bluuebunny/crossref_metadata_2025 huggingface dataset:
#2587 Survival and access to renal transplantation of patients with type 1 diabetes: a study from the REIN registry
Authors: Elsa Vabret , Bayat Sahar , Lassalle Mathilde , Raffray Maxime , Foucher Yohann , Vigneau Cécile
Published: May 2024

Background and Aims

One of the most severe complication of type 1 diabetes (D1) is renal injury which can lead to end stage renal disease. Even though improvement have been made to slow the progression of the renal disease, some of D1 patients still reach dialysis. Those patients seem to have more comorbidities and poor prognosis compare to patients without diabetes (D0) starting dialysis or patients with type 2 (D2) diabetes.

Method

The French Renal Epidemiology and Information Network (REIN) registry collects information on all patients starting dialysis in France. We used this cohort to explore survival and access to renal transplantation of D1 on dialysis patients compare to D0 and D2 patients, using Cox proportional hazard models and graphical representation of the variables to explore the pathway from type 1 diabetes to the outcomes of interest. We performed sensitivity analysis on the imputed base obtain by MICE (in order to reduce the influence of missing data) to compare HR.

Results

From January 1, 2010 to December 31,2016, 1596 D1 patients were compared to 39540 D0 patients and 28170 D2 patients. Excess in all-cause mortality rate were 1.26 [1.14-1.40] (p < 0.001) for D1 versus D0 and rises to 1.45 [1.32-1.59] (p < 0.001) when considering diabetes-related comorbidities on the pathway from diabetes to death. D1 had a poorer access to kidney transplantation (0.74 [0.66-0.82] p < 0.001) adjusting for non-diabetes-related comorbidities. Using the survival model to compare D1 and D2 on the imputed bases, we obtained an HR: 1.11; 95% CI: 1.01-1.21 p = 0.027, in favor of a worse survival of D1 patients in dialysis compare to D2 patients

Conclusion

These results confirm that D1 patients starting dialysis are severely ill and particular care need to be given to detect and so reduce diabetes-related comorbidities and increase access to kidney transplantation.
#69 Validation of the Visayan Translation of the End Stage Renal Disease—Adherence Questionnaire (VESRD-AQ)
Authors: Canoy Julienne Marie , Torres Hariett
Published: May 2024

Background and aims

End-stage renal disease (ESRD) is one of the chronic diseases that rely heavily on patient's adherence to treatment. Measuring the factors related to adherence have been done but are difficult to compare due to non-uniformity of the tools used. The 46-item End-Stage Renal Disease—Adherence Questionnaire (ESRD-AQ) by Kim, et.al (2010) is a validated tool used to measure treatment adherence to the whole of ESRD management: hemodialysis, medications, fluid restrictions, and diet prescription. About 2000 ESRD patients have been registered in the Central Visayas, Philippines in 2022. The availability of a standardized and validated tool in the Visayan native language will help in assessing adherence and its related factors which can lead to interventions that could improve outcomes in ESRD patients. This study was done to translate the End-stage renal disease (ESRD-AQ) into the Visayan dialect (Visayan ESRD-AQ) and test its validity.

Method

The ESRD-AQ underwent forward translation into a Visayan version. This translation was evaluated for content validity using the Content Validity Index (CVI) rated by 5 experts, and face validity with a group of 5 ESRD patients. Blind backward translation was done and compared to the original ESRD-AQ. Construct validity was tested via a Known-Group Analysis. Test-retest reliability was done using the Intraclass Correlation Coefficient (ICC) to establish the questionnaire's stability overtime.

Results

The Visayan ESRD-AQ had adequate Content Validity Index of 1.0 which shows that each item on the questionnaire was relevant to its aim. Construct validity showed that the known adherers had higher scores than the known non-adherers. This means that the questionnaire was able to differentiate between the two groups. The responses of two patients were evaluated through the Intraclass Correlation Coefficient (ICC) and had the scores of 0.52 and 0.69, meaning that the questionnaire can be reliably used over time.

Conclusion

The Visayan ESRD-AQ is a valid and reliable tool for measuring adherence behaviors in a sample of Visayan-speaking dialysis patients as supported by the results of the Content Validity Index and known-group analysis. The can also be used reliably over time as it showed moderate test- retest reliability score. The validated VESRD-AQ may be valuable to researchers in studies of advanced chronic kidney disease. It could be used for studying adherence behaviors of ESRD patients across the Visayan region of the Philippines and the factors that contribute to adherence or non-adherence. Results of these studies can be used to improve services in dialysis units and can even be a tool in policy making with regards to hemodialysis in the Philippines. Further translations into other dialects or languages can also be done to be able to reach a broader population.
#1370 Frailty prevalence and short-term outcomes among younger end-stage renal disease patients on maintenance hemodialysis
Authors: Adelee Magboo Edna Jane , Polito Eratosthenes
Published: May 2024

Background and Aims

Frailty is a medical condition of reduced function and health, or a state of heightened risk for catastrophic decline in vitality and function which is evident among end-stage renal disease (ESRD) patients. There has been only limited data regarding its occurrence in the younger age group since most of the published frailty studies involved the elderly as their study population. It is important to identify who among the younger hemodialysis patients are frail, since frailty is related to a higher risk of hospitalization and mortality. This study aims to estimate the prevalence of frailty among younger ESRD patients on maintenance hemodialysis using the Edmonton Frail Scale (EFS) and its association with short-term outcomes: hospital consultations, use of emergency room services, hospitalizations, and mortality.

Method

A prospective single-center cohort study was conducted. All ESRD patients aged 18-64 years old on maintenance hemodialysis on an outpatient basis were included. Data collection included the patients’ demographic data, underlying diseases, comorbid conditions, body mass index, and recent laboratory results. The EFS was administered during the first month of the study, and patients were then monitored for consultations, use of emergency room services, hospitalizations, and mortality in the succeeding months until the end of the study period.

Results

Out of 166 ESRD patients, 94 belong to the younger age group and 87 patients were included: 33 (37.9%) were frail, 21 (24.1%) were vulnerable, and 33 (37.9%) were fit. Chronic Glomerulonephritis was the leading cause of ESRD in the younger population, and Diabetic Nephropathy was the primary cause among those categorized as frail. Hypertension was the predominant comorbid condition across all categories. Frail patients had the greatest number of hospital consultations (54%) and had frequent utilization of emergency room services. They also exhibited the highest number of hospitalizations consisting 69% of the total admissions across all categories. All deaths in this study came from the patients categorized as frail.

Conclusion

Frailty is prevalent among younger ESRD patients on maintenance hemodialysis and is associated with increased risk for hospital consultation, use of emergency room services, hospitalization, and mortality.
#2080 Prevalence and development of sarcopenia in chronic hemodialysis patients, a single center, prospective, observational study
Authors: Lys Zdenek , Balner Tomas , Kollarova Stanislava , Kupcova Monika , Valkovsky Ivo
Published: May 2024

Background and Aims

Sarcopenia is a progressive muscle disease (muscle failure) associated with age and various factors including chronic kidney disease that increases the risk of falls, fractures, and mortality. We aimed to analyze the prevalence of sarcopenia and other related problems, such as nutrition or physical fitness, in a group of patients in a chronic dialysis program.

Method

In our dialysis center, we conducted a prospective observational study to monitor the prevalence and development of sarcopenia. We performed repeated SARC-F (simple five-item questionnaire), grip strength, bioimpedance analysis of body composition, short physical performance battery (SPPB), muscle sonography and MNA (Mini Nutritional Assessment) in chronic hemodialysis patients. Here we report the cross-sectional results of the prevalence of probable sarcopenia (according to the recommendations, enough to trigger assessment of causes and start intervention) defined by EWGSOP2 (the European Working Group on Sarcopenia in Older People), risk of malnutrition, physical fitness, and its development in 1 year follow up.

Results

The median age in our cohort was 64 years (IQR 16.5). We examined 58 patients (36 men and 22 women) who signed informed consent in the period from 1 October 2020 to 31 January 2023. The prevalence of probable sarcopenia was 20.7%. A higher prevalence was observed in women than in men (27.3% vs 16.7%, P = 0.505), in patients ≥65 years than in the <65 years (26.5% vs 8.3%, P = 0.102) and in the group of patients more than one year on dialysis compared to the group up to one year (27.8% vs 4.5%, P = 0.039). We observed reduced physical performance (SPPB test) in 20 subjects (34.5%) and risk of malnutrition according to MNA in 33 subjects (56.9%). Seven of 29 evaluated patients (24.1%) had a worsening of physical performance (SPPB) after one year. Ten out of 29 patients (34.5%) had worsened MNA scores; the prevalence of malnutrition risk in this group remained the same (51.7%). The development of other parameters did not lead to significant conclusions, given the heterogeneity of characteristics and the relatively small number of subjects.

Conclusion

Sarcopenia is a serious and potentially impactful problem. The prevalence of probable sarcopenia in our cohort was 20.7% and was higher, although not statistically significant, in women, in patients ≥65 years of age and in patients more than one year on dialysis.
#2647 Assessing atherosclerosis using epicardial adipose tissue in hemodialysis patients: a meta-analysis
Authors: Yadav Rukesh
Published: May 2024

Background and Aims

Hemodialysis (HD) patients had higher cardiovascular mortality due to accelerated atherosclerosis in such patients. Epicardial adipose tissue (EAT) thickness is a marker of atherosclerosis and independent predictor of coronary artery disease. The potential use of EAT as an imaging biomarker for cardiovascular disease risk stratification has attracted attention in the recent times. EAT's value in cases of HD hasn't been thoroughly analyzed, though. A meta-analysis of the literature assessing the mean differences in EAT value between HD patients and healthy controls was conducted.

Method

Pubmed, Google Scholar and Embase databases were searched from inception till 15 January 2024 for studies that measured EAT thickness of adult patients with HD and matched healthy controls. Outcomes included mean difference (MD) and 95% confidence interval (CI) of EAT thickness between the HD patients and the healthy controls. The results were combined using a fixed or random effect model as per heterogeneity among the included studies in Revman 5.4 software. The between-study heterogeneity of effect size was quantified using the Q statistic and I2. The results were represented in forest plots. Statistical significance was determined as P value of less than 0.05.

Results

Eight studies comprising 757 patients were included in this analysis. EAT thickness were significantly higher in HD patients as compared to healthy controls [MD: 1.88, Confidence Interval (CI): 0.74-3.02, I2 = 98%, P value = 0.001] (Fig. 1).

Conclusion

This meta-analysis concluded that HD patients are independently associated with higher EAT as compared to healthy controls. The utility of EAT as an imaging biomarker for predicting atherosclerosis in HD patients is promising. EAT represent readily available clinical markers useful in estimating risk of cardiovascular mortality in HD patients.
#452 Cardiac troponins are independent predictors of cardiovascular mortality in haemodialysis patients
Authors: Tyden Maria , Westerlund Magnus , Svensson Maria K , Eriksson Niclas , Soveri Inga , Girerd Nicolas , Rossignol Patrick , Zannad Faiez , Fellström Bengt
Published: May 2024

Background and Aims

Patients with end-stage kidney disease (ESKD) and haemodialysis treatment (HD) have a high risk of cardiovascular (CV) events. The underlying pathophysiology is complex and multifactorial. This study aimed to explore the role of high-sensitivity cardiac Troponin I (hs-cTnI) as a predictor of major adverse cardiac events (MACE), CV- and all-cause mortality.

Method

A retrospective analysis using data from the AURORA study (CT00240331). Association with baseline hs-cTnI and MACE, CV- and all-cause mortality were assessed using Cox-regression analyses. The analyses were adjusted for multiple background factors and available biomarkers. hs-cTnI was log2 transformed and modelled using a four knot restricted cubic spline. The hazard ratio [HR] estimates are presented for the upper quartile (32.6 pg/mL) vs the lower quartile (10.1 pg/mL) of the distribution of hs-cTnI. Variables were ordered by variable importance in the models using χ2 value minus degrees of freedom.

Results

During the follow-up, there were 1094 total deaths of which 598 were CV deaths, and 734 MACE in patients with hsTnI measurements available at baseline. Baseline hs-cTnI was associated with an increased risk for MACE (HR 1.92; 95% Confidence interval [CI] 1.57-2.35), CV mortality (HR 2.12; 95% CI 1.69-2.66), all-cause mortality (HR 1.84; 95% CI 1.55-2.17) and non-CV mortality (HR 1.59; 95% CI 1.23-2.05) after adjustments for age, ethnicity, sex, smoking status, diabetes status, history of coronary heart disease, atrial fibrillation, blood pressure, heart rate, height, weight, years on HD, hemoglobin, cholesterol, LDL-C, HDL-C, triglycerides, hs-CRP, creatinine, albumin, phosphate, erythropoietin treatment, ACE -inhibitor use, anticoagulation treatment, treatment with rosuvastatin, sevelamer use, iron supplements, ferritin, transferrin, galectin-3, pro-BNP, CICP and SCF. When ranking variables by variable importance, hs-cTnI was the strongest predictor for MACE (Fig. 1), CV- and all-cause mortality. For non-CV mortality age was the most important variable.

Conclusion

Baseline hs-cTnI, is a strong and independent risk marker for MACE and all-cause mortality in patients with haemodialysis treatment.
#1943 The association of uncarboxylated, non-phosphorylated Matrix Gla protein with arterial stiffness in hemodialysis and peritoneal dialysis patients
Authors: Roumeliotis Stefanos , Varouktsi Garyfallia , Tsinari Ariti , Neofytou Ioannis , Kourtidou Christodoula , Vaios Vasilios , Divanis Dimitrios , Schurgers Leon , Liakopoulos Vassilios
Published: May 2024

Background and Aims

Vitamin K deficiency has been identified as a marker of vascular calcification AND STIFNESS and an independent cardiovascular risk factor in hemodialysis (HD) and peritoneal dialysis (PD) patients, as the most powerful inhibitor of vascular calcification, Matrix Gla Protein requires vitamin K to become activated. However, until to date, it has not yet been clarified whether hepatic or extrahepatic markers of vitamin K status reflect the arterial status of dialysis patients. In this study we aimed to investigate the association of vitamin K deficiency with arterial stiffness in End-Stage Kidney Disease (ESKD) patients.

Method

In 42 ESKD patients undergoing either HD or PD, we measured plasma levels of the inactive vitamin-K dependent Matrix Gla Protein (dp-ucMGP) and serum levels of prothrombin (PIVKA-II) as markers of extrahepatic and hepatic insufficiency of vitamin K (CARIM Institute, Maastricht, Netherlands). In these patients we determined arterial stiffness parameters (pulse wave velocity-PWV) by the Mobil-O-Graph device (IEM, Stolberg, Germany).

Results

Serum PIVKA-II was associated with T2D duration (r = −0.38, p = 0.013), phosphorus levels (r = −0.41, p = 0.009) serum albumin (r = −0.33, p = 0.036) Spearman's rho test, and the type of transporter in PD patients (p = 0.039), Kruskal-Wallis test. Plasma dp-ucMGP was associated with PWV (r = 0.51, p = 0.001), peripheral (r = −0.37, p = 0.016) and central diastolic blood pressure (BP) (r = −0.34, p = 0.026) and age (r = 0.41, p = 0.007), Spearman's rho. Patients with T2DM, history of acute myocardial infarction and those receiving warfarin had significantly increased levels of circulating dp-ucMGP (p = 0.036, p = 0.039 and p < 0.0001, respectively, Kruskal-Wallis). Warfarin was associated with a 2.5-fold and a 23-fold increase in dp-ucMGP and PIVKA-II levels, respectively. Stepwise multiple regression analysis showed that PWV (p = 0.001, B = 494, 95% CI: 242-746) was an independent predictor of dp-ucMGP, independent of age, T2T2, history of myocardial infraction and diastolic BP.

Conclusion

Elevated plasma dp-ucMGP levels (suggesting extrahepatic vitamin K deficiency) were associated with increased arterial stiffness in dialysis patients.
#2032 Heart rate-adjusted augmentation index reduces after switching low-flux dialyzers to medium cut-off dialyzers in maintenance hemodialysis patients
Authors: Korucu Berfu , Erbay Efe , Vural Akif , Caylan Saime Betul , Bildaci Yelda Deligoz , Oktan Mehmet Asi , Cavdar Caner , Deger Serpil Muge
Published: May 2024

Background and Aims

Arterial stiffness affects almost all maintenance hemodialysis (MHD) patients and is one of the most important predictors of cardiovascular morbidity and mortality. Medium cut-off (MCO) membrane technology provides higher clearance of large-middle uraemic toxin and cytokines compared to conventional dialyzers. In this case-control study, we investigated the change in the arterial stiffness parameters after the transition to MCO dialyzers in MHD patients receiving treatment with low-flux dialyzers.

Method

We conducted a prospective, single-center cross-over study including 19 MHD patients receiving treatment with low-flux dialyzers. Baseline and repeated parameters were measured from the brachial artery on a mid-week HD session at 0th, 120th, and 240th minutes, and the average of the three measurements were analyzed. The repeated parameters were measured two weeks after the switching to MCO dialyzers which were decided by the clinician according to clinical indication.

Results

The median age was 71 (51, 79) years, and 57.9% of the patients were female. The frequency of diabetes was 36.8%, and hypertension was 73.7%. 21.1% patients were smokers. 31.6% of the patients had a history of cardiovascular disease. Two weeks after switching to MCO dialyzers, the Kt/Vs, urea reduction ratios, laboratory parameters, systolic, diastolic, and mean arterial pressures remained similar to baseline. The mean pulse wave velocity was 10.3 m/s (8.4, 11.0) with low-flux dialyzers and 10.2 m/s (7.0, 11.5) with MCO dialyzers (p = 0.38). The mean heart rate adjusted augmentation index [AIx(75)] was 20.0% (15.0, 30.3) with low-flux dialyzers and 13.0% (11.0, 22.0) with MCO dialyzers (p = 0.04).

Conclusion

Our study showed that the rapid effect of MCO membranes is the reduction in peripheral wave reflections defined by AIx(75). Additional long-term diseases are required to determine whether MCO dialyzers might improve the cardiovascular prognosis of MHD patients.
#695 Modulation of probiotics on intestinal flora and related short-chain fatty acids in patients with peritoneal dialysis
Authors: Li Philip K T , Tian Na , Zhou Shengnan
Published: May 2024

Background and Aims

Probiotics may play a role in inflammation, nutritional status, kidney function and quality of life. However, few studies were performed to study the effects of probiotics on metabolites of intestinal flora in patients.

Method

We investigated the effects of Lactobacillus paracasei N1115 on intestinal flora and related short-chain fatty acids in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study (ChiCTR-TRC2016254). Fifty one patients on peritoneal dialysis underwent an intervention with the probiotic supplement (n = 36, PR group) or placebo (n = 15, PL group) for twelve weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and short-chain fatty acids (SCFAs) analysis, gastrointestinal symptom was also assessed at baseline and after the intervention. Moreover, PR group was divided into gastrointestinal symptom remission group (n = 30, GR group) and gastrointestinal symptom non-remission group (n = 5, GNR group).

Results

Probiotic administration caused significant changes in the composition of gut microbiota, as indicated by increased abundance of beneficial bacteria (Firmicutes), decreased Bacteroidetes, and opportunistic pathogens (Fusobacterium, Bilophila) (p < 0.05). However, there was no significant difference in intestinal microbial diversity, SCFAs levels increased in PR group although the change was not statistically significant between the two groups (P > 0.05). In addition, probiotic administration could effectively reduce gastrointestinal symptoms, particularly in dyspepsia and constipation (p < 0.05). The contents of SCFAs was increased in GNR group (p < 0.05), and there was a significant correlation between these SCFAs and the differential bacterial genera with significant changes between the GR and GNR groups (p < 0.05).

Conclusion

Together, the results suggest that probiotic can promote the beneficial changes of intestinal flora in PD patients. Probiotic supplementation can improve the gastrointestinal symptoms of PD patients, possibly by affecting the composition of intestinal bacteria and their metabolites.
#593 Prevalence and outcomes of tuberculous peritonitis among CAPD patients in National Kidney and Transplant Institute from January 2016 to January 2023
Authors: Garcia Maria Angelica Carrene , Imperial Pamela Marie
Published: May 2024

Background

Continuous ambulatory peritoneal dialysis is a cost effective and efficient modality of renal replacement therapy. However, infectious processes such as peritonitis may lead to peritoneal membrane failure necessitating shift to hemodialysis. Tuberculous peritonitis is an unusual cause of peritonitis, which may lead to risk of hospitalization and significant morbidity and mortality.

Aims

To determine the prevalence and outcomes of tuberculous peritonitis among patients on continuous ambulatory peritoneal dialysis

Method

A retrospective, descriptive study of patients on continuous ambulatory peritoneal dialysis with tuberculous peritonitis from January 2016 to January 2023 in National Kidney and Transplant Institute. Demographic, clinical and laboratory data of patients with TB peritonitis were collected via chart review.

Results

Among 1182 patients on continuous ambulatory peritoneal dialysis, 2.03% had tuberculous peritonitis. Average length of time from development of symptoms to diagnosis is 24.5 days. Majority of presenting symptoms were hazy drain and abdominal pain. 66.7% retained their peritoneal dialysis catheter. PD catheter was removed in 33% of TB peritonitis due to peritoneal dialysis failure and unresolving peritonitis. Mortality was 37.5% after diagnosis of tuberculous peritonitis. Only significant factor associated with mortality was length of time on continuous ambulatory peritoneal dialysis to development of TB peritonitis (p = 0.0332).

Conclusion

Relative high prevalence of tuberculous peritonitis could be related to high background occurrence of tuberculosis in the country. Majority of cases had resolution of symptoms and effective dialysis during course of anti-tuberculous treatment and did not warrant peritoneal dialysis catheter removal.
#2881 Glucose free-based solutions reduce oxidative stress in peritoneal dialysis: support for a new promising approach
Authors: Basso Anna , Anastasio Paola Baldini , Bertoldi Giovanni , Driussi Giulia , Caputo Ilaria , Cacciapuoti Martina , Lorenzo Calò
Published: May 2024

Background and Aims

Oxidative stress (OxSt) and inflammation are common in CKD which are known CV and mortality risk factors. In peritoneal dialysis (PD) OxSt and Inflammation even increase due to the use of glucose-based solutions. This study evaluated in PD patients the effect of 3 and 6 months treatment with icodextrin-based glucose-free solutions on OxSt and inflammation.

Method

In 15 PD patients using a molecular biology approach, p22phox protein expression (Western blot), subunit of NADPH oxidase, essential for OxSt activation, MYPT-1 phosphorylation state, marker of RhoA/Rho kinase pathway activity, deeply involved in OxSt generation (Western blot) and Malondialdehyde (MDA) production (fluorimetric assay), marker of lipid peroxidation, have been evaluated. High-sensitive C Reactive Protein (hsCRP) (immunoturbidimetric assay) and interleukin (IL)-6 (chemiluminescence assay), have been used as marker of inflammation.

Results

p22phox protein expression, MYPT-1 phosphorylation, and MDA level were reduced after 3 months from the start of icodextrin based solutions (1.28 ± 0.18 d.u. vs 1.50 ± 0.19, p = 0.049; 0.89 ± 0.03 vs 0.98 ± 0.03, p = 0.004; 4.20 ± 0.18 nmol/mL vs 4.84 ± 0.32 nmol/mL, p = 0.045, respectively). In a subgroup of 9 patients who continued the treatment up to 6 months MYPT-1 phosphorylation was further reduced at 6 months compared to baseline (0.84 ± 0.06 vs 0.99 ± 0.04, p = 0.043), while p22phox protein expression was reduced only at 6 months from baseline (1.03 ± 0.05 vs 1.68 ± 0.22, p = 0.021). In this subgroup MDA blood level was reduced at 6 months from baseline (4.03 ± 0.24 nmol/mL vs 4.68 ± 0.32, p = 0.024) and was also significantly reduced vs 3 months (4.03 ± 0.24 vs 4.35 ± 0.21, p = 0.008). IL-6 level, although reduced compared to baseline, did not reach statistical significance both at 3 and 6 months, while hsPCR was unchanged.

Conclusion

The icodextrin-based PD solutions mediated reduction of OxSt related proteins and inflammation we have provided, although obtained in a small cohort of patients and for a limited time duration, strongly support the rationale of using in PD osmo-metabolic agents-based solutions replacing the currently used glucose-based fluids. The results of ongoing studies with these agents in PD patients will provide definitive proofs to better preserve peritoneal membrane integrity and residual renal function but also to reduce CV risk factors such as OxSt and inflammation.
#2894 pre-mRNA FOXP3 levels after transplant do not reflect risk of rejection
Authors: Saleh Qais , Rasmussen Marianne , Tepel Martin
Published: May 2024

Background and Aims

Forkhead box P3 (FOXP3) is the master gene regulator of T regulatory cells, and is crucial for their suppressive function. In kidney transplant recipients, low post-transplant levels of FOXP3 in peripheral blood has been associated with increased risk of kidney allograft rejection. However, it is unknown if low post-transplant levels of FOXP3 pre-mRNA is also associated with increased risk of kidney allograft rejection. Here we aim to test if pre-mRNA FOXP3 levels are associated with the risk of rejection post-transplant in kidney transplant recipients.

Method

We collected blood samples from incident kidney transplant recipients the first day after transplantation. From these, we extracted peripheral blood mononuclear cell ribonucleic acid and measured pre-mRNA FOXP3 transcripts with quantitative reverse transcription polymerase chain reaction. Pre-mRNA FOXP3 levels were normalized to β-actin, and converted to a logarithmic scale. We collected data concerning rejection episodes through medical record review. Kidney transplant recipients that had at least one recorded acute kidney allograft rejection episode within the first three months post-transplant were defined as recipients with a rejection episode. Data is presented as median [interquartile range] and tested with Wilcoxon rank sum test.

Results

We measured pre-mRNA FOXP3 in 515 incident kidney transplant recipients, 52 experienced a rejection episode within the first three months post-transplant. Pre-mRNA levels did not differ between recipients with vs without rejection, logarithmic value of normalized pre-mRNA FOXP3 −4.48 [−4.63 to −4.10] vs −4.41 [−4.69 to −4.11], p = 0.80. The pattern persisted regardless of donor type, deceased recipients with rejection (N = 25) vs deceased recipients without—(N = 268), −4.47 [−4.62 to −4.26] vs −4.46 [−4.71 to −4.25], p = 0.90. Living ABO-compatible recipients with rejection (N = 19) vs living ABO-compatible recipients without—(N = 139), −4.49 [−4.64 to −4.14] vs −4.35 [−4.65 to −3.93], p = 0.30. Living ABO-incompatible recipients with rejection (N = 8) vs living ABO-compatible recipients without—(N = 56), −4.13 [−4.48 vs −3.88] vs −4.20 [−4.61 to −3.88], p = 0.70.

Conclusion

In kidney transplant recipients, early post-transplant abundance of pre-mRNA FOXP3 transcripts were similar regardless of risk of kidney allograft rejection post-transplant.
#1866 Gender gap in renal transplantation, myth or truth?
Authors: Acosta-Ochoa Isabel , Ardura Paula , Moultamis Aya , Martínez María , Ronda Teresa , Abad Cristina , Coca Armando , Cobo Kenia , Merizalde Carlos , Fernández Beatriz , Mendiluce Alicia
Published: May 2024

Background and Aims

Multiple works show that women are less likely to receive a kidney transplant (Tx) compared to their male counterparts. We aimed to study the sex differences in access to Tx in our waiting list. We also studied the rate of masculine and feminine donors (Do) and their match to same-sex recipients (Rc).

Method

We included all adult patients active in our transplant waiting list during a 2-year period (from January 1-2021 to December 31-2022). Our center is a medium volume transplant center, and we only perform Tx from deceased donors, and don't perform combined organ transplantation. We analyzed the rate of women vs male, and Rc's and Do's sex, the degree of sex match and mismatch. We evaluated differences in time in waiting list until Tx, re-transplantation, and hyperimmunized patients, between groups.

Results

270 individuals were active in our waiting list, 174 (64%) men, and 96 (36%) women. 142 were transplanted during the study period, 92 (65%) were males, and 50 (35%) females. We found no differences in terms of age, BMI, time to Tx, condition of hyperimmunized or re-Tx in the Rc's group and the rate of Tx (p = 0.34) (see Table A). We had 102 donors, ♀ 41 (40%), ♂ 61 (60%), regarding to their features, differences between age and BMI were statistically non-significant, neither in individually nor delta analysis (see Tables B-C, and Figs A-B). Proportionally more male kidneys were transplanted to female Rc's.

Conclusion

In our sample, we had a 2:1 rate of males to women in our waiting list, and in access to Tx. Relatively more women received a kidney form a male Do (46 vs 31%). Although other studies find a gender gap in access to kidney Tx, this phenomenon was not found in our sample. However, our results may be conditioned by a small sample size. We need to design well powered and multicentric studies, to dilucidate this controversial issue.
#2935 Kidney transplantation outcomes following non-kidney solid organ transplantation
Authors: Alonso Marta , Villanego Florentino , Singh Arshdeep , Amaro José Manuel , López Verónica , Roncero Francisco Manuel González , Rodríguez-Benot Alberto , Ruiz-Fuentes Maria Carmen , Castro Pablo , Mazuecos Auxiliadora
Published: May 2024

Background and Aims

Approximately 15% of recipients of non-kidney solid organ transplantation (NKSOT) develop end-stage chronic kidney disease (CKD), requiring kidney transplantation (KT). There are controversy whether KT after NKSOT outcomes are poor or whether these patients should be prioritized.

Method

Retrospective analysis of KT after NKSOT in Andalusia between 1978-2023. We performed a case-control study, choosing 2 controls for each case (1 recipient of a second KT [reKT] and 1 recipient of a first KT without previous NKSOT), the closest ones with KT date and similar age and gender between donor and recipient. Patients with renopancreatic transplantation were excluded. We compared clinical characteristics and outcomes.

Results

During this period, we followed 12217 KT in Andalusia. Of these, 35 (0.003%) are KT after NKSOT: 26 (74.3%) liver transplant recipients, 7 (20%) heart transplant recipients and 2 (5.7%) lung transplant recipients. All of them are recipients of a first KT.

When comparing KT after NKSOT vs. reKT and first KT recipients, demographic characteristics and donor type are similar in all 3 groups. The reKT recipients were on dialysis longer before receiving the second KT, with no difference between the other 2 groups. Graft survival of reKT patients was lower than the rest (vs. KT after NKSOT, p = 0.014; vs. first KT p < 0.001). Survival between KT after NKSOT and first KT was slightly worse in those who had received a previous NKSOT, but without significant differences. In multivariate analysis, adjusted for time on waiting list, reKT remained a risk factor at the limit of statistical significance (p = 0.072). There was no difference in patient survival.

Conclusion

KT after NKSOT has similar graft and patient survival outcomes to recipients of a first KT, and better than in recipients of a second KT.
Urban Resilience
Authors: Alpermann Hendrikje , Fürst Moritz , Hedayatifard Maede , Ince Keller Irem , Ruegg Jean , Yip Maurice
Published: May 2024

The concept of urban resilience has gained increasing attention not only among academic researchers, but also among urban practitioners and policymakers since the 2010s, after its initial emergence in the 2000s, a time when cities faced different types of urban disturbances and felt the urgent need to address them with encompassing policies. Over the years, urban resilience has been embedded in the global urban landscape through various urban policies, programs, and practices. Today, urban governance incorporates elements of urban resilience by improving infrastructure, making urban and territorial plans, and formulating risk management strategies. Urban resilience has close intellectual ties with some earlier work dating back to the second half of the 20th century in other fields of study, such as the conceptions of resilience in ecological studies, science and technology studies, development studies, and sustainability studies. But it is the urban dimension that distinguishes the idea and practices of urban resilience from other notions of resilience. Based on the understanding that cities are complex networks, recent studies draw attention to key factors in operationalizing urban resilience, such as spatial and temporal scales, different urban systems and their multi-scalar networks, historical background, and local specificities. This annotated bibliography organizes the burgeoning publications on urban resilience into three parts: the basics, the practices, and the critique. The basics part contains four sections: General Overviews and Definitions presents the debates over definitions of urban resilience; Conceptual Foundations considers groundbreaking works on urban resilience since the 2000s; Urban Shocks and Stresses introduces the works that clarify what counts as the disturbance that concerns scholars of urban resilience; the works presented in Urban Materialities and Specificities address an often overlooked, yet important, conceptual question about the meaning of the urban that makes urban resilience different from other forms of resilience. The four sections of the second part focus on how scholars have studied resilient practices in cities and how these practices inform, and are informed by, academic work: beginning with Implementation and Governance of Urban Resilience, this part goes through different arenas of urban resilience, including Infrastructure, Risk Management, Planning Theory, and Planning Practices. The third part, The Critique of Urban Resilience, presents the academic literature that challenges the conceptualization of urban resilience, questions the real-world consequences of urban resilience practices, and addresses the limitation of urban resilience in Western-centric urban studies scholarship.
Hostile Design
Authors: Rosenberger Robert
Published: May 2024

The notion of “hostile design” or “hostile architecture” has become an important part of online critical analyses of the politics of public spaces, and it is now increasingly receiving academic attention. These lines of academic study and criticism at once build on long-established insights and research from across a variety of disciplines, and at the same time represent a reinvigorated focus on the specifics of the design of public spaces. An expanding variety of specific objects in public spaces are investigated as instances of hostile design. However, a few have become go-to examples. Public-space benches are often called out for the ways their designs make it difficult to use them as a place to sleep. Such designs can include the addition of armrests or seat dividers, or bucket seating arrangements. Another central example is spikes added to ledges to deter people from sitting or leaning. Skatestoppers—i.e., small, often metal nubs—are affixed to railings or ledges to ward off skateboarders looking to do tricks. And also a multitude of other objects have been criticized as examples of hostile design, from garbage can lids that deter trash picking to public-space security cameras that encourage people to behave themselves to loud sound systems that discourage loitering or camping to sprinkler systems that water down potential sleeping spaces to locks on fire hydrants to bollards to fences and even to the absence of expected public-space amenities (such as restrooms, water fountains, sidewalks, and shade). There are many populations that are targeted by hostile design, including loitering youths, skateboarders, and the poor. However, those living unhoused are possibly the most consistently subjected, and hostile design has become a part of the larger strategies that many cities take up in addressing the problem of homelessness. The topic of hostile design has enabled a new path into the study and criticism of long-standing issues in the politics of the built environment. The novelty and open-ended statuses of these ideas can be seen in the fact that there are many different terms in usage within this literature to refer to these same public-space objects in addition to “hostile design” and “hostile architecture,” including “unpleasant design,” “architectural exclusion,” “disciplinary architecture,” and “defensible space,” among others. And most often, the notion of hostile design is wielded as a term of criticism. Or as Petty 2016 (cited under Specific Objects of Hostility) puts it, hostile design is “a pejorative term usually used to signify opposition to the structure identified” (p. 69). Thus, for many scholars at least, these ideas retain a normative edge. While it is possible to connect work on these issues to a vast history of research and thought on urban space across a variety of disciplines, what follows in this article focuses on contemporary pieces on this specific topic.
Otherness in the Hebrew Bible
Authors: Jang Ki-Eun
Published: May 2024

As a philosophical idea, otherness is perceived in relation to sameness, just as the Other exists in relation to the Self in both human and nonhuman realms. Understanding otherness, therefore, presupposes the presence of the Other as a subject or object of study, and it could also involve the process of Othering. Ever since Edward Said’s critique on the notion of a “constitutive otherness,” which assumes a natural correlation between essential characteristics and the othered person(s), thereby functioning as an operating logic of Orientalism, studies on otherness have engaged in critical examinations of the idea’s origins and receptions. As a sociological concept, the scope of otherness spans differentiated social categories such as gendered otherness, racial/ethnic otherness, foreignness, illegal otherness, and nonhuman otherness, among others. Likewise, the sociological approaches to the concept have been developed in conversation with the fields of gender/sexuality studies, ethnic studies, postcolonial studies, animal studies, and migration studies, which have emerged and grown to a great extent since the mid-twentieth century, especially in North America. In response, a more focused engagement with the idea of otherness as a heuristic lens and an interpretive methodology in biblical scholarship was noted at the turn of the twenty-first century. Furthermore, discourses on other gods and goddesses in the Hebrew Bible broaden the scope of otherness to encompass divinity. This article primarily focuses on studies that examine differing ideas and representations of Other and Othering within the Hebrew Bible/Old Testament.
The Notre Dame School and the Music of the Magnus liber organi
Authors: Wolinski Mary E.
Published: May 2024

The Notre Dame School encompasses the musicians who created a distinctive style of music for the Cathedral of Notre Dame in Paris from roughly the mid-twelfth to the mid-thirteenth centuries. The term is apt, for the Cathedral boasted of a school well before the emergence of the university of Paris. While its most prominent scholars were known for theology, the cathedral also trained its own boy choristers. The music of the Notre Dame School consisted of special types of polyphony that exhibit a breadth of conception and rhythmic organization that was unprecedented. Organa are arrangements of chant melodies for more than one voice that were sung during Mass or Divine Offices at Notre Dame. Conducti are musical settings, either polyphonic or monophonic, of Latin poems. Most are devotional, but others have historical and even secular themes. The earliest motets combine short passages of chant in the lowest voice (tenor) with Latin or French poems, sacred or secular, in the upper voices. Clausulae are musically the same as motets, but without any poetry. They occur within organa or collections of clausulae. Unlike organa, which were specifically for the services, conducti and motets were extraliturgical and sung in various venues, including at the feasts of the educated according to the theorist Johannes de Grocheio. The English medieval theorist known as Anonymous IV tells us that Master Leoninus was the best composer of organa and made the great book of organum (magnus liber organi) based on the chant books for the Mass and Divine Offices to enhance those services. This magnus liber organi was in use until the time of Master Perotinus, who made better clausulae. Anonymous IV attributes certain four-part and three-part organa, as well as polyphonic and monophonic conducti, to Perotinus and asserts that the books of Perotinus were in use in the choir of the Cathedral of Notre Dame. Anonymous IV also names several other church musicians active in Paris and England. Three manuscripts that preserve the most complete versions of the magnus liber organi are known as W1, W2, and F. Two originated in Paris, while W1 is Scottish, reflecting the wide dissemination of the repertory. Other sources of Notre Dame repertory were copied in the British Isles and the continent, from the Iberian Peninsula to eastern Europe.
Adjectives
Authors: Sleeman Petra
Published: May 2024

Adjectives are a nominal syntactic category that is distinct from but shows also overlap with nouns and verbs, and also with determiners and adverbs. Important questions that have been raised concern their universal availability, their emergence, their distinction from nouns and verbs, and their morphological derivation. Adjectives became a prominent topic of study after the popularization of the Determiner Phrase (DP) in the analysis of the noun phrase and the introduction of several other functional projections dominated by the DP. This led to the distinction between attributive and predicative adjectives within the noun phrase and to the investigation of the relation between position and interpretation within the noun phrase. With respect to their interpretation, their gradability and the semantic and syntactic impact of gradation has been the subject of many studies. Other important questions concern the establishment, the types, and the role of adjectival inflection or agreement and their possible role in the licensing of nominal ellipsis. Besides adjectival inflection, another typical characteristic distinguishing the adjective as a category in certain languages has been claimed to be the adjectival article. The study of the acquisition of aspects of the adjective has been used to support various theories on language acquisition.
Lorraine Hansberry
Authors: Gómez-Galisteo M. Carmen
Published: May 2024

Lorraine Hansberry (19 May 1930–12 January 1965), at twenty-eight years old, became the first female African American playwright who had a drama produced on Broadway with A Raisin in the Sun (1959). A Raisin in the Sun opened at the Ethel Barrymore Theatre in March 1959. Hansberry received the New York Drama Critics’ Circle Award and was celebrated as one of the most promising American playwrights. Born of college-educated parents, the youngest of four children, Hansberry was raised in a middle-class family on the South Side of Chicago. Her father combined his career in real estate with civil rights activism while her mother was a teacher. When she was seven, her family moved into a white neighborhood, where they were the victims of abuse and harassment from neighbors who did not want African American residents in their area. This experience would be an inspiration for A Raisin in the Sun. Her father legally fought the existence of neighbors’ covenants that caused housing discrimination against African Americans, winning the case after a several-year fight that reached the Supreme Court, Hansberry v. Lee. Hansberry studied at the University of Wisconsin (1948–1950) but she left before having completed her degree. She enrolled in the School of the Art Institute of Chicago and Roosevelt University and would later study at the New School for Social Research in New York City. She would fix her permanent residence in New York since 1950. Hansberry embraced communism and wrote for several leftist publications. For this political activism, she came under the surveillance of the FBI. A Raisin in the Sun (whose working title had been The Crystal Stair) takes its name from a line in Langston Hughes’s poem, “Harlem” (also known as “A Dream Deferred”). A Raisin in the Sun soon had a movie version (1961) directed by Daniel Petrie and starring Sidney Poitier and Louis Gossett Jr. Her next play to open on Broadway was The Sign in Sidney Brustein’s Window, and it would be the last production during her lifetime. It opened on 15 October 1964 and was not so successful (although it had Broadway revivals in 1972 and 2023). Hansberry was already terminally ill at the time and died before its run was over. Despite her homosexuality, in 1953 Hansberry married Jewish political activist and songwriter Robert Nemiroff. At the time, homosexuality was illegal, as was interracial marriage in several states. The marriage ended in divorce in 1964 but they remained close friends. After her death from pancreatic cancer at age thirty-four, he became her literary executor until his death in 1991. He was in charge of the Broadway production of Les Blancs in 1970 and he coauthored with Charlotte Zaltzberg Raisin, a Broadway musical version of A Raisin in the Sun which opened in 1973. In 1986, A Raisin in the Sun opened at the Kennedy Center in Washington, DC, to celebrate its twenty-fifth anniversary. A television adaptation, starring Danny Glover, followed. In 2008, it became a TV film whose cast and director had already participated in a 2004 Broadway revival.