Search

Abstract Background Physical performance is low and physical activity declines in people with chronic kidney disease (CKD). Both factors are associated with decreased survival. Our hypothesis was that improved physical performance after 12 months of exercise training would result in better survival in patients with CKD stages 3 to 5 not on kidney replacement therapy (KRT). Our aims in this study were to investigate the survival effects of (1) baseline physical performance and (2) physical performance after 12 months of exercise training. Methods This is a post-hoc analysis of the RENEXC trial, a randomized controlled study comparing 12 months of strength- and balance training both in combination with aerobic training. Both groups improved physical performance with no between group differences. Patients were categorized into five groups: improved ≥ 5%, unchanged, deteriorated ≥ 5%, non-completers, missing data. Univariate and multivariate Cox regression analyses were used and adjusted for age, sex, comorbidity, time on dialysis and time with a kidney transplant. Results 151 patients participated, mean age 66 ± 14 years, 65% men, eGFR 22.5 ± 8.2 ml/min/1.73m2, average follow-up 60 months. Multivariate analyses The baseline 6-minute walk test (6MWT) (HR 0.996; 95% CI [0.993–0.998]) and 30-second sit-to-stand (30s-STS) (HR 0.94 CI [0.89–1.0]) were positively associated with survival. After 12 months of exercise improved handgrip strength (HGS) right (HR 2.66; 95% CI [1.07–6.59]) was associated with better survival compared with deterioration. Improvement compared with noncompletion was associated with better survival (6MWT (HR 2.88; 95% CI [1.4–5.88]), HGS right (HR 4.44; 95% CI [1.79–10.98]), functional reach (HR 3.69; 95% CI [1.82–7.48]), isometric quadriceps strength right (HR 2.86; 95% CI [1.43–5.72]), 30s-STS (HR 3.44; 95% CI [1.66–7.11]). Conclusion Baseline walking distance, muscular strength and endurance in the legs were independently associated with survival in people with CKD stages 3–5 without KRT. After completing 12 months of exercise training improved walking distance, muscular strength and endurance, and balance were positively associated with survival, compared with noncompleters. Better physical performance at baseline and the ability to complete 12 months of exercise training conferred survival benefits. There are probably several factors affecting better survival. These factors require elucidation in future studies. Trial registration ClinicalTrials.gov NCT02041156. Registration date 20,240,107.

This is the story of a course in higher education that, over a period of ten years, went from being one of the most popular courses, among both students and teachers, to becoming one of the more problematic. Students and teachers felt that the course had many problems that needed to be addressed. For the course round of 2022, the decision was taken to redesign the course using gamification. Research on gamification in education is widespread and many have studied its effectiveness, with varying results. Most of the existing studies have a narrow view of gamification, which both limits its potential and is a risk for counterproductivity. Gamification in education requires careful planning and a game-thinking approach to the design of the learning environment. In this paper, I show how this can be done and what the outcomes may be. In the work, I draw upon motivation theory and gamification literature. Empirical insights are gained through analysing the course over the years and the outcome of the redesign. In this analysis, I make use of course evaluations, the results of a Kahoot quiz and student feedback. The contribution to research and practice is to show how courses can be redesigned into a gamified design that is good for both the students and the teachers.

Purpose – Management and risk techniques within industries have been studied from various disciplines in nondefense-affiliated industries. Given the assumption that these techniques, strategies and mitigations used in one industry apply to other similar industries, this paper examines the defense industry for risk assessment. We characterize interactions for onward application to risk identification in the defense industry. Design/methodology/approach – This research employs a systems theory approach to the characterization of industry interactions, using three dimensions including environment, boundaries and relationships. It develops a framework for identifying relationship types within system-of-systems (SoS) environments by analyzing the features of interactions that occur in such environments. Findings – The study’s findings show that different systems environments within the defense industry SoS exhibit different interaction characteristics and hence display different relationship patterns, which can indicate potential vulnerabilities. Research limitations/implications – By employing interaction as a means for evaluating potential risks, this research emphasizes the role played by relationship factors in reducing perceived risks and simultaneously increasing trust. Originality/value – This paper intends to develop an initial snapshot of the relationship status of the Swedish defense industry in light of the global consolidation in this industry, which is a relevant contextual contribution.

Cells respond to mitochondrial poisons with rapid activation of the adenosine monophosphate-activated protein kinase (AMPK), causing acute metabolic changes through phosphorylation and prolonged adaptation of metabolism through transcriptional effects. Transcription factor EB (TFEB) is a major effector of AMPK that increases expression of lysosome genes in response to energetic stress, but how AMPK activates TFEB remains unresolved. We demonstrate that AMPK directly phosphorylates five conserved serine residues in folliculin-interacting protein 1 (FNIP1), suppressing the function of the folliculin (FLCN)-FNIP1 complex. FNIP1 phosphorylation is required for AMPK to induce nuclear translocation of TFEB and TFEB-dependent increases of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) and estrogen-related receptor alpha (ERRα) messenger RNAs. Thus, mitochondrial damage triggers AMPK-FNIP1-dependent nuclear translocation of TFEB, inducing sequential waves of lysosomal and mitochondrial biogenesis.

Neuroendocrine neoplasms (NENs) are a diverse group originating from endocrine cells/their precursors in pancreas, small intestine, or lung. The key serum marker is chromogranin A (CgA). While commonly elevated in patients with NEN, its prognostic value is still under discussion. Secretion/posttranslational proteolytic cleavage of CgA results in multiple bioactive fragments, which are essential regulators of the cardiovascular and immune system. miR-223, regulator of Nrlp3 inflammasome and neutrophil activation, was recently found to have decreased in patients with NEN. We performed flow cytometry of circulating neutrophils in a patient cohort (n = 10) with NEN, microdissection and histology of tumor tissue. Subsequently, in vitro transfections using the well-established human pancreatic NEN cell line (BON), and co-culture experiments with primary macrophages and neutrophils were performed. Serum miR-223 in patients correlated with the expression of the neutrophil activation marker CD15 in circulating cells. Neutrophilic CD62L/CD63 showed good discrimination compared to healthy controls. Immune cell-derived miR-155, miR-193 and miR-223 colocalize with neutrophil in the extra-tumoral tissue alongside Nlrp3-associated caspase-1 activation. miR-223 knockdown in BON decreased the CgA intracellularly, increased in cellular granularity and caspase-1 activation. Plasmin inhibitor a2-aP reverted those effects. Western Blot showed fragmented CgA following miR-223 knockdown, which altered the inflammatory potential of neutrophils. Our data hence provide initial insights into an immunoregulatory mechanism via miR-223 and CgA in NEN cells, as regulation of miR-223 in NEN may affect tumor-associated inflammation.

Purpose: This article investigates the establishment of commitment in pedagogical practices through what are known as 'behavioural contracts'. Such contracts are seen as a participatory element of democratic pedagogy and are linked to the aim of strengthening students' self-determination. The objective is to demonstrate that as a pedagogical phenomenon, contractual pedagogy is oriented towards a practice of self-control achieved through external control, assuming a basis of sovereignty and reason. Methodology: The article provides an investigation of material from an ethnographic research project in Germany on social learning in school-based pedagogical contexts. The study is informed by practice theory, theory of school and theory of social pedagogics. Findings: This article argues that contractual pedagogy as a subjectivising constellation is primarily directed towards re-establishing the pre-existing institutional order. It demonstrates that contractual pedagogy can neither be understood as a particularly participatory method of democratic pedagogy, nor as a governmental power strategy, but as a subjectivising exercise that introduces students to a central tenet in modern societies. Through this, connections are formed between specific forms of (collective) subjectivation. Research implications: Further theoretical and empirical analyses are required, which make other pedagogical impulses, such as an ethics of care or the critique of the subject, fruitful for Democratic Pedagogy.

BackgroundIn order to identify and possibly offer prophylactic treatment to women at risk for preterm birth (PTB), novel prediction models for PTB are needed. Our objective was to utilize high-sensitive plasma protein profiling to investigate whether early prediction of spontaneous PTB (sPTB) before 34 gestational weeks (gw) was possible in a low-risk population.MethodsA case-control study was conducted on 46 women with sPTB before 34 gw and 46 women with normal pregnancies and term deliveries. Prospectively collected plasma sampled at gw 11 (range 7-16) and gw 25 (range 23-30) was analyzed with a high-sensitivity Proximity Extension Assay for levels of 177 inflammation-associated proteins, and statistically processed with multivariate logistic regression analysis.ResultsIn the first trimester, higher levels of hepatocyte growth factor (HGF) were associated with sPTB

The Contamination Sanitization Inspection and Disinfection (CSI-D) device is a handheld fluorescence-based imaging system designed to disinfect food contact surfaces using ultraviolet-C (UVC) illumination. This study aimed to determine the optimal CSI-D parameters (i.e., UVC exposure time and intensity) for the inactivation of the following foodborne bacteria plated on non-selective media: generic Escherichia coli (indicator organism) and the pathogens enterohemorrhagic E. coli, enterotoxigenic E. coli, Salmonella enterica, and Listeria monocytogenes. Each bacterial strain was spread-plated on non-selective agar and exposed to high-intensity (10 mW/cm2) or low-intensity (5 mW/cm2) UVC for 1–5 s. Control plates were not exposed to UVC. The plates were incubated overnight at 37 °C and then enumerated. Three trials for each bacterial strain were conducted. Statistical analysis was carried out to determine if there were significant differences in bacterial growth between UVC intensities and exposure times. Overall, exposure to low or high intensity for 3–5 s resulted in consistent inhibition of bacterial growth, with reductions of 99.9–100 % for E. coli, 96.8–100 % for S. enterica, and 99.2–100 % for L. monocytogenes. The 1 s exposure time showed inconsistent results, with a 66.0–100 % reduction in growth depending on the intensity and bacterial strain. When the results for all strains within each species were combined, the 3–5 s exposure times showed significantly greater (p 0.05) in growth inhibition between the high and low UVC intensities. The results of this study show that, in pure culture conditions, exposure to UVC with the CSI-D device for ≥3 s is required to achieve consistent reduction of E. coli, S. enterica, and L. monocytogenes.