A model of rat early distal convoluted tubule (DCT) is developed in conjunction with a kinetic representation of the thiazide-sensitive NaCl cotransporter (TSC). Realistic constraints on cell membrane electrical conductance require that most of the peritubular Cl(-) reabsorption proceeds via a KCl cotransporter,along with most of the K(+) recycled from the Na-K-ATPase. The model tubule reproduces the saturable Cl(-) reabsorption of DCT but not the micropuncture finding of linear Na(+) flux in response to load, more likely a feature of late DCT (CNT). As in proximal tubule, early DCT HCO(3)(-) reabsorption is mediated by a luminal Na(+)/H(+) exchanger (NHE), but in contrast to proximal tubule, the DCT exchanger is operating closer to equilibrium. In the model DCT, two consequences of the lesser driving force for NHE exchange are an acidic cytosol and wider swings in NHE flux with perturbations of luminal composition. Variations in luminal NaCl provide a challenge to cell volume, which can be blunted by volume dependence of the KCl cotransporter. Cell swelling can also be induced by increases in peritubular K(+) concentration. In this case, volume-dependent inhibition of TSC could provide volume homeostasis that also enhances distal Na(+) delivery, and ultimately enhances renal K(+) excretion. In the model DCT, proton secretion is blunted by peritubular HCO(3)(-), so that there is little contribution by this segment to the maintenance of metabolic alkalosis. During alkalosis, the model predicts that increasing luminal NaCl concentration enhances NHE flux, so that these calculations provide no support for a role of early DCT in recovery from Cl(-) depletion alkalosis.
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http://dx.doi.org/10.1152/ajprenal.00043.2005 | DOI Listing |
Clin Transl Sci
December 2024
Boehringer Ingelheim International GmbH, Biberach an der Riss, Germany.
The feasibility of conducting a fully remote, interventional, phase II decentralized clinical trial (DCT) was investigated in major depressive disorder (MDD). Key learnings were collated to improve future DCTs. A double-blind, placebo-controlled, parallel-group, DCT enrolled adult MDD patients with inadequate response to first-line antidepressant monotherapy (ongoing ≥8 weeks) and a Montgomery-Åsberg Depression Rating Scale total score (MADRS) ≥22 at screening.
View Article and Find Full Text PDFInt J Nurs Sci
November 2024
Department of Emergency Medicine, Zhejiang Hospital, Hangzhou, Zhejiang Province, China.
Objective: Early thrombolytic therapy for ischemic stroke within the therapeutic window is associated with improved clinical outcomes. This study investigated whether optimizing intravenous thrombolytic (IVT) therapy strategies for stroke could reduce treatment delays.
Methods: To reduce delays in IVT therapy for ischemic stroke, a series of quality improvement measures were implemented at a tertiary hospital in Hangzhou, Zhejiang Province, from June 2021 to August 2023, which included developing a timeline process management system, forming a nurse-led stroke process management team, providing homogeneous training, standardizing the IVT therapy process for ischemic stroke, and introducing an incentive policy.
Npj Viruses
December 2024
Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA USA.
Although assessments of influenza A virus transmissibility in the ferret model play a critical role in pandemic risk evaluations, few studies have investigated which virological data collected from virus-inoculated animals are most predictive of subsequent virus transmission to naïve contacts. We compiled viral titer data from >475 ferrets inoculated with 97 contemporary IAV (including high- and low-pathogenicity avian, swine-origin, and human viruses of multiple HA subtypes) that served as donors for assessments of virus transmission in the presence of direct contact (DCT) or via respiratory droplets (RDT). A diversity of molecular determinants, clinical parameters, and infectious titer measurements and derived quantities were examined to identify which metrics were most statistically supported with transmission outcome.
View Article and Find Full Text PDFUnlabelled: The metabolic health of the kidney is a primary determinant of the risk of progressive kidney disease. Our understanding of the metabolic processes that fuel kidney functions is limited by the kidney's structural and functional heterogeneity. As the kidney contains many different cell types, we hypothesize that intra-renal mitochondrial heterogeneity contributes to cell-specific metabolism.
View Article and Find Full Text PDFAm J Sports Med
November 2024
Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
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