Long-term lithium treatment in bipolar disorder. effects on glomerular filtration rate and other metabolic parameters

.BACKGROUND: Concerns about potential adverse effects of long-term exposure to lithium as a mood-stabilizing treatment notably include altered renal function. However, the incidence of severe renal dysfunction; rate of decline over time; effects of lithium dose, serum concentration, and duration of treatment; relative effects of lithium exposure vs. aging; and contributions of sex and other factors all remain unclear. METHODS: Accordingly, we acquired data from 12 collaborating international sites and 312 bipolar disorder patients (6142 person-years, 2669 assays) treated with lithium carbonate for 8-48 (mean 18) years and aged 20-89 (mean 56) years. We evaluated changes of estimated glomerular filtration rate (eGFR) as well as serum creatinine, urea-nitrogen, and glucose concentrations, white blood cell count, and body-mass index, and tested associations of eGFR with selected factors, using standard bivariate contrasts and regression modeling. RESULTS: Overall, 29.5% of subjects experienced at least one low value of eGFR ( 55; risk of ≥2 low values was 18.1%; none experienced end-stage renal failure. eGFR declined by 0.71%/year of age and 0.92%/year of treatment, both by 19% more among women than men. Mean serum creatinine increased from 0.87 to 1.17 mg/dL, BUN from 23.7 to 33.1 mg/dL, glucose from 88 to 122 mg/dL, and BMI from 25.9 to 26.6 kg/m2. By multivariate regression, risk factors for declining eGFR ranked: longer lithium treatment, lower lithium dose, higher serum lithium concentration, older age, and medical comorbidity. Later low eGFR was also predicted by lower initial eGFR, and starting lithium at age ≥ 40 years. LIMITATIONS: Control data for age-matched subjects not exposed to lithium were lacking. CONCLUSIONS: Long-term lithium treatment was associated with gradual decline of renal functioning (eGFR) by about 30% more than that was associated with aging alone. Risk of subnormal eGFR was from 18.1% (≥2 low values) to 29.5% (≥1 low value), requiring about 30 years of exposure. Additional risk factors for low eGFR were higher serum lithium level, longer lithium treatment, lower initial eGFR, and medical comorbidity, as well as older age

The Nature of Starbursts : II. The Duration of Starbursts in Dwarf Galaxies

The starburst phenomenon can shape the evolution of the host galaxy and the surrounding intergalactic medium. The extent of the evolutionary impact is partly determined by the duration of the starburst, which has a direct correlation with both the amount of stellar feedback and the development of galactic winds, particularly for smaller mass dwarf systems. We measure the duration of starbursts in twenty nearby, ongoing, and "fossil" starbursts in dwarf galaxies based on the recent star formation histories derived from resolved stellar population data obtained with the Hubble Space Telescope. Contrary to the shorter times of 3-10 Myr often cited, the starburst durations we measure range from 450 - 650 Myr in fifteen of the dwarf galaxies and up to 1.3 Gyr in four galaxies; these longer durations are comparable to or longer than the dynamical timescales for each system. The same feedback from massive stars that may quench the flickering SF does not disrupt the overall burst event in our sample of galaxies. While five galaxies present fossil bursts, fifteen galaxies show ongoing bursts and thus the final durations may be longer than we report here for these systems. One galaxy shows a burst that has been ongoing for only 20 Myr; we are likely seeing the beginning of a burst event in this system. Using the duration of the starbursts, we calculate that the bursts deposited 10^(53.9)-10^(57.2) ergs of energy into the interstellar medium through stellar winds and supernovae and produced 3%-26% of the host galaxy's mass.Comment: 28 pages, 4 figure

Evidence of association of the NLRP1 gene with giant cell arteritis

Recent studies have focused attention on the involvement of NLRP1 to confer susceptibility for extended autoimmune/inflammatory disorders, being considered a common risk factor in autoimmunity. NLRP1 provides a scaffold for the assembly of the inflammasome that activates caspases 1 and 5, required for processing and activation of the proinflammatory cytokines interleukin 1β (IL-1β), IL-18 and IL-33 and promoting inflammation

Enabling low-carbon development in poor countries

The challenges associated with achieving sustainable development goals and stabilizing the world’s climate cannot be solved without significant efforts by developing and newly-emerging countries. With respect to climate change mitigation, the main challenge for developing countries lies in avoiding future emissions and lock-ins into emission-intensive technologies, rather than reducing today’s emissions. While first best policy instruments like carbon prices could prevent increasing carbonization, those policies are often rejected by developing countries out of a concern for negative repercussions on development and long-term growth. In addition, policy environments in developing countries impose particular challenges for regulatory policy aiming to incentivize climate change mitigation and sustainable development. This chapter first discusses how climate policy could potentially interact with sustainable development and economic growth. It focuses, in particular, on the role of industrial sector development. The chapter then continues by discussing how effective policy could be designed, specifically taking developing country circumstances into account

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Climate change and its influence on water systems increases the cost of electricity system decarbonization

The electric sector simultaneously faces two challenges: decarbonization to mitigate, and adaptation to manage, the impacts of climate change. In many regions, these challenges are compounded by an interdependence of electricity and water systems, with water needed for hydropower generation and electricity for water provision. Here, we couple detailed water and electricity system models to evaluate how the Western Interconnection grid can both adapt to climate change and develop carbon-free generation by 2050, while accounting for interactions and climate vulnerabilities of the water sector. We find that by 2050, due to climate change, annual regional electricity use could grow by up to 2% from cooling and water-related electricity demand, while total annual hydropower generation could decrease by up to 23%. To adapt, we show that the region may need to build up to 139 GW of additional generating capacity between 2030 and 2050, equivalent to nearly thrice California's peak demand, and could incur up to $150 billion (+7%) in extra costs

Identifying metabolic pathways for production of extracellular polymeric substances by the diatom Fragilariopsis cylindrus inhabiting sea ice

Diatoms are significant primary producers in sea ice, an ephemeral habitat with steep vertical gradients of temperature and salinity characterizing the ice matrix environment. To cope with the variable and challenging conditions, sea ice diatoms produce polysaccharide-rich extracellular polymeric substances (EPS) that play important roles in adhesion, cell protection, ligand binding and as organic carbon sources. Significant differences in EPS concentrations and chemical composition corresponding to temperature and salinity gradients were present in sea ice from the Weddell Sea and Eastern Antarctic regions of the Southern Ocean. To reconstruct the first metabolic pathway for EPS production in diatoms, we exposed Fragilariopsis cylindrus, a key bi-polar diatom species, to simulated sea ice formation. Transcriptome profiling under varying conditions of EPS production identified a significant number of genes and divergent alleles. Their complex differential expression patterns under simulated sea ice formation was aligned with physiological and biochemical properties of the cells, and with field measurements of sea ice EPS characteristics. Thus, the molecular complexity of the EPS pathway suggests metabolic plasticity in F. cylindrus is required to cope with the challenging conditions of the highly variable and extreme sea ice habitat

A Parallel Evolutionary Algorithm to Optimize Dynamic Data Types in Embedded Systems

New multimedia embedded applications are increasingly dynamic, and rely on dynamically-allocated data types (DDTs) to store their data. The optimization of DDTs for each target embedded system is a time-consuming process due to the large searching space of possible DDTs implementations. That implies the minimization of embedded design variables (memory accesses, power consumption and memory usage). Up to know, some very effective heuristic algorithms have been developed in order to solve this problem, but it is unknown how good the selected DDTs are since the problem is NP-complete and cannot be fully explored. In these cases the use of parallel processing can be very useful because it allows not only to explore more solutions spending the same time, but also to implement new algorithms. This paper describes several parallel evolutionary algorithms for DDTs optimization in Embedded Systems, where parallelism improves the solutions found by the corresponding sequential algorithm, which indeed is quite effective compared with other previously proposed procedures. Experimental results show how a novel parallel multi-objective genetic algorithm, which combines NSGA-II and SPEA2, allows designers to reach a larger number of solutions than previous approximations