180 research outputs found
Infections in patients with chronic kidney disease : patterns, outcomes and the role of vitamin D for future prevention
No full textBackground: Chronic kidney disease (CKD) is increasingly recognized as a global public health problem. Patients with CKD are at high risk of infections. Frequent episodes of infections with greater use of antibiotics might put this population at risk of infections caused by resistant organisms. Thus, infection issues in patients with CKD could be related to another public health problem - antibiotic resistance.Aim: To investigate the antibiotic resistant patterns of pathogens responsible for infections, ascertain short-term and long-term patient outcomes during and after hospitalizations with infections and explore the role of vitamin D for infection prevention in patients with CKD.Methods: The thesis consists of two observational studies (Paper I & II), one cohort study (Paper III) and one systematic review and meta-analysis (Paper IV). Paper I, II & III explored the association between kidney function (defined as estimated glomerular filtration rate, eGFR) and various outcomes. These outcomes included microbial pattern (Paper I), prevalence of infections with multi-drug resistant organisms (MDROs) in the first positive microbial cultures (Paper I), intensive care unit admission (Paper II), length of hospital stay (Paper II), medical expense (Paper II), and mortality (Paper II & III). These were assessed in patients hospitalized with infections, using electronic medical records from four hospitals from 2012 to 2015 in China. Paper IV obtained data from existing literature to explore the association of infections with vitamin D status or use of vitamin D in patients treated with long-term dialysis.Results: In adult patients hospitalized with infections, the proportion of Gram-negative bacteria decreased while the proportion of Gram-positive bacteria increased across eGFR strata. Compared with the reference eGFR, lower eGFR was associated with: higher odds of infections by MDROs (19% and 41% higher in those with eGFR between 30-59 ml/min/1.73 m2 and eGFR Conclusions: CKD patients hospitalized with infections have a higher risk of infections by MDROs, poorer in-hospital outcomes resulting in higher medical costs and increased risk of cardiovascular mortality in the long-run. Use of vitamin D to achieve high/normal serum levels of 25(OH)-vitamin D might help lowering the risk of infections in maintenance dialysis patients. Further research is needed to investigate the potential role of vitamin D therapy in infection prevention among non-dialysis dependent CKD patients.List of scientific papersI. Guobin Su, Hong Xu, Emilia Riggi, Zhiren He, Liming Lu, Bengt Lindholm, Gaetano Marrone, Zehuai Wen, Xusheng Liu, David W Johnson, Juan Jesus Carrero, Cecilia Stålsby Lundborg. Association of Kidney Function with Infections by Multidrug-Resistant Organisms: An Electronic Medical Record Analysis. Scientific Reports. 2018, 8(1):13372. https://doi.org/10.1038/s41598-018-31612-1 II. Guobin Su, Hong Xu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, Juan Jesus Carrero, Cecilia Stålsby Lundborg. Chronic kidney disease is associated with poorer in-hospital outcomes in patients hospitalized with infections: Electronic record analysis from China. Scientific Reports. 2017, 7(1):11530. https://doi.org/10.1038/s41598-017-11861-2 III. Guobin Su, Yanjun Xu, Xiaojun Xu, Hong Xu, Liming Lu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, David W Johnson, Juan Jesus Carrero, Cecilia Stålsby Lundborg. Association between reduced renal function and cardiovascular mortality in patients hospitalized with infection: A multi-center cohort study. European Journal of Internal Medicine. 2018, 57:32-38. https://doi.org/10.1016/j.ejim.2018.06.017 IV. Guobin Su, Zhuangzhu Liu, Xindong Qin, Hong Xu, Xusheng Liu, Zehuai Wen, Bengt Lindholm, Juan Jesus Carrero, David W Johnson, Nele Brusselaers, Cecilia Stålsby Lundborg. Vitamin D deficiency and treatment versus risk of infection in end-stage renal disease patients under dialysis: A systematic review and meta-analysis. Nephrology Dialysis Transplantation. 2019, 34(1):146-156. https://doi.org/10.1093/ndt/gfy216 </p
FERMI BUBBLES INFLATED BY WINDS LAUNCHED FROM THE HOT ACCRETION FLOW IN SGR A*
No full textNatural Science Foundation of China [11103061, 11133005, 11121062, 11103059]; National Basic Research Program of China (973 Program) [2014CB845800]; Strategic Priority Research Program "The Emergence of Cosmological Structures" of the Chinese Academy of Sciences [XDB09000000]; China Scholarship Council [[2013] 3009]; NASA through Einstein Postdoctoral Fellowship by the Chandra X-ray Center [PF2-130102]; NASA [NAS8-03060]A pair of giant gamma-ray Bubbles has been revealed by Fermi-LAT. In this paper we investigate their formation mechanism. Observations have indicated that the activity of the supermassive black hole located at the Galactic center, Sgr A*, was much stronger than at the present time. Specifically, one possibility is that while Sgr A* was also in the hot accretion regime, the accretion rate should be 10(3)-10(4) times higher during the past similar to 10(7) yr. On the other hand, recent magnetohydrodynamic numerical simulations of hot accretion flows have unambiguously shown the existence and obtained the properties of strong winds. Based on this knowledge, by performing three-dimensional hydrodynamical simulations, we show in this paper that the Fermi Bubbles could be inflated by winds launched from the "past" hot accretion flow in Sgr A*. In our model, the active phase of Sgr A* is required to last for about 10 million years and it was quenched no more than 0.2 million years ago. The central molecular zone (CMZ) is included and it collimates the wind orientation toward the Galactic poles. Viscosity suppresses the Rayleigh-Taylor and Kelvin-Helmholtz instabilities and results in the smoothness of the Bubbles edge. The main observational features of the Bubbles can be well explained. Specifically, the ROSAT X-ray features are interpreted by the shocked interstellar medium and the interaction region between the wind and CMZ gas. The thermal pressure and temperature obtained in our model are consistent with recent Suzaku observations
Le régime juridique des droits et des obligations des fonctionnaires de l'État chinois
No full textBased on the first General Statutes of the State Civil Servants, this thesis deals with three main themes : the professional obligations, the rights and the protection of the civil servants, the legal responsibility and the disciplinary regime. It begins with an introduction about the legal and political principles which closely frames the legal regime of chinese new civil service. The author studies at a comparative angle several delicate questions as following : the obligation of political neutrality, the obligation of disinterestedness and the public liberties of the civil servants. Finally, while insisting upon the importance of establishing a new System of civil service in China, the author emphasises also that this civil service would be in need of further improvements.Basée sur le premier Statut général des fonctionnaires de l'État chinois, cette étude se développe autour de trois grands thèmes : les obligations professionnelles, les droits et la protection des fonctionnaires, la responsabilité juridique et le régime disciplinaire. L'article commence d'abord par une introduction des principes centralisateurs juridiques et politiques, qui encadrent étroitement le régime juridique de la nouvelle fonction publique chinoise. Sous un angle comparatif, l'auteur étudie quelques questions délicates concernant la fonction publique, par exemple l'obligation de la neutralité politique, l'obligation de désintéressement ainsi que les libertés publiques des fonctionnaires. Tout en insistant sur l'importance de l'établissement d'une nouvelle fonction publique en Chine, l'auteur souligne également que cette fonction publique aurait besoin de nouvelles améliorations.Zhu Guobin. Le régime juridique des droits et des obligations des fonctionnaires de l'État chinois. In: Revue internationale de droit comparé. Vol. 47 N°1, Janvier-mars 1995. pp. 99-128
NGOs and the search for Chinese civil society environmental non-governmental organisations in the Nujiang campaign
No full textvoluntary organizations; nonprofit organizations; grass roots groups; environmentalism; civil society; advocacy; China;
Statistically optimal estimation of surface mass anomalies by directly using GRACE level-2 spherical harmonic coefficients as measurements
No full textPoint-mass inversion is widely employed in GRACE level-2 data processing. Conventionally, the spherical harmonic (SH) coefficients are used indirectly: a set of pseudo measurements is generated first using the SH coefficients through SH synthesis; then the point-mass inversion is done with these pseudo measurements. To be statistically optimal, the covariance matrix of pseudo measurements should be calculated and used to appropriately weigh the parameter estimation. In this work, we propose a statistically optimal point-mass inversion scheme by directly using the SH coefficients as measurements. We prove the equivalence between this direct approach and the conventional indirect approaches. We also demonstrated their comparable performance through both simulation and real GRACE data processing. Choosing and calculating pseudo measurements, propagating covariance matrix, and potentially dealing with the singularity of the covariance matrix involved in the conventional indirect approaches are avoided in the proposed direct approach. This statistically optimal direct approach can readily be employed in mascon inversion of GRACE data and other radial basis functions-based approaches in regional gravity modeling.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Physical and Space Geodes
Dietary Phosphorus, Its Sources, and Mortality in Adults on Haemodialysis: The DIET-HD Study
No full textDietary phosphorus restrictions are usually recommended for people on haemodialysis, although its impact on patient-relevant outcomes is uncertain. We aimed to evaluate the association between total phosphorus intake and its sources with mortality in haemodialysis. Phosphorus intake was ascertained within the DIET-HD study in 8110 adults on haemodialysis. Adjusted Cox regression analyses were conducted to evaluate the association between the total and source-specific phosphorus (plant-, animal-, or processed and other sources) with mortality. During a median 3.8 years of follow-up, there were 2953 deaths, 1160 cardiovascular-related. The median phosphorus intake was 1388 mg/day. Every standard deviation (SD) (896 mg/day) increase in total phosphorus was associated with higher all-cause mortality [hazard ratio (HR), 1.16; 95% confidence intervals (CI), 1.06–1.26] and cardiovascular mortality (HR, 1.18; 95% CI, 1.03–1.36). Every SD (17%) increase in the proportion of phosphorus from plant sources was associated with lower all-cause mortality (HR, 0.95; 95% CI, 0.90–0.99). Every SD (9%) increase in the proportion of phosphorus from the processed and other sources was associated with higher all-cause mortality (HR, 1.06; 95% CI, 1.02–1.10). A higher total phosphorus intake was associated with increased all-cause and cardiovascular death. This association is driven largely by the phosphorus intake from processed food. Plant based phosphorus was associated with lower all-cause mortality
Lifestyle interventions for preventing and ameliorating CKD in primary and secondary care
No full textPURPOSE OF REVIEW: Despite the growth in chronic kidney disease (CKD) epidemics, evidence-based lifestyle recommendations for primary prevention of CKD are limited by reliance on observational studies and predominantly pilot clinical trials. RECENT FINDINGS: Emerging data have shown lifestyle modification strategies for primary CKD prevention with the most evidence favoring a healthy dietary pattern (rich in fruit, vegetables, potassium and have a higher plant-based to animal protein ratio), and diet low in sodium, being physically active, avoiding tobacco smoking, moderating alcohol consumption and maintaining a healthy body weight. The way these behavioral interventions can be implemented in practice should consider their synergistic benefit as well as mechanisms to facilitate long-term behavior change. Sustaining long-term behavior change remains a challenge in practice, particularly due to a lack of healthcare resources and behavior relapse. Some suggestions to mitigate this include ensuring adequate time is spent in intervention codesign and planning, utilizing adaptive trial/intervention designs with regular intervention tailoring for intervention dose, intensity, duration, and modality. SUMMARY: A number of modifiable lifestyle behaviors consistently associate with developing CKD in the community. The current evidence base, despite its inherent limitations, may inform both public health recommendations and clinical practice.No Full Tex
Correction: Lin, G.; Huang, H. The Dynamical and Kinetic Equations of Four-Five-Six-Wave Resonance for Ocean Surface Gravity Waves in Water with a Finite Depth. Symmetry 2024, 16, 618
No full textAddition of an author and his email [...
Performance of reduced-scale Vortex amplifiers used to control glovebox dust
No full textVentilation systems for a nuclear plant must have a very high reliability and effectiveness. In this application, fluidic devices have advantages which electro-mechanical and pneumatic devices lack. Fluidic devices will not easily wear out, they have a relatively fast response and in some cases they may be cheaper than an equivalent conventional device. Most importantly, they have fewer moving parts (usually none) so are inherently reliable, so long as the fluidic design is effective. So vortex amplifiers (VXA) are ideal for active ventilation systems where access for maintenance is problematic.
From 1995 to 2000, space limitations at Sellafield drove the desire to minimise VXA size and also glovebox size. Recently completed plant expansions use a smaller version of VXA produced by scaling geometrically the existing standard model. It is called the mini-VXA. Subsequent performance of the mini-VXA has been disappointing with high oxygen levels noted in the inerted gloveboxes; this required an expensive increase in the inert gas supply rate of gloveboxes to mitigate against fire risk.
After doing experiments using a mini-VXA and typical glovebox, the author has confirmed the high 02 levels. The 02 distribution in the glovebox indicates that oxygen is entering the glovebox by the VXA supply ports; against the general direction of flow.
The ultimate source of this back leakage is the control port (that is open to atmosphere) and smoke visualisation studies on the mock VXA indicate a mechanism. This is due to separated flow patterns with excessive control port momentum. A temporary solution using an orifice plate and spacing chamber has been shown to reduce essential nitrogen supply to one quarter that without the modification. Addition of the orifice plates enables further reduction in nitrogen use, and the smallest orifice tested performs best with no discernable cost in pressure drop and therefore fan power. The author also found the following points. The ratio of control port area to supply port area is a critical parameter affecting mixing of the two airstreams. Yet exit port area is unimportant. The ratio of supply port area to exit port area has no influence on discharge coefficient (at least within the scope of current work). It is also identified that the ratio of chamber height to exit port radius does not affect the discharge coefficient or two angle parameters. Doubling chamber height, supply port area and control port area at the same time has a slight effect on the discharge coefficient (attributed partly to a viscous effect), but no effect on the two angle parameters. The chamber height has little effect on Reynolds number. If the supply port area is not too small relative to the exit port, the supply port area will not significantly affect Reynolds number. The use of discharge coefficient and the two angle parameters to characterize VXA performance breaks with the traditional form of dimensionless characteristics that are used for the purpose. Testing these alternate characteristics has enabled the momentum
(which dominates control of VXA performance) to be more explicitly expressed in updated design rules
- …
