Health care on a global scale significantly contributes to carbon emissions, with high-income countries being the primary culprits. Within health care, dialysis plays a significant role as a major ...source of emissions. Low- and middle-income countries have a high burden of kidney disease and are facing an increasing demand for dialysis. This reality presents multiple opportunities to plan for environmentally sustainable and quality kidney care. By placing a stronger emphasis on primary and secondary prevention of kidney disease and its progression, within the framework of universal health coverage, as well as empowering patients to enhance self-care, we can significantly reduce the need for costly and environmentally detrimental kidney replacement therapy. Mandating the adoption of lean and innovative low-carbon dialysis practices while also promoting the growth of kidney transplantation would enable low- and middle-income countries to take the lead in implementing environmentally friendly nephrology practices and reducing costs, thus optimizing sustainability and the well-being of individuals living with kidney disease.
Exotic plant species impact belowground processes by influencing resource availability through enhanced microbial activity as a consequence of litter inputs. Soil communities cultured by Ageratina ...adenophora, a neotropical invader in Asia, retain available N that influence the growth of the invader. Invader triggers higher microbial activities through terpene-rich litter inputs to release nitrogen, which facilitates the invasion of A. adenophora. Our results provide evidence that microbial-linked nitrogen availability exert positive impact on A. adenophora biomass accumulation. Our work emphasizes the importance of soil communities-drive nitrogen availability in invasion success. Exotic plant species impact belowground processes by influencing resource availability through enhanced microbial activity as a consequence of litter inputs. We have little understanding of the impact of microbe-driven nutrient fluctuations on the biomass accumulation of invasive species. Here we attempt to answer the question on whether soil community-driven nitrogen availability influences invader biomass. We discovered that soil communities cultured by Ageratina adenophora, a neotropical invader in Asia, retain available nitrogen that influences the biomass of the invader. Through soil manipulation experiments we found that A. adenophora grows better in soil with a higher available nitrogen content. Ageratina adenophora-invaded soil had higher microbial activity and available nitrogen due to higher inputs of terpene-rich litter compared with soil not yet invaded by it. Our results provide evidence that microbe-linked nitrogen availability exerts a positive impact on A. adenophora biomass accumulation. Our work emphasizes the importance of soil community-driven nitrogen availability in invasion success. PUBLICATION ABSTRACT
Background: Diarrhea in kidney transplant recipients (KTRs) can be associated with significant morbidity.
Material and Methods: We evaluated 198 KTRs for a history of diarrhea post-kidney transplant ...at a tertiary care center in western India over 1 year. A protocol-based evaluation of diarrhea was done with respect to clinical features, diagnostic evaluation, associated acute allograft dysfunction, and its impact on long-term allograft function. Primary outcomes of interest were: chronic allograft injury (CAI) and the need for mycophenolate mofetil (MMF) withdrawal. We also assessed the effect of MMF withdrawal on the risk of the development of CAI.
Results: Eighty-five of 198 (42.5%) recipients experienced diarrhea and a total of 140 diarrheal episodes were evaluated. The mean age of these 85 recipients was 38 ± 12 years and 72 (84.7%) were males. 73 of 85 recipients were on MMF at the time of diarrhea and in 35 (48%) of them MMF withdrawal was needed for chronic and persistent symptoms. Diarrhea was attributed to infective etiologies in 90 of 140 (64.2%) cases. Among the microbiologically confirmed infective diarrheal episodes, giardia and cryptosporidium were the common pathogens in 11/28 (39%) and 6/28 (21.4%) episodes respectively. One hundred and twenty-eight episodes out of 140 (91.4%) episodes were complicated by acute allograft dysfunction. Forty-one of 85 recipients (48.2%) developed chronic allograft injury and 12 (14.1%) developed allograft rejection (acute and/or chronic). Probability of chronic allograft injury was higher in those with MMF withdrawal.
Conclusion: Diarrhea post-kidney transplant adversely affects graft function, especially after MMF withdrawal.
HIV-mediated immune dysfunction may influence CD4(+) T cell recovery during suppressive antiretroviral therapy (ART). We analyzed cellular biomarkers of immunological inflammation, maturation, and ...senescence in HIV-infected subjects on early suppressive ART. We performed longitudinal analyses of peripheral immunological biomarkers of subjects on suppressive ART (n = 24) from early treatment (median 6.4 months, interquartile range IQR 4.8-13.9 months) to 1-2 years of follow-up (median 19.8 months, IQR 18.3-24.6 months). We performed multivariate regression to determine which biomarkers were associated with and/or predictive of CD4(+) T cell recovery. After adjusting for the pre-ART CD4(+) T cell count, age, proximal CD4(+) T cell count, and length of ART medication, the percentage of CD27(+)CD8(+) T cells remained significantly associated with the CD4(+) T cell recovery rate (β = 0.092 cells/ul/month, P = 0.028). In HIV-infected subjects starting suppressive ART, patients with the highest percentage of CD8(+) T cells expressing CD27 had the greatest rate of CD4(+) T cell recovery.
PurposeUltrasonic welding is an emerging apparel manufacturing technique. However, the applications are widely explored in the field of technical textiles, with less exploration in the apparel ...endues. The purpose of this study is to explore the application of ultrasonic welding in apparel by analyzing the impacts of different parameters.Design/methodology/approachThis study analyzed the influence of ultrasonic welding parameters, including pressure, welding speed and ultrasonic power on the seam performances (seam strength, seam bursting strength, seam thickness and seam stiffness). The parameters are optimized using Box–Behnken experimental design to achieve better seam performances.FindingsThe properties of ultrasonic seams are influenced by welding and fabric properties. Ultrasonically welded seams showed better performances in the case of comfort properties of seams, whereas the functional properties are lesser compared to conventional seams.Originality/valueThe findings of the research clearly outline the level of influence of different parameters on the performance of the ultrasonically welded seams in knitted fabrics, which can greatly help in applying ultrasonic welding manufacturing methods in apparel manufacturing.
The recognition of antigen by membrane immunoglobulin M (mIgM) results in a complex series of signaling events in the cytoplasm leading to gene activation. Bruton's tyrosine kinase (BTK), a member of ...the Tec family of tyrosine kinases, is essential for the full repertoire of IgM signals to be transduced. We examined the ability of BTK to regulate the nuclear factor (NF)-κB/Rel family of transcription factors, as the activation of these factors is required for a B cell response to mIgM. We found greatly diminished IgM- but not CD40-mediated NF-κB/Rel nuclear translocation and DNA binding in B cells from X-linked immunodeficient (xid) mice that harbor an R28C mutation in btk, a mutation that produces a functionally inactive kinase. The defect was due, in part, to a failure to fully degrade the inhibitory protein of NF-κB, IκBα. Using a BTK-deficient variant of DT40 chicken B cells, we found that expression of wild-type or gain-of-function mutant BTK, but not the R28C mutant, reconstituted NF-κB activity. Thus, BTK is essential for activation of NF-κB via the B cell receptor.
Low plutonium content acidic waste is generated in nuclear chemical facilities. Study was initiated to develop hollow fiber supported liquid membrane (HFSLM) technique for quantitative separation and ...recovery of plutonium (Pu) from such wastes using tri-
n-butyle phosphate (TBP) in dodecane as carrier. Hollow fiber test module was fabricated using 20 lumens of 33.91
cm
2 surface area and 9
cm length. After satisfactory testing of the hydrodynamic condition of the module, it was operated at a flow rate of 3
ml
min
−1 on recycling mode with acidic waste solution containing Pu=8
mg
dm
−3, uranium=15
dm
−3, gross
β
−=49.33
mCi
dm
−3, gross
γ=15.73
mCi
dm
−3 and acidity 3
M HNO
3. In presence of various fission products, selective permeation of Pu(IV) through the bundle of hollow fiber test module was observed to be more than 90% into a stripping phase consisting 0.1
M NH
2OH·HCl in 0.3
M HNO
3. A model is presented to describe the transport mechanism and to evaluate the mass transfer coefficient. The radiation stability was also tested by exposing the membrane upto irradiation level of 1
M
rad. Potentiality of the method for the selective separation of plutonium from acidic waste is, thus, clearly seen.
A considerable number of end-stage renal disease patients undergo tunneled cuffed catheter insertion for hemodialysis under ultrasonographic guidance while awaiting arteriovenous fistula creation. We ...report a case of a 62-year-old female who underwent tunneled catheter insertion in the left internal jugular vein under ultrasound and fluoroscopic guidance, which was followed by pericatheter serous discharge. Fluid examination confirmed the diagnosis of lymphorrhea, and lymphoscintigraphy facilitated its localization. This case is reported for its rarity and with a discussion on literature review, complications of lymphorrhea, and their management.
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