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OBJECTIVE: Arterial remodeling aims to maintain a constant circumferential wall stress (sigmac). A failing remodeling process is associated with stroke. Data on the relationship between chronic kidney disease and arterial remodeling are scarce. METHODS: We investigated the association between a lower glomerular filtration rate (GFR) and microalbuminuria with arterial remodeling of the common carotid artery (CCA) in a population-based study of 806 patients. CCA properties including intima-media thickness and interadventitial diameter (IAD) were assessed. Lumen diameter, circumferential wall tension (CWT), and circumferential wall stress (sigmac) were calculated. GFR was estimated (eGFR) by the Modification of Diet in Renal Disease formula. Albuminuria was expressed as urinary albumin/creatinine ratio. RESULTS: Mean eGFR was 60.3 (+/-10.8) ml/min/1.73 m2; median urinary albumin/creatinine ratio was 0.57 (range 0.10-26.6 mg/mmol). After adjustment for age, sex, glucose tolerance status, and prevalent cardiovascular disease, eGFR was not independently associated with CCA properties. A greater urinary albumin/creatinine ratio (per quartile) was associated with a greater lumen diameter [regression coefficient beta with 95% confidence interval, 0.14 (0.08-0.20; P < 0.01)], IAD [0.15 (0.09-0.21; P < 0.01)], CWT [0.95 (0.52-1.38; P < 0.01)], and sigmac [1.7 (0.5-2.9; P < 0.01)] but not with a greater IMT [0.01 (-0.002-0.02; P = 0.12)]. Additional adjustments for mean arterial pressure, pulse pressure, and eGFR did not change the results. CONCLUSION: Greater albuminuria is independently associated with an increase in lumen diameter and IAD of the CCA. In addition, greater albuminuria is associated with a maladaptive carotid remodeling process as shown by an increase in CWT and sigmac. These findings may explain, why microalbuminuria is associated with a greater risk of cardiovascular disease and especially stroke.  相似文献   
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Heart Failure Reviews - This study aimed to evaluate the diagnostic performance of echocardiographic markers of heart failure with preserved ejection fraction (HFpEF) and left ventricular diastolic...  相似文献   
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Evidence for declining populations of both wild and managed bees has raised concern about a potential global pollination crisis. Strategies to mitigate bee loss generally aim to enhance floral resources. However, we do not really know whether loss of preferred floral resources is the key driver of bee decline because accurate assessment of host plant preferences is difficult, particularly for species that have become rare. Here we examine whether population trends of wild bees in The Netherlands can be explained by trends in host plants, and how this relates to other factors such as climate change. We determined host plant preference of bee species using pollen loads on specimens in entomological collections that were collected before the onset of their decline, and used atlas data to quantify population trends of bee species and their host plants. We show that decline of preferred host plant species was one of two main factors associated with bee decline. Bee body size, the other main factor, was negatively related to population trend, which, because larger bee species have larger pollen requirements than smaller species, may also point toward food limitation as a key factor driving wild bee loss. Diet breadth and other potential factors such as length of flight period or climate change sensitivity were not important in explaining twentieth century bee population trends. These results highlight the species-specific nature of wild bee decline and indicate that mitigation strategies will only be effective if they target the specific host plants of declining species.Pollinating insects such as bees play an essential role in the pollination of wild plants (1) and crops (2). However, reported population declines in both wild and managed bees (35) have raised concerns about loss of pollination services and triggered interest in identifying the underlying causes for bee decline (6). Land use change and agricultural intensification are major drivers of biodiversity loss in general (7, 8) and are considered the most important environmental drivers of loss of wild bee diversity in particular (6, 9). It is generally believed that these drivers affect bees, which depend on floral resources in both their larval and adult life stages, through repercussions on the availability of floral resources in contemporary anthropogenic landscapes (911), but, so far, scientific evidence that loss of floral resources is driving bee decline is lacking. Nevertheless, current strategies to mitigate bee decline focus primarily on enhancing floral resources (12). To prioritize and develop effective mitigation strategies, it is essential to identify the mechanisms underlying bee population trends and assess whether these are mediated by floral resources.Although bees as a group are declining, individual species show more variable responses, with some species declining sharply while others remain stable or even increase under current land use change and agricultural intensification (3, 4, 13). These differential responses can be used to disentangle the effects of floral resource availability from those of other potential factors affecting bee population trends. The proportion of the floral resources in contemporary anthropogenic landscapes that can be used for forage by a bee species depends on its diet breadth and host plant preference, and it may be expected that species that have declined have a narrower diet breadth and prefer host plants that have declined (14, 15). However, diet breadth and host plant preference of bee species is difficult to assess. Presently observed host plant use does not necessarily reflect actual preference, as preferred host plants may have gone locally extinct and bees that have declined may have become restricted in their food choice in their remaining habitats (15). In addition, if host plant use is measured for more individuals of abundant, widespread species than for rare ones, an apparent link between diet breadth and population trend may simply arise as a sampling artifact (16). Furthermore, the relationship between host plant use and population trend may be confounded by species’ rarity prior to the onset of major environmental changes (17), as rarity in itself increases susceptibility to stochastic events (18) and has been shown to be one of the most important factors predicting population decline in various taxa (1921). Surprisingly, to our knowledge, none of the studies that have so far examined the relationship between diet breadth and/or host plant preference and bee population trends have taken species’ initial rarity into account (e.g., refs. 3, 4, 15, and 22). Other factors, such as body size (4, 23), phenology (4, 22), and sensitivity to climate change (4, 24, 25) may be associated with bee decline as well, and, to date, the relative importance of diet breadth and pollen host plant preference in explaining bee population trends remains unclear.Here we solve this problem by analyzing historical pollen preferences of wild bees (15). Bees are generally more selective in their choice of food plants when foraging for pollen (source of protein and minerals for both larvae and adults) than nectar (source of energy) (26, 27). Distributional changes in plant species from which pollen is collected therefore probably exerts a larger influence on bee populations than changes in nectar plants. We investigate whether and to what extent loss of preferred floral resources drives bee population trends in The Netherlands, one of the most human-modified and intensively farmed countries in the world. Over the course of the twentieth century, agriculture has intensified in The Netherlands (Fig. S1) and the area of seminatural habitat preferred by bees has diminished to only one-fifth of the area at the beginning of the twentieth century (Fig. S2). More than half of the bee species are currently on the national Red List (28). As such, this country is a particularly suitable study area to identify critical factors associated with bee population decline.We assessed pollen host plant use of bee species independently from their population trends by analyzing pollen loads on the bodies of bee specimens that were collected before 1950 (15), before the onset of agricultural intensification in The Netherlands. Altogether, our analysis included trend and trait data of 57 bee species in 10 genera and 4 subfamilies (Table S1). We calculated population trend indices for bee species and their host plants (period 1902–1949 vs. 1975–1999) using extensive national species distribution datasets (13, 29). Linear mixed models, with bee subfamily as a random factor to account for phylogeny, and a multimodel inference approach were used to examine the relationship between bee population trends and pollen host plant use, simultaneously taking into account differences in species’ rarity before the onset of agricultural intensification and other factors that have been proposed to explain bee population trends.  相似文献   
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Extracorporeal circulation is accompanied by changes in red blood cell morphology and structural integrity that affect cell function and survival, and thereby may contribute to the various side effects of heart–lung machine-assisted surgery. Our main objectives were to determine the effect of circulation of red blood cells in a stand-alone extracorporeal circuit on several parameters that are known to be affected by, as well as contribute to red blood cell aging. As a source of RBCs, we employed blood bank storage units of different ages. In order to assess the relevance of our in vitro observations for the characterization of extracorporal circulation technology, we compared these changes in those of patients undergoing extracorporeal circulation-assisted cardiac surgery. Our results show that circulation in a heart–lung machine is accompanied by changes in red blood cell volume, an increase in osmotic fragility, changes in deformability and aggregation behavior, and alterations in the exposure of phosphatidylserine and in microvesicle generation. RBCs from 1-week-old concentrates showed the highest similarities with the in vivo situation. These changes in key characteristics of the red blood cell aging process likely increase the susceptibility of red blood cells to the various mechanical, osmotic, and immunological stress conditions encountered during and after surgery in the patient’s circulation, and thereby contribute to the side effects of surgery. Thus, aging-related parameters in red blood cell structure and function provide a foundation for the validation and improvement of extracorporeal circulation technology.  相似文献   
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Besides food restriction, hyperactivity is considered a key behavioral trait of anorexia nervosa (AN), playing a major role in the pathogenesis and progression of the disorder. However, the underlying neurophysiology remains poorly understood. We used functional magnetic resonance imaging during two affective go/no-go tasks to probe inhibitory control in response to stimuli depicting physical activity vs inactivity and food vs non-food in AN patients compared with 26 healthy athlete and non-athlete controls. We hypothesized that neural correlates of behavioral inhibition are biased by the emotional information of the stimuli in AN patients, leading to a differential neural inhibitory pattern during the two tasks. Indeed, we found reduced response inhibition for food and non-food images in the putamen, while stimuli depicting physical activity resulted in an exaggerated response of the prefrontal cortex (PFC) and cerebellum in AN patients. However, both AN patients and athletes revealed an increased response in the somatosensory cortex to physical activity stimuli. These results suggest that physical activity stimuli might place an increased demand on the inhibitory control system in AN patients. The resulting hyperactivity of the PFC and cerebellum may lead to altered executive function and motor control, sustaining increased physical activity in AN patients.  相似文献   
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International Journal of Clinical Pharmacy - Background Drug-related problems (DRP) following hospital discharge may cause morbidity, mortality and hospital re-admissions. It is unclear whether a...  相似文献   
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