Highlights d A comprehensive model is presented of the yeast nuclear pore complex (NPC) d Connectors link together different structural and functional layers in the NPC d Multiple structural and functional NPC isoforms co-exist in each cell d Modular construction allows structural plasticity and inner ring dilation of the NPC
The internal medicine residents from our training program rarely participated in scholarly activity prior to 1994. In an attempt to increase the quality and quantity of resident research, we initiated a research program that included: (1) a mandatory research project, (2) 2 months of dedicated research time, (3) appointment of a research director, (4) lectures on the critical appraisal of medical literature and research design, (5) technical support, (6) faculty mentoring, (7) a research meeting and competition involving five residency programs, and (8) military achievement awards. From 1994 to 1999, our house staff has had 134 research presentations and 21 manuscripts accepted for publication in peer-reviewed journals. Ninety percent of our residents presented at least one project at a scientific meeting by completion of their training between 1996 and 1999. Resident scholarly activity is significantly enhanced by a structured research program, an opportunity to present at a scientific meeting, and award recognition.
Background: Recombinant human erythropoietin (rHuEPO) is recommended pre-dialysis to correct the anemia of chronic kidney disease. This study evaluated the impact of pre-dialysis rHuEPO on mortality in incident end-stage renal disease (ESRD) patients with varying levels of pre-ESRD care. Methods: The study included 15,807 individuals whose exposure to rHuEPO was determined from HCFA 2728 forms. Results: Median follow-up after starting dialysis was 32.8 months. Pre-ESRD rHuEPO use occurred in only 3,994 (25.3%) subjects and was more common in individuals with insurance, currently employed, started on outpatient dialysis, and initiated on peritoneal dialysis. During the study, 8,608 (54.5%) patients died. The risk of death was lower for rHuEPO-treated patients versus non-treated (relative risk 0.87, 95% CI 0.82–0.92). The survival benefit with rHuEPO was greatest early after dialysis initiation (relative risk at 1 vs. 7 years post-dialysis 0.73, 95% CI 0.66–0.80 vs. 0.87, 95% CI 0.82–0.92, respectively), did not vary across several surrogates for quality of care, and was greatest in those with the highest achieved hematocrit pre-ESRD. Conclusion: Pre-dialysis rHuEPO confers a survival benefit that depends on achieved hematocrit and diminishes post-dialysis, but is independent of several surrogates for quality of care except for insurance status pre-ESRD.
The effects of short-term oral creatine (Cr) supplementation on exercise performance and on blood pressure and renal function were assessed. Thirty-five healthy, active duty, U.S. Army volunteers (20 men and 15 women; age, 22-36 years) at Fort Sam Houston, Texas, supplemented their diet for 7 days with 20 g/day of either Cr or taurine (as placebo). There was no significant difference in 2-minute push-up counts between the Cr and taurine groups from before to after supplementation (p = 0.437; power = 0.98). The Cr group demonstrated a significant increase in serum creatinine levels (p < 0.001), compared with the taurine group, and this increase could be misinterpreted as impairment of renal function. No adverse changes in blood pressure, body composition, weight, or serum Cr phosphokinase levels were observed. We conclude that short-term Cr supplementation appears to be safe but does not enhance push-up performance.
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