Soil diversity under semi-natural grassland within the forest-steppe zone - examples from Transylvania (Romania)

In the Transylvanian Basin, extensively managed hay meadows with a particular biodiversity could survive until today. Under a temperate-continental climate of the forest steppe and within the colline zone, they are situated on north-facing slopes with an erratic ondulated relief, dominated by small slumpings. A mosaic of different site conditions is illustrated by a patchy distribution of wet meadow, dry- and semi-dry grassland sites. However, little is still known about the edaphic properties of these ecosystems. Precise pedological studies, even less entire soil sequences, are nonexistent. Therefore, the presented findings are a first approach to outline the distribution of different soil types under such semi-natural grasslands. As preliminary results, they are embedded into a pedological-morphodynamic study about the regional grassland-dependent landscape development. Two northern exposed hay meadows were investigated through the application of catenas. Soil description was done according to 'Bodenkundliche Kartieranleitung' (KA 5), based on data gathered from cores, test pits, and laboratory analysis. Several different soil types were detected: On the upper slope and on exposed positions, driest conditions and lowest clay contents led to the formation of subtypes of 'Pararendzina', 'Tschernosem', and 'Kalktschernosem'. Along more inclined parts of the slope, 'Tschernosem' and 'Pelosol' occur with accented processes of soil creep. Within colluvial infillings of punctually distributed small depressions, highest clay- and SOM-amounts were recorded. Especially in 'Pelosol'-subtypes occuring there, intense seasonal waterlogging and desiccation dominates soil formation. Along the investigated slopes, the generally deep, clay- and organic matter-rich soil cover reveals a small-scale mosaic of different soil types, reflecting the variety of site conditions. The specific soil features further let assume a long lasting constancy of semi-natural grassland on these potentially forested sites within the forest steppe

Essays on sovereign default

University of Minnesota Ph.D. dissertation. May 2014. Major: Economics. Advisor: Timothy J. Kehoe. 1 computer file (PDF); viii, 113 pages.This thesis consists of three separate chapters. In the first chapter, I review the literature on sovereign debt crises. In the second chapter, I analyze the role nominal debt plays in sovereign debt crises, and in particular default and inflation policies. Using bond-level data on government borrowing, I document that nominal obligations are a large fraction of government debt in emerging market countries. I then show that default and inflation rates vary systematically with debt denomination: high nominal debt shares are associated with low inflation and default rates in these countries. I build a monetary model of sovereign debt with lack of commitment, in which differences in debt denomination generate this pattern, and the government inflates more when debt is real. Issuing real instead of nominal debt has two effects in the model. On the one hand, real debt reduces the incentive to create costly inflation because the value of the debt is fixed in real terms. It thus helps mitigate the commitment problem. On the other hand, because the commitment problem is less severe, real debt facilitates more debt accumulation over time, causing the government to resort to the printing press after all to finance the debt burden. In a calibrated version of the model this second effect dominates: As in the data, inflation and default rates are higher on average when debt is real instead of nominal. Default risk helps generate large differences in inflation and default rates across debt regimes as the government optimally inflates in order to avoid default.In the third chapter, I study incomplete debt relief in sovereign debt crises. I show that, in the data, sovereign defaults typically do not result in a full debt write-down. On the contrary, creditors recover on average more than half of their investment. I then build a model of sovereign default and incomplete debt relief to study the causes and consequences of incomplete debt relief. In the model, the degree of debt relief directly affects default incentives via bond prices. In particular, a high debt recovery rate - equivalently, little debt relief - reduces recovery risk to investors and tends to offset the effects of default risk. In equilibrium, incomplete debt relief lowers spreads and increases debt-to-output ratios and welfare. Default rates are non-monotonically related to debt relief and lowest for intermediate, but relatively low degrees of debt relief. I use the model to analyze the trade-off between long renegotiations and low debt relief and show that the latter is a more effective tool for achieving low equilibrium default rates and high welfare. Finally, the model predicts that countercyclical recovery rates are not welfare-improving.Sunder-Plassmann, Laura. (2014). Essays on sovereign default. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/163918

P-475: Uncontrolled hypertension in Fabry disease

Fabry disease is a x-linked lysosomal storage disease leading to early death related to renal, cardiac, and cerebrovascular disease. Therefore, proper diagnosis and therapy of elevated blood pressure may improve morbidity and mortality of these patients. However, the prevalence of uncontrolled hypertension in Fabry disease is unknown. We examined blood pressure of patients with Fabry disease using a large international database, the Fabry Outcome Survey (FOS). We defined uncontrolled hypertension as a systolic blood pressure (SBP) ≥130, and/or a diastolic blood pressure (DBP) ≥ 80 mmHg (threshold for blood pressure control in renal disease, JNC7). We used the short MDRD-GFR formula for assessment of renal function, and we classified chronic kidney disease according to K/DOQI. Among 459 patients with Fabry disease, 306 had blood pressure readings entered in the database. Mean SBP was 124.6 ± 16.9 mmHg and mean DBP was 73.6 ± 11.7 mmHg (mean age: 38.4 ± 15.6 years, 142 females, 164 males). Fourty-three percent of men and and 28% of women showed uncontrolled hypertension. In 291 patients both, blood pressure readings and GFR estimates, were available. In patients with normal GFR (>90 ml/min/1.73m2) mean SBP was 119.5 ± 15.6 mmHg and mean DBP was 69.7 ± 11.1 mmHg (n=120). In patients with mild decreased GFR (60-89 ml/min/1.73m2) mean SBP was 126.7 ± 15.9 mmHg and mean DBP was 75.0 ± 11.0 mmHg (n=110). In patients with moderate decreased GFR (30-59 ml/min/1.73m2) mean SBP was 132.7 ± 20.8 mmHg and mean DBP was 79.0 ± 13.3 mmHg (n=41). In 70 patients blood pressure readings were available before start of enzyme replacemen therapy (ERT) with agalsidase alfa (Replagal, TKT 5S Europe, 0.2 mg/kg bodyweight fortnightly i.v.), in 87 at 12 months and in 76 at 24 months of therapy. At baseline, at 12 and at 24 months of ERT, 39%, 30% and 42%of the patients presented with uncontrolled hypertension, respectively. Our study revealed a high prevalence of uncontrolled hypertension among patients with Fabry disease. Thus, there is need for improvement of blood pressure control in these patients. Am J Hypertens (2004) 17, 206A-206A; doi: 10.1016/j.amjhyper.2004.03.54

Agalsidase Alfa Slows the Decline in Renal Function in Patients with Fabry Disease

The aim of this study was to determine the effects of enzyme replacement therapy with agalsidase α on renal function in patients with Fabry nephropathy. Serum creatinine data were collected from 165 adult patients during 3 years of treatment. Serum creatinine increased in all men whereas it was stable in women, except in stage II renal disease (Kidney Disease Outcomes Quality Initiative). The estimated glomerular filtration rate (eGFR) declined in males with stage I and II (from 115.0 ± 22.2 to 98.3 ± 27.3 and from 76.5 ± 8.1 to 66.3 ±21.6 ml/min/1.73 m2, respectively; both p 2; p = 0.01). The 24-hour proteinuria was <1 g in all patients, and most patients (96%) were treated with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme (ACE) inhibitors. Agalsidase α in combination with ACE inhibitors/ARB may be effective in slowing the deterioration in renal function in Fabry nephropathy

Prevalence of Uncontrolled Hypertension in Patients With Fabry Disease

Background: Fabry disease is a rare X-linked disease arising from deficiency of α-galactosidase A. It results in early death related to renal, cardiac, and cerebrovascular disease, which are also important outcomes in patients with elevated blood pressure (BP). The prevalence of uncontrolled hypertension, as well as the effect of enzyme replacement therapy on BP, in patients with Fabry disease is unknown. Methods: We examined uncontrolled hypertension (systolic BP [SBP] ≥130 mm Hg or diastolic BP [DBP] ≥80 mm Hg) among 391 patients with Fabry disease who were participating in the Fabry Outcome Survey (FOS). Results: Uncontrolled hypertension was present in 57% of men and 47% of women. In patients with chronic kidney disease (CKD) stage 1 (n100), median SBP was 120 mm Hg and median DBP was 74 mm Hg. In patients with CKD stage 2 (n172), median SBP was 125 mm Hg and median DBP was 75 mm Hg. In patients with CKD stage 3 (n63), median SBP was 130 mm Hg and median DBP was 75 mm Hg. There was a significant decrease in both SBP and DBP during a 2-year course of enzyme replacement therapy. Conclusions: This study revealed a high prevalence of uncontrolled hypertension among patients with Fabry disease. Thus there is a need to improve BP control and renoprotection in patients with Fabry diseas

YOU+ME. Discurso artístico contemporáneo sobre la relación hombre-naturaleza/naturaleza- hombre

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Effect of statin therapy on serum activity of proteinases and cytokines in patients with abdominal aortic aneurysm

Bernd Muehling1, Alexander Oberhuber1, Hubert Schelzig1, Gisela Bischoff1, Nikolaus Marx2, Ludger Sunder-Plassmann1, Karl H Orend11Department of Thoracic and Vascular surgery; 2Department of Internal Medicine, University of Ulm, Ulm, GermanyBackground and aims: Metalloproteinases (MMPs) are considered to be key enzymes in the pathogenesis of abdominal aortic aneurysms (AAA), with elevated levels in diseased aorta and in patient sera. Statins seem to exert an inhibitory effect on MMP activity in the aortic wall. No data exist on the effect of statins on serum activity of MMPs and inflammatory cytokines (interleukins, IL).Methods: The serum activities of MMP2 and MMP9, osteoprotegerin (OPG), and IL6 and IL10 in 63 patients undergoing elective infrarenal aneurysm repair were measured on the day before surgery. Levels were correlated to statin therapy and aneurysm diameter.Results: There was no significant difference between the two groups in the activity of circulating levels of MMP2/9, OPG, and IL6/10 in patients with infrarenal aortic aneurysm. IL6 levels in patients with AAA larger than 6 cm were significantly elevated; differences in serum activities of MMP2/9, OPG, and IL10 were not related to AAA diameter.Conclusion: Serum activities of MMP2/9, OPG, and IL6/10 are not correlated to statin therapy; IL6 levels are higher in patients with large aneurysms. Hence the effect of statin therapy in the treatment of aneurismal disease remains to be elucidated.Keywords: biomarkers, aneurismal disease, statin therap

Oral Sodium Bicarbonate Supplementation Does Not Affect Serum Calcification Propensity in Patients with Chronic Kidney Disease and Chronic Metabolic Acidosis

Background: Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD) and metabolic acidosis might accelerate vascular calcification. The T50 calcification inhibition test (T50-test) is a global functional test analyzing the overall propensity of calcification in serum, and low T50-time is associated with progressive aortic stiffening and with all-cause mortality in non-dialysis CKD, dialysis, and transplant patients. Low serum bicarbonate is associated with a short T50-time and alkali supplementation could be a simple modifier of calcification propensity. The aim of this study was to investigate the short-term effect of oral sodium bicarbonate supplementation on T50-time in CKD patients. Material and Methods: The SoBic-study is an ongoing randomized-controlled trial in CKD-G3 and G4 patients with chronic metabolic acidosis (serum HCO3– ≤21 mmol/L), in which patients are randomized to either achieve serum HCO3– levels of 24 ± 1 mmol/L (intervention group) or 20 ± 1 mmol/L (rescue group). The effect of bicarbonate treatment on T50-time was assessed. Results: The study cohort consisted of 35 (14 female) patients aged 57 (±15) years, and 18 were randomized to the intervention group. The mean T50-time was 275 (± 64) min. After 4 weeks, the mean change of T50-time was 4 (±69) min in the intervention group and 18 min (±56) in the rescue group (β = –25; 95% CI: –71 to 22; p = 0.298). Moreover, change of serum bicarbonate in individual patients was not associated with change in T50-time, analyzed by regression analysis. Change of serum phosphate had a significant impact on change of T50-time (β = –145; 95% CI: –237 to –52). Conclusion: Oral sodium bicarbonate supplementation showed no effect on T50-time in acidotic CKD patients

Web-Based Development of Standard Operating Procedures and Midwifery Trainings at Ugandan Birth Clinic in the Framework of Implementing a Quality Improvement System for the MEWU—Midwife Exchange with Uganda

Abstract Introduction: High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital. We focused on assessing midwives’ confidence in midwifery core competencies. Methods: The study was conducted in a prospective, non-controlled intervention design. As a quality improvement tool, the Plan, Do, Check, Act cycle was implemented. SOPs for standard obstetric care were developed and trained in online meetings. Qualitative and quantitative data were collected through a questionnaire completed pre- and post-intervention by participating midwives, evaluations, minutes and video recordings of each case training, and annual analytical reports from Mutolere Hospital containing morbidity and mortality data. Results: The online intervention was successfully implemented. Nine SOPs on basic obstetric care were developed, trained in online case training, and integrated into clinical practice at Mutolere Hospital. An increase in midwives’ confidence regarding all surveyed core competencies was observed. There were no significant changes in the hospital’s morbidity and mortality rates. The quality management system was implemented to optimize the follow-up projects further