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Background Hyperfiltration (HF) has been linked to the development of diabetic kidney disease (DKD), but the causative or predictive role of HF in the pathogenesis of DKD still remains unclear. To date, there have been no studies of HF in Indigenous Australians, a population with high rates of both diabetes and end-stage kidney disease. We aimed to compare the characteristics and frequency of HF in Indigenous Australians with and without type 2 diabetes.Methods Indigenous Australian participants, recruited across five pre-defined strata of health, diabetes status and kidney function, had a reference glomerular filtration rate (GFR) measured using plasma disappearance of iohexol [measured GFR(mGFR)] over 4 h. HF was defined in various ways: (i) mGFR > 144 mL/min/1.73 m2, which is mGFR > 1.96 × SD above the mean of the mGFR in non-diabetic participants with normal albuminuria and normal renal function (mGFR > 90 mL/min/1.73 m2); (ii) age-corrected mGFR (>144 mL/min/1.73 m2) to account for the effect of ageing on GFR in subjects over 40 years of age with cut-off 1 mL/min/1.73 m2 lower for every year; (iii) mGFR > 144 mL/min, without correction for body surface area or age, as well as (iv) mGFR > 125 mL/min/1.73 m2, without adjustment for age.Results A total of 383 Indigenous participants, 125 with and 258 without diabetes, with mGFR > 90 mL/min/1.73 m2 were studied. The proportion of participants with HF was 7% using mGFR > 144 mL/min/1.73 m2, 11% using the age-adjusted definition, 19% using mGFR > 144 mL/min and 27% using mGFR > 125 mL/min/1.73 m2. Diabetes was more common in participants with HF (40–74%) compared with normofiltering participants (28–31%), regardless of the definition of HF.Conclusions HF exists in Indigenous Australians with and without diabetes. A greater proportion of participants had diabetes in HF group compared with normofiltration group. Long-term follow-up of this cohort is necessary to determine

Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatininebased estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians.Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dualenergy X-ray absorptiometry. A ques

An examination of past experiences can provide insight to avoid future pitfalls. As the United States Army prepares for the 21st Century, it must struggle with how to transform and reorganize itself. Because of fiscal limitations, the Army faces tough decisions of funding current readiness or modernizing for the future; affording both given current budget constraints is not possible without reducing force structure. This paper briefly examines the military/political environment between 1945 and the beginning of the Korean War and compares and contrasts it to today's environment. Budget drawdowns, military force reductions, balanced budget issues, and a changing world order are common threads for both eras that make them worth comparison.

This report describes some simple yet realistic ways to examine the effect of current trends in hardware and tactics on the accuracy of conventional artillery munitions. Examples are provided to illustrate the main points. A computer program that models predicted fire techniques is also included in this report. Artillery accuracy, Artillery tactics, Error budget, Direct support weapon system, Self-propelled Howitzers, Guns.