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The uptake of the current concept of chronic kidney disease (CKD) by the public, physicians and health authorities is low. Physicians still mix up CKD with chronic kidney insufficiency or failure. In a recent manuscript, only 23% of participants in a cohort of persons with CKD had been diagnosed by their physicians as having CKD while 29% has a diagnosis of cancer and 82% had a diagnosis of hypertension. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. A prevalent view is that for those in whom kidneys fail, the problem is ``solved'' by dialysis or kidney transplantation. However, the main burden of CKD is accelerated aging and all-cause and cardiovascular premature death. CKD is the most prevalent risk factor for lethal COVID-19 and the factor that most increases the risk of death in COVID-19, after old age. Moreover, men and women undergoing KRT still have an annual mortality which is 10-100-fold higher than similar age peers, and life expectancy is shortened by around 40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth global cause of death by 2040 and the second cause of death in Spain before the end of the century, a time when 1 in 4 Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded CIBER network research structure in Spain. Leading Spanish kidney researchers grouped in the kidney collaborative research network REDINREN have now applied for the RICORS call of collaborative research in Spain with the support of the Spanish Society of Nephrology, ALCER and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true. However, only the highest level of research funding through the CIBER will allow to adequately address the issue before it is too late. (C) 2021 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.

Background/Objectives: Epidemiological studies suggest a link between chromium (Cr) status and cardiovascular disease. Increased urinary excretion of Cr was reported in subjects with diabetes compared with non-diabetic controls and those with non-diabetic insulin resistance. Epigenetic alterations have been linked to the presence of Cr, and microRNA (miRNA) expression has been implicated in the pathogenesis of metabolic diseases and cardiovascular diseases (CVDs). We investigated the association between Cr excretion and miRNA expression in leukocytes from obese subjects. We also examined the relationship between altered miRNA expression and selected clinical parameters to further investigate mechanisms linking Cr to metabolic diseases and CVDs. Subjects/Methods: We analyzed urinary Cr in 90 Italian subjects using inductively coupled plasma-mass spectrometry. Peripheral blood miRNA levels were screened with TaqMan Low-Density Array Human MicroRNA A. Cr level-associated expression of miRNAs was detected with multivariate regression analyses, and the top 10 candidate miRNAs were selected for validation. We also used multivariate regression analyses to assess possible associations between validated miRNAs and glycated hemoglobin (A1c) and blood pressure (BP). The validated miRNAs were further investigated by functional analysis with Ingenuity Pathway Analysis software. Results: Urinary Cr levels (mean: 0.35 μg/l; s.d.=0.24) ranged from 0.05 to 1.27 μg/l. In the screening phase, 43 miRNAs were negatively associated with Cr. Of the top 10 miRNAs selected for validation, nine (miR-451, miR-301, miR-15b, miR-21, miR-26a, miR-362-3p, miR-182, miR-183 and miR-486-3p) were downregulated in association with Cr (P-false discovery rate (FDR)

Made available in DSpace on 2018-08-02T00:17:23Z (GMT). No. of bitstreams: 1 tese_11902_Cassio Favero.pdf: 14664452 bytes, checksum: dc0a968827ddd316249e683634e23e70 (MD5) Previous issue date: 2018-03-16 Paisagens culturais e iluminação artificial são, atualmente, duas temáticas da arquitetura que contribuem no panorama da preservação cultural e histórica dos conjuntos arquitetônicos urbanos. Nas cidades, os cuidados com o período noturno originam uma nova paisagem a ser explorada e valorizada, a paisagem noturna. A cultura de valorização dos monumentos e as diversas formas atuais de aplicação das tecnologias de iluminação artificial geram uma demanda para a exploração desse tipo de paisagem. Destacam-se, desta forma, elementos que compõem a paisagem noturna por intermédio da iluminação artificial, em níveis impossíveis de se atingir na paisagem diurna. Todavia, há uma lacuna no que se refere às metodologias voltadas para a estruturação e valorização da paisagem urbana em período noturno, principalmente relacionadas às cidades históricas. As aplicações da iluminação ocorrem, em grande parte, de modo padrão para todos os locais, sem qualquer preocupação de adequação à realidade local ou tentativa de afirmação dos valores embutidos no espaço urbano. Desse modo, é necessário buscar maneiras mais eficazes de implantação das técnicas luminosas, sendo essas capazes de transmitir ao usuário do espaço os valores nele embutidos, bem como, o destaque de sua importância. Assim, essa pesquisa tem como objetivo propor metodologia para elaboração de iluminação em áreas urbanas patrimoniais. Para alcançar o objetivo proposto, o experimento metodológico é aplicado na cidade de Santa Leopoldina (ES), importante sítio histórico urbano e tombado em nível estadual pelo Conselho Estadual de Cultura, por meio de visita. A metodologia de trabalho se baseou inicialmente em pesquisa bibliográfica referente à definição de paisagem urbana noturna, análise dos movimentos de iluminação urbana o movimento francês, LUrbanisme Lumière, e o movimento americano, City Beautification , análise do tratamento da paisagem noturna de cidades europeias e brasileiras no cenário atual, as técnicas e efeitos proporcionados pela iluminação artificial. Como conclusão observa-se que o experimento metodológico contemplou duas fases, cada uma dividida em três etapas. As etapas da primeira fase são etapas: visitas técnicas ao local de intervenção, registro fotográfico da paisagem e identificação da imagem comum e elementos de importância da paisagem. As etapas da segunda fase são: hierarquização do espaço urbano, estratégias técnicas e de efeitos de iluminação e dinamização do sistema de iluminação. Observou-se também que a aplicação do experimento metodológico em Santa Leopoldina possibilitou a elaboração de quinze diretrizes de intervenção/estratégias para iluminação noturna de áreas urbanas patrimoniais visando a valorização integrada, harmoniosa e coerente de todo o espaço urbano e seus monumentos, naturais ou artificiais. Palavras chaves: Paisagem noturna. Iluminação artificial. Patrimônio urbano.

Objectives: It has been amply reported that nursing home (NH) residents are largely inactive, a condition that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have mainly focused on individual characteristics that may decrease residents’ involvement in activities. Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian context, identifying predictors of inactivity at the individual and NH levels. Design: Retrospective regional-based study performed in 2014. Setting: All NHs (n ¼ 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy. Participants: A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least 1 year. Measurements: The dependent variable was inactivity in the last week, defined as the resident not being involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity, a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and random effects, was performed. Results: A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI) 3.880e5.132], unsociable behavior (OR 2.961, 95% CI 2.522e3.473), night restlessness (OR 1.605, 95% CI 1.395e1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199e1.643), pressure sores (OR 1.314, 95% CI 1.065e1.622), depressive disorders (OR 1.242, 95% CI 1.089e1.416), and clinical instability (OR 1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964, 95% .933-.996). Conclusions: Approximately one-half of the residents in this study living in Italian NHs are inactive. Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders (eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores, depressive symptoms, and clinical instability. Moreover, receiving care from professional educators whose aim in their training program and professional mission is to improve individual and social engagement, decreased the likelihood of resident inactivity.

The aim of this paper is to analyse the implications of the theory of irreversible investment under uncertainty for investment in oilfields on the United Kingdom Continental Shelf (UKCS). We model the decision to proceed with the development investment as an optimal stopping problem and apply the established theory to derive the determinants of the optimal policy. Data OH the length of the time period between discovery and development are available for individual oilfields on the UKCS. The theory is empirically examined by exploring the significance of the determinants of the optimal policy in explaining the variation in the development lag of individual oilfields. Applying statistical duration analysis to the North Sea data, we find a strong effect of expected price and associated price uncertainty on the length of the appraisal stage of the investment projects.

RATIONALE AND OBJECTIVES A few case reports have suggested a possible thrombogenic effect of nonionic contrast media. In vitro investigations have lead to conflicting results. The authors performed three ex vivo studies to evaluate the influence of an ionic, ioxaglate, and a nonionic, iopamidol, low-osmolality contrast medium on a series of clotting and fibrinolytic parameters, after intravenous or intra-arterial administration, during routine diagnostic procedures. METHODS In the first study, iopamidol was given to 20 consecutive patients through an arterial catheter for digital subtraction arteriography (DSA). In the second study, iopamidol was compared with ioxaglate. The media were randomly and blindly administered intravenously to 21 consecutive patients undergoing brain computed tomography (CT). Finally, ioxaglate was administered intra-arterially to 20 consecutive patients, in a situation comparable with that of the first study. RESULTS In the first study, a weak anticoagulant effect and an activation of fibrinolysis were found, associated with indirect markers of thrombin generation, such as increased plasma levels of fibrinopeptide A (FpA) and thrombin-antithrombin III complexes (TAT). In the second study, no significant changes were seen with either contrast medium, for thrombin or fibrinolysis activation parameters. In the third study, the intra-arterially administered contrast medium elicited a marked increase of FpA and TAT, together with an anticoagulant effect. CONCLUSION Both ionic and nonionic contrast media are able to interfere with the clotting/fibrinolytic system in the general circulation when they are administered to patients at the usual dosages. Ioxaglate shows more marked anticoagulant and thrombin-generating effects than iopamidol. The procedure (ie, arterial catheter versus intravenous infusion) seems to be more important than the category of contrast medium in conditioning the magnitude of these effects.