Investigation into cardiac sympathetic innervation during the commencement of haemodialysis in patients with chronic kidney disease

Background: Patients with chronic kidney disease (CKD) who undergo chronic haemodialysis (HD) show altered sympathetic tone, which is related to a higher cardiovascular mortality. The purpose of this study was to investigate the effect of transition from pre-HD to HD on cardiac sympathetic innervation. Methods: Eighteen patients aged 58 ± 18 years (mean ± standard deviation [SD]), 13 males and five females, with stage 5 CKD and nine healthy control subjects aged 52 ± 17 (mean ± SD), three males and six females, were included in this prospective study between May 2010 and December 2013. All patients underwent 123I-labelled meta-iodobenzylguanidine (123I-MIBG) scintigraphy for cardiac sympathetic innervation and electrocardiographically gated adenosine stress and rest 99mTc-labelled tetrofosmin single-photon emission computed tomography for myocardial perfusion imaging prior to (pre-HD) and 6 months after the start of HD. Results of 123I-MIBG scans in patients were compared to controls. Impaired cardiac sympathetic innervation was defined as late heart-to-mediastinum ratio (HMR) < 2.0. Results: Mean late HMR was lower in patients during HD (2.3) than in controls (2.9) (p = 0.035); however, in patients it did not differ between pre-HD and after the start of HD. During HD, two patients showed new sympathetic innervation abnormalities, and in three patients innervation abnormalities seemed to coincide with myocardial perfusion abnormalities. Conclusions: CKD patients show cardiac sympathetic innervation abnormalities, which do not seem to progress during the maintenance HD. The relationship between sympathetic innervation abnormalities and myocardial perfusion abnormalities in HD patients needs further exploration

An intensity-based LIF measurement technique to quantify film thicknesses in the air gap of an electric motor with direct liquid cooling

The air gap of an optically accessible model of a directly cooled radial flux electric motor is investigated using laser-induced fluorescence (LIF). The cooling oil enters the air gap and a film forms on the stator surface, which resembles a thin film in a shear flow. The flow phenomena at different rotational speeds (2000 rpm to 10,000 rpm) are described. An intensity-based LIF measurement technique is developed and used to measure the film thickness on the stator in a realistic air gap environment. The rotational speed influences the flow phenomena and the film thickness of the stator film. With increasing rotational speed, i.e., increasing gas Reynolds number, the film thickness probability density functions (PDFs) shift to lower film thicknesses and become narrower, which is in agreement with the characteristic behavior of films in shear flows as reported in the literature. Additionally, the velocities of the wave crests which move across the film surface are evaluated and used to calculate the film Reynolds number ReF, which characterizes the investigated operating points

Cholecystectomy Risk in Crohn’s Disease Patients After Ileal Resection: a Long-term Nationwide Cohort Study

Background: The risk of gallstone disease necessitating cholecystectomy after ileal resection (IR) in Crohn’s disease (CD) patients is not well established. We studied the incidence, cumulative and relative risk of cholecystectomy after IR in CD patients, and associated risk factors. Methods: CD patients with a first IR between 1991 and 2015 were identified in PALGA, a nationwide pathology database in the Netherlands. Details on subsequent cholecystectomy and IR were recorded. Yearly cholecystectomy rates from the general Dutch population were used as a reference. Results: A cohort of 8302 (3466 (41.7%) males) CD patients after IR was identified. During the 11.9 (IQR 6.3–18.0) years median follow-up, the post-IR incidence rate of cholecystectomy was 5.2 (95% CI 3.5–6.4)/1000 persons/year. The cumulative incidence was 0.5% at 1 year, 2.4% at 5 years, 4.6% at 10 years, and 10.3% after 20 years. In multivariable analyses, female sex (HR 1.9, CI 1.5–2.3), a later calendar year of first IR (HR/5-year increase, HR 1.27, CI 1.18–1.35), and ileal re-resection (time-dependent HR 1.37, CI 1.06–1.77) were associated with cholecystectomy. In the last decade, cholecystectomy rates increased and were higher in our postoperative CD population than in the general population (relative incidence ratio 3.13 (CI 2.29–4.28; p < 0.0001) in 2015). Conclusions: Although higher in females, increasing in recent years, and higher than in the general population, the overall risk of cholecystectomy in CD patients following IR is low and routine prophylactic measures seem unwarranted

Disease burden in primary sclerosing cholangitis in the Netherlands: A long-term follow-up study

Background & Aims: Primary sclerosing cholangitis (PSC) is a progressive, cholestatic liver disease which greatly impacts the lives of individuals. Burden of disease due to shortened life expectancy and impaired quality of life is ill-described. The aim of this study was to assess long-term disease burden in a large population-based registry with regard to survival, clinical course, quality adjusted life years (QALYs), medical consumption and work productivity loss.Methods: All PSC patients living in a geographically defined area covering similar to 50% of the Netherlands were included, together with patients from the three liver transplant centres. Survival was estimated by competing risk analysis. Proportional shortfall of QALYs during disease course was measured relative to a matched reference cohort using validated questionnaires. Work productivity loss and medical consumption were evaluated over time.Results: A total of 1208 patients were included with a median follow-up of 11.2 year. Median liver transplant-free survival was 21.0 years. Proportional shortfall of QALYs increased to 48% >25 years after diagnosis. Patients had on average 12.4 hospital contact days among which 3.17 admission days per year, annual medical costs were (sic)12 169 and mean work productivity loss was 25%.Conclusions: Our data quantify for the first time disease burden in terms of QALYs lost, clinical events, medical consumption, costs as well as work productivity loss, and show that all these are substantial and increase over time.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Disease burden in primary sclerosing cholangitis in the Netherlands: A long-term follow-up study

Background & Aims: Primary sclerosing cholangitis (PSC) is a progressive, cholestatic liver disease which greatly impacts the lives of individuals. Burden of disease due to shortened life expectancy and impaired quality of life is ill-described. The aim of this study was to assess long-term disease burden in a large population-based registry with regard to survival, clinical course, quality adjusted life years (QALYs), medical consumption and work productivity loss. Methods: All PSC patients living in a geographically defined area covering ~50% of the Netherlands were included, together with patients from the three liver transplant centres. Survival was estimated by competing risk analysis. Proportional shortfall of QALYs during disease course was measured relative to a matched reference cohort using validated questionnaires. Work productivity loss and medical consumption were evaluated over time. Results: A total of 1208 patients were included with a median follow-up of 11.2 year. Median liver transplant-free survival was 21.0 years. Proportional shortfall of QALYs increased to 48% >25 years after diagnosis. Patients had on average 12.4 hospital contact days among which 3.17 admission days per year, annual medical costs were €12 169 and mean work productivity loss was 25%. Conclusions: Our data quantify for the first time disease burden in terms of QALYs lost, clinical events, medical consumption, costs as well as work productivity loss, and show that all these are substantial and increase over time

Increasing Hybridization Rate and Sensitivity of Bead-Based Assays Using Isotachophoresis

マイクロ流体技術を用いた網羅的・高速DNA分析技術の開発に成功 -網羅的・短時間・高感度のバイオマーカ検出技術の確立に期待-. 京都大学プレスリリース. 2014-10-15.We present an electrokinetic technique to increase the reaction rate and sensitivity of bead-based assays. We use isotachophoresis (ITP) to preconcentrate and co-focus target molecules and beads into a single ITP zone. The process achieves rapid mixing, stirring, and strongly increases the binding reaction rate. We demonstrate our assay with quantitative detection of 24 nt single-stranded DNA over a dynamic range of three orders of magnitude and multiplexed detection of ten target species per sample. We show that ITP can achieve approximately the same sensitivity as a well-stirred standard reaction in 60-fold reduced reaction time (20 min versus 20 h). Alternately, compared to standard reaction times of 30 min, we show that 20 min ITP hybridization can achieve 5.3-fold higher sensitivity

Between Apathy and Anger: Challenges to the Union from the 2014 Elections to the European Parliament. EPIN [Working] Paper No. 39, 20 May 2014

This EPIN study brings together contributions from a ​broad selection of member states ​and ​provid​es ​insightful analysis ​into the 2014 elections to the European Parliament on the ground. The report reveals the different factors that impede the development of genuine European elections and the consequences of the ballot in the member states covered by the study​, namely Bulgaria, Finland, France, Germany, Greece, Italy, the Netherlands, Poland, Romania, Spain and the UK​,​ and at EU level. The report finds that: • The EP Resolution to encourage European parties to nominate candidates for the next Commission President has not really increased public interest in the EU and voter turnout will probably remain low. • Visibility of the European top candidates in most member states has been quite limited. • National manifestos do not coincide – and sometimes event conflict with – the European parties’ manifestos. • Election debates focus on national issues; EU issues are only brought to public debate when they are relevant for domestic politics. • Again, we will see a protest vote against governments and large parties. The EP elections are still perceived as a test ahead of local and national elections, or as a vote of confidence in national governments. • This year the protest vote also concerns the EU. The report predicts a more eurosceptic ballot that might complicate decision-making in the EU, exacerbate the conflict between the national and European levels and increase tensions among member states

Simplicity kreasi busana seprai

67 p. : il.; 30 c