bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant Decrease in Dialysate Albumin Concentration during Molecular Adsorbent Recirculating System (M.A.R.S.) Therapy
Authors: Gong D. , Ji D. , Ren B. , Tao J. , Xu B. , Ronco C. , Li L.
Published: January 2018

Aim

The molecular adsorbent recirculating system (M.A.R.S.) is widely used as liver support therapy in patients with hepatic dysfunction. The goal of this study was to measure changes in dialysate albumin and bilirubin concentrations during clinical MARS treatments.

Methods

Eight patients with acute liver dysfunction and hyperbilirubinemia were enrolled in this study. Five of them received a total of 10 treatments with MARS, in which 600 mL of 20% human albumin was used as dialysate, continuously regenerated by two adsorbent columns in the circuit. Three patients received 4 treatments of a modified MARS, in which the two adsorbent columns were bypassed in the first course for 4 h, and then connected to the circuit in the second course for another 4 h. The total, conjugated and unconjugated bilirubin (TB, CB, UCB) and albumin concentrations in serum and albumin dialysate were dynamically measured, and the adsorbent column inlet pressures were recorded during each session. In one session, dialysate albumin levels were measured during the priming process, at the time points prior to the priming process, immediately after priming, and at the end of the treatment.

Results

During MARS therapies, the reduction ratio of serum TB, CB and UCB was 26.6±9.0%, 29.5±9.6% and 14.8±12.3%, respectively. The molar ratio of TB/albumin in serum was approximately 20-fold higher than dialysate at all time points. A significant albumin concentration decrease from baseline in the dialysate was found (mean±SD, 34.6±16.6%). For the first four hours of modified treatments, in which only albumin dialysis without albumin regeneration by adsorbent columns was performed, the dialysate albumin decrease was substantially smaller (mean, 8.3±1.5%). After switching to standard MARS, there was a further decrease in the dialysate albumin concentration of 35.1±14.5%. In one session, dialysate albumin concentrations were measured during the priming process, and levels decreased from 196.9 g/L to 144.4 g/L. Adsorber inlet pressure increased from 40±10mmHg at the start of priming to 150±50mmHg at the end of priming, and further increased to 340±100mmHg at the end of treatment.

Conclusion

There is a significant reduction in dialysate albumin concentration during MARS therapy. Binding of albumin to the adsorbent columns used for albumin regeneration is largely responsible for this decrease.
High Serum Levels of Soluble Fas (sFas) in Ckd Patients: Effects of Renal Clearance, Reabsorption and Synthesis
Authors: Dalboni M. A. , Cenedeze M. A. , Manfredi S. R. , Cruz Andreoli M. C. , Paväo Dos Santos O. , Canziani M. E. , Boim M. A. , GÓes M. Â. , Draibe S. A. , Balakrishnan V. , Cendoroglo M.
Published: January 2018

Purpose

Increased serum concentrations of soluble Fas (sFas) have been reported in patients with chronic kidney disease (CKD). However, little is known about the renal clearance of sFas, whether sFas is reabsorbed in the renal tubules, or the behavior of sFas synthesis in CKD.

Materials and Methods

We studied 69 patients with CKD (60±15 years old, creatinine clearance 37+19 ml/min/1.73 m2) and 14 healthy subjects (61±17 years, creatinine clearance 79±24 ml/min/1.73 m2). ELISA was used to measure the levels of sFas (pg/mL) and retinol binding protein (RBP - mg/L). RT-PCR was used to quantify sFasmRNA of leukocytes.

Results

Serum sFas levels were significantly higher in patients with CKD (2781±1214 vs. 2196±773, p=0.02). The concentrations of sFas in 24-hour urine samples (23±27 vs. 40±17, p=0.006) and sFas Clearance (0.019±0.022 vs. 0.036±0.020, p=0.01) were significantly lower in patients with CKD. sFas clearance correlated with creatinine clearance (r=0.25, p=0.02). Urine concentrations of RBP correlated with sFas concentrations in the urine (r=0.80, p<0.001). sFasmRNA were higher in patients with CKD (3.9±1.8 vs. 2.5±0.9, p<0.001).

Conclusions

In CKD patients, the decrease in renal function is followed by a decrease in sFas clearance and an increase in serum sFas. In patients with proximal tubule dysfunction (high urinary RBP concentrations), urinary sFas is also increased, suggesting that sFas is reabsorbed by the proximal tubule. It is possible that an increase in sFas synthesis also contributes to the increase of serum sFas concentrations in uremia.
The Importance of Dialysate Sodium Concentration in Determining Interdialytic Weight Gains in Chronic Hemodialysis Patients: The PanThames Renal Audit
Authors: Davenport A. , Cox C. , Thuraisingham R.
Published: January 2018

Background and Objectives

There is controversy as to the optimum dialysate sodium to be used for hemodialysis patients, with reports of hypertension and increased interdialytic weight gains with high sodium dialysates and intradialytic hypotension and cramps with low sodium dialysates.

Methods

We analyzed the effect of different dialysate sodium concentrations during a one-week period in an audit of 2187 established patients regularly receiving dialysis three times a week. Patients were given general dietary advice to restrict dietary sodium intake, but no systematic assessment of dietary sodium intake was undertaken.

Results

The prescription of a dialysate sodium concentration of 140 mmol/L and >140 mmol/L, was associated with greater interdialytic weight gains, 3.5% and 4.1% respectively, compared to 2.8% and 2.7% for those using dialysate sodium concentrations of 137 and 136 mmol/L, respectively (p<0.05). The mean pulse pressure was greater patients dialyzing using a sodium of 140 mmol/L, compared to 136 mmol/L, 70 (13) vs 63 (15) mmHg (p<0.011). In addition, 13.5% of patients using the highest sodium dialysate suffered symptomatic intradialytic hypotension requiring intravenous fluid resuscitation, compared to 2.7% who used the lowest sodium concentrate (p<0.05).

Conclusions

This analysis would support the use of lower dialysate sodium concentrations to aid in reducing interdialytic weight gains and subsequent intradialytic hypotension.
Effect of Dynamic Compression on in vitro Chondrocyte Metabolism
Authors: Tsuang Y.-H. , Lin Y.-S. , Chen L.-T. , Cheng C.-K. , Sun J.-S.
Published: January 2018

Background

Chondrocytes can detect and respond to the mechanical environment by altering their metabolism. This study was designed to explore the effects of dynamic compression on chondrocyte metabolism.

Methods

Chondrocytes were harvested from newborn Wistar rats. After 7 days of expansion, chondrocytes embedded in agarose discs underwent uniaxial unconfined dynamic compression loads at different amplitudes (5%, 10%, and 15%) and frequencies (0.5 Hz, 1.0 Hz, 2.0 Hz, and 3.0 Hz) with a duration of 24 hours. The delayed effects on the chondrocytes were studied at 1, 3, and 7 days after the experiment.

Results

The results showed that at 10% strain, higher-frequency compression pressure can enhance the proliferation of chondrocytes. The synthesis of glycosaminoglycan (GAG) increased at 10%-15% strain and a 1-Hz load. The synthesis of nitric oxide (NO) increased at the 0.5-Hz load; while decreasing at the 15% strain. With 10% strain, 1 Hz dynamic compression, the proliferation of chondrocytes and GAG synthesis increased and persisted for 7 days, and NO synthesis decreased at the third and seventh days of culture.

Conclusions

This study showed that chondrocytes respond metabolically to compressive loading, which is expected to modulate the growth and the resultant biomechanical properties of these tissue-engineered constructs during culture.
Human Adipose-Derived Stem Cells as Future Tools in Tissue Regeneration: Osteogenic Differentiation and Cell-Scaffold Interaction
Authors: De Girolamo L. , Sartori M. F. , Arrigoni E. , Rimondini L. , Albisetti W. , Weinstein R. L. , Brini A. T.
Published: January 2018

Tissue engineering is now contributing to new developments in several clinical fields, and mesenchymal stem cells derived from adipose tissue (hASCs) may provide a novel opportunity to replace, repair and promote the regeneration of diseased or damaged musculoskeletal tissue. Our interest was to characterize and differentiate hASCs isolated from twenty-three donors. Proliferation, CFU-F, cytofluorimetric and histochemistry analyses were performed. HASCs differentiate into osteogenic, chondrogenic, and adipogenic lineages, as assessed by tissue-specific markers such as alkaline phosphatase, osteopontin expression and deposition of calcium matrix, lipid-vacuoles formation and Glycosaminoglycans production. We also compared osteo-differentiated hASCs cultured on monolayer and loaded on biomaterials routinely used in the clinic, such as hydroxyapatite, cancellous human bone fragments, deproteinized bovine bone granules, and titanium. Scaffolds loaded with pre-differentiated hASCs do not affect cell proliferation and no cellular toxicity was observed. HASCs tightly adhere to scaffolds and differentiated-hASCs on human bone fragments and bovine bone granules produced, respectively, 3.4- and 2.1-fold more calcified matrix than osteo-differentiated hASCs on monolayer. Moreover, both human and deproteinized bovine bone is able to induce osteogenic differentiation of CTRL-hASCs. Although our in vitro results need to be confirmed in in vivo bone regeneration models, our data suggest that hASCs may be considered suitable biological tools for the screening of innovative scaffolds that would be useful in tissue engineering.
Effect of Vitamin E-Coated Dialysis Membranes on Anemia in Patients with Chronic Kidney Disease: An Italian Multicenter Study
Authors: Cruz D.N. , De Cal M. , Garzotto F. , Brendolan A. , Nalesso F. , Corradi V. , Ronco C.
Published: January 2018

Background

Increased oxidant stress is increasingly recognized as a crucial factor in anemia in patients with chronic kidney disease. Vitamin E-coated membranes (VECMs) consist of a multilayer membrane with liposoluble vitamin E on the blood surface allowing direct free radical scavenging at the membrane site, which is of potential clinical benefit. Our objective was to examine the effect of VECMs on anemia in chronic hemodialysis (HD).

Methods

We enrolled 172 stable chronic HD patients (94 men, 78 women, age 65.4 ± 13.4 years) in an open-label multicenter study. They were shifted from their previous dialyzer to VECM for 1 year. Hemoglobin (Hb) levels and recombinant human erythropoietin (rHuEpo) dosage were analyzed after 4, 8, and 12 months on the VECM and compared with baseline values using paired tests.

Results

Hb significantly increased from 10.9 ± 1.2 g/dL at baseline to 11.7 ± 1.2 g/dL after 12 months (p<0.001) on VECMs. Conversely, the rHuEpo dosage decreased from 7,762 ± 5,865 IU/week at baseline to 6,390 ± 5,679 IU/week after 12 months (p<0.001). The proportion of patients who were at target Hb levels (European Best Practice Guidelines) increased from 49.4% at baseline to 80% after 12 months (p<0.001).

Conclusions

Dialysis with VECM in stable chronic HD patients was associated with significantly improved Hb levels and lower rHuEpo requirements. These results suggest that the antioxidant properties of VECMs may impact favorably on anemia management in chronic HD patients. Possible mechanisms include enhanced membrane biocompatibility, reduced oxidative stress and inflammation with VECMs, resulting in improved red blood cell survival and/or rHuEpo responsiveness. This therapy may potentially contribute to more effective anemia management in hemodialysis patients, and merits further rigorous study.
Monitoring Chronic Hemodialysis Patients: A Questionnaire-Based Survey
Authors: Presta P. , Fuiano L. , Comi N. , Andreucci M. , Gigliotti P. , Tozzo C. , Fuiano G.
Published: January 2018

Background

The monitoring program for patients on regular hemodialysis treatment (RDT) is not well defined yet by current international guidelines (CIG).

Methods

To evaluate the extent to which CIG are implemented, we sent a questionnaire to 100 Italian hemodialysis units (DU) with questions concerning: (a) the frequency with which routine tests were performed for the follow-up of patients on RDT; (b) which other non-routine tests were performed. We analyzed the response data and compared them with the CIG.

Results

We received 37 replies. We found several differences between the monitoring program of our respondents and the CIG.

Conclusion

Because of the small number of responses, this survey is only preliminary; however, it shows the difficulty nephrologists have in using the CIG to create a correct monitoring program in patients on RDT. Although our analysis is limited to 37 DUs, it suggests that specific guidelines are necessary to optimize the management of patients on RDT.
Nanostructured Materials for Inhibition of Bacterial Adhesion in Orthopedic Implants: A Minireview
Authors: Montanaro L. , Campoccia D. , Arciola C.R.
Published: January 2018

Orthopedic implants may fail owing to different reasons: poor osseointegration at the tissue-implant interface, generation of wear debris, stress and strain imbalance between implant and surrounding tissues, and infections. To ensure success in orthopedics, implant materials must not evoke an undesirable inflammatory response, they must be habitable by bone-forming cells (favoring adhesion of osteoblasts), hinder formation of soft connective tissue (hindering adhesion of fibroblasts), and be anti-infective (discouraging bacterial adhesion). Recent studies have suggested that nanophase materials have a better efficacy as bone implants in favoring osseointegration compared to conventional orthopedic implant materials. This minireview discusses studies on nanophase materials as bone implants, focusing on the effect of these materials in inhibiting bacterial adhesion for the prevention of implant infections. (Int J Artif Organs 2008; 31: 771–6)
Hemodialysis Modality, Percentage of Body Fat, and Patient Survival
Authors: Stosovic M. , Stanojevic M. , Radovic M. , Simic-Ogrizovic S. , Lezaic V. , Naumovic R. , Jovanovic D. , Ristic G. , Djukanovic L. , Marinkovic J.
Published: January 2018

Background

A number of studies have reported lower mortality of overweight hemodialysis patients. This post hoc analysis of an observational prospective single-center study was aimed at elucidating whether both being overweight and surviving longer could result from changes in the hemodialysis modality.

Methods

The study included a cohort of 242 patients who were gradually switched from cuprophane membrane and acetate dialysis to polysulfone (including high-flux) membranes and bicarbonate dialysis. The analysis involved 12 months of baseline data obtained during the first calendar year after the patients entered the study (1994–2001) and repeated measurements for up to 132 months of follow-up (until 2004). Anthropometric measurements were made during the winter season and the percentage of body fat (%fat) was calculated from triceps, biceps, subscapular, and suprailiac skinfolds (K/DOQI guidelines). Kt/V, normalized protein catabolic rate, and cardiovascular comorbidity were also determined and laboratory analyses undertaken.

Results

Significant correlations were found between %fat and bicarbonate dialysate as well as polysulfone membrane and high-flux membrane. The linear mixed model showed dependence of %fat on polysulfone and high-flux membrane (p<0.01) Multivariate Cox regression (time-dependent covariates) found %fat to be an independent factor for longer survival, in addition to polysulfone and high-flux membranes.

Conclusion

Changes in hemodialysis modality were followed by both higher body fat percentage and patient survival. The reverse epidemiology of overweight patients might be at least partially the result of the influence of nonnutritional factors, such as a change in hemodialysis modality (introducing biocompatible high-flux and low-flux membranes and bicarbonate dialysis).
Coagulation Meets Calcification: The Vitamin K System
Authors: Krüger Thilo , Westenfeld Ralf , Schurgers Leon J. , Brandenburg Vincent M.
Published: January 2018

Morbidity and mortality are massively increased in patients with chronic kidney disease (CKD) and patients with end-stage renale disease (ESRD). Bone disease (renal osteodystrophy) and vascular disease (accelerated arteriosclerosis) are two typical entities contributing to this excess morbidity and mortality. Vitamin K and vitamin K-dependent-proteins play pivotal roles in the physiology of mineralization and in preventing ectopic calcification: two of these vitamin K-dependent-proteins are osteocalcin (regulating bone mineralization) and matrix-Gla protein (MGP, local calcification inhibitor in the vessel wall). Vitamin K deficiency impairs the physiological function of osteocalcin and MGP and, therefore, presumably contributes to bone demineralisation and vascular calcification (the so-called calcification paradox). In this context, the usage of vitamin K antagonists for long-term oral anticoagulation therapy might be risky especially in CKD patients exhibiting a high background level of vascular calcification. We present a summary of data describing the potential role of vitamin K deficiency and supplementation in bone and vascular disease in patients with CKD or ESRD.
Vitamin D Receptor Activators
Authors: Mazzaferro Sandro , Pasquali Marzia , Conte Carmina , Mandanici Giusy , Muci Maria L. , Lavini Raffaella
Published: January 2018

The fields for clinical employment of vitamin D analogs are growing and under active evaluation in different medical specialties, ranging from dermatology to immunology and oncology. In this review we provide a brief description of the drugs that have been developed more specifically for the treatment of secondary hyperparathyroidism (SH) associated with uremia.
Terlipressin for Hepatorenal Syndrome: A Meta-Analysis of Randomized Trials
Authors: Fabrizi Fabrizio , Dixit Vivek , Messa Piergiorgio , Martin Paul
Published: January 2018

Background

Hepatorenal syndrome (HRS) is a severe complication of end-stage renal disease whose management still constitutes a big challenge. Various approaches have been used for hepatorenal syndrome treatment, including vasoconstrictor therapy. Terlipressin, a vasopressin analogue, has frequently been used.

Aim

To evaluate the efficacy and safety of terlipressin in patients with HRS by performing a systematic review with a meta-analysis of controlled, clinical trials.

Methods

Only prospective, placebo-controlled, randomized clinical trials (RCTs) were included. We used the random effects model of DerSimonian and Laird, with heterogeneity and subgroups analyses. The primary end-point of interest was the HRS reversal after terlipressin (or placebo) therapy in study patients vs. control patients (as a measure of efficacy). The secondary outcome was the rate of ischemic side-effects in study patients vs. placebo patients (as a measure of tolerability). The additional end-point was the impact of terlipressin on survival in the HRS population.

Results

We identified five studies involving 243 unique patients with HRS. Pooling of study results showed a significant increase in HRS reversal among study (terlipressin) versus control (placebo) patients; the pooled odd ratio (OR) of HRS reversal was 8.09; 95% CI, 3.521; 18.59; p=0.0001. The p-value was 0.5 for our test of study heterogeneity. In a subgroup analysis excluding case-control trials these results did not change. The rate of severe ischemic events was higher in study than control patients, pooled OR=2.907; 95% CI, 1.094; 7.723 (p=0.032). The test for heterogeneity was not significant. Terlipressin use had no significant impact upon survival (pooled OR for survival rate, 2.064; 95% CI, 0.939; 4.538; p=0.07). No significant heterogeneity (NS) was found.

Conclusions

Our meta-analysis shows that terlipressin has higher efficacy than placebo in reversing renal function in the HRS population. There was no apparent impact of terlipressin therapy on survival in HRS patients but further large-size trials are needed. Terlipressin use in the HRS population requires careful selection of patients and close clinical surveillance. These results support the use of terlipressin for reversal of renal function in the HRS population.
Risk Factors for Aortic Valve Calcification in Patients on Regular Hemodialysis
Authors: Petrović Dejan , Obrenović Radmila , Stojimirović Biljana
Published: January 2018

Introduction

Aortic valve calcification (AVC) accelerates development of aortic valve stenosis and cardiovascular complications. Hyperphosphatemia is one of the key risk factors for aortic valve calcification.

Aim

The aim of this study was to evaluate the prevalence of AVC in patients on regular hemodialysis and to assess the impact of different factors on its appearance. Method: The study investigated a total of 115 patients treated in the Hemodialysis Department of the Urology and Nephrology Clinic at the Kragujevac Clinical Center in Serbia. The variables investigated were: serum albumin, C-reactive protein (CRP), homocysteine, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG), Apolipoprotein A-I (Apo A-I), Apolipoprotein B (Apo B) and lipoprotein (a), calcium, phosphate and parathormone, and calcium-phosphorus product (Ca × P). Patients were evaluated by echocardiography for AVC. Statistical analysis included univariate and multivariate logistic regression analysis.

Results

Univariate regression analysis showed that serum phosphate levels and Ca × P are the most important risk factors for AVC (p<0.001). Multivariate logistic regression analysis revealed that hyperphosphatemia is an independent risk factor for AVC (p<0.001).

Conclusion

Hyperphosphatemia is an independent risk factor for aortic valve calcification.
Fixed Bearing Knee Congruency – Influence on Contact Mechanics, Abrasive Wear and Kinematics
Authors: Grupp Thomas M. , Stulberg Dave , Kaddick Christian , Maas Allan , Fritz Bernhard , Schwiesau Jens , Blömer Wilhelm
Published: January 2018

The objective of our study was to evaluate the in vitro wear behavior of fixed bearing designs for total knee arthroplasty in relation to contact mechanics and resultant kinematics for different degrees of congruency.

A finite element model was created for three knee articulations with increasing degrees of tibio-femoral congruency (flat, curved, and dished design). For the three different knee design configurations, in vitro wear simulation was performed according to ISO 14243–1.

Contact areas increased with increasing knee congruency, whereas the peak surface contact stresses decreased. The wear rates for the knee design configurations differed substantially between the three test groups (flat, curved, and dished).

Our observations demonstrate that increased congruency in conjunction with decreased surface contact stresses significantly contributes to reducing wear in fixed bearing knee articulations.
Responses of Free Radicals to Subcutaneous Implantation of Alginate-Chitosan-Alginate (ACA) Microcapsules in Mice
Authors: Zhu Haibao , Xi Zhaofang , Yang Shijin , Zhang Yanhong , Wang Hong , Guo Huitian , Zhang Yao , Chen Dachi , Guo Dingzong
Published: January 2018

The objective of this study was to characterize the levels of free radicals in serum and antioxidase activity after microcapsules were implanted into the subcutaneous space of mice. Cell viability was evaluated using AO/EB staining. Serum free radicals, malondialdehyde and superoxide dismutase levels were evaluated by colorimetry analysis. The mice were divided into three groups: saline injection group (n=15), empty microcapsules injected group (n=21), encapsulated cells injected group (n=21). Cell viability and serum analysis were executed at 1, 4 and 7 days post-implantation. Hydrogen peroxide and malondialdehyde levels initially increased in the recipients of the empty microcapsules, before decreasing to the basal level. However, in mice receiving the encapsulated cells, the levels were higher at the end of study. Nitric oxide and superoxide dismutase increased after the implantation of microcapsules with or without the BHK-21 cells, but were not changed in response to the saline injection. The viability of the encapsulated cells was high in vivo, although some microcapsules had broken by 7 days post-implantation. These results suggest that nitric oxide plays a role in the specific response to microcapsules. The levels of free radicals rapidly increased immediately following microcapsule transplantation, but they caused only slight cellular damage before the microencapsulated cells were exposed.
Effect of Hemodialysis on Whole Blood Viscosity
Authors: Vaisman S. , Kensey K. , Cho Y. I.
Published: January 2018

Purpose

The purpose of the present study was to examine the effect of hemodialysis procedures on the hemoconcentration status of end-stage renal disease (ESRD) patients.

Methods

We measured whole blood viscosity (WBV) of 30 ESRD patients using a scanning-capillary-tube viscometer before and after hemodialysis. The blood sample size required for WBV measurements was approximately 3 mL. Pre-dialysis specimens for viscosity measurements were obtained via the fistula needle or Perma catheter prior to initiating hemodialysis, and post-dialysis specimens were drawn from the arterial sample port of the hemodialysis line 3.5 hours after initiation of dialysis treatment.

Results

Changes in WBV were measured at high and low shear rates: 80% of patients showed an increased high shear viscosity, whereas 73% of patients demonstrated an increased low shear viscosity. The actual percentage increase in WBV observed after hemodialysis at high and low shear rate ranges varied broadly in the 30 patients.

Conclusions

The observed increase in the WBV of ESRD patients over hemodialysis procedures indicates that a segment of patients experience increased flow resistance, particularly at the microcirculatory level. In addition, for the segment of patients experiencing marked increases in WBV during hemodialysis, the vessel wall at the dialysis fistula is exposed to blood with a higher viscosity than at the beginning of the process. The higher blood viscosity at the dialysis fistula is directly related to increased kinetic force and shear stress on the vessel wall, which may be playing a role in increasing the risk of stenosis.
In vitro Tests and Modelization of Bicarbonate Kinetics and Mass Transfers During Online Hemodiafiltration
Authors: Morel HÉLÈNE , Jaffrin Michel Y. , Paullier Patrick , Legallais CÉCILE
Published: January 2018

This paper proposes an in vitro hemodiafiltration (HDF) model in which the patient is represented by a 2 L bag of fresh heparinized bovine blood circulated by a 4008H monitor through a 0.6 m2 hemodialyzer to investigate kinetics of bicarbonate (HCO3-) during online post-dilution HDF. Five tests were carried out, with three ultrafiltration rates, zero (HD test), 30 and 50 ml/min. Blood gases, pH, HCO3- hematocrit and electrolytes were measured with an ABL77 (Radiometer) blood gas analyzer, and HCO3- was simultaneously measured with a biochemistry analyzer. The variation over time of plasma HCO3- concentrations was also calculated using mass conservation and the model of Legallais et al (JMS 168, 2000, 3–15). Agreement between theoretical and measured concentrations was good during the first 25 minutes of each test, corresponding to the time necessary to dialyze the blood. In hemodialysis (HD), there was an HCO3- mass transfer into blood through the membrane due to diffusion which vanished after 40 minutes, while in HDF tests, blood lost HCO3- due to ultrafiltration after 10 minutes. With reinjection, the net HCO3- mass flow rate to the “patient” decayed, from 1.8 mmol/min at t=0 to zero at the end of the test (t=60 min), and was higher in HD than in HDF. “Patient” dialysance, taking into account reinjection, was positive in all tests, and decayed from about 110 ml/min to 40 ml/min at the end of dialysis. These data confirmed that online HDF automatically corrects acidosis without creating alkalosis when HCO3- dialysate concentration is around 30 mmol/L.
Surface Protein EF3314 Contributes to Virulence Properties of Enterococcus faecalis
Authors: Creti Roberta , Fabretti Francesca , Koch Stefanie , Huebner Johannes , Garsin Danielle A. , Baldassarri Lucilla , Montanaro Lucio , Arciola Carla Renata
Published: January 2018

Purpose

Identification of putative new virulence factors as additional targets for therapeutic approaches alternative to antibiotic treatment of multi-resistant enterococcal infections.

Methods

The EF3314 gene, coding for a putative surface-exposed antigen, was identified by the analysis of the Enterococcus faecalis V583 genome for LPXTG-motif cell wall anchor surface protein genes. A non-polar EF3314 gene deletion mutant in the E. faecalis 12030 human clinical isolate was obtained. The wild type and the isogenic mutant strain were investigated for biofilm formation, adherence to Hela cells, survival in human macrophages and a Caenorhabditis elegans infection model. The aminoterminal portion of the EF3314 protein was overexpressed in E. coli to obtain mouse polyclonal antibodies for use in Western blotting and immunolocalization experiments.

Results

The EF3314 gene has an unusually high GC content (46.88% vs. an average of 37.5% in the E. faecalis chromosome) and encodes a protein of 1744 amino acids that presents a series of 14 imperfect repeats of 90 amino acids covering almost the entire length of the protein. Its global organization is similar to the alpha-like protein family of group B streptococci, enterococcal surface protein Esp and bio film associated protein Bap from S. aureus. The EF3314 gene was always present and specific for E. faecalis strains of human, food and animal origin. Differences in size depended on variable numbers of repeats in the repetitive region.

Conclusions

EF3314 is a newly described, surface exposed protein that contributes to the virulence properties of E. faecalis.
Panton-Valentine Leukocidin Gene Detected in a Staphylococcus Aureus Strain Isolated from a Knee Arthroprosthesis Infection
Authors: Montanaro Lucio , Baldassarri Lucilla , Corazzari Tolmino , Creti Roberta , Ravaioli Stefano , Cangini Ilaria , Pirini Valter , Maso Alessandra , Donati M. ELENA , Pegreffi Francesco , Visai Livia , Campoccia Davide , Speziale Pietro , Arciola Carla Renata
Published: January 2018

This report focuses on the molecular characterization of a Staphylococcus aureus strain isolated from a knee arthroprosthesis infection and recognized retrospectively as a carrier of the Panton-Valentine leukocidin gene. The stored microbiological isolate, which belonged to the strain collection of the Research Unit on Implant Infections of the Rizzoli Orthopaedic Institute, was retrieved for molecular analysis. Genotyping was carried out, revealing an interesting profile. In addition to the positivity for the Panton-Valentine toxin gene, the results indicated that the isolate belonged to the agr III group and was endowed with bbp and cna genes, both encoding for staphylococcal adhesins that bind bone proteins. The strain had the mecA gene for methicillin resistance, even though it was unable to resist any of the β-lactam or other antibiotics. Its gene configuration matched that of other community-acquired methicillin-resistant and methicillin-susceptible Staphylococcus aureus (CA-MRSA and CA-MSSA) strains which have recently been reported worldwide. As far as we know, this is the first report on a PVL-positive S. aureus strain associated with an orthopedic implant (knee arthroprosthesis) infection.
Evaluation of a Novel System for Hypothermic Oxygenated Pulsatile Perfusion Preservation
Authors: Doorschodt Benedict M. , Schreinemachers Marie-Claire J.M. , Florquin Sandrine , Lai Wei , Sitzia Mario , Zernecke Alma , Tolba Rene H.
Published: January 2018

Background

Recently, a novel innovative machine perfusion (MP) system for hypothermic oxygenated pulsatile perfusion called the Airdrive (AD) has been developed. The aim of the study was to evaluate the biological safety of the AD system for perfusion preservation of kidney grafts in a porcine autotransplantation model using the low-viscosity perfusion solution Polysol (PS) in comparison with cold storage (CS) using PS or the University of Wisconsin solution (UW). In addition, we evaluated real-time microcirculation parameters. At sacrifice, grafts were retrieved for histological analysis and immunohistochemistry

Methods

After assessment of the microcirculation, left kidneys were retrieved. Following the washout, kidneys were preserved for 20 hr using AD-PS, CS-PS or CS-UW. Thereafter, contralateral kidneys were removed followed by heterotopic autotransplantation of the preserved graft. Seven days after transplantation animals were sacrificed with retrieval of the grafts for histological analysis. Renal function, renal microcirculation and tissue injury including the proliferative response of tubular epithelial cells (TECs) were compared.

Results

Preservation using AD-PS or CS-PS resulted in higher microcirculatory flow compared with CS-UW. Improved recovery of renal function was seen in the AD-PS and CS-PS groups compared with CS-UW. Structural integrity was better preserved using AD-PS compared with both CS groups. Proliferative response of TECs was higher in CS-UW preserved grafts compared to grafts preserved using AD-PS.

Conclusion

This study demonstrates the biological safety of the AD system in a porcine autotransplantation model. Also, the microcirculation was better preserved and less morphological injury was observed after 20 hr MP compared with CS.
Dialysis Access: An Increasingly Important Clinical Issue
Authors: Gallieni Maurizio , Martini Alma , Mezzina Nicoletta
Published: January 2018

Dialysis access, including vascular access for hemodialysis and peritoneal access for peritoneal dialysis, is critical in the clinical care of patients with end-stage renal disease. It is associated with increases in morbidity, mortality, and health care costs. A number of problematic issues are involved, some of which are addressed in this paper with reference to the most recent publications, including: the inappropriately low prevalence of peritoneal dialysis in Western countries, which is relevant to access placement in the pre-dialysis stage; the excessively high use of central venous catheters in incident and prevalent dialysis patients; the diagnosis and treatment of steal syndrome; the advantages and limitations of antiplatelet therapy; and finally, the correct pre-operative evaluation and subsequent surveillance of the vascular access.
Inflammation and Oxidative Stress in End-Stage Renal Disease Patients Treated with Hemodialysis or Peritoneal Dialysis
Authors: Filiopoulos Vassilis , Hadjiyannakos Dimitrios , Takouli Lambrini , Metaxaki Polixeni , Sideris Vasilis , Vlassopoulos Dimosthenis
Published: January 2018

Purpose

The impact of different dialysis modalities on oxidative stress and inflammation and the factors implicated in this interrelationship have not been adequately studied. This study was designed to comparatively evaluate the effect of hemodialysis (HD) and peritoneal dialysis (PD) on oxidative stress and inflammatory biomarkers and to search for associated factors.

Methods

We studied 20 HD, 11 PD patients and 11 healthy controls. Calculations were based on total antioxidant capacity (TAC) and superoxide dismutase (SOD), by spectrophotometry, as oxidative stress biomarkers; and high sensitivity CRP (hs-CRP), lnterleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α), by ELISA, as inflammation biomarkers.

Results

HD and PD patients showed significantly increased levels of TAC, SOD and hs-CRP compared to healthy controls. No significant difference was observed in TNF-α and IL-6. Compared to HD patients, PD patients showed TNF-α levels that were increased, although non-significantly and significantly higher homocysteine (Hcy). No differences were observed for IL-6, hs-CRP, TAC and SOD. In HD patients, significant positive correlations were found between intact parathyroid hormone (iPTH) and TNF-α, and between uric acid (UA) and TAC. β2-microglobulin (β2M) was negatively correlated with TAC, total cholesterol (TC) positively with TNF-α and negatively with SOD, and triglycerides (TG) correlated positively with TNF-α. In PD patients, TG correlated positively with TNF-α, HDL-cholesterol negatively with TNF-α, LDL-cholesterol negatively with SOD, and β2M negatively with SOD.

Conclusions

HD and PD patients show similar degrees of inflammation and oxidative stress activation. Factors such as UA, iPTH, β2M and lipid profile correlate to oxidative stress and inflammatory biomarkers in both HD and PD patients.
A review on new mesostructured composite materials: Part I. synthesis of polymer-mesoporous silica nanocomposite
Authors: Salimian S , Zadhoush A , Mohammadi A
Published: January 2018

Mesoporous silicas are inorganic materials with large surface areas, uniform framework structures and readily controlled pore diameters which are synthesized in the presence of surfactants as structure-directing agents, followed by the removal of the surfactant by extraction or calcination. Due to their characteristics, such as ordered structure, high surface area, and favorable interfacial interactions between silica surface and the polymer, they have found excellent potential application for use as reinforcing agents for several engineering polymer systems. While a large number of different synthesis approaches for the preparation of mesoporous silica-polymer nanocomposites has been reported in literature, there is nevertheless a growing need for verified synthesis methods of mesoporous silica-polymer materials. This paper presents a review of the literature on the methods for synthesizing polymer-mesoporous silica nanocomposites and discusses some unique properties of these composites.
Failure analyses of unconfined CCWBM body in uniaxial compression based on central pressure variation
Authors: Du Xianjie , Feng Guorui , Guo Yuxia , Qi Tingye , Zhang Yujiang , Guo Jun
Published: January 2018

Cemented coal waste backfill material (CCWBM) is made of coal gangue, fly ash and cementitious materials. It has been widely used in the field of backfill mining to control surface subsidence and protect the environment. A large number of unconfined backfill bodies without lateral support are formed in partial backfill mining. To study the failure characteristics of unconfined CCWBM body in partial backfill, the stress–strain curves of the CCWBM were obtained by uniaxial compression tests at different ages (1–28 d). The central pressure was measured by the embedded pressure sensors. The failure characteristics of the specimen were monitored by acoustic emission (AE) positioning technique. Three observations can be made.

1. The central pressure variation curves lag behind the mean stress change curves. The central pressure curve can be divided into three stages: slow increase stage, rapid growth stage and decline stage. It has two pressure manifestations: early appearance and peak appearance. They can be as the failure precursor and instability critical, respectively.

2. The specimen forms a central elastic bearing area in the process of compression. The plastic area develops to the inner side with the increase of pressure, and an upper and lower compound cone-shaped residual area is finally formed.

3. The embedded pressure sensor can be used to monitor the instability of the unconfined backfill body. The research results can provide guidance for the in-situ stability monitoring and reinforcement of unconfined CCWBM body in partial backfill.
Psychosocial Features of Neurofibromatosis Type 1 in Children and Adolescents
Authors: Domon-Archambault Vincent , Gagnon Louise , Benoît Amélie , Perreault Sébastien
Published: January 2018

Neurofibromatosis type 1 (NF1) is a common neurologic condition associated with a wide variety of developmental deficits that have an important impact on children and adolescents.

Objective:

This article aims to document the psychosocial features of NF1 and to report the interventions described to address the needs of pediatric patients with NF1.

Methods:

A literature review was conducted concerning the social life, mental health, and quality of life (QOL) of children and adolescents with NF1 as well as the psychosocial interventions addressed to this population.

Results:

Compared to unaffected children and adolescents of the general population, pediatric patients with NF1 have an increased risk of having social difficulties, mental health disorders, behavioral and emotional problems, as well as diminished QOL. Only 3 articles describe interventions within the NF1 population to address these difficulties.

Conclusion:

There is a need to develop and assess psychosocial interventions for patients with NF1.
The Apparatus of Social Reproduction
Authors: Lane William A. , Seelman Kristie L.
Published: January 2018

The apparatus of social reproduction describes the process by which knowledge production contributes to oppressive conditions. This article explains and defines this process through the application of a critical theoretical lens informed the Foucauldian concept of apparatus or dispositif and social reproduction as developed by feminist activists and intellectuals. This process has a notable influence on the political economic conditions of transgender women, conditions that include disproportionate reliance on the use of criminalized economies such as sex work. Social workers inadvertently influence this process through an overreliance on broad categorizations for lesbian, gay, bisexual, transgender, and queer populations, which impede our ability to adequately assess such complex oppressive social relationships. Increasing the profession’s familiarity and competence with critical theory is necessary to reduce our participation in such processes and identify effective interventions for this population. Presenting a review of social work literature and a discussion of the proposed lens, the following seeks to illuminate the apparatus of social reproduction and explain how broad social categorization of transgender women is problematic. The authors recommend the adoption of the proposed lens as a tool social workers can use to better assess their research and practice and better understand the complexities of power and exploitation.
Motivating Men: Social Science and the Regulation of Men’s Reproduction in Postwar India
Authors: Balasubramanian Savina
Published: January 2018

This article analyzes efforts to govern men’s reproduction in postwar India’s population control program from 1960 to 1977. It argues that the Indian state’s unconventional emphasis on men was linked to a gendered strand of social scientific research known as family planning communications and its investments in reframing reproductive control in behavioral terms. Communication scientists’ goal to understand the role of mass communications in shaping “reproductive decision-making” dovetailed with prevailing cultural ideologies of masculinity that readily associated men with economic rationality and calculative reasoning. Consequently, scientists cast Indian men as indispensable targets of behavioral interventions into reproduction due to their ostensible status as familial and social “decision-makers.” This reframing prompted Indian family planning officials to create novel interventions into men’s reproductive bodies and beliefs, exhorting them to use contraception and desire fewer children. The study thus offers new approaches for theorizing how men become framed as legitimate subjects of reproductive control.
Adaptive mesh refinement for elastic modulus reconstruction in elastography
Authors: Wang Wenxia , Zou Wei , Hu Danfeng , Wang Jiajun
Published: January 2018

Meshes play a crucial role in determining the accuracy of the elastic modulus reconstruction in the elastography when the finite element method is employed. In this article, we propose an adaptive mesh refinement strategy which can ensure the coincidence of the meshes with the shape of the inclusions in the observed tissue. This strategy is based on the intensity distribution of the strain image where the variance of the strain distribution in each element of the meshes is used to measure the homogeneity of the element, that is, the larger the strain variance is the more inhomogeneous the element will be and hence more detailed information will be included in this element. For more accurate reconstruction of such detailed information, mesh refinement procedure is implemented in such elements. Besides, two refinement steps are employed for the reconstruction to improve the fitness of the reconstructed image and the observed tissue. Simulation results show that the two-stage adaptive mesh refinement algorithm performs well without needing any prior information about the internal geometric shape in tissue. Not only Young’s moduli of models but also shapes of the inclusions can be reconstructed perfectly and quickly with our proposed method.
Contemporary French cinema and the langue de passage: From Dheepan to Welcome
Authors: King Gemma
Published: January 2018

In contemporary films like Dheepan (Jacques Audiard, 2015) and Welcome (Philippe Lioret, 2009), effects of (post)colonialism, immigration and globalisation transform French spaces into multilingual ones, in which language use is impacted by a complex network of spheres of influence. This article offers a new approach to understanding the place of the language in French films about border-crossing in today’s Europe. It paraphrases terminology from Abdellatif Kechiche’s La Graine et le mulet to examine the films Dheepan and Welcome, in which the French language is crucial to migrants’ survival, but in temporary and conditional ways. Finally, the article analyses how French co-exists alongside other languages such as Tamil, English, and Kurdish in such films, and proposes a new term for understanding the use of language by shifting and migrating subjects: the langue de passage.
Improving the energy efficiency of a 110 MW thermal power plant by low-cost modification of the cooling system
Authors: Jović Milica , Laković Mirjana , Banjac Miloš
Published: January 2018

The electric power system of the Republic of Serbia relies mostly on lignite-fired thermal power plants, with 70% of the total electricity generation. Most of these plants are over 30 years old, and investment in their modernization is necessary. The energy efficiency of the 110 MW coal-fired power plant in which the condenser is cooled by the mechanical draught wet cooling towers system is analyzed in this paper. Attention is primarily devoted to operating conditions of the cold end of the plant, i.e. to the interrelationship of the condenser and cooling towers. Most important parameters that affect the operation of the cooling towers system are ambient air temperature and relative humidity, specific mass flow rate, and temperature of cooled water. With the existing cooling system, the overall energy efficiency of the plant is low, especially in the summer months, even less than 30%, due to adverse weather conditions. By upgrading existing cooling tower system by adaptation of two additional cooling tower cells, overall energy efficiency can be increased by 1.5%. The cooling tower system rehabilitation investments payback period is estimated to be less than one year. Static method for economic and financial assessment is used.