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Periodic regeneration is required to clean the diesel particulate filter (DPF) of heavy-duty diesel vehicle. In this study we analyze real-time particulate matter (PM) mass, particle number, and black carbon emissions during steady state driving active and passive diesel particulate filter (DPF) regenerations on a heavy-duty chassis dynamometer. Regeneration PM emissions were dominated by particles with count median diameter

Vehicle activity is an integral component in the estimation of mobile source emissions and the study of emission inventories. In the Environmental Protection Agency’s (EPA’s) Motor Vehicle Emission Simulator (MOVES) model and the California Air Resources Board’s (CARB’s) Emission Factor (EMFAC) model, vehicle activity is defined for source types, in which vehicles within a source type are assumed to have the same activity. In both of these models, source types for heavy-duty vehicles are limited in number and the assumption that the activity within these source types is similar may be inaccurate. The focus of this paper is to improve vehicle emission estimates by improving characterization of heavy-duty vehicle activity using vehicle vocation. This paper presents results and analysis from the collection of real-world activity data of 90 vehicles from 19 vehicle categories made up from a combination of vehicle vocation, gross vehicle weight, and geographical area— namely, line haul—out of state; line haul—in state; drayage—Northern California; drayage—Southern California; agricultural—Southern Central Valley; heavy construction; concrete mixers; food distribution; beverage distribution; local moving; airport shuttle; refuse; urban buses; express buses; freeway work; sweeping; municipal work; towing; and utility repair. Results show that real-world activity patterns of heavy-duty vehicles vary greatly by vocation and in some cases by geographic region. Vocation-specific activity information can be used to update assumptions in EPA’s MOVES model or CARB’s EMFAC model to address this variability in emission inventory development.

Over the past decade, efforts to reduce emissions of particulate matter (PM) and oxides of nitrogen (NO + NO2, or NOx) from heavy-duty diesel vehicles (HDDVs) have led to the widespread adoption of both Diesel Particulate Filters (DPFs) to control PM and Selective Catalytic Reduction (SCR) to control NOx. We evaluated the performance of DPFs and SCR with 13,327 real-world fuel-based Black Carbon (BC) and NOx emission factors from 9,167 unique heavy-duty vehicles (primarily HDDVs) measured at four sites in California (two ports, two highways) from 2011 to 2018. BC emission factors have decreased by 90% during the past decade. At the same time, BC distributions have become increasingly skewed toward ���high-emitters��� ��� e.g., the portion of the HDDV fleet responsible for half of all BC emissions has decreased from ~16% to ~3%. NOx emission factors have also decreased over the past decade, but by only 31%. They remain roughly five times greater than in-use thresholds.We examined changes in BC and NOx emissions with engine age. BC emissions from DPF-only trucks decreased slightly but insignificantly, by 6 �� 15 mg/kg fuel per year, while for DPF+SCR trucks they increased by 5 �� 3. These changes are less than 5% of in-use thresholds. The annual increase in NOx emissions with age was much greater: 1.44 �� 0.28 g/kg for older SCR trucks without on-board diagnostic (OBD) capabilities and 0.48 �� 0.35 for newer trucks with OBD, roughly 20��� 50% of in-use thresholds. Paired t-tests on the over 600 vehicles that were observed in multiple campaigns were consistent with these results. Observed changes in BC emissions with age were best fit with a ���gross emitter��� model assuming an annual DPF failure rate of 0.83 �� 0.01% for DPF-only trucks and 0.56 �� 0.01% for DPF+SCR trucks.Implications: These observations of real-world HDV emission factors have several major implications for regulatory efforts to reduce them. The increasing importance of a relatively small number of high BC emitters suggests that widespread sampling of the on-road fleet will be necessary to identify these vehicles. On the other hand, the much more ubiquitous deterioration in NOx control measures may be better addressed by incorporating on-board diagnostic systems, with telematic data transfer when possible, into inspection and maintenance programs. These NOx observations also highlight the need for strengthening heavy-duty SCR durability demonstration requirements.

To argue that gentrification is one facet of capitalist property regimes is rather obvious. But to demonstrate how the relations usually bundled as gentrification come to play a key role in the con...

BackgroundPeritoneal dialysis (PD)-related infections lead to significant morbidity. The International Society for Peritoneal Dialysis (ISPD) guidelines for the prevention and treatment of PD-related infections are based on variable evidence. We describe practice patterns across facilities participating in the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS).MethodsPDOPPS, a prospective cohort study, enrolled nationally representative samples of PD patients in Australia/New Zealand (ANZ), Canada, Thailand, Japan, the UK and the USA. Data on PD-related infection prevention and treatment practices across facilities were obtained from a survey of medical directors’.ResultsA total of 170 centers, caring for >11 000 patients, were included. The proportion of facilities reporting antibiotic administration at the time of PD catheter insertion was lowest in the USA (63%) and highest in Canada and the UK (100%). Exit-site antimicrobial prophylaxis was variably used across countries, with Japan (4%) and Thailand (28%) having the lowest proportions. Exit-site mupirocin was the predominant exit-site prophylactic strategy in ANZ (56%), Canada (50%) and the UK (47%), while exit-site aminoglycosides were more common in the USA (72%). Empiric Gram-positive peritonitis treatment with vancomycin was most common in the UK (88%) and USA (83%) compared with 10–45% elsewhere. Empiric Gram-negative peritonitis treatment with aminoglycoside therapy was highest in ANZ (72%) and the UK (77%) compared with 10–45% elsewhere.ConclusionsVariation in PD-related infection prevention and treatment strategies exist across countries with limited uptake of ISPD guideline recommendations. Further work will aim to understand the impact these differences have on the wide variation in infection risk between facilities and other clinically relevant PD outcomes.

Recent tightening of particulate matter (PM) emission standards for heavy-duty engines has spurred the widespread adoption of diesel particulate filters (DPFs), which need to be regenerated periodically to remove trapped PM. The total impact of DPFs therefore depends not only on their filtering efficiency during normal operation, but also on the emissions during and the frequency of regeneration events. We performed active (parked and driving) and passive regenerations on two heavy-duty diesel vehicles (HDDVs), and report the chemical composition of emissions during these events, as well as the efficiency with which trapped PM is converted to gas-phase products. We also collected activity data from 85 HDDVs to determine how often regeneration occurs during real-world operation. PM emitted during regeneration ranged from 0.2 to 16.3 g, and the average time and distance between real-world active regenerations was 28.0 h and 599 miles. These results indicate that regeneration of real-world DPFs does not substantially offset the reduction of PM by DPFs during normal operation. The broad ranges of regeneration frequency per truck (3-100 h and 23-4078 miles) underscore the challenges in designing engines and associated aftertreatments that reduce emissions for all real-world duty cycles.

The California Air Resources Board (ARB) and the City of Sacramento undertook this study to characterize the in-use emissions from model year (MY) 2010 or newer diesel, liquefied natural gas (LNG), and hydraulic hybrid diesel engines during real-world refuse truck operation. Emissions from five trucks, two diesels equipped with selective catalytic reduction (SCR), two LNG's equipped with three-way catalyst (TWC), and one hydraulic hybrid diesel equipped with SCR, were measured using a portable emissions measurement system (PEMS) in the Sacramento area. Results showed that the brake-specific NOx emissions for the LNG trucks equipped with the TWC catalyst were lowest of all the technologies tested. Results also showed that the brake specific NOx emissions from the conventional diesel engines were significantly higher despite the exhaust temperature being high enough for proper SCR function. Like diesel engines, the brake specific NOx emissions from the hydraulic hybrid diesel also exceeded certification although this can be explained on the basis of the temperature profile. Future studies are warranted to establish whether the below average SCR performance observed in this study is a systemic issue or is it a problem specifically observed during this work.

The use of antibiotic lock solutions as prophylaxis for catheter-associated blood stream infection (CRBSI) has been shown to be effective in previous randomized controlled trials. However, the cost-effectiveness of this approach had not been studied. In 2012, the routine gentamicin-heparin lock solution used in Auckland City Hospital was withdrawn from the market, leading to a change to heparin-only lock. This was then replaced with gentamicin-citrate lock in 2014. This situation allowed review of the CRBSI rate and financial impact of different catheter lock solutions. A retrospective audit was performed from 1 January 2011 to 31 December 2015 to investigate the rate of culture-proven CRBSI in patients with tunneled cuffed dialysis catheters. There were 89 cases of CRBSI involving 64 patients in the 5-year period. In comparison with the heparin-only lock, both gentamicin-heparin and gentamicin-citrate locks had a significantly lower rate of bacteremia, with rate ratios of 0.46 (confidence interval 0.30-0.72) and 0.11 (confidence interval 0.05-0.22), respectively. The inpatient costs as a consequence of the CRBSI were NZ$27 792 per 1000 catheter days for heparin-only lock, NZ$10 608.56 per 1000 catheter days for gentamicin-heparin lock, and NZ$ 1898.45 per 1000 catheter days for gentamicin-citrate lock. The lack of antibiotic lock solutions led to an increase in bacteremia rates and higher financial cost for inpatient management of bacteremia. Our findings highlight the importance of consistent supply of pharmaceuticals.

Introduction of a selective catalytic reduction system for heavy-duty diesel trucks (HDDTs) has substantially reduced emissions of oxides of nitrogen (NOx). However, it was found that in-use NOx emissions measured from three 2010-technology HDDTs were higher than the certification standard and higher than the levels measured during engine certification. In-use NOx emissions from three HDDTs tested over chassis dynamometer cycles were 1.7 to 9 times higher than the NOx certification standard of 0.20 grams per brake horsepower-hour, and the emissions measured with a portable emissions measurement system over highway test routes were up to five times higher than the certification standard. Such high in-use NOx emissions occurred primarily during low-speed operations (25 mph or less). This is a concern in California because more than 50% of running-exhaust NOx emissions from HDDTs will occur during low-speed operations that constitute only 11% of total vehicle miles traveled by 2025. This substantial contribution of NOx emissions during low-speed operations should be addressed carefully in the process of developing regulations and strategies to improve air quality in California. For better understanding and control of high in-use NOx emissions, there is a strong need for investigation of NOx control technologies effective at low-speed operation, differences between engine testing and whole vehicle testing procedures, and the roles of both engine certification requirements and in-use compliance requirements in reducing real-world NOx emissions.

Background. Membranous nephropathy (MN) can be associated with malignancy. However, the relative risk for malignancy remains unclear. It has been reported that higher numbers of inflammatory cells seen in the glomeruli at biopsy correlate with the occurrence of malignancy in patients with MN and might be used to direct screening. Methods. We examined the occurrence of malignancy in 201 MN patients in Auckland, New Zealand. We also examined the pathology of renal biopsies from 17 MN patients with malignancies and compared the number of inflammatory cells per glomerulus with matched control patients with MN but no malignancy. Results. 40 malignancies were identified in 37 patients, 28 of which occurred after the MN diagnosis. The standardized incidence ratio (SIR) was 2.1 (95% CI, 1.3–2.85) which was similar between patients ≥ 60 years and those p value 0.56). Conclusions. The relative risk of malignancy in MN patients was similar across different age groups. The number of inflammatory cells per glomerulus did not differentiate between MN patients with and without malignancies.

Item does not contain fulltext BACKGROUND: Change in albuminuria as a surrogate endpoint for progression of chronic kidney disease is strongly supported by biological plausibility, but empirical evidence to support its validity in epidemiological studies is lacking. We aimed to assess the consistency of the association between change in albuminuria and risk of end-stage kidney disease in a large individual participant-level meta-analysis of observational studies. METHODS: In this meta-analysis, we collected individual-level data from eligible cohorts in the Chronic Kidney Disease Prognosis Consortium (CKD-PC) with data on serum creatinine and change in albuminuria and more than 50 events on outcomes of interest. Cohort data were eligible if participants were aged 18 years or older, they had a repeated measure of albuminuria during an elapsed period of 8 months to 4 years, subsequent end-stage kidney disease or mortality follow-up data, and the cohort was active during this consortium phase. We extracted participant-level data and quantified percentage change in albuminuria, measured as change in urine albumin-to-creatinine ratio (ACR) or urine protein-to-creatinine ratio (PCR), during baseline periods of 1, 2, and 3 years. Our primary outcome of interest was development of end-stage kidney disease after a baseline period of 2 years. We defined an end-stage kidney disease event as initiation of kidney replacement therapy. We quantified associations of percentage change in albuminuria with subsequent end-stage kidney disease using Cox regression in each cohort, followed by random-effects meta-analysis. We further adjusted for regression dilution to account for imprecision in the estimation of albuminuria at the participant level. We did multiple subgroup analyses, and also repeated our analyses using participant-level data from 14 clinical trials, including nine clinical trials not in CKD-PC. FINDINGS: Between July, 2015, and June, 2018, we transferred and analysed data from 28 cohorts in the CKD-PC, which included 693 816 individuals (557 583 [80%] with diabetes). Data for 675 904 individuals and 7461 end-stage kidney disease events were available for our primary outcome analysis. Change in ACR was consistently associated with subsequent risk of end-stage kidney disease. The adjusted hazard ratio (HR) for end-stage kidney disease after a 30% decrease in ACR during a baseline period of 2 years was 0.83 (95% CI 0.74-0.94), decreasing to 0.78 (0.66-0.92) after further adjustment for regression dilution. Adjusted HRs were fairly consistent across cohorts and subgroups (ie, estimated glomerular filtration rate, diabetes, and sex), but the association was somewhat stronger among participants with higher baseline ACR than among those with lower baseline ACR (pinteraction

Diesel particle number and mass emissions were measured during parked active regeneration of diesel particulate filters (DPF) in two heavy-duty diesel trucks: one equipped with a DPF and one equipped with a DPF + SCR (selective catalytic reduction), and compliant with the 2007 and 2010 emission standards, respectively. The emission measurements were conducted using an ambient air dilution tunnel. During parked active regeneration, particulate matter (PM) mass emissions measured from a 2007 technology truck were significantly higher than the emissions from a 2010 technology truck. Particle number emissions from both trucks were dominated by nucleation mode particles having a diameter less than 50 nm; nucleation mode particles were orders of magnitude higher than accumulation mode particles having a diameter greater than 50 nm. Accumulation mode particles contributed 77.8 %–95.8 % of the 2007 truck PM mass, but only 7.3 %–28.2 % of the 2010 truck PM mass.

Rationale & Objective Chronic kidney disease (CKD) is complicated by abnormalities that reflect disruption in filtration, tubular, and endocrine functions of the kidney. Our aim was to explore the relationship of specific laboratory result abnormalities and hypertension with the estimated glomerular filtration rate (eGFR) and albuminuria CKD staging framework. Study Design Cross-sectional individual participant-level analyses in a global consortium. Setting & Study Populations 17 CKD and 38 general population and high-risk cohorts. Selection Criteria for Studies Cohorts in the CKD Prognosis Consortium with data for eGFR and albuminuria, as well as a measurement of hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, or calcium, or hypertension. Data Extraction Data were obtained and analyzed between July 2015 and January 2018. Analytical Approach We modeled the association of eGFR and albuminuria with hemoglobin, bicarbonate, phosphorus, parathyroid hormone, potassium, and calcium values using linear regression and with hypertension and categorical definitions of each abnormality using logistic regression. Results were pooled using random-effects meta-analyses. Results The CKD cohorts (n = 254,666 participants) were 27% women and 10% black, with a mean age of 69 (SD, 12) years. The general population/high-risk cohorts (n = 1,758,334) were 50% women and 2% black, with a mean age of 50 (16) years. There was a strong graded association between lower eGFR and all laboratory result abnormalities (ORs ranging from 3.27 [95% CI, 2.68-3.97] to 8.91 [95% CI, 7.22-10.99] comparing eGFRs of 15 to 29 with eGFRs of 45 to 59 mL/min/1.73 m 2), whereas albuminuria had equivocal or weak associations with abnormalities (ORs ranging from 0.77 [95% CI, 0.60-0.99] to 1.92 [95% CI, 1.65-2.24] comparing urinary albumin-creatinine ratio > 300 vs < 30 mg/g). Limitations Variations in study era, health care delivery system, typical diet, and laboratory assays. Conclusions Lower eGFR was strongly associated with higher odds of multiple laboratory result abnormalities. Knowledge of risk associations might help guide management in the heterogeneous group of patients with CKD. © 2018. This is the authors’ accepted and refereed manuscript to the article. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ "

Introduction: Patients with chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) Methods: We undertook a meta-analysis of risk factors for kidney failure treated with kidney replacement therapy (KRT), cardiovascular disease (CVD) events, and death in participants with CKD G4þ from 28 cohorts (n ¼ 185,024) across the world who were part of the CKD Prognosis Consortium.Results: In the fully adjusted meta-analysis, risk factors associated with KRT were time-varying CVD, male sex, black race, diabetes, lower eGFR, and higher albuminuria and systolic blood pressure. Age was associated with a lower risk of KRT (adjusted hazard ratio: 0.74; 95% confidence interval: 0.69–0.80) overall, and also in the subgroup of individuals younger than 65 years. The risk factors for CVD events included male sex, history of CVD, diabetes, lower eGFR, higher albuminuria, and the onset of KRT. Systolic blood pressure showed a U-shaped association with CVD events. Risk factors for mortality were similar to those for CVD events but also included smoking. Most risk factors had qualitatively consistent associations across cohorts.Conclusion: Traditional CVD risk factors are of prognostic value in individuals with an eGFR

On-road heavy-duty diesel vehicles are a major contributor of oxides of nitrogen (NO(x)) emissions. In the US, many heavy-duty diesel vehicles employ selective catalytic reduction (SCR) technology to meet the 2010 emission standard for NO(x). Typically, SCR needs to be at least 200 °C before a significant level of NO(x) reduction is achieved. However, this SCR temperature requirement may not be met under some real-world operating conditions, such as during cold starts, long idling, or low speed/low engine load driving activities. The frequency of vehicle operation with low SCR temperature varies partly by the vehicle’s vocational use. In this study, detailed vehicle and engine activity data were collected from 90 heavy-duty vehicles involved in a range of vocations, including line haul, drayage, construction, agricultural, food distribution, beverage distribution, refuse, public work, and utility repair. The data were used to create real-world SCR temperature and engine load profiles and identify the fraction of vehicle operating time that SCR may not be as effective for NO(x) control. It is found that the vehicles participated in this study operate with SCR temperature lower than 200 °C for 11–70% of the time depending on their vocation type. This implies that real-world NO(x) control efficiency could deviate from the control efficiency observed during engine certification.

Many vehicle owners in the United States recharge their vehicles' air conditioning systems with small containers of hydrofluorocarbon-134a (HFC-134a, CH2FCF3), at a frequency estimated to be once every year on average. Such nonprofessional service produces immediate emissions of this potent greenhouse gas during service and from the residual heel in partially used containers. The nonprofessional operations are also associated with increased delayed refrigerant emissions that occur because owners are less likely to repair leaks than professional technicians. In California, an estimated 1.3 million nonprofessional service operations performed each year generate 0.27 ± 0.07 million metric ton CO2 equivalent (MMTCO2e) of immediate emissions and 0.54 ± 0.08 MMTCO2e of delayed emissions, using a Global Warming Potential of 1300 for HFC-134a. The immediate emissions can be largely mitigated by a regulation that requires self-sealing valves and improved labeling instructions on the containers, a deposit-return-recycling program for the containers, and a consumer education program. If 95% of the used containers were to be returned by consumers for recycling of the container heel, the annual immediate emissions would be reduced by 0.26 ± 0.07 MMTCO2e. In the United States, an estimated 24 million nonprofessional service operations are performed each year, generating 5.1 ± 1.4 MMTCO2e of immediate emissions and 10.4 ± 1.5 MMTCO2e of delayed emissions. Mitigation measures equivalent to the California regulation would reduce nationwide immediate emissions by 4.9 ± 1.4 MMTCO2e, if 95% of the used cans were returned for recycling. These business-as-usual emissions and mitigation potentials are projected to stay approximately constant until around 2022, and remain at significant levels into the 2030s.

The majority of particulate matter (PM) emitted from diesel engines is captured by advanced emission aftertreatment, here defined as the combination of a diesel particulate filter (DPF) and selective catalytic reduction (SCR). Some PM is still emitted, however, and because PM from uncontrolled diesel engines is known to be carcinogenic, any changes in diesel PM chemistry with aftertreatment would be of interest. Here, we present PM chemical composition from emissions of a 2010 compliant heavy-duty diesel vehicle (HDDV) with original equipment manufacturer aftertreatment collected on bulk filters and impactor stages. Results reported include inorganic ions, water-soluble organic carbon (WSOC), thermo-optical organic and elemental carbon (OC/EC), and specific polycyclic aromatic hydrocarbons (PAHs). We compare the model year 2010 composition to that emitted by a model year 1998 HDDV without DPF/SCR. We found that diesel PM mass emissions are reduced by one to two orders of magnitude by aftertreatment, but that a carbon-based accumulation mode (∼100 nm), the defining feature of traditional diesel PM, is still present in 2010 compliant HDDVs. Under heavier engine load conditions (high-speed cruise), the 2010 vehicle also emitted a sulfate-rich nucleation mode that, at times, made up the majority of particulate mass. OC and EC size distributions are similar for the two HDDVs, although during cruise, a second OC peak was found in the 2010 nucleation mode. PAH and WSOC data suggest that the OC emitted with aftertreatment is more oxidized and has a smaller relative contribution of unmodified fuel and lube hydrocarbons.

Resumen No Centro Historico de Salvador, Bahia [O Pelourinho], as tentativas policiais de inibir os movimentos de turistas e baianos, tanto quanto o apoio oferecido por estos oficiais as tentativas por parte de representantes do Instituto do Patrimonio Artistico e Cultural da Bahia de separar os moradores das suas praticas cotidianas memorializadas como patrimonio cultural, geram um desdobramento da paisagen urbana/historica do Pelourinho. Estos buracos metaforicos perforam o cotidiano obviamente construido pelo Estado baiano e apoiam a alegacao ideologica oferecida pela burocracia patrimonial baiana de que esta instituicao realmente proteja os bens e os legados da nacao e da humanidade. Isto nao quer dizer que tais buracos no tecido do centro historico sejam icones veridicos do passado baiano ou a vida popular. Ao contrario, isto revela a importância surpreendente do policiamento as tentativas estaduais de apoiar representacoes supostamente duradouros e autenticos em espacos que, mesmos patrimonializados, continuam sendo socialmente complexos. Abstract Social scientists typically treat policing as repressive and historical centers as impoverished imitations of unmarked social relations. Yet in Salvador, Brazil's Pelourinho Historical Center, police attempts to discipline both tourists and working-class residents, together with these officers’ violent support of attempts to separate people from their practices memorialized as public culture, generate perforations or folds in the musealized landscape. These structures of feeling support the neighborhood's aura of rooted authenticity. In this way they punctuate, and thus veil, the heritage zone's fraught construction and support the ideological goals of Bahia's cultural heritage bureaucracy that claims to safeguard humankind's shared legacies. This emphasis on the productivity of policing is not to argue that such spaces are bona fide tokens of Brazilian pasts or popular vitality, but to suggest the importance of policing in animating supposedly homogeneous spaces.

Objective Non-diabetic renal disease (NDRD) is common in patients with type 2 diabetes (T2D), but the relationship between its presentation and prognosis is unknown. Research design and methods In a retrospective cohort study, we compared renal and patient survival among 263 patients with T2D who had native renal biopsies between 2002 and 2008 from three Auckland hospitals in New Zealand. The presence of diabetic nephropathy (DN), NDRD or mixed (DN and NDRD) was determined from biopsy. We examined clinical associations according to NDRD etiologies and mode of presentation—acute (defined by acute kidney injury (AKI)) or non-acute. Patients were followed until end-stage renal disease, death or December 2015. Survival was compared using Log-rank test. Results 94 (36%) patients had DN, 72 (27%) had NDRD, and 97 (37%) had mixed pathologies. Obesity-related focal segmental glomerulosclerosis was the most common NDRD (46%) in patients with non-acute presentations, whereas interstitial nephritis or immune-complex glomerulonephritides were the most prevalent in those with acute presentations (60%). DN was commonly associated with AKI (p

Aims: To highlight the population demographics and socio-economic status of Maori and Pacific people in New Zealand, and relate this to their relative incidence and prevalence of kidney disease, relative access to renal replacement therapies and provide a comparison of their outcomes relative to non-Maori/non-Pacific people with kidney disease in New Zealand. Methods: A review was carried out of relevant New Zealand Statistics and Health data, literature on kidney disease in New Zealand including reports of the Australian and New Zealand Dialysis and Transplant Registry and further analysis of the New Zealand Diabetic Cohort Study. Results: There are large differences in the incidence of microalbuminuria, glomerulonephritis and hypertension amongst Maori and Pacific people in comparison to others. There is a 3.5 fold higher relative incidence of Maori and Pacific patients commencing renal replacement therapy. Identified associations with CKD include an increased incidence of obesity, smoking and poverty relative to other members of the population. Maori and Pacific people are less likely to be transplanted and have a reduced graft survival. Conclusions: Maori and Pacific people have a higher incidence of chronic kidney disease and end-stage renal failure in comparison to the rest of the population with poorer outcomes. The causes are likely to be multi-factorial with poverty an important contributor.

Heavy-duty diesel trucks (HDDTs, >33,000 pounds gross vehicle weight rating) are commonly equipped with diesel particulate filters (DPFs) to meet the California model year (MY) 2007 PM emissions standard. Particulate matter (PM) emissions were measured from nine parked active DPF regenerations of two HDDTs, a 2007 and 2010 MY, using a novel ambient-dilution wind tunnel. This work specifically evaluated PM mass emissions during regeneration by measurements from the following instruments: TSI DustTrak DRX 8533, TSI Engine Exhaust Particle Sizer 3090 (EEPS) and TSI Scanning Mobility Particle Sizer 3936L88 (SMPS), filters by gravimetric analysis, and for one test a Dekati Mass Monitor 230-A (DMM). Active regeneration by fuel injection upstream of the DPF began with the Soot Combustion Regime, where PM emissions had a count median diameter (CMD) of >30 nm and some faint gray smoke was observed flowing from the tunnel. During brief moments of the Soot Combustion Regime, the DustTrak DRX reported more than half of the mass was >1 µm. As active regeneration continued, aftertreatment inlet temperature increased to >500 °C, beginning the Fuel Combustion Regime, defined conversely where the CMD of the emissions was

Chemical and toxicological properties of emissions from compressed natural gas (CNG) fueled transit buses with stoichiometric combustion engines and three-way catalyst (TWC) exhaust control systems were measured using a chassis dynamometer testing facility and compared to the data from earlier CNG engine and exhaust control technologies. Gaseous and particulate matter emissions from buses with stoichiometric engines and TWC were significantly lower than the emissions from buses with lean-burn engines. Carbonyls and volatile organic compounds (VOCs) from buses with stoichiometric engines and TWC were lower by more than 99% compared to buses with lean-burn engines. Elemental and organic carbons (EC and OC), polycyclic aromatic hydrocarbons (PAHs), and trace elements from buses with stoichiometric engines and TWC were effectively controlled and significantly lower than the emissions from buses with lean-burn engines. Potential mutagenicity measured using a microsuspension modification of the Salmonella/microsome assay was lower by more than 99% for buses with stoichiometric engines and TWC, compared to buses with lean-burn engines and OxC.

(ProQuest: ... denotes non-US-ASCII text omitted.)In early June of 2013, flush with what was really only a small reserve of research money gleaned from various academic and government institutions in the US and Brazil, I traveled from Rio de Janeiro to the northeastern city of Salvador, Bahia to give a talk to the Federal University of Bahia's Anthropology Department. Before departing, and while getting breakfast in Rio's Urca neighborhood, I listened to men at the lunch counter talking about the quebra quebra (literally "break break") in Rio's buses and city center the night before. They argued that the manifestations were the work of professional agitators who were part of an ongoing battle for control of Brazil's left-leaning political parties. I was intrigued, especially since the quebra quebra around buses has a long history in Rio and Salvador, Urca is well-known as the home of high-ranking military officers, and I have more than a passing interest in the contradictions of life in Brazil today. But I must admit that I thought little of the protests or of the fact that they might spread, until my spider sense tingled in Bahia as, finishing my talk, some graduate students asked about my teaching in New York. As I responded that CUNY Graduate Center's program is filled with students committed to political organizing, including a number of people quite active in Occupy Wall Street, I felt a buzz pass through the room as the audience members seemed to straighten and refocus on the visitor. "Gosh, they're really into Occupy," I thought myopically. "Is it the movement itself, or is there something else at play?"Later that afternoon, I escaped the lecture hall and visited some old friends in the working class neighborhood of Arraial do Retiro (hereafter "Arraial"). As I approached their house, a young boy, who I will call Miguel, spotted me and cried out, "Mommy, who's that man?!? Who's that man?!? Get him out of here." His grandmother said soothingly, "No, Miguel, that's tio [uncle]; you know Tio John," to which he responded, "No, I Don't! Get that man out of here!" Miguel had cuddled in my lap during my last visit, just two months earlier, to hear stories of airplanes and to brag about how brave he would be if he traveled alone to New York. But in June, he failed to recognize me. His grandmother explained, "You don't know what's happened here. You don't know the half of it!" She continued with a shocking story involving the assassination of Miguel's 21-year-old father weeks earlier, as his son sat on his lap. After the shots rang out, Miguel ran back home-covered in blood and pieces of brain-screaming, "They killed my daddy! They killed my daddy!"On the day in June that I visited the neighborhood, the same gang of teenagers who had killed Miguel's father-in a dispute for control of a valuable highway drug dealing point where they could meet expensive automobiles driven by Salvador's bourgeoisie-came strolling past his grandmother's house, kicking dogs, cats, and household instruments. I sought to melt into the tiny front room's miniature couch, and all present struggled to assuage the dangerous passersby by silencing the barking dogs. Yet such scenes, no matter how terrible they may be, are not novel in the impoverished Arraial, sandwiched between an abandoned quarry and the highway that links Salvador to Brasilia. Nor do they deviate all that much from dominant representations of the peripheries of Sao Paulo or Rio de Janeiro. But what is novel in Salvador, and I believe relevant to the recent waves of protest in Brazil, is the fact that 14 and 15 year olds are now walking in the street heavily armed during daylight, and they are taking in large amounts of cash.I had an inkling that something new was afoot when, in 2010, I received an electronic Christmas card from Miguel's now 21-year-old mother, "Lara." Unemployed except for occasional jobs braiding hair, Lara's card depicted her with her three children in a new, expensive shopping mall. …

Summary Background and objectives The Initiating Dialysis Early and Late study showed that planned early or late initiation of dialysis, based on the Cockcroft and Gault estimation of GFR, was associated with identical clinical outcomes. This study examined the association of all-cause mortality with estimated GFR at dialysis commencement, which was determined using multiple formulas. Design, setting, participants, & measurements Initiating Dialysis Early and Late trial participants were stratified into tertiles according to the estimated GFR measured by Cockcroft and Gault, Modification of Diet in Renal Disease, or Chronic Kidney Disease-Epidemiology Collaboration formula at dialysis commencement. Patient survival was determined using multivariable Cox proportional hazards model regression. Results Only Initiating Dialysis Early and Late trial participants who commenced on dialysis were included in this study (n=768). A total of 275 patients died during the study. After adjustment for age, sex, racial origin, body mass index, diabetes, and cardiovascular disease, no significant differences in survival were observed between estimated GFR tertiles determined by Cockcroft and Gault (lowest tertile adjusted hazard ratio, 1.11; 95% confidence interval, 0.82 to 1.49; middle tertile hazard ratio, 1.29; 95% confidence interval, 0.96 to 1.74; highest tertile reference), Modification of Diet in Renal Disease (lowest tertile hazard ratio, 0.88; 95% confidence interval, 0.63 to 1.24; middle tertile hazard ratio, 1.20; 95% confidence interval, 0.90 to 1.61; highest tertile reference), and Chronic Kidney Disease-Epidemiology Collaboration equations (lowest tertile hazard ratio, 0.93; 95% confidence interval, 0.67 to 1.27; middle tertile hazard ratio, 1.15; 95% confidence interval, 0.86 to 1.54; highest tertile reference). Conclusion Estimated GFR at dialysis commencement was not significantly associated with patient survival, regardless of the formula used. However, a clinically important association cannot be excluded, because observed confidence intervals were wide. Clin J Am Soc Nephrol 9: 135–142, 2014. doi: 10.2215/CJN.02310213