In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since u...In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individu展开更多
The study of Russian Formalism from a paradigm perspective has an integrative methodological value compared with traditional approaches. From the three different levels(philosophy, knowledge and operation) inherent to...The study of Russian Formalism from a paradigm perspective has an integrative methodological value compared with traditional approaches. From the three different levels(philosophy, knowledge and operation) inherent to the paradigm perspective, this paper reexamines several theoretical problems that were previously thought to be settled: the theoretical construction of Russian Formalism, its development and its theoretical foundation. It shows that the Russian Formalistic paradigm is not only a literary phenomenon, but also relates to the fields of linguistics and philosophy, and at the knowledge level consists of the three schools of Formalistic Literature, Formalistic Linguistics and Formalistic Functionalism. The paper also points out that the lifespan of the paradigm from beginning to decline was longer than the ten years generally believed by scholars. Finally, the paradigm's theoretical foundation does not originate from Husserl's phenomenology or the literary schools related to it, as previously assumed, but from the linguistic methodologies of historical comparativism and structuralism, as well as the common aesthetic theory within philosophy.展开更多
文摘In 2002,the National Kidney Foundation Kidney Disease Outcomes Quality Initiative(NKF KDOQI)instituted new guidelines that established a novel chronic kidney disease(CKD)staging paradigm.This set of guidelines,since updated,is now very widely accepted around the world.Nevertheless,the authoritative United States Preventative Task Force had in August 2012acknowledged that we know surprisingly little about whether screening adults with no signs or symptoms of CKD improve health outcomes and that we deserve better information on CKD.More recently,the American Society of Nephrology and the American College of Physicians,two very well respected United States professional physician organizations were strongly at odds coming out with exactly opposite recommendations regarding the need or otherwise for"CKD screening"among the asymptomatic population.In this review,we revisit the various angles and perspectives of these conflicting arguments,raise unanswered questionsregarding the validity and veracity of the NKF KDOQI CKD staging model,and raise even more questions about the soundness of its evidence-base.We show clinical evidence,from a Mayo Clinic Health System Renal Unit in Northwestern Wisconsin,United States,of the pitfalls of the current CKD staging model,show the inexactitude and unpredictable vagaries of current CKD prediction models and call for a more cautious and guarded application of CKD staging paradigms in clinical practice.The impacts of acute kidney injury on CKD initiation and CKD propagation and progression,the effects of such phenomenon as the syndrome of late onset renal failure from angiotensin blockade and the syndrome of rapid onset end stage renal disease on CKD initiation,CKD propagation and CKD progression to end stage renal disease all demand further study and analysis.Yet more research on CKD staging,CKD prognostication and CKD predictions are warranted.Finally and most importantly,cognizant of the very serious limitations and drawbacks of the NKF K/DOQI CKD staging model,the need to individu
文摘The study of Russian Formalism from a paradigm perspective has an integrative methodological value compared with traditional approaches. From the three different levels(philosophy, knowledge and operation) inherent to the paradigm perspective, this paper reexamines several theoretical problems that were previously thought to be settled: the theoretical construction of Russian Formalism, its development and its theoretical foundation. It shows that the Russian Formalistic paradigm is not only a literary phenomenon, but also relates to the fields of linguistics and philosophy, and at the knowledge level consists of the three schools of Formalistic Literature, Formalistic Linguistics and Formalistic Functionalism. The paper also points out that the lifespan of the paradigm from beginning to decline was longer than the ten years generally believed by scholars. Finally, the paradigm's theoretical foundation does not originate from Husserl's phenomenology or the literary schools related to it, as previously assumed, but from the linguistic methodologies of historical comparativism and structuralism, as well as the common aesthetic theory within philosophy.
