13.1–12.9 ka (~11,000–10,900 14C years) is followed by an apparent 600–800 year gap in the archaeological record, which is followed by indications of a larger-scale colonization after 12.2 ka. Although a number of processes could have contributed to a post 18 ka decline in M. exilis populations (e.g., reduction of habitat due to sea-level rise and human exploitation of limited insular populations), we argue that the ultimate demise of M. exilis was more likely a result of continental scale ecosystem disruption that registered across North America at the onset of the Younger Dryas cooling episode, contemporaneous with the extinction of other megafaunal taxa. Evidence for ecosystem disruption at 13–12.9 ka on these offshore islands is consistent with the Younger Dryas boundary cosmic impact hypothesis [Firestone, R.B., West, A., Kennett, J.P., Becker, L., Bunch, T.E., Revay, Z.S., Schultz, P.H., Belgya, T., Kennett, D.J., Erlandson, J.M., Dickenson, O.J., Goodyear, A.A., Harris, R.S., Howard, G.A., Kloosterman, J.B., Lechler, P., Mayewski, P.A., Montgomery, J., Poreda, R., Darrah, T., Que Hee, S.S., Smith, A.R., Stich, A., Topping, W., Wittke, J.H. Wolbach, W.S., 2007. Evidence for an extraterrestrial impact 12,900 years ago that contributed to the megafaunal extinctions and Younger Dryas cooling. Proceedings of the National Academy of Sciences 104, 16016–16021.]

Association between routine and standardized blood pressure measurements and left ventricular hypertrophy among patients on hemodialysis

<p>Abstract</p> <p>Background</p> <p>Left ventricular (LV) hypertrophy is common among patients on hemodialysis. While a relationship between blood pressure (BP) and LV hypertrophy has been established, it is unclear which BP measurement method is the strongest correlate of LV hypertrophy. We sought to determine agreement between various blood pressure measurement methods, as well as identify which method was the strongest correlate of LV hypertrophy among patients on hemodialysis.</p> <p>Methods</p> <p>This was a post-hoc analysis of data from a randomized controlled trial. We evaluated the agreement between seven BP measurement methods: standardized measurement at baseline; single pre- and post-dialysis, as well as mean intra-dialytic measurement at baseline; and cumulative pre-, intra- and post-dialysis readings (an average of 12 monthly readings based on a single day per month). Agreement was assessed using Lin's concordance correlation coefficient (CCC) and the Bland Altman method. Association between BP measurement method and LV hypertrophy on baseline cardiac MRI was determined using receiver operating characteristic curves and area under the curve (AUC).</p> <p>Results</p> <p>Agreement between BP measurement methods in the 39 patients on hemodialysis varied considerably, from a CCC of 0.35 to 0.94, with overlapping 95% confidence intervals. Pre-dialysis measurements were the weakest predictors of LV hypertrophy while standardized, post- and inter-dialytic measurements had similar and strong (AUC 0.79 to 0.80) predictive power for LV hypertrophy.</p> <p>Conclusions</p> <p>A single standardized BP has strong predictive power for LV hypertrophy and performs just as well as more resource intensive cumulative measurements, whereas pre-dialysis blood pressure measurements have the weakest predictive power for LV hypertrophy. Current guidelines, which recommend using pre-dialysis measurements, should be revisited to confirm these results.</p