bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular Homology and the Luminal Transport of Hg2+ in the Renal Proximal Tubule
Authors: CANNON VERNON T. , BARFUSS DELON W. , ZALUPS RUDOLFS K. 
Published: April 2021

Abstract.
The aim of this study was to define mechanisms involved in the luminal uptake of inorganic mercury in the kidney using isolated perfused straight (S2) segments of the proximal tubule. When mercuric conjugates of glutathione (GSH), cysteinylglycine, or cysteine (containing 203Hg2+) were perfused through the lumen, the rates of luminal disappearance flux (J
D) of inorganic mercury were approximately 39, 53, and 102 fmol/min per mm, respectively. Thus, the rates of luminal uptake of mercury are greater when the mercury is in the form of a mercuric conjugate of cysteine than in the form of a mercuric conjugate of cysteinylglycine or GSH. Addition of acivicin to the perfusate, to inhibit activity of the γ-glutamyltransferase, caused significant reductions in the J
D for mercury in tubules perfused with mercuric conjugates of GSH. Addition of cilastatin, an inhibitor of dehydropeptidase-1 (cysteinylglycinase) activity, caused significant reductions in the uptake of mercury in tubules perfused with mercuric conjugates of cysteinylglycine. These findings indicate that a significant amount of the luminal uptake of mercury, when mercuric conjugates of GSH are present in the lumen, is dependent on the activity of both γ-glutamyltransferase and cysteinylglycinase. Finally, the J
D for mercury in tubules perfused with mercuric conjugates of cysteine was reduced by approximately 50% when 3.0 mM L-lysine or 5.0 mM cycloleucine was added to the perfusate. It is concluded that these findings indicate that at least some of the luminal uptake of mercuric conjugates of cysteine occurs at the site of one or more amino acid transporters via a mechanism involving molecular homology.
Downregulation of SPARC Expression Is Mediated by Nitric Oxide in Rat Mesangial Cells and during Endotoxemia in
Authors: WALPEN SEBASTIAN , BECK KARL-FRIEDRICH , EBERHARDT WOLFGANG , APEL MARTINA , CHATTERJEE PRABAL K. , WRAY GILLIAN M. H. , THIEMERMANN CHRISTOPH , PFEILSCHIFTER JOSEF 
Published: April 2021

Abstract.
Nitric oxide (NO) has been implicated in several forms of glomerulonephritis. In this study, a low stringency reversed transcription/PCR protocol was used to evaluate the action of NO on the mRNA expression pattern in rat mesangial cells (MC). To mimic the state of glomerular inflammation, MC were stimulated by exposure to the cytokines interleukin-1β and tumor necrosis factor-α into producing high levels of NO via expression of inducible nitric oxide synthase (NOS). To detect NO-mediated effects, the resulting expression pattern was compared to that of MC stimulated by the cytokines in the presence of the NOS inhibitor N
G-monomethyl-L-arginine (L-NMMA). Computer analysis of a differentially expressed cDNA fragment resulted in a 100% homology to the recently characterized mRNA of SPARC (secreted protein acidic and rich in cysteine). Further characterization of SPARC regulation revealed a cytokine- and cAMP-dependent decrease in SPARC mRNA and protein levels. Blocking NO formation by L-NMMA reversed the effects of cytokines and cAMP on SPARC expression, suggesting an NO-mediated mechanism. The NO donors S-nitroso-N-acetyl-penicillamine and diethyl-enetriamine/NO further reduced SPARC expression in cytokine-treated MC as well as in controls. Moreover, downregulation of SPARC mRNA and protein expression in whole kidneys obtained from rats treated with endotoxin was observed. This downregulation of SPARC was reversed by treatment with L-N
6-l (iminoethyl) lysine dihydrochloride, a potent and highly selective inhibitor of inducible NOS. These data characterize SPARC as an NO-regulated gene. This observation may be important in the context of tissue remodeling in chronic inflammatory kidney diseases.
Lipoprotein(a) in the Nephrotic Syndrome
Authors: DOUCET CHANTAL , MOOSER VINCENT , GONBERT SOPHIE , RAYMOND FRANC[COMBINING CEDILLA]OISE , CHAPMAN JOHN , JACOBS CLAUDE , THILLET JOËLLE 
Published: April 2021

Abstract.
Plasma levels of lipoprotein(a) (Lp(a)), an atherogenic particle, are elevated in kidney disease, which suggests a role of this organ in the metabolism of Lp(a). Additional evidence for a role of the kidney in the clearance of Lp(a) is provided by the fact that circulating N-terminal fragments of apolipoprotein(a) (apo(a)) are processed and eliminated by the renal route. To further understand the mechanism underlying such renal excretion, the levels of apo(a) fragments in plasma and urine relative to plasma Lp(a) levels were determined in patients with nephrotic syndrome (n = 15). In plasma, the absolute (24.7 ± 20.4 versus 2.16 ± 2.99 μg/ml, P < 0.0001) as well as the relative amounts of apo(a) fragments (4.6 ± 3.4% versus 2.1 ± 3.3% of total Lp(a), P < 0.0001) were significantly elevated in nephrotic patients compared with a control, normolipidemic population. In addition, urinary apo(a) excretion in patients with nephrotic syndrome was markedly elevated compared with that in control subjects (578 ± 622 versus 27.7 ± 44 ng/ml per mg creatinine, P < 0.001). However, the fractional catabolic rates of apo(a) fragments were similar in both groups (0.68 ± 0.67% and 0.62 ± 0.47% in nephrotic and control subjects, respectively), suggesting that increased plasma concentrations of apo(a) fragments in nephrotic subjects are more dependent on the rate of synthesis rather than on the catabolic rate. Molecular analysis of apo(a) immunoreactive material in urine revealed that the patterns of apo(a) fragments in nephrotic patients were distinct from those of control subjects. Full-length apo(a), large N-terminal apo(a) fragments similar in size to those present in plasma, as well as C-terminal fragments of apo(a) were detected in urine from nephrotic patients but not in urine from controls. All of these apo(a) forms were in addition to smaller N-terminal apo(a) fragments present in normal urine. This study also demonstrated the presence of Lp(a) in urine from nephrotic patients by ultracentrifugal fractionation. These data suggest that in nephrotic syndrome, Lp(a) and large fragments of apo(a) are passively filtered by the kidney through the glomerulus, whereas smaller apo(a) fragments are secreted into the urine.
Naltrexone Does Not Relieve Uremic Pruritus
Authors: PAULI-MAGNUS CHRISTIANE , MIKUS GERD , ALSCHER DOMINIK M. , KIRSCHNER TILLMANN , NAGEL WILFRIED , GUGELER NADJA , RISLER TEUT , BERGER ELKE D. , KUHLMANN ULRICH , METTANG THOMAS 
Published: April 2021

Abstract.
Improvement of uremic pruritus was reported under short-term administration of the μ-receptor antagonists naltrexone and naloxone. The aim of the present study was to confirm the efficacy and safety of the oral μ-receptor antagonist naltrexone during a 4-wk treatment period in patients on hemodialysis and peritoneal dialysis. A placebo-controlled, double-blind crossover study of uremic patients with persistent, treatment-resistant pruritus was performed. Of 422 patients screened between December 1997 and June 1998, 93 suffered from pruritus and 23 were eligible for the study. Patients were started either with a 4-wk naltrexone sequence (50 mg/d) or matched placebo. This was followed by a 7-d washout, and patients continued with a 4-wk sequence of the alternate medication. Pruritus intensity was scored daily by a visual analogue scale (VAS) and weekly by a detailed score assessing scratching activity, distribution of pruritus, and frequency of pruritus-related sleep disturbance. Sixteen of 23 patients completed the study. During the naltrexone period, pruritus decreased by 29.2% (95% confidence interval [CI], 18.7 to 39.6) on the VAS and by 17.6% (95% CI, 4.2 to 31.1) on the detailed score. In comparison, pruritus decreased by 16.9% (95% CI, 6.8 to 26.9) on the VAS and by 22.3% (95% CI, 9.3 to 35.2) on the detailed score during the placebo period. The difference between the naltrexone and the placebo treatment period was not statistically significant. Nine of 23 patients complained of gastrointestinal disturbances during the naltrexone period compared with only one of 23 patients during the placebo period (P < 0.05). These results show that treatment of uremic pruritus with naltrexone is ineffective. In addition, a high incidence of adverse effects was observed during treatment with naltrexone.
Validation of Comorbid Conditions on the End-Stage Renal Disease Medical Evidence Report
Authors: LONGENECKER J. CRAIG , CORESH JOSEF , KLAG MICHAEL J. , LEVEY ANDREW S. , MARTIN ALICE A. , FINK NANCY E. , POWE NEIL R. 
Published: April 2021

Abstract.
Since 1995, the Medical Evidence Report for endstage renal disease (Form 2728) has been used nationally to collect information on comorbid conditions. To date, these data have not been validated. A national cross-sectional study of 1005 incident dialysis patients (734 hemodialysis and 271 peritoneal dialysis) enrolled between October 1995 and June 1998 was conducted using clinical data to validate 17 comorbid conditions on Form 2728. Sensitivity and specificity were calculated for each condition. The relationship between patient characteristics and sensitivity was assessed in multivariate analysis. Sensitivity was fairly high (0.67 to 0.83) for HIV disease, diabetes, and hypertension; intermediate (0.40 to 0.52) for peripheral vascular disease, neoplasm, myocardial infarction, cerebrovascular disease, coronary artery disease, cardiac arrest, and congestive heart failure; and poor (<0.36) for dysrhythmia, ambulation status, pericarditis, chronic obstructive pulmonary disease, and smoking. Sensitivity did not change significantly over calendar time. The sensitivity of Form 2728 averaged across all 17 conditions was 0.59 (95% confidence interval, 0.43 to 0.75). The average sensitivity was 0.10 greater in peritoneal dialysis than hemodialysis patients, 0.11 greater in diabetic patients than nondiabetic patients, and 0.04 less with each added comorbid condition. The specificity was very good for hypertension (0.91) and excellent (>0.95) for the other 16 conditions. Comorbid conditions are significantly underreported on Form 2728, but diagnoses are not falsely attributed to patients. Scientific research, quality of care comparisons, and payment policies that use Form 2728 data should take into account these limitations. Considerable effort should be expended to improve Form 2728 coding if it is to provide accurate estimates of total disease burden in end-stage renal disease patients.
Optimization of Epoetin Therapy with Intravenous Iron Therapy in Hemodialysis Patients
Authors: BESARAB ANATOLE , AMIN NEETA , AHSAN MUHAMMAD , VOGEL SUSAN E. , ZAZUWA GARY , FRINAK STANLEY , ZAZRA JAMES J. , ANANDAN J. V. , GUPTA AJAY 
Published: April 2021

Abstract.
Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease (ESRD) patients. Functional iron deficiency occurs with serum ferritin >500 ng/ml and/or transferrin saturation (TSAT) of 20 to 30%. This study examines the effects of a maintenance intravenous iron dextran (ivID) protocol that increased TSAT in ESRD hemodialysis patients from conventional levels of 20 to 30% (control group) to those of 30 to 50% (study group) for a period of 6 mo. Forty-two patients receiving chronic hemodialysis completed a 16- to 20-wk run-in period, during which maintenance ivID and rhEPO were administered in amounts to achieve average TSAT of 20 to 30% and baseline levels of hemoglobin of 9.5 to 12.0 g/dl. After the run-in period, 19 patients randomized to the control group received ivID doses of 25 to 150 mg/wk for 6 mo. Twenty-three patients randomized to the study group received four to six loading doses of ivID, 100 mg each, over a 2-wk period to achieve a TSAT >30% followed by 25 to 150 mg weekly to maintain TSAT between 30 and 50% for 6 mo. Both regimens were effective in maintaining targeted hemoglobin levels. Fifteen patients in the control group and 17 patients in the study group finished the study in which the primary outcome parameter by intention to treat analysis was the rhEPO dose needed to maintain prestudy hemoglobin levels. Maintenance ivID requirements in the study group increased from 176 to 501 mg/mo and were associated with a progressive increase in serum ferritin to 658 ng/ml. Epoetin dose requirements for the study group decreased by the third month and remained 40% lower than for the control group, resulting in an overall cost savings in managing the anemia. Secondary indicators of iron-deficient erythropoiesis were also assessed. Zinc protoporphyrin did not change in either group. Reticulocyte hemoglobin content increased only in the study group from 28.5 to 30.1 pg. It is concluded that maintenance of TSAT between 30 and 50% reduces rhEPO requirements significantly over a 6-mo period.
Effect of Intravenous Fluids on Blood Pressure Course during Hemodialysis in Hypotensive-Prone Patients
Authors: VAN DER SANDE FRANK M. , LUIK ANTINUS J. , KOOMAN JEROEN P. , VERSTAPPEN VIC , LEUNISSEN KAREL M. L. 
Published: April 2021

Abstract.
Hypertonic and hyperoncotic solutions are generally used as acute treatment for symptomatic hypotension during dialysis. Administration of hydroxyethylstarch (HES) was recently shown to be an effective substitution fluid in preserving blood volume (BV) and systolic BP (SBP) in a group of stable dialysis patients during dialysis. In this study, in nine cardiac-compromised dialysis patients with frequent symptomatic hypotensive episodes, the efficacy of three fluids (hypertonic saline [3%], albumin [20%], and HES [10%]) was assessed during three treatment sessions with combined ultrafiltration and hemodialysis, which only differed in the type of fluid administered intravenously. Changes in SBP and relative BV were compared. Fluids were given when SBP was less than 100 mmHg or when the decrease in SBP was more than 25 mmHg versus the start of the treatment. The ultrafiltration was continued at the same rate. When comparing SBP at the end of the dialysis session (t = end) with that at the time of infusion (t = iv), SBP decreased with saline, increased with albumin, and increased significantly with HES. The change in SBP in t = end versus t = iv was significantly greater when using saline compared with HES, and tended to decrease more when using saline compared with albumin (P = 0.09). Between albumin and HES there were no significant differences. BV decreased significantly (t = end) versus baseline (t = 0) during ultrafiltration and hemodialysis in all three treatment sessions. The decrease was significantly higher when using saline compared with albumin and saline compared with HES. Between albumin and HES there were no significant differences. When the values at t = end were compared with those at t = iv, BV decreased, although not significantly, with saline and albumin, but remained unchanged with HES. It is concluded that HES is an effective fluid in maintaining SBP and preserving BV in hypotensive-prone dialysis patients, comparable to albumin but superior to hypertonic saline.
Teacher and actor perceptions of a recent journey involving clinical simulation
Authors: Carneiro Ana Cláudia , Aleluia Iêda , Fagundes Marília , Sestelo Maristela , Brasil Regina , Soares Tânia 
Published: April 2021

INTRODUCTION: Medical education is under many modifications, insertions and new perspectives on the learning teaching process, and the realistic simulation is one of these changes. It includes technical skills, but also attitudinal skills. The original idea of simulation is to integrate theoretical knowledge, skills and attitude. OBJECTIVES: to tell the experience of building a simulation core in our institution, with faculty development and culture changes. METHODS: using the cartography, 04 teachers and 02 female actors told their narratives by memories and reflections about the path travelled and the knowledge built. RESULTS AND DISCUSSION: each one experience on the first simulation scenario in 2018.2. We reached the original objective (students’ participation and study), but also the depth of each one experience and reflection. There was a balance between technique and sensibility. The actor’s role to build and concretize the project was essential in this balance. CONCLUSIONS: the simulation strengthened the attitudinal competences, promoted the faculty development and showed the importance to put together art and technique on the health professional training.
The San Andreas Fault Paleoseismic Record at Elizabeth Lake: Why are There Fewer Surface-Rupturing Earthquakes on the Mojave Section?
Authors: Bemis Sean P. , Scharer Kate , Dolan James F. 
Published: April 2021

ABSTRACTThe structural complexity of active faults and the stress release history along the fault system may exert control on the locus and extent of individual earthquake ruptures. Fault bends, in particular, are often invoked as a possible mechanism for terminating earthquake ruptures. However, there are few records available to examine how these factors may influence the along-fault recurrence of earthquakes. We present a new paleoearthquake chronology for the southern San Andreas fault at Elizabeth Lake and integrate this record with existing paleoearthquake records to examine how the timing and frequency of earthquakes vary through a major restraining bend. This restraining bend features a mature, throughgoing right-lateral strike-slip fault, two major fault intersections, proposed subsurface fault dip changes, and a &gt;200  km long section of fault misaligned with the regional plate motion. The Frazier Mountain, Elizabeth Lake, Pallett Creek, Wrightwood, and Pitman Canyon paleoseismic sites are located on this relatively linear surface trace of the San Andreas fault between fault bends. Our paleoseismic investigations at Elizabeth Lake document 4–5 earthquakes, since ∼1100  C.E., similar to the number of earthquakes recorded at Pallett Creek. In contrast, the Frazier Mountain and Wrightwood sites each record 8–9 earthquakes during this same time period. Differences in earthquake frequency demonstrate that fewer earthquakes rupture the central portion of the restraining bend than occur near the fault bends and intersections. Furthermore, the similarity of earthquake records from the Bidart Fan paleoseismic site northwest of the restraining bend and the Frazier Mountain paleoseismic site suggests that the broad, 30° curve of the Big Bend section of the San Andreas fault exerts less influence on fault rupture behavior than the 3D geometry of the Mojave sections of the fault.
Ağız Florasındaki Streptokokların Adli Bilimlerde Kimliklendirme Açısından Araştırılması
Authors: Bozaslan Buse Sabiha , Çakan Hüseyin 
Published: April 2021

Forensic Microbiology which is a new field and mentioned about this microscobic evidences in forensic science; comes into question in terms of defined of microorganisms with protected innocents and defined guilty at the result of changing social life. Located in mind that study of oral microflora streptococcus that we might be made on various objects; named in identification of microorganisms used and can not be used, planned to investigate.
This study; 50 people in the mouth, apples, cigarettes and chewing gum swabs cultivation operation, including 200 different swab broth is made. All of microorganisms that have been investigated in the oral microflora of people. According to the obtained data; as the predominant species in these microorganisms has been determined that alpha hemolytic streptococci. It is unique flora in the mouth of people the rare microorganisms in the mouth that some people are determined to make it special in terms of identification. In this case, the bite mark left in any place, in any event and any objects it has been possible to say that an evidence of the gain will betray that person.
As a result; so much in terms of clinical and forensic science is important to us that these bacteria Streptococcus, we aim to contribute with a different approach in terms of forensic microbiology.
Dampak E-Learning terhadap Anggaran Pelatihan Kementerian Keuangan
Authors: Rakhmadina Dita , Setyaningrum Dyah 
Published: April 2021

This study aimed to analyze the impact of e-learning on training budgets, compare the standard costs of traditional training and e-learning, and formulate standard output costs of e-learning. This study was conducted to provide recommendations for improving budget efficiency in government organizations. This research uses a qualitative method with a case study approach by exploring phenomena in the government budget due to e-learning implementation. Data collection techniques were interviews, observation, and documentation. The results showed that e-learning implementation significantly saves the training budget and increases the number of training participants. However, the cost standard is less optimal because they do not cover all the costs needed to deliver e-learning. The standard costs should be differentiated for each type of e-learning. Also, the current organizational structure needs to be changed to achieve maximum efficiency in e-learning implementation.Keywords: Budget, Efficiency, E-Learning, New Public Management AbstrakPenelitian ini bertujuan untuk menganalisis dampak e-learning terhadap anggaran pelatihan, perbandingan standar biaya keluaran pelatihan klasikal dan e-learning, dan penyusunan standar biaya keluaran sesuai dengan komponen pembentuk biaya yang diperlukan untuk menyelenggarakan e-learning. Penelitian ini diharapkan dapat memberikan rekomendasi dalam rangka meningkatkan efisiensi anggaran pada organisasi pemerintah penyelenggara pendidikan dan pelatihan. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus dengan menggali fenomena yang terjadi pada anggaran suatu instansi pemerintah sebagai akibat dari penyelenggaraan e-learning. Pengumpulan data dilakukan dengan teknik wawancara, observasi, dan telaah dokumen. Hasil penelitian menunjukkan bahwa penyelenggaraan pelatihan e-learning secara signifikan dapat menghemat anggaran pelatihan dan meningkatkan jumlah peserta yang dapat dilatih. Namun, standar biaya yang disusun saat ini belum optimal karena belum mencerminkan seluruh biaya yang diperlukan untuk menyelenggarakan e-learning. Standar biaya yang disusun sebaiknya dibedakan sesuai jenis pelatihan e-learning. Selain itu, untuk meningkatkan efisiensi anggaran atas pelaksanaan e-learning diperlukan penyesuaian kebutuhan kompetensi SDM dan struktur organisasi yang ada saat ini yang lebih sesuai dengan proses bisnis pelatihan e-learning.Kata Kunci: Anggaran, Standar Biaya, Efisiensi, E-Learning