The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Streptomyces hyderabadensis sp. nov., an actinomycete isolated from soil

A novel actinomycete, designated strain OU-40(T), was isolated from farm soil collected from the Hyderabad region of Andhra Pradesh, southern India. The strain was found to have morphological and chemotaxonomic characteristics typical of species of the genus Streptomyces. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain OU-40(T) belonged to the genus Streptomyces, and was related most closely to Streptomyces pactum NBRC 13433(T) (99.0% sequence similarity), Streptomyces olivaceus NBRC 12805(T) (99.0%) and Streptomyces parvulus NBRC 13193(T) (98.8%). Strain OU-40(T) could be distinguished from the type strains of its closest phylogenetic relatives based on levels of DNA DNA relatedness and comparison of morphological and phenotypic data. It is therefore concluded that strain OU-40(T) represents a novel species of the genus Streptomyces, for which the name Streptomyces hyderabadensis sp. nov. is proposed. The type strain is OU-40(T) (=CCTCC AA 209024(T) =PCM 2692(T))

Serving a heterogeneous Muslim identity? Private governance arrangements of halal food in the Netherlands

The consumption of halal food may be seen as an expression of the Muslim identity. Within Islam, different interpretations of ‘halal’ exist and the pluralistic Muslim community requests diverse halal standards. Therefore, adaptive governance arrangements are needed in the halal food market. Globalization and industrialization have complicated the governance of halal food. A complex network of halal governors has developed from the local to the global level. In this paper, we analyze to what extent halal certification bodies in the Netherlands address the needs of the Muslim community and how they are influenced by international halal governance. The Netherlands serves as a case study with its growing Muslim community and its central position in international trade. The data comes from literature review and eleven qualitative semi-structured interviews with the most prominent actors in the Dutch halal governance system. Our analysis shows that the halal governance system in the Netherlands is weakly institutionalized and hardly adaptive to the needs of a heterogeneous Muslim community. Improvements are needed concerning stakeholder engagement, transparency, accessibility, impartiality and efficiency