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Background/Aims: Contrast induced acute kidney injury (CI-AKI) remains a serious complication of contrast media enhanced procedures like coronary angiography. There is still a lack of established biomarkers that help to identify patients at high risk for short and long-term complications. The aim of the current study was to evaluate plasma kynurenine as a predictive biomarker for CI-AKI and long-term complications, measured by the combined endpoint "major adverse kidney events" (MAKE) up to 120 days after CM application.
Methods: In this prospective cohort study 245 patients undergoing coronary angiography were analyzed. Blood samples were obtained at baseline, 24h and 48h after contrast media (CM) application to diagnose CI-AKI. Patients were followed for 120 days for adverse clinical events including death, the need for dialysis, and a doubling of plasma creatinine. Occurrence of any of these events was summarized in the combined endpoint MAKE.
Results: Preinterventional plasma kynurenine was not associated with CI-AKI. Patients who later developed MAKE displayed significantly increased preinterventional plasma kynurenine levels (p<0.0001). ROC analysis revealed that preinterventional kynurenine is highly predictive for MAKE (AUC=0.838; p<0.0001). The optimal cutoff was found at >= 3.5 mu mol/L. Using this cutoff, the Kaplan-Meier estimator demonstrated that concentrations of plasma kynurenine >= 3.5 mu mol/L were significantly associated with a higher prevalence of MAKE until follow up (p<0.0001). This association remained significant in multivariate Cox regression models adjusted for relevant factors of long-term renal outcome.
Conclusion: Preinterventional plasma kynurenine might serve as a highly predictive biomarker for MAKE up to 120 days after coronary angiography.
Background/Aims: A recent study revealed that global overexpression of ET-1 causes a slight reduction in systemic blood pressure. Moreover, heterozygous ET-1 knockout mice are hypertensive. The role of ET-1 in human hypertension was so far not addressed by a strict meta-analysis of published human clinical studies.
Methods: We included studies published between January 1, 1990 and February 28, 2017. We included case control studies analyzing untreated essential hypertension or hypertensive patients where antihypertensive medication was discontinued for at least two weeks. Based on the principle of Cochrane systematic reviews, case control studies (CCSs) in PubMed (Medline) and Google Scholar designed to identify the role of endothelin-1 (ET-1) in the pathophysiological of hypertension were screened. Review Manager Version 5.0 (Rev-Man 5.0) was applied for statistical analysis. Mean difference and 95% confidence interval (CI) were shown in inverse variance (IV) fixed-effects model or IV random-effects models.
Results: Eleven studies fulfilling our in-and exclusion criteria were eligible for this meta-analysis. These studies included 450 hypertensive patients and 328 controls. Our meta-analysis revealed that ET-1 plasma concentrations were higher in hypertensive patients as compared to the control patients [mean difference between groups 1.57 pg/mL, 95%Ci [0.47 similar to 2.68, P = 0.005]. These finding were driven by patients having systolic blood pressure higher than 160 mmHg and diastolic blood pressure higher than 100 mmHg.
Conclusions: This meta-analysis showed that hypertensive patients do have elevated plasma ET-1 concentrations. This finding is driven by those patients with high systolic/diastolic blood pressure. Given that the ET-1 gene did not appear in any of the whole genome association studies searching for hypertension associated gene loci, it is very likely that the elevated plasma ET-1 concentrations in hypertensive patients are secondary to hypertension and may reflect endothelial cell damage.
The illness-related evaluation of bodily symptoms is considered to be an important maintaining factor in somatoform disorders. However, little is known about context variables that could influence this evaluation process. In the current study, participants completed three versions of the Health Norms Sorting Task (HNST) and evaluated bodily symptoms in different contexts (i.e., different evaluation perspectives and time frames of evaluation). Additionally, the three HNST versions were presented in different orders. Bodily symptoms were evaluated more often as a sign of illness when a specific time frame (i.e., one week) was given. However, this context effect was only large when participants had previously evaluated symptoms existing without a concrete duration. Thus, previously completed symptom evaluations appear to represent an important frame of reference in terms of a cue that makes specific context variables salient. The results further suggested that these cueing effects might be less relevant for participants with elevated somatic symptom reports.
Securing e-prescription from medical identity theft using steganography and antiphishing techniques
(2017)
Drug prescription is among the health care process that usually makes references to the patients’ medical and insurance information among other personal data, because this information is very vital and delicate, it should be adequately protected from identity thieves. This article aims at securing Electronic Prescription (EP) in order to minimize patient’s data theft and foster patients’ trust of EP system.
This paper presents a steganography and antiphishing technique for preventing medical identity theft in EP. The proposed EP system design focused on the security features in the prescriber and dispensers’ modules of EP by ensuring the prescriber sends the prescription of the patient in a safe manner and to the right dispenser without the interference of fake third parties. Hexadecimal steganography image system is used to cover and secure the
sent prescription details. Malicious electronic dispensing system is prevented through an authentication technique where a dispenser uses a captcha together with a one-time password, and the web server encrypted token for prescriber’s device authentication. The steganography system is evaluated using Peak Signal to Noise Ratio (PSNR).
The system implementation results showed that steganography
and antiphishing techniques are capable of providing a secure EP systems.
Dieser Beitrag beschäftigt sich mit der Frage, welche Relevanz arbeitsstatis-tische und -rechtliche Kategorisierungen im Zeitraum von 1880 bis 1992 für den Wandel der Deu-tungsmodelle des Geschlechts haben. Aus vergleichstheoretischer stellt die Durchsetzung desmodernen Konzepts der Erwerbsarbeit um 1900 im nationalen Kontext und dessen Veränderung aufglobaler Ebene ein spezifisches Ordnungsverfahren dar, das im Mittelpunkt dieses Aufsatzes steht.Auf der Grundlage von zwei Mikrostudien zur Klassifizierung und Reklassifizierung der „Mithel-fenden Familienangehörigen“ und des „Nachtarbeitsverbots“ wird zum einen die Globalisierung derErwerbsarbeit als Beobachtungsschema, zum anderen der Wandel des Deutungsmodells derGeschlechterdifferenz im Zuge transnationaler Vergleichsverfahren erforscht. In dem Beitrag wirddie Auffassung vertreten, dass der Vergleich einen Globalisierungsmechanismus in der Weltgesell-schaft darstellt.
Impact of normal weight obesity on fundamental motor skills in pre-school children aged 3 to 6 years
(2017)
Normal weight obesity is defined as having excessive body fat, but normal BMI. Even though previous research revealed that excessive body fat in children inhibited their physical activity and decreased motor performance, there has been only little evidence about motor performance of normal weight obese children. This study aims to establish whether normal weight obese pre-school children aged 3-6 years will have a significantly worse level of fundamental motor skills compared to normal weight non-obese counterparts. The research sample consisted of 152 pre-schoolers selected from a specific district of Prague, the Czech Republic. According to values from four skinfolds: triceps, subscapula, suprailiaca, calf, and BMI three categories of children aged 3-6 years were determined: A) normal weight obese n = 51; B) normal weight non-obese n = 52; C) overweight and obese n = 49. The Movement Assessment Battery for Children (MABC-2) was used for the assessment of fundamental motor skills. Normal weight obese children had significantly higher amount of adipose tissue p < 0.001 than normal weight non-obese children but the same average BMI. Moreover, normal weight obese children did not have significantly less amount of subcutaneous fat on triceps and calf compared to their overweight and obese peers. In majority of MABC-2 tests, normal weight obese pre-schoolers showed the poorest performance. Moreover, normal weight obese children had significantly worse total standard score = 38.82 compared to normal weight non-obese peers = 52.27; p < 0.05. In addition, normal weight obese children had a more than three times higher frequency OR = 3.69 CI95% (1.10; 12.35) of severe motor deficit performance <= 5th centile of the MABC-2 norm. These findings are strongly alarming since indices like BMI are not able to identify normal weight obese individual. We recommend verifying real portion of normal weight obese children as they are probably in higher risk of health and motor problems than overweight and obese population due to their low lean mass.
When trying to extend the Hodge theory for elliptic complexes on compact closed manifolds to the case of compact manifolds with boundary one is led to a boundary value problem for the Laplacian of the complex which is usually referred to as Neumann problem. We study the Neumann problem for a larger class of sequences of differential operators on a compact manifold with boundary. These are sequences of small curvature, i.e., bearing the property that the composition of any two neighbouring operators has order less than two.
Background:
Physical growth of children and adolescents depends on the interaction of genetic and environmental factors e.g. diet and living conditions. Aim: We aim to discuss the influence of socioeconomic situation, using income inequality and GDP per capita as indicators, on body height, body weight and the variability of height and weight in infants and juveniles.
Material and methods:
We re-analyzed data from 439 growth studies on height and weight published during the last 35 years. We added year-and country-matched GDP per capita (in current US$) and the Gini coefficient for each study. The data were divided into two age groups: infants (age 2) and juveniles (age 7). We used Pearson correlation and principal component analysis to investigate the data.
Results:
Gini coefficient negatively correlated with body height and body weight in infants and juveniles. GDP per capita showed a positive correlation with height and weight in both age groups. In infants the standard deviation of height increases with increasing Gini coefficient. The opposite is true for juveniles. A correlation of weight variability and socioeconomic indicators is absent in infants. In juveniles the variability of weight increases with declining Gini coefficient and increasing logGDP per capita.
Discussion:
Poverty and income inequality are generally associated with poor growth in height and weight. The analysis of the within-population height and weight variations however, shows that the associations between wealth, income, and anthropometric parameters are very complex and cannot be explained by common wisdom. They point towards an independent regulation of height and weight.
Contactless pressure monitoring based on Forster resonance energy transfer between donor/acceptor pairs immobilized within elastomers is demonstrated. The donor/acceptor energy transfer is employed by dispersing terbium(III) tris[(2-hydroxybenzoyl)-2-aminoethyl] amine complex (LLC, donor) and CdSe/ZnS quantum dots (QD655, acceptor) in styrene-ethylene/buthylene-styrene (SEBS) and poly(dimethylsiloxane) (PDMS). The continuous monitoring of QD luminescence showed a reversible intensity change as the pressure signal is alternated between two stable states indicating a pressure sensitivity of 6350 cps kPa(-1). Time-resolved measurements show the pressure impact on the FRET signal due to an increase of decay time (270 ms up to 420 ms) for the donor signal and parallel drop of decay time (170 mu s to 155 mu s) for the acceptor signal as the net pressure applied. The LLC/QD655 sensors enable a contactless readout as well as space resolved monitoring to enable miniaturization towards smaller integrated stretchable opto-electronics. Elastic FRET sensors can potentially lead to developing profitable analysis systems capable to outdo conventional wired electronic systems (inductive, capacitive, ultrasonic and photoelectric sensors) especially for point-of-care diagnostics, biological monitoring required for wearable electronics.
Web-based E-Learning uses Internet technologies and digital media to deliver education content to learners. Many universities in recent years apply their capacity in producing Massive Open Online Courses (MOOCs). They have been offering MOOCs with an expectation of rendering a comprehensive online apprenticeship. Typically, an online content delivery process requires an Internet connection. However, access to the broadband has never been a readily available resource in many regions. In Africa, poor and no networks are yet predominantly experienced by Internet users, frequently causing offline each moment a digital device disconnect from a network. As a result, a learning process is always disrupted, delayed and terminated in such regions. This paper raises the concern of E-Learning in poor and low bandwidths, in fact, it highlights the needs for an Offline-Enabled mode. The paper also explores technical approaches beamed to enhance the user experience inWeb-based E-Learning, particular in Africa.
The oceans absorb about a quarter of the annually produced anthropogenic atmospheric carbon dioxide (CO2), resulting in a decrease in surface water pH, a process termed ocean acidification (OA). Surprisingly little is known about how OA affects the physiology of heterotrophic bacteria or the coupling of heterotrophic bacteria to phytoplankton when nutrients are limited. Previous experiments were, for the most part, undertaken during productive phases or following nutrient additions designed to stimulate algal blooms. Therefore, we performed an in situ large-volume mesocosm (similar to 55 m(3)) experiment in the Baltic Sea by simulating different fugacities of CO2 (fCO(2)) extending from present to future conditions. The study was conducted in July-August after the nominal spring bloom, in order to maintain low-nutrient conditions throughout the experiment. This resulted in phytoplankton communities dominated by small-sized functional groups (picophytoplankton). There was no consistent fCO(2)-induced effect on bacterial protein production (BPP), cell-specific BPP (csBPP) or biovolumes (BVs) of either free-living (FL) or particle-associated (PA) heterotrophic bacteria, when considered as individual components (univariate analyses). Permutational Multivariate Analysis of Variance (PERMANOVA) revealed a significant effect of the fCO(2) treatment on entire assemblages of dissolved and particulate nutrients, metabolic parameters and the bacteria-phytoplankton community. However, distance-based linear modelling only identified fCO(2) as a factor explaining the variability observed amongst the microbial community composition, but not for explaining variability within the metabolic parameters. This suggests that fCO(2) impacts on microbial metabolic parameters occurred indirectly through varying physicochemical parameters and microbial species composition. Cluster analyses examining the co-occurrence of different functional groups of bacteria and phytoplankton further revealed a separation of the four fCO(2)-treated mesocosms from both control mesocosms, indicating that complex trophic interactions might be altered in a future acidified ocean. Possible consequences for nutrient cycling and carbon export are still largely unknown, in particular in a nutrient-limited ocean.
It is found that the differential cross section of photon-photon scattering is a function of the degree of polarization entanglement of the two-photon state. A reduced general expression for the differential cross section of photon-photon scattering is derived by applying simple symmetry arguments. An explicit expression is obtained for the example of photon-photon scattering due to virtual electron-positron pairs in quantum electrodynamics. It is shown how the effect in this explicit example can be explained as an effect of quantum interference and that it fits with the idea of distance-dependent forces.
Grounded in the expectancy-value and hope theories, the present
study was conducted to examine the extent to which self-efficacy,
task value, and academic hope predict persistence among science
teacher-trainees in Uganda. The sample consisted of 278 undergrad-
uate science teacher-trainees selected from a large public university
in northern Uganda. Data were collected using several scales from
the modified Motivated Strategies for Learning Questionnaire,
Academic Hope Scale, and College Persistence Questionnaire and
analyzed using structural equation modeling. Task value and aca-
demic hope significantly predicted students’ persistence. Academic
hope made a greater contribution to students’ persistence compared
to task value. The combined effect of task value and academic hope
did not make any significant contribution to students’ persistence.
The study highlights the need to strengthen students’ hopeful think-
ing and task value in order to increase their chances of completing
their studies. Implications of the study findings for educational practice and for the training of science teacher-trainees are elaborated in the article.
Processes driving the production, transformation and transport of methane (CH4 / in wetland ecosystems are highly complex. We present a simple calculation algorithm to separate open-water CH4 fluxes measured with automatic chambers into diffusion-and ebullition-derived components. This helps to reveal underlying dynamics, to identify potential environmental drivers and, thus, to calculate reliable CH4 emission estimates. The flux separation is based on identification of ebullition-related sudden concentration changes during single measurements. Therefore, a variable ebullition filter is applied, using the lower and upper quartile and the interquartile range (IQR). Automation of data processing is achieved by using an established R script, adjusted for the purpose of CH4 flux calculation. The algorithm was validated by performing a laboratory experiment and tested using flux measurement data (July to September 2013) from a former fen grassland site, which converted into a shallow lake as a result of rewetting. Ebullition and diffusion contributed equally (46 and 55 %) to total CH4 emissions, which is comparable to ratios given in the literature. Moreover, the separation algorithm revealed a concealed shift in the diurnal trend of diffusive fluxes throughout the measurement period. The water temperature gradient was identified as one of the major drivers of diffusive CH4 emissions, whereas no significant driver was found in the case of erratic CH4 ebullition events.
The molecular structure and conformational preferences of 1-phenyl-1-X-1-silacyclohexanes C5H10Si(Ph,X) (X = F (3), Cl (4)) were studied by gas-phase electron diffraction, low-temperature NMR spectroscopy, and high-level quantum chemical calculations. In the gas phase only three (3) and two (4) stable conformers differing in the axial or equatorial location of the phenyl group and the angle of rotation about the Si-C-ph bond (axi and axo denote the Ph group lying in or out of the X-Si-C-ph plane) contribute to the equilibrium. In 3 the ratio Ph-eq:Ph-axo:Ph-axi is 40(12):55(24):5 and 64:20:16 by experiment and theory, respectively. In 4 the ratio Ph-eq:Ph-axo is 79(15):21(15) and 71:29 by experiment and theory (M06-2X calculations), respectively. The gas-phase electron diffraction parameters are in good agreement with those obtained from theory at the M06-2X/aug-ccPVTZ and MP2/aug-cc-pVTZ levels. Unlike the case for M06-2X, MP2 calculations indicate that 3-Ph-eq conformer lies 0.5 kcal/mol higher than the 3-Ph-axo, conformer. As follows from QTAIM analysis, the phenyl group is more stable when it is located in the axial position but produces destabilization of the silacyclohexane ring: By low temperature NMR spectroscopy the six-membered ring interconversion could be frozen, at 103 K and the present conformational equilibria of 3 and 4 could be determined. The ratio of the conformers is 3-Ph-eq:3-Ph-ax = (75-77):(23-25) and 4-Ph-eq:4-Ph-ax = 82:18.
We investigate source processes of fluid-induced seismicity from The Geysers geothermal reservoir in California to determine their relation with hydraulic operations and improve the corresponding seismic hazard estimates. Analysis of 869 well-constrained full moment tensors (M-w 0.8-3.5) reveals significant non-double-couple components (>25%) for about 65% of the events. Volumetric deformation is governed by cumulative injection rates with larger non-double-couple components observed near the wells and during high injection periods. Source mechanisms are magnitude dependent and vary significantly between faulting regimes. Normal faulting events (M-w<2) reveal substantial volumetric components indicating dilatancy in contrast to strike-slip events that have a dominant double-couple source. Volumetric components indicating closure of cracks in the source region are mostly found for reverse faulting events with M-w>2.5. Our results imply that source processes and magnitudes of fluid-induced seismic events are strongly affected by the hydraulic operations, the reservoir stress state, and the faulting regime.
Reproductive development of grapevine and berry composition are both strongly influenced by temperature. To date, the molecular mechanisms involved in grapevine berries response to high temperatures are poorly understood. Unlike recent data that addressed the effects on berry development of elevated temperatures applied at the whole plant level, the present work particularly focuses on the fruit responses triggered by direct exposure to heat treatment (HT). In the context of climate change, this work focusing on temperature effect at the microclimate level is of particular interest as it can help to better understand the consequences of leaf removal (a common viticultural practice) on berry development. HT (+8 degrees C) was locally applied to clusters from Cabernet Sauvignon fruiting cuttings at three different developmental stages (middle green, veraison and middle ripening). Samples were collected 1, 7, and 14 days after treatment and used for metabolic and transcriptomic analyses. The results showed dramatic and specific biochemical and transcriptomic changes in heat exposed berries, depending on the developmental stage and the stress duration. When applied at the herbaceous stage, HT delayed the onset of veraison. Heating also strongly altered the berry concentration of amino acids and organic acids (e.g., phenylalanine, raminobutyric acid and malate) and decreased the anthocyanin content at maturity. These physiological alterations could be partly explained by the deep remodeling of transcriptome in heated berries. More than 7000 genes were deregulated in at least one of the nine experimental conditions. The most affected processes belong to the categories "stress responses," protein metabolism" and "secondary metabolism," highlighting the intrinsic capacity of grape berries to perceive HT and to build adaptive responses. Additionally, important changes in processes related to "transport," "hormone" and "cell wall" might contribute to the postponing of veraison. Finally, opposite effects depending on heating duration were observed for genes encoding enzymes of the general phenylpropanoid pathway, suggesting that the HI induced decrease in anthocyanin content may result from a combination of transcript abundance and product degradation.
A series of new sulfobetaine methacrylates, including nitrogen-containing saturated heterocycles, was synthesised by systematically varying the substituents of the zwitterionic group. Radical polymerisation via the RAFT (reversible addition–fragmentation chain transfer) method in trifluoroethanol proceeded smoothly and was well controlled, yielding polymers with predictable molar masses. Molar mass analysis and control of the end-group fidelity were facilitated by end-group labeling with a fluorescent dye. The polymers showed distinct thermo-responsive behaviour of the UCST (upper critical solution temperature) type in an aqueous solution, which could not be simply correlated to their molecular structure via an incremental analysis of the hydrophilic and hydrophobic elements incorporated within them. Increasing the spacer length separating the ammonium and the sulfonate groups of the zwitterion moiety from three to four carbons increased the phase transition temperatures markedly, whereas increasing the length of the spacer separating the ammonium group and the carboxylate ester group on the backbone from two to three carbons provoked the opposite effect. Moreover, the phase transition temperatures of the analogous polyzwitterions decreased in the order dimethylammonio > morpholinio > piperidinio alkanesulfonates. In addition to the basic effect of the polymers’ precise molecular structure, the concentration and the molar mass dependence of the phase transition temperatures were studied. Furthermore, we investigated the influence of added low molar mass salts on the aqueous-phase behaviour for sodium chloride and sodium bromide as well as sodium and ammonium sulfate. The strong effects evolved in a complex way with the salt concentration. The strength of these effects depended on the nature of the anion added, increasing in the order sulfate < chloride < bromide, thus following the empirical Hofmeister series. In contrast, no significant differences were observed when changing the cation, i.e. when adding sodium or ammonium sulfate.