Notes

Setup of a maternal earlier forewarning method through first postpartum. A potential observational study.
At initiation of maintenance dialysis, only 5% of countries used an arteriovenous access in almost all patients. Vascular access education was suboptimal, funding for vascular access procedures was not uniform, and copayments were greater in countries with lower levels of income. Patients in 23% of the low-income countries had to pay >75% of HD costs compared with patients in only 4% of high-income countries.

A cross-sectional survey with possibility of response bias, social desirability bias, and limited data collection preventing in-depth analysis.

In summary, findings reveal substantial variations in global HD use, availability, accessibility, quality, and affordability worldwide, with the lowest use evident in low- and lower-middle-income countries.
In summary, findings reveal substantial variations in global HD use, availability, accessibility, quality, and affordability worldwide, with the lowest use evident in low- and lower-middle-income countries.
Observational studies have reported a U-shaped association between blood pressure (BP) before a hemodialysis session and death. In contrast, because a linear association between out-of-dialysis-unit BP and death has been reported, home BP may be a better target for treatment. To test the feasibility of this approach, we conducted a pilot trial of treating home versus predialysis BP in hemodialysis patients.

A 4-month, parallel, randomized, controlled trial.

50 prevalent hemodialysis patients in San Francisco and Seattle. Participants were randomly assigned using 11 block randomization, stratified by site.

To target home systolic BP (SBP)of 100-<140 mm Hg versus predialysis SBP of 100-<140mm Hg. Home and predialysis SBPs were ascertainedevery 2 weeks. Dry weight and BP medications were adjusted to reach the target SBP.

Primary outcomes were feasibility, adherence, safety. and tolerability.

50 of 70 (71%) patients who were approached agreed to participate. All enrollees completed the study except for 1 who received a kidney transplant. In the home BP treatment group, adherence to obtaining/reporting home BP was 97.4% (and consistent over the 4 months). There was no increased frequency of high (defined as SBP>200mm Hg; 0.2% vs 0%) or low (defined as<90mm Hg; 1.8% vs 1.2%) predialysis BP readings in the home versus predialysis treatment arms, respectively. However, participants in the home BP arm had higher frequency of fatigue (32% vs 16%).

Small sample size.

This pilot trial demonstrates feasibility and high adherence to home BP measurement and treatment in hemodialysis patients. Larger trials to test the long-term feasibility, efficacy, and safety of home BP treatment in hemodialysis patients should be conducted.

National Institutes of Health, Satellite Healthcare, and Northwest Kidney Centers.

Registered at ClinicalTrials.gov with study number NCT03459807.
Registered at ClinicalTrials.gov with study number NCT03459807.Methylmercury (MeHg) is a ubiquitous environmental contaminant and developmental toxicant known to cause a variety of persistent motor and cognitive deficits. While previous research has focused predominantly on neurotoxic MeHg effects, emerging evidence points to a myotoxic role whereby MeHg induces defects in muscle development and maintenance. A genome wide association study for developmental sensitivity to MeHg in Drosophila has revealed several conserved muscle morphogenesis candidate genes that function in an array of processes from myoblast migration and fusion to myotendinous junction (MTJ) formation and myofibrillogenesis. Here, we investigated candidates for a role in mediating MeHg disruption of muscle development by evaluating morphological and functional phenotypes of the indirect flight muscles (IFMs) in pupal and adult flies following 0, 5, 10, and 15 μM MeHg exposure via feeding at the larval stage. Developmental MeHg exposure induced a dose-dependent increase in muscle detachments (myospheres) within dorsal bundles of the IFMs, which paralleled reductions eclosion and adult flight behaviors. These effects were selectively phenocopied by altered expression of kon-tiki (kon), a chondroitin sulfate proteoglycan 4/NG2 homologue and a central component of MTJ formation. Temsirolimus MeHg elevated kon transcript expression at a crucial window of IFM development and transgene overexpression of kon could also phenocopy myosphere phenotypes and eclosion and flight deficits. Finally, the myosphere phenotype resulting from 10 μM MeHg was partially rescued in a background of reduced kon expression using a targeted RNAi approach. Our findings implicate a component of the MTJ as a MeHg toxicity target which broaden the understanding of how motor deficits can emerge from early life MeHg exposure.The purpose of this research is to investigate the influence of incidental fitness cues on caloric food intake in restrained (vs. unrestrained) eaters. The authors show that the effect of incidental fitness cues (made salient via a priming procedure in a seemingly unrelated study prior to the main study) on caloric food intake differs between dietary forbidden and permitted foods. For food that is perceived as dietary forbidden, calorie intake decreases if restrained eaters are incidentally primed with fitness. In contrast, calorie intake of dietary permitted food increases for restrained eaters in response to incidental fitness primes. The study extends prior research on priming effects on eating behavior and derives important implications on how to help restrained eaters control energy intake.Recent research on choice architecture has highlighted the role of external aspects such as stimulus proximity or availability on consumption. How such external factors interact with internal, intraindividual factors, however, is very poorly understood. Here we show how the wanting for palatable food emerges from the interplay of one key external factor, availability, and two key internal factors central to motivation science, need state and learning history. Across three experiments in the food domain, we find converging evidence for a main effect of stimulus availability which is qualified in theoretically predicted ways by a three-way interaction such that food desire peaks when the availability of tempting food stimuli is accompanied by high need states and a positive learning experience. A pooled analysis across the three studies supported this general conclusion. We conclude that nudging effects are strongest when external factors of choice architecture synergize with internal factors in critical ways.
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