Apolipoprotein A, fibrinogen, age, and history of stroke are predictors of death in dialysed diabetic patients: a prospective study in 412 subjects

BACKGROUND: Diabetic patients with end-stage renal failure (ESRD) have a high cardiovascular morbidity and mortality. The underlying mechanisms are not completely elucidated. The aim of our study was to define predictors of death in diabetic patients with end-stage renal disease. PATIENTS AND METHODS: We performed a prospective study in 35 dialysis centres in Germany between 1985 and 1994. To evaluate predictors and risk factors in this population we examined 412 diabetic patients at the time of admission to dialysis treatment (peritoneal dialysis (PD) or haemodialysis (HD)). Classification of the type of diabetes was done according the criteria of the National Diabetes Data Group [1,2]. Items assessed at the time of admission were coronary artery disease (CAD), peripheral occlusive disease (POD), and stroke. CAD was defined as a history of myocardial infarction with the corresponding changes in the ECG or luminal narrowing by more than 50% in at least one coronary artery upon coronarangiography; POD was defined as claudication and/or brachial-tibial ratio (BTR) less than 0.9 or a history of amputation. Assessment of the nutritional state comprised body mass index, skinfold thickness of the upper arm and lateral thorax area, and urea concentration. Cholesterol, HDL, LDL, apolipoprotein A (ApoA-I) and B (ApoB), triglycerides, lipoprotein(a) (Lp(a)), and fibrinogen were measured. As an index of disturbed cardiac innervation beat-to-beat variation was measured. Outcome measurements were causes of death (i.e. cardiac and non-cardiac) and time of survival. RESULTS: One hundred and eighty of 412 (44%) patients died during the observation period. Patients who died were older (61 +/- 12 versus 53 +/- 15 years P < 0.0001), had lower skin fold thickness (13.1 +/- 6.0 versus 15.1 +/- 7.3 mm P < 0.04), lower ApoA-I (100 +/- 35 versus 111 +/- 32 mg/dl P < 0.005) and higher fibrinogen (515 +/- 146 versus 451 +/- 155 mg/dl P < 0.02). Type II diabetic patients had a lower mean survival time than type I (34 versus 66 months P < 0.0006). The mode of renal replacement therapy (PD or HD) had no adverse effect on survival time. Survivors less frequently had a history of CAD, POD and stroke than non-survivors. In multivariate analysis ApoA-I, fibrinogen, age and stroke were independent predictors of cardiac and non-cardiac death in diabetic patients with end-stage renal failure. Lipid values and nutritional state did not independently predict the overall and cardiovascular mortality. CONCLUSION: This study in dialysed diabetic patients identifies several predictors of death, some of which are susceptible to intervention.     

Mesopore development in PAN-ACF resulting from non-metal additives

The narrow pore-size distribution of activated carbon fibres (ACF) limits their application in the fields concerning larger molecules, such as liquid adsorption and catalyst support. On the addition of carbon particles and organic materials to polyacrylonitrile fibres, and after stabilizing and activating, the mesoporosity in the resultant ACF has been obviously increased. Among these additives, carbon black gives the best effect. With 1 wt% carbon black I in precursor and on activating at 880°C for 30 min, a mesoporosity of 48.2% (total pore volume 0.704 ml g-1, mesopore volume 0.340 ml g-1) has been obtained. The mechanism of mesopore formation is also discussed. This revised version was published online in November 2006 with corrections to the Cover Date.     

Wideband wattmeter based on RMS voltage measurements

A wideband wattmeter for measuring active power over a frequency range of dc to 500 kHz is described. The wattmeter is based on the three-voltmeter method in which three rms voltage measurements are used to calculate power. The wattmeter active power uncertainty is estimated to be within 0.03% from dc to 20 kHz and within 1.5% to 500 kHz     

Noise contribution of the body resistance in partially-depleted SOIMOSFETs

An additional noise component is observed in the noise spectrum of transistors in a partially-depleted (PD) medium-thickness SOI-CMOS technology. We identify the origin of this additional noise in the noisy resistance of the body film. This resistance, coupled to the gate capacitance, forms an RC filter and generates the hump-shape of the additional noise component. Several experimental observations that support this model are presented     

Modeling statistical dopant fluctuations in MOS transistors

The impact of statistical dopant fluctuations on the threshold voltage V_T and device performance of silicon MOSFET's is investigated by means of analytical and numerical modeling. A new analytical model describing dopant fluctuations in the active device area enables the derivation of the standard deviation, σV_T , of the threshold voltage distribution for arbitrary channel doping profiles. Using the MINIMOS device simulator to extend the analytical approach, it is found that σV_T, can be properly derived from two-dimensional (2-D) or three-dimensional (3-D) simulations using a relatively coarse simulation grid. Evaluating the threshold voltage shift arising from dopant fluctuations, on the other hand, calls for full 3-D simulations with a numerical grid that is sufficiently refined to represent the discrete nature of the dopant distribution. The average V_T-shift is found to be positive for long, narrow devices, and negative for short, wide devices. The fast 2-D MINIMOS modeling of dopant fluctuations enables an extensive statistical analysis of the intrinsic spreading in a large set of compact model parameters for state-of-the-art CMOS technology. It is predicted that V_T-variations due to dopant fluctuations become unacceptably large in CMOS generations of 0.18 μm and beyond when the present scaling scenarios are pursued. Parameter variations can be drastically reduced by using alternative device designs with ground-plane channel profiles     

Pseudoexfoliation syndrome and secondary cataract

AIM/BACKGROUND: The pseudoexfoliation (PEX) syndrome is frequently associated with impairment of the blood-aqueous barrier. This study analysed if this might stimulate secondary cataract following cataract extraction. METHODS: This historical cohort study included 197 eyes of 197 patients (99 with and 98 without PEX) that underwent extracapsular cataract extraction with posterior chamber lens implantation (PMMA optic) between 1985 and 1991. Secondary cataract was defined as opacification of the axial posterior capsule and decrease of visual acuity by two or more lines. Mean follow up was 23.8 months. For statistical analysis, the Kaplan-Meier method and multivariate Cox regression analysis were used. RESULTS: Secondary cataract was observed within 24 months in 35% (SD 7%) of all eyes, and was significantly more frequent in eyes with PEX (45 (11)%) than in eyes without PEX (24 (9)%, p < 0.03). Eyes with diabetes mellitus (n = 32) showed a significantly lower frequency of secondary cataract (11 (11)%) than eyes without diabetes mellitus (39 (8)%, p < 0.01). The influences of sex, open angle glaucoma, type of cataract, surgeon, positioning of IOL, and phacoemulsification versus nuclear expression on secondary cataract did not reach statistical significance. CONCLUSION: The higher frequency of secondary cataract could be considered as another potential complication of cataract surgery in eyes with PEX.     

Superconducting control for surge currents

Systems designed to use superconductors to limit fault currents in power grids are undergoing testing. The authors describe superconducting fault current limiters (SCFCL) which may be categorised into resistive or shielded core types. The features and operation of each type of device are outlined. Both the shielded-core and resistive types of SCFCL use the same amount of superconductor material to achieve a given limitation behavior. This is because the rated power per volume of conductor is determined by the product of fault-induced field and critical current, which is the same for both devices, assuming the same type of superconducting material is employed. The shielded-core limiter works only with AC currents and is much larger and heavier than the resistive SCFCL. While there is only one large program left in the low-temperature type of SCFCL, more than 10 major projects are under way worldwide on the high-temperature type of device. The main reason is the lower HTS cooling cost     

Mechanisms of virus assembly probed by Raman spectroscopy: the icosahedral bacteriophage P22

A microdialysis flow cell has been developed for time-resolved Raman spectroscopy of biological macromolecules and their assemblies. The flow cell permits collection of Raman spectra concurrent with the efflux of small solute molecules into a solution of macromolecules and facilitates real-time spectroscopic detection of structural transitions induced by the effluent. Additionally, the flow cell is well suited to the investigation of hydrogen-isotope exchange phenomena that can be exploited as dynamic probes of viral protein folding and solvent accessibility along the assembly pathway. Here, we describe the application of the Raman dynamic probe to the maturation of the icosahedral capsid of bacteriophage P22, a double-stranded DNA virus. The P22 virion is constructed from a capsid precursor (procapsid) consisting of 420 coat subunits (gp5) in an outer shell and a few hundred scaffolding subunits (gp8) within. Capsid maturation involves expulsion of scaffolding subunits coupled with shell expansion at the time of DNA packaging. Raman static and dynamic probes reveal that the scaffolding subunit is highly alpha-helical and highly thermolabile, and lacks a typical hydrophobic core. When bound within the procapsid, the alpha-helical fold of gp8 is thermostabilized; however, this stabilization confers no apparent protection against peptide NH-->ND exchange. A molten globule model is proposed for the native scaffolding subunit that functions in procapsid assembly. Accompanying capsid expansion, a small conformational change (alpha-helix-->beta-strand) is also observed in the coat subunit. Domain movement mediated by hinge bending is proposed as the mechanism of capsid expansion. On the basis of these results, a molecular model is proposed for assembly of the P22 procapsid.