Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morb...Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.展开更多
Advanced glycation end products(AGEs)are a heterogeneous collection of compounds formed during industrial processing and home cooking through a sequence of nonenzymatic glycation reactions.The modern western diet is f...Advanced glycation end products(AGEs)are a heterogeneous collection of compounds formed during industrial processing and home cooking through a sequence of nonenzymatic glycation reactions.The modern western diet is full of heat-treated foods that contribute to AGE intake.Foods high in AGEs in the contemporary diet include processed cereal products.Due to industrialization and marketing strategies,restaurant meals are modified rather than being traditionally or conventionally cooked.Fried,grilled,baked,and boiled foods have the greatest AGE levels.Higher AGE-content foods include dry nuts,roasted walnuts,sunflower seeds,fried chicken,bacon,and beef.Animal proteins and processed plant foods contain furosine,acrylamide,heterocyclic amines,and 5-hydroxymethylfurfural.Furosine(2-furoil-methyl-lysine)is an amino acid found in cooked meat products and other processed foods.High concentrations of carboxymethyl-lysine,carboxyethyl-lysine,and methylglyoxal-O are found in heat-treated nonvegetarian foods,peanut butter,and cereal items.Increased plasma levels of AGEs,which are harmful chemicals that lead to age-related diseases and physiological aging,diabetes,and autoimmune/inflammatory rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis.AGEs in the pathophysiology of metabolic diseases have been linked to individuals with diabetes mellitus who have peripheral nerves with high amounts of AGEs and diabetes has been linked to increased myelin glycation.Insulin resistance and hyperglycemia can impact numerous human tissues and organs,leading to long-term difficulties in a number of systems and organs,including the cardiovascular system.Plasma AGE levels are linked to all-cause mortality in individuals with diabetes who have fatal or nonfatal coronary artery disease,such as ventricular dysfunction.High levels of tissue AGEs are independently associated with cardiac systolic dysfunction in diabetic patients with heart failure compared with diabetic patients without heart failure.It is widely recognized that AGEs and oxidative stress play a key role in the cardiovascular complications of diabetes because they both influence and are impacted by oxidative stress.All chronic illnesses involve protein,lipid,or nucleic acid modifications including crosslinked and nondegradable aggregates known as AGEs.Endogenous AGE formation or dietary AGE uptake can result in additional protein modifications and stimulation of several inflammatory signaling pathways.Many of these systems,however,require additional explanation because they are not entirely obvious.This review summarizes the current evidence regarding dietary sources of AGEs and metabolism-related complications associated with AGEs.展开更多
The trend in die/mold manufacturing at present is towards the hard machining at high speed to replace the electron dis- charge machining. Failure forms of the AlTiN-coated micro-grain carbide endmill when used for th...The trend in die/mold manufacturing at present is towards the hard machining at high speed to replace the electron dis- charge machining. Failure forms of the AlTiN-coated micro-grain carbide endmill when used for the machining of JIS SKD61 (HRC 53), a widely used material in die/mold manufacturing, are investigated. The endmill shows a characteristic that tool life decreases greatly due to the chipping when overload occurs or the rapid increase of wear when over-heat accumulation in cutting edges. As a consequence of the investigation, a strategy to regulate heat generation in the end milling process is proposed. This is accomplished by controlling the cutting arc length, i.e. the length of each flute engaging workpiece in a cutting cycle. Case studies on the slot end milling and comer rounding are conducted. The results show that the proposed strategy suggests the optimal tool path as well as the optimal pitch between successive tool paths under the cutting time criterion.展开更多
目的:对临终沟通障碍-家庭版量表(Difficulties in End of Life Discussions-Family Inventory,DEOLD-FI)进行汉化,检验其在癌症人群中的信效度。方法:获得原作者授权后根据量表引进原则对DEOLD-FI进行汉化。对315例癌症病人进行调查,...目的:对临终沟通障碍-家庭版量表(Difficulties in End of Life Discussions-Family Inventory,DEOLD-FI)进行汉化,检验其在癌症人群中的信效度。方法:获得原作者授权后根据量表引进原则对DEOLD-FI进行汉化。对315例癌症病人进行调查,检验量表的信效度。结果:中文版DEOLD-FI共提取情感负担、消极态度、家庭负担、死亡恐惧、沟通能力5个公因子,累计方差贡献率为64.772%。总量表的Cronbach’sα系数为0.897,分半信度为0.828,重测信度为0.938,各维度的Cronbach’sα系数均在0.85以上。结论:中文版DEOLD-FI具有较好的信效度,可用于评估国内癌症病人与家庭成员进行临终沟通的障碍程度。展开更多
基金Supported by a NIH grant to Dr.Cukor(MD006875)(in part)
文摘Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease(CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.
基金Supported by the Deputyship for Research and Innovation,Ministry of Education and Qassim University,Saudi Arabia(Project No.QUIF-2-2-1-27012).
文摘Advanced glycation end products(AGEs)are a heterogeneous collection of compounds formed during industrial processing and home cooking through a sequence of nonenzymatic glycation reactions.The modern western diet is full of heat-treated foods that contribute to AGE intake.Foods high in AGEs in the contemporary diet include processed cereal products.Due to industrialization and marketing strategies,restaurant meals are modified rather than being traditionally or conventionally cooked.Fried,grilled,baked,and boiled foods have the greatest AGE levels.Higher AGE-content foods include dry nuts,roasted walnuts,sunflower seeds,fried chicken,bacon,and beef.Animal proteins and processed plant foods contain furosine,acrylamide,heterocyclic amines,and 5-hydroxymethylfurfural.Furosine(2-furoil-methyl-lysine)is an amino acid found in cooked meat products and other processed foods.High concentrations of carboxymethyl-lysine,carboxyethyl-lysine,and methylglyoxal-O are found in heat-treated nonvegetarian foods,peanut butter,and cereal items.Increased plasma levels of AGEs,which are harmful chemicals that lead to age-related diseases and physiological aging,diabetes,and autoimmune/inflammatory rheumatic diseases such as systemic lupus erythematosus and rheumatoid arthritis.AGEs in the pathophysiology of metabolic diseases have been linked to individuals with diabetes mellitus who have peripheral nerves with high amounts of AGEs and diabetes has been linked to increased myelin glycation.Insulin resistance and hyperglycemia can impact numerous human tissues and organs,leading to long-term difficulties in a number of systems and organs,including the cardiovascular system.Plasma AGE levels are linked to all-cause mortality in individuals with diabetes who have fatal or nonfatal coronary artery disease,such as ventricular dysfunction.High levels of tissue AGEs are independently associated with cardiac systolic dysfunction in diabetic patients with heart failure compared with diabetic patients without heart failure.It is widely recognized that AGEs and oxidative stress play a key role in the cardiovascular complications of diabetes because they both influence and are impacted by oxidative stress.All chronic illnesses involve protein,lipid,or nucleic acid modifications including crosslinked and nondegradable aggregates known as AGEs.Endogenous AGE formation or dietary AGE uptake can result in additional protein modifications and stimulation of several inflammatory signaling pathways.Many of these systems,however,require additional explanation because they are not entirely obvious.This review summarizes the current evidence regarding dietary sources of AGEs and metabolism-related complications associated with AGEs.
文摘The trend in die/mold manufacturing at present is towards the hard machining at high speed to replace the electron dis- charge machining. Failure forms of the AlTiN-coated micro-grain carbide endmill when used for the machining of JIS SKD61 (HRC 53), a widely used material in die/mold manufacturing, are investigated. The endmill shows a characteristic that tool life decreases greatly due to the chipping when overload occurs or the rapid increase of wear when over-heat accumulation in cutting edges. As a consequence of the investigation, a strategy to regulate heat generation in the end milling process is proposed. This is accomplished by controlling the cutting arc length, i.e. the length of each flute engaging workpiece in a cutting cycle. Case studies on the slot end milling and comer rounding are conducted. The results show that the proposed strategy suggests the optimal tool path as well as the optimal pitch between successive tool paths under the cutting time criterion.
文摘目的:对临终沟通障碍-家庭版量表(Difficulties in End of Life Discussions-Family Inventory,DEOLD-FI)进行汉化,检验其在癌症人群中的信效度。方法:获得原作者授权后根据量表引进原则对DEOLD-FI进行汉化。对315例癌症病人进行调查,检验量表的信效度。结果:中文版DEOLD-FI共提取情感负担、消极态度、家庭负担、死亡恐惧、沟通能力5个公因子,累计方差贡献率为64.772%。总量表的Cronbach’sα系数为0.897,分半信度为0.828,重测信度为0.938,各维度的Cronbach’sα系数均在0.85以上。结论:中文版DEOLD-FI具有较好的信效度,可用于评估国内癌症病人与家庭成员进行临终沟通的障碍程度。
