bluuebunny/crossref_metadata_2025 huggingface dataset:
#1054 Dietary manganese intake and risk of chronic kidney disease: insights from the UK Biobank Study
Authors: Park Jung Tak , Choi Da Sol , Park Cheol Ho , Heo Ga Young , Kim Hyung Woo , Han Seung Hyeok , Yoo Tae-Hyun , Kang Shin-Wook
Published: May 2024

Background and Aims

Manganese, an essential trace element crucial for various physiological processes, has been linked to metabolic syndrome and cardiovascular health. Despite these associations, the relationship between dietary manganese intake and incident chronic kidney disease (CKD) remains unclear. In this study, the connection between dietary manganese consumption and the development of CKD in individuals with normal kidney function was investigated.

Method

A total of 135,577 participants enrolled in the UK Biobank were assessed. Dietary manganese intake was determined through a 24-hour dietary recall questionnaire and categorized into quartiles. Individuals with prevalent CKD or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 at baseline were excluded. The primary outcome was incident CKD diagnosed using ICD-10 and OPCS-4 codes. Incident CKD, defined as eGFR <60 mL/min/1.73 m2 or a urine albumin-to-creatinine ratio (UACR) ≥30 mg/g, was also evaluated in a sub-cohort that included eGFR and UACR follow-up data.

Results

During a follow-up period of 1,492,228 person-years (median, 11.2 years), incident CKD occurred in 4,900 (3.6%) participants. The incidence of CKD exhibited a progressive increase among individuals with low manganese intake (2.3, 3.0, 3.6, and 4.2 events per 1000 person-years in Q4–Q1, respectively). In a multivariate Cox proportional hazard model, the adjusted hazard ratios (95% confidence intervals) for the lowest, second, and third quartiles were 1.39 (1.26–1.54), 1.22 (1.11–1.34), and 1.12 (1.02–1.23), respectively, compared to the highest quartile. Similar findings were observed in relation to eGFR or UACR-defined CKD outcomes.

Conclusion

Lower dietary manganese consumption was found to be associated with an elevated risk of incident CKD in adults with normal kidney function. This implies that a deficiency in dietary manganese intake may contribute to an increased risk of CKD development.
#2577 Sodium-mediated blood pressure rise is associated with a lower vasodilation response to nitroglycerin in healthy controls, but not in CKD
Authors: van Duin Robert , Oppelaar Marjet , van den Born Bert-Jan , Engberink Rik Olde , Vogt Liffert
Published: May 2024

Background and Aims

Chronic kidney disease (CKD) is characterized by endothelial dysfunction, that is partly caused by reduced bioavailability of NO. In addition to volume overload, endothelial dysfunction may contribute to hypertension in CKD. High sodium consumption affects NO levels, potentially leading to impaired vasorelaxation and a salt-sensitive blood pressure (BP) response. Whether salt-sensitivity in CKD is related to impaired NO bioavailability remains unknown. In this randomized-crossover-study, the vasoresponse to the NO donor nitroglycerin (NTG) during a high sodium diet in both CKD and healthy controls (HC) was assessed.

Method

CKD-patients (KDIGO stage G2-3A, proteinuria >0.5 g/d) and HC followed a 7-day low sodium control diet (<50 mmol/d) and high sodium diet (>200 mmol/d) in random order. After each diet, the hemodynamic profile was assessed by daytime BP and cardiac output (CO) measurements, by which systemic vascular resistance (SVR) was calculated. Nitroglycerin was administered to assess SVR changes.

Results

We included 15 CKD-patients (mean age, 49 yrs; median (IQR) proteinuria 0.7 (0.6-1.4) g/d; and plasma creatinine 129 (105-160) µmol/l) and 16 HC (41 yrs). Dietary salt intervention was comparable in the CKD and HC groups. After HSD, mean (SD) systolic BP increased in CKD by 9.7 mmHg (9.8; p < 0.01) as compared to 3.1 mmHg ((6.0), p = 0.07)) in HC (between-group difference p = 0.04). After HSD, changes in body weight and CO did not differ between groups. Median (IQR) SVR change after HSD was 163.0 (−34.9-275.7) in CKD and −13.8 ((−299.4–61.4),p = 0.03) dyn⋅sec⋅cm-5 in HC. In HC, salt-mediated blood pressure change was positively associated with a NTG-induced SVR change during HSD (r = 0.70, p = 0.01). This association was not present in CKD (r = −0.24, p = 0.34) and significantly different from that in HC (p < 0.01).

Conclusion

CKD-patients have a higher sodium-mediated BP response with comparable change of fluid status but a different SVR change as compared to HC. In HC, impaired sensitivity to the NO donor nitro-glycerin associates with higher BP response to sodium. No such association was found in CKD-patients, suggesting that persistent endothelial dysfunction is pivotal for salt sensitivity in CKD.
#755 Endotrophin as an early marker of kidney outcomes in persons with type 2 diabetes: findings from the PROVALID study
Authors: Møller Alexandra Louise , Thöni Stefanie , Keller Felix , Sharifli Samir , Genovese Federica , Karsdal Morten Asser , Mayer Gert
Published: May 2024

Background and Aims

Diabetic kidney disease (DKD) is driven by a set of pathophysiological processes, including fibrosis. Endotrophin (ETP), a pro-fibrotic fragment generated during collagen type VI formation, has previously been shown to be a biomarker of DKD progression. The aim of this study was to investigate, for the first time, circulating ETP as a risk marker for kidney outcomes in persons with type 2 diabetes (T2D) being taken care of at the primary level of healthcare.

Method

Levels of ETP were measured using the nordicPRO-C6TM ELISA in plasma at baseline from 3226 persons with T2D enrolled in the Prospective Cohort Study in Patients with Type 2 Diabetes Mellitus for Validation of Biomarkers (PROVALID). Outcomes included a composite kidney endpoint defined as a sustained 40% decline in estimated glomerular filtration rate (eGFR) < an eGFR of 60 ml/min/173 m2, sustained 30% increase in albuminuria including a transition in albuminuria stage, or kidney failure with replacement therapy or kidney death. A decline in eGFR and an increase in albuminuria were considered sustained if they persisted over at least two consecutive measurements. Crude and adjusted Cox proportional hazards regression models were applied to investigate the potential of ETP as a risk marker of the kidney endpoint. Levels of ETP were log-transformed before analysis. The Kaplan–Meier estimator was used to compare the risks of experiencing the kidney endpoint according to ETP levels split by the median in persons with baseline eGFR > 90 ml/min/1.73 m2 (n = 976).

Results

The cohort consisted of 57% males; median age was 64 (58-70) years, and mean eGFR was 79 ± 24 ml/min/1.73 m2. Median follow-up was 3.9 years. Higher levels of ETP were associated with a higher risk of developing the kidney endpoint, with a hazard ratio (HR) of 1.63 (p = 0.0012; n = 293/3226). After adjustment for the refined variables: age, diabetes duration, HbA1c, atherosclerotic cardiovascular disease, blood pressure, duration of hypertension, BMI, LDL-cholesterol, HDL-cholesterol, and eGFR, the HR was 1.55 (p = 0.012). In persons with an eGFR > 90 ml/min/1.73 m2, higher ETP was also associated with an increased risk of developing the kidney endpoint (p = 0.03; n = 69/976).

Conclusion

Plasma ETP was an independent risk marker for kidney outcomes in persons with T2D with early kidney disease. Higher levels of plasma ETP were associated with a significantly increased risk of developing the kidney endpoint in persons with eGFR > 90 ml/min/1.73 m2. These findings demonstrate that biomarkers of fibrosis, such as ETP, may serve as early markers for kidney disease progression or kidney failure in persons with T2D and apparently normal kidney function.
#1320 Differential microRNA expression profile in obesity-induced kidney disease driven by high-fat diet in mice
Authors: Sanjuan Auria Eritja , Caus Maite , Belmonte Thalia , de Gonzalo Calvo David , García-Carrasco Alicia , Bardaji Ana Martinez , Bozic Milica
Published: May 2024

Background and Aims

Obesity is one of the main causes of chronic kidney disease; however, the precise molecular mechanisms leading to the onset of kidney dysfunction in obesity-induced kidney disease (OIKD) remain unclear. MicroRNAs (miRNAs) have been implicated in the development and progression of obesity, and several candidates have been identified as critical regulators of adipogenesis and lipid metabolism, while their dysregulation contribute to obesity-related metabolic abnormalities. The aim of the present study was to decipher the kidney microRNA (miRNA) expression profile in a mouse model of obesity-induced kidney disease characterized by systemic metabolic disturbances and kidney injury that closely resemble those observed in human disease.

Method

Male C57BL/6J mice were randomly divided and placed either a standard diet (STD) or a high fat diet (HFD) for 10 weeks. Serum triglycerides and total, HDL and LDL cholesterol were determined by standard clinical methods. In the kidney sections, histopathological assessments were done by using PAS and Oil-Red-O staining's. Expression of renal MCP1, TNFα, α-SMA, Fibronectin, miR-146a, miR-551b and miR-5099 was assessed by real time PCR. In order to elucidate the role of differentially expressed miRNAs, a search for target genes was done using an online computational resource DIANA-miRPath v4.0.

Results

High fat diet (HFD)-induced obesity led to evident structural alterations in tubular and glomerular regions of the kidney, increased renal expression of adiposity-related proinflammatory and profibrotic genes, as well as an elevated renal expression of genes involved in cellular lipid metabolism. The miRNA sequencing analysis identified a set of 9 miRNAs differentially expressed in the kidney upon HFD feeding, with miR-5099, miR-551b-3p, miR-223-3p, miR-146a-3p and miR-21a-3p showing most significant differential expression between standard diet (STD) and HFD mice. Consistently, Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses revealed that 3 validated miRNAs (miR-5099, miR-551b-3p and miR-146a-3p) modulated target genes involved in metabolic and adipocytokine pathways, fatty acid and lipid metabolism, inflammatory, senescence and profibrotic pathways.

Conclusion

Our results propose that differentially expressed miRNAs play pivotal roles in the intricated pathophysiology of obesity-associated kidney disease and could potentially create novel treatment strategies to counteract the deleterious effects of obesity on kidney function.
#2484 Diffusion magnetic resonance imaging, a noninvasive tool to assess fibrosis level in both native and allograft kidneys
Authors: Huber Aurélie , Aslam Ibtisam , de Seigneux Sophie , De Perrot Thomas , Vallée Jean-Paul , Pruijm Menno , Berchtold Lena
Published: May 2024

Background and Aims

Renal cortical interstitial fibrosis is a well-established prognostic indicator for renal health, conventionally estimated by biopsy. Our prior research has enhanced DW-MRI sequencing, facilitating precise distinction between the renal cortex and medulla. This has enabled the measurement of the cortico-medullary apparent diffusion coefficient difference (ΔADC), which inversely correlates with the extent of histologically assessed interstitial fibrosis. The present study is designed to validate these findings, assess their reproducibility in a separate institution, and ascertain their significance in delineated subgroups, particularly between allograft recipients and native kidney patients.

Method

From 2014 to 2023, we orchestrated a prospective cohort study encompassing 309 patients diagnosed with chronic kidney disease (n = 106) or those with a renal allograft (n = 203). Each patient had undergone a biopsy, subsequent to which a multimodal magnetic resonance imaging (MRI) was systematically conducted in the following weeks. Initially, participants were recruited from Geneva hospitals, with subsequent inclusion of patients from Lausanne in Switzerland.

The study's objective was to evaluate the correlation between ΔADC and the degree of renal fibrosis at biopsy. We performed subgroup analyses (per center, native/allograft kidneys) and applied linear regression models to investigate these associations rigorously.

Results

We included 270 participants in Geneva and 39 patients in Lausanne. A significant negative correlation was observed between ΔADC and the degree of fibrosis across the entire cohort (R = −0.41, p < 0.001). Subgroup analyses yielded consistent findings in both Geneva (R = −0.43, p < 0.001) and Lausanne University Hospitals (R = −0.35, p < 0.001). Furthermore, this association remained significant within subgroups of both native and allograft kidneys (respectively: R = −0.48, p < 0.001 and R = −0.38, p < 0.001).

Conclusion

Our findings reinforce the link between ΔADC and renal fibrosis, indicating that this association is consistent regardless of the center or kidney type (native or allograft). This supports the potential utility of diffusion MRI as a non-invasive tool for the assessment of renal fibrosis.
#995 Effectiveness of Semaglutide once weekly as add-on to SGLT-2Is in T2DM and CKD: a single-center observational study with body composition assessment
Authors: Yang Qing , Liu Fang
Published: May 2024

Background and Aims

To explore body composition and metabolic profile changes in type 2 diabetes mellitus and chronic kidney disease (T2DM-CKD) using Semaglutide added to sodium-glucose transporter 2 inhibitors (SGLT-2Is).

Method

The study was performed on patients with T2DM-CKD in West China Hospital of Sichuan University. The outcomes were changes in body composition and metabolic profile after 6 months among patients administrated Semaglutide based on SGLT-2Is (Semaglutide plus SGLT-2Is group) and the comparison with patients only administrated SGLT-2Is (SGLT-2Is group).

Results

12 individuals with T2DM-CKD and BMI ≥28 kg/m2 were included in two groups, respectively. After 6 months, total fat mass was reduced by 0.9 kg (IQR −3.73, 0.4) vs. 0.7 kg (IQR −1.9, −0.37) with Semaglutide plus SGLT-2Is group and SGLT-2Is group (P = 0.908). Skeletal muscle mass was reduced by 0.97 kg (SD 0.86) vs. 0.5 kg (SD 0.93), respectively (P = 0.215). ACR (229.55 mg/g (IQR −389.7, −119.92) vs. 0.5 mg/g (IQR −104.6, 84.9), P = 0.032), HbA1c (−0.35% (IQR −0.85, 0) vs. 0.3% (IQR 0.15, 1.1), P = 0.024) and total cholesterol (−0.51 mmol/L (SD 1.1) vs. 0.75 mmol/L (SD 0.93), P = 0.015) significantly declined in Semaglutide plus SGLT-2Is group compared to SGLT-2Is group.

Conclusion

Semaglutide plus SGLT-2Is did not exacerbate muscle loss compared with SGLT-2Is alone in obese patients with T2DM-CKD, and improved glucolipid metabolism and albuminuria.
#217 Renin-angiotensin-aldosterone system blockers effect in CKD progression in hypertensive elderly patients without proteinuria: PROERCAN trial
Authors: Garcia-Prieto Ana , Guzmán Ursula Verdalles , de José Ana Pérez , Arroyo David , Aragoncillo Ines , Barbieri Diego , Juarez Rosa Camacho , Villa-Valdés Miguel , Pervan Emina , Goicoechea Marian
Published: May 2024

Background and Aims

Evidence about nefroprotective effect with RAAS blockers in elderly patients with chronic kidney disease (CKD) without proteinuria is lacking. The primary outcome of our study is to evaluate the impact of RAAS blockers in CKD progression in elderly patients without proteinuria.

Method

Multicenter open-label, randomized controlled clinical trial including patients over 65 year-old with hypertension and CKD stages 3-4 without proteinuria. Patients were randomized in a 1:1 ratio to either receive RAAS blockers or other antihypertensive drugs and were followed up for three years (Figure). Primary outcome is estimated glomerular filtration rate (eGFR) decline at 3 years. Secondary outcome measures include BP control, renal and cardiovascular events and mortality.

Results

88 patients were included with a mean age of 77.9 ± 6.1 years and a follow up period of 3 years: 40 were randomised to RAAS group and 48 to standard treatment. Etiology of CKD was: 53 vascular, 16 interstitial and 19 of unknown etiology. In the RAAS group eGFR slope during follow up was −4.3 ± 1.1 ml/min, whereas in the standard treatment group an increase on eGFR was observed after 3 years (+4.6 ± 0.4 ml/min), p = 0.024. We found no differences in blood pressure control, number of antihypertensive drugs, albuminuria, potassium serum levels, incidence of cardiovascular events nor mortality during the follow up period.

Conclusion

In elderly patients without diabetes nor cardiopathy and with non proteinuric CKD the use of RAAS blockers does not show a reduction in CKD progression.
#1982 Transcriptomic approach to predict drug targets in late-stage hypertensive nephropathy
Authors: Chen Tony , Furriol Jessica , Landolt Lea Zoe , Knoop Thomas , Hallan Stein I , Øvrehus Marius , Scherer Andreas , Eikrem Øystein , Marti Hans-Peter
Published: May 2024

Background and Aims

Hypertensive nephropathy (HN) is a significant contributor to chronic kidney disease, yet the factors influencing the disease progression remains elusive. Notably, late-stage chronic kidney disease significantly impacts patient outcome. This project aims to unveil novel therapeutic targets for late-stage of HN using transcriptomic approach.

Method

A cohort of adult patients (n = 21; n = 9 females, mean age 57 years) with biopsy-confirmed HN were selected from the Norwegian Kidney Biopsy Registry (NKBR). Patients were classified as late-stage if eGFR≤45 ml/min/1.73 m2 at the time of biopsy. Patients were thereafter divided into “stable” (eGFR decline <3 ml/min/year) or “progressive” (eGFR decline ≥3 ml/min/year or start of renal replacement therapy) after a median follow-up of 9 years (5-15). TruSeq Exome sequencing was performed post-RNA extraction (miRNeasy FFPE kit, Qiagen) at Novogene, Cambridge, UK. R Studio (v4.2.0) and drug CTD repository in ShinyGO 0.80 facilitated data and drug interaction analysis.

Results

We focused on two distinct subgroups of HN patients: late stable (LS, n = 9) and late progressive (LP, n = 12). A total of n = 674 of differentially expressed genes (DEG, p-value < 0.05 and fold change (FC) ≥1.5) was identified in LS vs. LP.

The subsequent drug interactive analysis of these DEGs unveiled 336 pathways with false discovery rate (FDR) < 0.05. Notably, the probenecid-related pathway demonstrated significant fold enrichment (FE=9, FDR = 1.5E-04), as depicted in Fig. 1. Particularly, key members of the SLC22 family, including SLC22A6 (FC=2.49, p-value = 0.002), SLC22A8 (FC=2.65, p-value = 0.004), SLC22A11 (FC=1.65, p-value = 0.036) and SLC22A12 (FC=1.97, p-value = 0.009) were prominently featured in this pathway. Besides their role as sole transporters, it is postulated that these proteins have central role in modulating local and systemic physiology, such as blood pressure, suggesting a potential significance of probenecid in the context of hypertensive nephropathy.

Conclusion

Transcriptomic profiling of kidney biopsies has strong potential to discover novel therapeutic targets, such as the probenecid-related pathway, in hypertensive nephropathy patients.
#607 Pre- and post-hemodialysis differences in heart failure diagnosis by current heart failure guidelines in patients with end-stage renal disease
Authors: Shin Ho Sik , Kim Ye Na , Kil Song Yi , Park Byung Hwa , Lim Sungil , Jung Yeonsoon , Rim Hark
Published: May 2024

Background and Aims

Patients with end-stage renal disease (ESRD) who are on hemodialysis (HD) have reduced vascular compliance and are likely to develop heart failure (HF). Dialysis patients experience a volume change of ∼3–4 kg before and after HD, which can affect hemodynamic indicators, some of which are highly influenced by a patient's volume status. Therefore, depending on when echocardiography is performed, there may be differences in hemodynamic parameters. However, it is not easy to perform echocardiography in the euvolemic state in the clinical setting. This study estimated pre- and post-HD in ESRD HF diagnosis prevalence using the current guidelines.

Method

We prospectively investigated ESRD patients on HD using echocardiography between pre and post HD. We used structural or functional abnormality criteria of 2021 ESC guideline.

Results

A total of 54 patients were enrolled. The mean age was 62.6 years and 40.1% were male. Forty-five patients (83.3%) had hypertension, 28 (51.9%) had diabetes, 20 (37.0%) had ischemic heart disease. Mean NT-pro BNP level was 11959.9pg/dL. The mean ideal body weight was 59.3 kg, mean hemodialysis time was 237.4 minutes, and mean real filtration was 2.8 kg. The mean LVEF was 62.4% and mean LVEDD was 52.0 mm in pre-HD. Post-HD echocardiography showed significantly lower LAVI (33.3 ± 15.9 vs. 40.6 ± 17.1, p = 0.030), TR jet V (2.5 ± 0.4 vs. 2.8 ± 0.4 m/s, p < 0.001), and RVSP (32.1 ± 10.3 vs. 38.4 ± 11.6, p = 0.005) compared with pre-HD. There was no difference in LVEF, E/E’ ratio, or LV GLS. A total of 88.9% for pre-HD and 66.7% for post-HD had at least structural or functional abnormalities in echocardiographic parameters according to recent HF guidelines, p = 0.007).

Conclusion

Our data showed that the majority of patients undergoing hemodialysis satisfy the diagnostic criteria for HF according to current HF guidelines, and the difference of prevalence of HF was 22.2% between pre- and post- HD.
#935 Exploring the impact of sensory-feedback in foot on physical activity in frail hemodialysis patients: a randomized controlled trial
Authors: Hamad Abdullah , Lee Myeounggon , Ibrahim Rania , Ateya Heba , Mathew Mincy , Talal Talal , Rodriguez Naima , Najafi Bijan , Al-Ali Fadwa
Published: May 2024

Background and Aims

Patients undergoing hemodialysis (HD) often face fatigue, time constraints, and impaired mobility, contributing to reduced physical activity and frailty. Intradialytic electrical stimulation (E-stim), particularly targeting the plantar region of the feet, is suggested as an alternative to traditional exercise programs. This study aims to investigate the association between sensory feedback in the foot and physical activity characteristics to demonstrate the efficacy of plantar electrical nerve stimulation (PENS) during HD in patients with frailty.

Method

43 participants with pre-frail to frail levels based on the Fried frail criteria were enrolled. They were randomized to either an intervention group (IG: n = 21, age=55.5 ± 14.3 years, BMI = 28.5 ± 6.0 kg/m2, female = 28.6%, pre-frail=38.1%, frail=61.9%) receiving PENS or a control group (CG: n = 22, age = 61.0 ± 7.8 years, BMI = 30.7 ± 6.2 kg/m2, female = 45.5%, pre-frail = 36.4%, frail = 63.6%). The IG received 1-hour PENS during HD session (3 sessions/week), while CG received an identical but non-functional device for 12 weeks. The maximum Vibratory Perceptual Threshold (VPT) value was measured to assess sensory-feedback in foot, and daily life physical activity was assessed using the wearable pendant at the baseline and 12-weeks. The delta values (Δ) between 12-weeks and baseline were calculated to explore the association between VPT and physical activity.

This study was supported by the Qatar National Research Foundation (QNRF, Award #NPRP10-0208-170400I).

Results

Age, gender, demographics, and other baseline characteristics were similar among IG and CG. 95% of participants completed 12 weeks regimen. In the IG, Δ walking duration (rho = −0.458, p = 0.037) and total step numbers (rho = 0.484, p = 0.026) were negatively correlated with Δ maximum VPT value, whereas there was no correlation in the CG.

Conclusion

Our study suggests that 12 weeks of E-stim therapy may enhance foot sensory feedback in the IG, potentially boosting walking-related activities in HD patients. Thus, we advocate for this practical therapy, especially for HD patients with frail symptoms, to promote increased physical activity.
#1744 Characteristics of patients on long-term dialysis for more than 30 years in our hospital
Authors: Sakamoto Emi , Suda Akio , Kobayashi Hideo
Published: May 2024

Background and Aims

In Japan, the prognosis of dialysis patients has improved over the years. The number of patients on dialysis for more than 20 years dramatically increased from less than 1% in 1992 to 8.6% in 2021. We analyzed the factors that contribute to the prolonged prognosis of dialysis patients.

Method

Of our 117 maintenance dialysis patients, we examine the dialysis profile of 26 (22.2%) long-term dialysis patients who have been on dialysis for more than 30 years.

Results

The mean age of dialysis induction is 32 years (13-55, ±10), the mean age is 71 years (46-87, ±9), and the longest duration of dialysis is 42 years. 12 patients are male. The majority cause of hemodialysis in them is chronic glomerulonephritis (22 patients). In addition, there are no patients with diabetes complications, 4 patients with hypertension, and 2 patients with coronary artery disease. 12 patients have carpal tunnel syndrome or destructive spondyloarthropathy. On-line HDF is generally used in 19 patients, mean blood flow is 215 ml/min (180-260, ±24), and mean dialysis time is 4.2 hours (3.5-5.0, ±0.4). Mean Kt/V is 1.76 (0.97-2.23, ±0.30), urea removal rate is 75.1% (57.8-84.2, ±6.6), β2-microglobulin is 23.8 μg/L (12.9-31.0, ±5.0). Mean DW is 51.0 kg (36.8-67.0, ±9.2), body mass index is 20.3 kg/m2 (16.1-24.4, ±2.5). Mean inter-dialysis weight gain is DW × 3.5% (2.9-4.9, ±0.9), nPCR is 0.9 g/kg/day (0.6-1.3, ±0.2), mean Albumin is 3.7 g/dl (3.2-4.4, ±0.3), whole-PTH is 160.4 pg/mL (0.0-902.7, ±178.8), Hemoglobin is 10.2 g/dL (7.8-13.9, ±1.4), 4 patients don't use ESA products.

Conclusion

According to the Japanese statistical survey of dialysis patients in 2020, 2.3% of the patients have been on dialysis for more than 30 years, which means that our hospital has a larger rate of long-term dialysis patients. These patients exceed the Japanese average in terms of both nutritional status and dialysis efficiency. The reasons for this may include the fact that our patients were on dialysis for at least 4 hours, and we intended to adhere to very mild dietary restrictions, specifically, the same diet as the family and that we did not recommend a low-protein diet.
#766 A prognostic model (BLEND35) with internal validation for treatment failure in patients with peritoneal dialysis-associated peritonitis
Authors: Liang Qichen , Zhao Huiping , Wu Bei , Niu Qingyu , Lu Lixia , Qiao Jie , Men Chuncui , He Yuting , Chu Xinxin , Zuo Li , Wang Mei
Published: May 2024

Background and Aims

Globally, peritoneal dialysis (PD)-associated peritonitis (PDAP) is a common and severe complication in PD. Early identification of high risk PDAP helps to prevent adverse outcomes. Currently, there is no recognized predictive tool for treatment failure of PDAP. Therefore, this study aimed to develop and validate a prediction model for treatment failure in patients with PDAP.

Method

We retrospectively collected 313 PDAP episodes occurred between January 2007 and August 2023, from real-world clinical practice in a tertiary center in Beijing, North China. The candidate predictors including patient characteristics, latest laboratory tests before PDAP, laboratory tests at PDAP onset and the causative organisms in peritoneal effluent. The prognostic model was developed from a multivariable logistic regression model with predictors selected using the stepwise backward regression. The C-statistic and the calibration curve plot were used to assess the discrimination and calibration of the prediction model. A bootstrap with 100 resampling was also performed as internal validation to further determine the robustness of the model.

Results

Among 313 PDAP episodes, 63 was reported treatment failure. The final model included 7 variables and was termed BLEND35 (sex, PD duration, platelet-to-lymphocyte ratio before PDAP, Gram-negative peritonitis, blood white cell counts at PDAP onset, dialysate white blood cell counts on day 3 and day 5). The C-statistic of the model was 0.936 (95% CI 0.897–0.974), revealing great discrimination. Calibration plot indicated that the model-predicted probabilities correlated well with the actual observed frequencies (Hosmer-Lemeshow test, P = 0.1223; Brier score = 0.064). Decision-curve analysis also revealed a positive net benefit.

Conclusion

The BLEND35 model will help to identify those with most high risk of treatment failure of PDAP and contribute to personalize and precise treatment. However, external validation is required before future application.
Introduction
Authors: Miller Seumas , Bossomaier Terry
Published: May 2024

Cybersecurity has become a strategic priority for governments worldwide. Individual citizens, businesses, and public-sector agencies are increasingly subject to cyberattacks from malevolent individuals, criminal organizations and, indeed, authoritarian governments. Cybersecurity has given rise to a plethora of ethical concerns such as, privacy and data security, disinformation/hate speech on social media, predictive policing and cognitive warfare, the addressing of which requires the analysis of core ethical principles and values of liberal democracy, e.g., privacy/autonomy, freedom of communication. This work addresses many of the most important of these ethical concerns. Moreover, a set of ethical guidelines have been devised to give direction to the required regulation and institutional redesign in the service of the collective good of cybersecurity.
Doctrinal Dichotomies
Authors: O’Rourke Maeve
Published: May 2024

This chapter considers two arenas in which the doctrine created by some treaty bodies under the anti-torture norm may prevent the norm’s effective application to older people’s care-related mistreatment. These doctrinal problem areas concern (i) state responsibility for suffering arising from lack of access to resources and (ii) the medical necessity of non-consensual care-related interventions. Here, the European Court of Human Rights and other treaty bodies to some extent appear to have carved out exceptions to their ordinary rules so that people in certain situations are deemed not to have the same claim as others to a state response to their suffering. I challenge logical inconsistencies in these positions and explain the alternative approaches of the Inter-American Court of Human Rights and United Nations disability rights bodies. This chapter establishes legal reasoning challenges to which the book’s conceptualization and application of dignity and vulnerability respond further.
Introduction
Authors: Rusterholz Caroline
Published: May 2024

The Introduction lays out the rationale behind a study of the Brook Advisory Centre. It situates the book’s arguments within the main scholarship on the history of youth, sexuality, expertise, race, and reproductive politics and makes the case for the need to study the history of young people’s sexuality from an intersectional perspective while taking their experiences and subjectivities into account. It highlights the key contributions this book makes to the history of postwar Britain, and in particular to the debate about the extent of the ‘permissive society’ and to the narrative of the liberalization of sexual behaviours. It then describes the methodology used and presents the sources. Finally, it provides an overview of the content of the book.
Conclusion
Authors: Rusterholz Caroline
Published: May 2024

The Conclusion highlights the main findings of the book. In particular, it highlights the ascent of a notion of responsible sexual behaviour for young people. The Conclusion reveals that this notion of ‘responsible sexuality’ functions as a useful explanatory tool to understand the so-called ‘sexual revolution’ period and its aftermath. The Conclusion argues that the concept of ‘responsible sexuality’ offers a narrative that illuminates the recurrent anxieties created by young people and sexuality over the three decades under study. The Conclusion also stresses Brook’s impact on changes in sexual politics nationally and locally. The Conclusion ends with some reflections about today’s situation.
The Paradoxes of Modesty
Authors: Taylor Helena
Published: May 2024

This chapter focuses on three texts from early in Madeleine de Scudéry’s career—Les Femmes illustres, Artamène ou le Grand Cyrus, and Clélie—to examine how she influenced literary taste with modern and feminised versions of ancient history. It treats the tensions between learning and modesty in her own ethos of amateurism and in the portrayal of her exemplary female intellectual ‘Sapho’, and her counterpart, the ‘savante’. The chapter then analyses Scudéry’s depictions of Lucrèce and Clélie in Clélie, showing how she creatively engaged with ancient sources and the exemplarity tradition, to argue that she departed from the patriarchal framing of the founding of the Roman Republic by modifying the role of masculinity and the narrative of Lucretia’s rape. With her emphasis on Sappho and ancient lyric, she reorientates the novel’s genealogies towards a lyric, rather than epic, tradition, and makes this innovation key to her bid for recognition and legitimacy.
Salon Verse and the Philosopher-Poet
Authors: Taylor Helena
Published: May 2024

Focusing on the poetry of Antoinette Deshoulières, this chapter examines her classical intertext, namely her nonsense version of Lucretius, her Virgilian pastoral, and her reworkings of Anacreon, Horace, and Ovid, to analyse her philosophical scepticism. It explores the playful hermeneutics of her Lucretius version, as her irony and ‘burlesque’ style allow her to use this philosopher-poet to reflect on poetry’s capacity to make meaning, a point she also examines in relation to the quarrels surrounding the eclogue in the 1680s; and shows how this scepticism extends to her scrutiny of man’s reason in her pastoral verse. The chapter then demonstrates how Deshoulières uses ancient models to reflect on salon verse and the status of the (female) poet. Showing that she takes an elusive position in the Quarrel of the Ancients and Moderns, the chapter argues that she ‘thinks with’ a range of ancient texts to explore ‘authority’ as both authorial and epistemological.
Introduction
Authors: Wadham John , Mountfield Helen , Desai Raj , Hannett Sarah , Jones Jessica , Mitchell Eleanor , Wills Aidan
Published: May 2024

chapter provides an introduction to how human rights were treated in the United Kingdom before the Human Rights Act came into force, including an assessment of rights in English common law, Magna Carta, and the Bill of Rights 1669. It covers postwar developments of human rights treaties, and describes the influence of the European Court of Human Rights and the Court’s judgments in UK cases up to the year 2000. The chapter summarizes the history of attempts to incorporate the Convention into UK law, and describes how the Human Rights Act affects the role of Parliament, the role of the courts, and of the judiciary. The chapter also focuses on the attempts since 1998 to amend the Act and the recent controversial Bill of Rights Bill. Finally, current and future threats to human rights protection are considered, including the erosion in the rights set out in the Illegal Migration Act 2023.
The Convention Protocols
Authors: Wadham John , Mountfield Helen , Desai Raj , Hannett Sarah , Jones Jessica , Mitchell Eleanor , Wills Aidan
Published: May 2024

This chapter summarizes the content of the significant Protocols of the European Convention. The chapter provides an overview of the jurisprudence of the European Court of Human RRights and the European Commission on Human Rights, including the protection of property (art 1 of the First Protocol), the right to education (art 2 of the First Protocol), and the right to free elections (art 3 of the First Protocol). Where the Protocol has been incorporated under the Human Rights Act the approach of domestic courts is discussed alongside the European case law, and any divergences are noted.
Introduction
Authors: Robert Howard Nathan , Schroeder Mark
Published: May 2024

This chapter, the first of Part 1: Parts, overviews the main goals for the book and key concepts and ideas that will be relied on throughout the book. The twin explanatory and deliberative roles for reasons are introduced, focusing on minimal accounts of each of these roles that allow us to see why these roles make reasons so important in different areas of philosophy but don’t pre-judge the theories of how reasons play these roles that are the subject of disagreement. Key concepts and distinctions are introduced, including the distinction between normative, motivating, and explanatory reasons, and the distinction between objective and subjective normative reasons.
An Introduction to Microbial Experimental Evolution
Authors: Kassen Rees
Published: May 2024

This chapter provides a brief history of the use of microbes to study adaptation and diversification in the laboratory and the foundational principles and theory on which the subject is based. I review the methods used to propagate microbes as well as those to measure key properties of interest such as fitness. As it is now standard practice to supplement the results of selection experiments with genomic data, what is often referred to as evolve-and-resequence experiments, a brief discussion of these techniques and the kinds of information obtained is included. The chapter closes by briefly introducing examples of microbial evolution experiments chosen because they have become emblematic of the approaches used in the field.
Phenotypic Disparity
Authors: Kassen Rees
Published: May 2024

This chapter explores how phenotypic disparity, or trait divergence, evolves. Four mechanisms contribute to trait divergence: drift, epistasis, divergent selection, and ecological interactions like competition. Data from the literature reveals that, as expected, disparity increases through time and decreases with population size, at least for bacterial experiments. Epistasis can generate divergence, but divergent selection, especially in concert with disruptive selection generated by selection against intermediate phenotypes caused by competition or predation, are more potent drivers of phenotypic disparity. Sexual selection can also contribute to disparity, although it has received rather little focused attention in the microbial literature.
Child Participation and Child Advocacy
Authors: Platt Stacey , Matthews-Jolly Laura
Published: May 2024

This chapter on child participation and child advocacy discusses the various professional views on child involvement in family dispute resolution. It examines the factors used to determine whether or not and how to involve a child’s voice and interests. The chapter also evaluates the critical role of the child advocate, who balances multiple conflicting values to help families reach solutions that build on their strengths. It describes the methods that are used to incorporate children’s views into family dispute processes, including family evaluations and judicial interviews. The chapter then reviews the various roles child advocates play and how the child’s voice is sometimes, but not always, brought to these processes by the child advocate. Finally, the chapter addresses challenges and ethical conundrums in child advocacy, proposing rigorous multidisciplinary training, strength-based family assessment, and child-focused settlement rather than litigation.
The Family Resolutions Specialty Court
Authors: Pruett Marsha Kline , Fidnick Linda S. , Stern Noelle Barrist
Published: May 2024

The Family Resolutions Specialty Court (FRSC) is a court-based, voluntary program offered to separating or divorcing parents with children who file cases in the western divisions of the Massachusetts Probate and Family Court. FRSC was inspired by two family dispute resolution models: Australia’s Family Relationship Centres and Less Adversarial Trial and Colorado’s Center for Out-of-Court Divorce. In FRSC, a multidisciplinary team uses a problem-solving approach to support families in order to reach an agreement for judgment or to have their case heard by a judge in a less adversarial setting. Each FRSC team consists of the parents; their attorneys, if represented; a family consultant (mental health professional); a child’s attorney; a mediator; and a team coordinator. One judge is assigned to each FRSC family. The team works collaboratively to reach resolution. FRSC’s goals are to reduce the harmful effects of family conflict on children; encourage cooperative, child-focused co-parenting; reduce the length of litigation; increase satisfaction with the process and in following court judgments; and reduce adversarial post-judgment complaints for modification and contempt. An evaluation of FRSC outcomes shows improvements in parental communication and problem-solving and decreases in children’s upset about separation and divorce.
The Musical Legacies of Childhood and Children
Authors: Custodero Lori A.
Published: May 2024

We rely on our memories of childhood and our experiences with children to help us retain or recapture a profound expression of musical experience. Looking at the autobiographical data, we might critically examine our own positionality: “How can we monitor the influence/power we have on the creation of musician identity in our students?” and “How are these questions answered in my own past and how does that affect my teaching?” Thinking about how creative musicians see children, we might ask more generative questions: “What is my student doing with the musical material?” or “What does my student most need to know [to follow the musical trajectory they have started]?” The book ends with a call to see the child as musical being so that we can envision their creative potential, and respect their individual, cultural, and evolving ways of being.
Glitter and Queer Embodiment in 1960s and 1970s Experimental Film and Performance
Authors: Suárez Juan A.
Published: May 2024

This chapter explores the use and meanings of glitter in underground performance and film of the 1960s and 1970s. It reconstructs the elusive history of glitter from its invention in the mid-1930s to its growing popularity in early and mid-1960s fashion. This popularity responded to a contemporary fascination with sheen and sparkle, the immersive, and the ephemeral—interests that also drove light-based art, multimedia events, and discotheque design. In underground film and performance, glitter produced bodies and interiors of uncertain outline and surface, blurred conventional gender morphology, and triggered queer affect. It was used to transfigure the ordinary, evoke spirituality and transcendence, and articulate a “dark” type of camp allied to scenarios of cruelty and aggression. The chapter studies this range of significations in the films of Jack Smith, Steven Arnold, Katharina Sieverding, Carles Comas, and of the members of the French cinema corporel school, Stéphane Marti and Teo Hernández.
Patient-Centered Measurement
Authors: McClimans Leah M.
Published: May 2024

Contemporary medicine is Janus-faced. Evidence-based medicine is one face of it, emphasizing evidence, statistics, and method. Patient-centered care is the other, prioritizing patient experiences, judgment, and values. Government agencies, policymakers, major insurers, and clinicians have sought ways to bring these faces together. This book is about one such approach, patient-centered measurement. Patient-centered measurement is the idea that patient perspectives on, for instance, physical functioning or quality of life, should play an evidentiary role in determining how effective a drug is taken to be, the degree to which a hospital provides good-quality care, or whether a particular intervention should be funded by an insurer. This idea may sound prosaic, but in fact it’s nothing short of revolutionary. Patient-centered measurement treats patient perspectives on par with more traditional metrics such as mortality, morbidity, and safety. It says that patient views matter—not as an afterthought and not only at the bedside, but in the nuts and bolts of creating our evidence base. What’s more, these measures are popular. They are part of Food and Drug Administration initiatives, the UK’s development of the National Health Service, and Denmark’s policy to improve patient care. Yet despite these policies, initiatives, and recommendations, patient-centered measures present a puzzle. And this puzzle has its source in the Janus-faced nature of medicine. How can measurement, which relies on standardization, represent patient perspectives, which, if not idiosyncratic are at least various and changeable? This book aims to solve that puzzle.
Core Connections
Authors: Sahin Christine M.
Published: May 2024

Core Connections investigates local, intra-Middle Eastern, and global circulations of belly dance centered on Cairo, Egypt, in the tumultuous aftermath of the January 25, 2011 revolution. This multi-sited ethnography moves through contemporary city-circuitries of dance venues and stories from the Nile cruising tourist boats and decadent five-star hotels to smoky late-night discos and Pyramid Street cabarets. While mapping the multiple maneuverings of Cairene dancers and non-dancers, the book centralizes dancers’ embodied political insight while fleshing out nuanced portraits of their lives and stories amidst ongoing political precarity. Its ethnographic approach embodies the dance itself by attending to the dual meanings of moving, both centralizing mobility and movement as sites of power and knowledge, and researching and writing in ways that move emotionally, leading to physical reaction, change, and connection. In other words, it aims to center the same aesthetics and values of Cairo belly dancing, to “move” with greater feeling to cultivate richer core connections within ourselves, between one another, and within our city-spaces. In doing so, the book stakes a claim for listening to the subtleties of otherwise marginalized bodily interaction, exchange, and wisdom as rippling with potential for stepping into more revolutionary realities and relationships.
Forks in the Digital Road
Authors: Shackelford Scott J. , Bradner Scott O.
Published: May 2024

Science fiction has long featured various visions of cyberspace. From the original “shared hallucination” in William Gibson’s Neuromancer, which first coined the term “cyberspace,” to the dystopian metaverse of the Matrix, authors and fans alike have been fascinated by how interconnected technologies that are being developed today will shape our collective future, for better and for worse. Less common is an urge to look back and understand how decisions made by a relatively small number of entrepreneurs, graduate students, researchers, and government officials have given us the Internet we have. But if we don’t know where we’ve been, it’s tough to understand where we are, to say nothing of where we’re headed. This book revisits some of these key decision points in the history of cybersecurity and Internet governance, revealing the potential alternative options that existed at the time, and engages with that perennial question—what if? What if encryption had been built into the Internet’s architecture from the beginning? What if Section 230, which shields Internet platforms from civil liability, had taken a different form? What if Tim-Berners Lee had taken the advice of counsel and patented the World Wide Web? And what if the U.S. government had not helped to establish the Internet Corporation for Assigned Names and Numbers (ICANN) in 1998 or elected not to launch a new era of cyber conflict in 2006? This book answers these questions, and many more.