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Background Cardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients. Methods One hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1–4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal). Results Patients with reduced HRR (p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012). Conclusion Our results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.

In agriculture, the human urine could have been used as a natural fertilizer, although there are some problems with the direct utilization, such as the presence of micropollutants in urine, odour and storage of large volume of urine. Therefore, nutrients, such as nitrogen, can be recovered from urine. Continuous flow laboratory membrane reactor was built to investigate nitrogen recovery from wastewater and from human urine. Membrane gas separation method has not been investigated for ammonia recovery from human urine yet. Nitrogen as ammonia gas was recovered in acid using Zeus Aeos™ ePTFE gas-permeable hydrophobic membrane. Acid flux, operating pH, hydraulic retention time and effective membrane surface were experimentally determined. The aim of this work was to verify wastewater experiments in professional flowsheet environment, rigorously modelled with ChemCAD and optimized by dynamic programming optimization method: the membrane separation. Such nitrogen recovery membrane separation has not been published in this professional flowsheet environment yet. The objective function of the process is the ammonia harvesting efficiency. Eighty-five percentage ammonia harvesting efficiency can be reached with 60 membrane surface area/reactor volume ratio, at 35 °C feed temperature with 350 L/m2h acid and in 8 h’ hydraulic retention time. It can be stated that this separation method is based on physical phenomena without any biological factors. The focus for nitrogen treatment in a wastewater treatment plant is removal instead of recovery. It can be determined that this system is capable for the nitrogen recovery from wastewater, and it can reduce the ammonia content of human urine too.

The role of tonsillectomy in the treatment of IgA nephropathy in Caucasian patients is controversial.A retrospective cohort study was conducted in 264 patients with biopsy-proven primary IgA nephropathy to examine the association between tonsillectomy and long-term renal survival, defined as the incidence of estimated glomerular filtration rates (eGFRs) of ≤30 ml/min/1.73 m(2) or end-stage renal disease (the composite of initiation of dialysis treatment or renal transplantation). The association of tonsillectomy with renal end-points was examined using the Kaplan-Meier method and Cox models.One-hundred and sixty-six patients did not undergo tonsillectomy (Group I, follow-up 130 ± 101 months) and 98 patients underwent tonsillectomy (Group II, follow-up 170 ± 124 months). The mean renal survival time was significantly longer for both end-points between those patients who underwent tonsillectomy (Group II) versus patients without tonsillectomy (Group I) (p0.001 and p = 0.005). The mean renal survival time was significantly longer for both end-points between those patients who had macrohaematuric episodes versus patients who had no macrohaematuric episodes (p = 0.035 and p = 0.019). Tonsillectomy, baseline eGFR and 24-h proteinuria were independent risk factors for both renal end-points.Tonsillectomy may delay the progression of IgA nephropathy mainly in IgA nephropathy patients with macrohaematuria. Prospective investigation of the protective role of tonsillectomy in Caucasian patients is needed.

In the file caching problem, the input is a sequence of requests for files out of a slow memory. A file has two attributes, a positive retrieval cost and an integer size. An algorithm is required to maintain a cache of size k such that the total size of files stored in the cache never exceeds k. Given a request for a file that is not present in the cache at the time of request, the file must be brought from the slow memory into the cache, possibly evicting other files from the cache. This incurs a cost equal to the retrieval cost of the requested file. Well-known special cases include paging (all costs and sizes are equal to 1), the cost model, which is also known as weighted paging, (all sizes are equal to 1), the fault model (all costs are equal to 1), and the bit model (the cost of a file is equal to its size). If bypassing is allowed, a miss for a file still results in an access to this file in the slow memory, but its subsequent insertion into the cache is optional. We study a new online variant of caching, called caching with rejection. In this variant, each request for a file has a rejection penalty associated with the request. The penalty of a request is given to the algorithm together with the request. When a file that is not present in the cache is requested, the algorithm must either bring the file into the cache, paying the retrieval cost of the file, or reject the file, paying the rejection penalty of the request. The objective function is the sum of total rejection penalty and the total retrieval cost. This problem generalizes both caching and caching with bypassing. We design deterministic and randomized algorithms for this problem. The competitive ratio of the randomized algorithm is O(logk), and this is optimal up to a constant factor. In the deterministic case, a k-competitive algorithm for caching, and a (k+1)-competitive algorithm for caching with bypassing are known. Moreover, these are the best possible competitive ratios. In contrast, we present a lower bound of 2k+1 on the competitive ratio of any deterministic algorithm for the variant with rejection. The lower bound is valid already for paging. We design a (2k+2)-competitive algorithm for caching with rejection. We also design a different (2k+1)-competitive algorithm, that can be used for paging and for caching in the bit and fault models.

Recently, associations were found between autoimmune diseases and variants of interleukin-23 receptor (IL23R) gene; here, we analyzed the association of nine IL23R polymorphisms with psoriasis and with immunoglobulin A nephropathy (IgAN). Groups of patients with psoriasis, IgAN, and controls were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods. We observed a significant increase in the carriage of the minor allele of rs11805303 in psoriasis patients compared to controls. Similarly, for rs2201841 prevalence of the CC genotype and for rs10889677, the AA genotype showed a more than two- and threefold increase, respectively in patients compared to controls. There was no difference in the distribution of IL23R variants between controls and IgAN patients. We confirmed the association of IL23R with psoriasis in a Hungarian population and demonstrated the effect of the rs11805303 SNP, which was tested so far only for other autoimmune diseases. We could not detect any association between the IL23R variants and IgAN.

The study analyses teachers’ perceptions of methods, teacher roles, success and evaluation in PBL and traditional classroom instruction. The analysis is based on empirical data collected in primary schools and vocational secondary schools. An analysis of 109 questionnaires revealed numerous differences based on degree of experience and type of school. In general, project-based methods were preferred among teachers, who mostly perceived themselves as facilitators and considered motivation and transmission of values central to their work. Teachers appeared not to capitalize on the use of ICT tools or emotions. Students actively participated in the evaluation process via oral evaluation.

Merkel cell carcinoma was diagnosed in a 79-year-old Caucasian woman. The tumour was localised to the upper lip and was in stage T2. After successful cryosurgery and a 7-year tumour-free period, a new tumour developed in her palatine tonsil. Histologically and immunohistochemically, this resembled the tumour in the lip. The regional lymph nodes were devoid of metastasis. The paraffin-embedded material of the two tumours and the unaffected lymphatic tissue were analysed with DNA microarrays for comparative genomic hybridisation to assess the genetic relationship of the tumours. In both tumours, regions on 2p and 10p were commonly over-represented, while 41 regions on chromosomes 1-4, 6, 8-9, 11 and 14-22 were commonly under-represented. Chromosomes 1, 3, 4, 16-18 and X were most frequently involved in the DNA losses. In gene copy numbers in the two tumours, 31 chromosome locations were found to be differently affected. The partly similar and partly different molecular patterns indicated a genetic relationship between the tumours and excluded the possibility that the tonsillar tumour was a metastasis. The findings suggest that a genetically altered field was the reason for the development of the tonsillar cancer; thus, it can be regarded pathogenetically as a second field tumour.