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

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

XVI International Congress of Control Electronics and Telecommunications: "Techno-scientific considerations for a post-pandemic world intensive in knowledge, innovation and sustainable local development"

Este título, sugestivo por los impactos durante la situación de la Covid 19 en el mundo, y que en Colombia lastimosamente han sido muy críticos, permiten asumir la obligada superación de tensiones sociales, políticas, y económicas; pero sobre todo científicas y tecnológicas. Inicialmente, esto supone la existencia de una capacidad de la sociedad colombiana por recuperar su estado inicial después de que haya cesado la perturbación a la que fue sometida por la catastrófica pandemia, y superar ese anterior estado de cosas ya que se encontraban -y aún se encuentran- muchos problemas locales mal resueltos, medianamente resueltos, y muchos sin resolver: es decir, habrá que rediseñar y fortalecer una probada resiliencia social existente - producto del prolongado conflicto social colombiano superado parcialmente por un proceso de paz exitoso - desde la tecnociencia local; como lo indicaba Markus Brunnermeier - economista alemán y catedrático de economía de la Universidad de Princeton- en su libro The Resilient Society…La cuestión no es preveerlo todo sino poder reaccionar…aprender a recuperarse rápido.This title, suggestive of the impacts during the Covid 19 situation in the world, and which have unfortunately been very critical in Colombia, allows us to assume the obligatory overcoming of social, political, and economic tensions; but above all scientific and technological. Initially, this supposes the existence of a capacity of Colombian society to recover its initial state after the disturbance to which it was subjected by the catastrophic pandemic has ceased, and to overcome that previous state of affairs since it was found -and still is find - many local problems poorly resolved, moderately resolved, and many unresolved: that is, an existing social resilience test will have to be redesigned and strengthened - product of the prolonged Colombian social conflict partially overcome by a successful peace process - from local technoscience; As Markus Brunnermeier - German economist and professor of economics at Princeton University - indicates in his book The Resilient Society...The question is not to foresee everything but to be able to react...learn to recover quickly.Bogot

Reduction of Enteric Methane Emissions in Heifers Fed Tropical Grass-Based Rations Supplemented with Palm Oil

Vegetable oils have been shown to reduce enteric methane (CH4) production by up to 20%. However, when the level of incorporation exceeds the threshold of 70 g/kg DM, dry matter intake (DMI) and nutrient digestibility may be reduced. The objective of this study was to determine the effects of the incorporation of three levels of palm oil (PO) on enteric CH4 emissions, rumen fermentation and apparent digestibility in heifers fed low-quality grass. Four rumen-cannulated heifers (Bos taurus &times; Bos indicus) were randomly assigned to four treatments: control (CON) and three increasing PO levels: 20, 40 and 60 g/kg in a 4 &times; 4 Latin square design with four periods of 22 days (14 days of adaptation to the ration), 5 days of feces and rumen fluid sampling (day 18, 4 h postprandial) and the last 3 days for measurements of CH4 in respiration chambers. With the exception of CP (p = 0.04), starch (p = 0.002) and EE (p &lt; 0.001), the intake of nutrients was not affected by the inclusion of PO (p &gt; 0.05). The apparent digestibility (AD) of nutrients was not affected by the inclusion of PO (p &gt; 0.05), except for starch, which reduced its AD as the PO level was increased (p &lt; 0.05). The gross energy intake was higher in PO-containing rations (p = 0.001), on the other hand, the digestible energy intake was similar between treatments (p &gt; 0.05). In situ ruminal digestion kinetics and the potential degradability remained unchanged (p &gt; 0.05), however, the effective degradability decreased with the inclusion of PO in the rations (p &lt; 0.05). The ruminal pH and molar proportions of acetic, isovaleric and valeric acid were not different between treatments (p &gt; 0.05). The ruminal concentration of propionic acid increased as the PO level increased, reaching its highest molar proportion with 60 g/kg PO (p &lt; 0.05), however, the acetic/propionic ratio and the molar proportions of butyric acid and isobutyric acid decreased as the PO level increased (p &lt; 0.05). The total daily CH4 production was lower in diets containing 20, 40 and 60 g/kg PO compared to the CON diet (p &lt; 0.001). The production of CH4 per kg DMI and DOMI was greater (p &lt; 0.05) for the CON diet compared to all three rations containing PO. The emission intensity, Ym, energy lost as CH4, emission factor (EF) and kg CO2 eq/year were reduced as an effect of the inclusion of PO (p &lt; 0.05). Based on the results obtained, it is concluded that the incorporation of PO in cattle rations has the potential to reduce enteric methane emissions by 4% for every 10 g/kg PO in the ration, without affecting DMI, apparent digestibility or the consumption of digestible nutrient fractions

Reduction of Enteric Methane Emissions in Heifers Fed Tropical Grass-Based Rations Supplemented with Palm Oil

Vegetable oils have been shown to reduce enteric methane (CH4) production by up to 20%. However, when the level of incorporation exceeds the threshold of 70 g/kg DM, dry matter intake (DMI) and nutrient digestibility may be reduced. The objective of this study was to determine the effects of the incorporation of three levels of palm oil (PO) on enteric CH4 emissions, rumen fermentation and apparent digestibility in heifers fed low-quality grass. Four rumen-cannulated heifers (Bos taurus × Bos indicus) were randomly assigned to four treatments: control (CON) and three increasing PO levels: 20, 40 and 60 g/kg in a 4 × 4 Latin square design with four periods of 22 days (14 days of adaptation to the ration), 5 days of feces and rumen fluid sampling (day 18, 4 h postprandial) and the last 3 days for measurements of CH4 in respiration chambers. With the exception of CP (p = 0.04), starch (p = 0.002) and EE (p p > 0.05). The apparent digestibility (AD) of nutrients was not affected by the inclusion of PO (p > 0.05), except for starch, which reduced its AD as the PO level was increased (p p = 0.001), on the other hand, the digestible energy intake was similar between treatments (p > 0.05). In situ ruminal digestion kinetics and the potential degradability remained unchanged (p > 0.05), however, the effective degradability decreased with the inclusion of PO in the rations (p p > 0.05). The ruminal concentration of propionic acid increased as the PO level increased, reaching its highest molar proportion with 60 g/kg PO (p p 4 production was lower in diets containing 20, 40 and 60 g/kg PO compared to the CON diet (p 4 per kg DMI and DOMI was greater (p m, energy lost as CH4, emission factor (EF) and kg CO2 eq/year were reduced as an effect of the inclusion of PO (p < 0.05). Based on the results obtained, it is concluded that the incorporation of PO in cattle rations has the potential to reduce enteric methane emissions by 4% for every 10 g/kg PO in the ration, without affecting DMI, apparent digestibility or the consumption of digestible nutrient fractions

Variación genética en el complejo infraespecífico de chayote evaluada mediante sistemas isoenzimáticos.

El objetivo de este trabajo fue estimar el grado de variación genética dentro del complejo infraespecífico de Sechium mediante el uso de sistemas isoenzimáticos. Se analizaron 23 loci codificados por 12 sistemas isoenzimáticos, en geles de almidón, en 10 individuos de cada una de las 30 accesiones (27 cultivadas y tres silvestres). La variación genética se estimó con base en el número promedio de alelos por locus (NPAL), porcentaje de porlimorfismo (PP), heterocigosidad observada y esperada (Ho y He), índice relativo de heterocigosidad (IRH) e índice de Shannon (IS). Para NPAL y PP, el promedio para las 30 accesiones fue de 2, 03 y 59, 8%, respectivamente. El análisis de Ho y He mostró variación genética en el complejo infraespecífico de Sechium, con valores promedio de 0, 05 y 0, 26, respectivamente. El IRH mostró una deficiencia de individuos heterocigotos (promedio de -0, 75). El IS mostró gran diversidad en las 30 accesiones (0, 41). Las poblaciones con mayor diversidad fueron Negrito, Verde liso, Negro xalapa, Verde espinoso y Negro cónico; con una variación intermedia fueron Castilla blanco, Caldero y Blanco pequeño; y, con poca variación, Castilla verde, Cambray y los parientes silvestres

Variación genética en chayote (Sechium spp) mediante sistemas isoenzimáticos

El objetivo de este trabajo fue estimar el grado de variación genética dentro del complejo infraespecífico de Sechium mediante el uso de sistemas isoenzimáticos. Se analizaron 23 loci codificados por 12 sistemas isoenzimáticos, en geles de almidón, en 10 individuos de cada una de las 30 accesiones (27 cultivadas y tres silvestres). La variación genética se estimó con base en el número promedio de alelos por locus (NPAL), porcentaje de porlimorfismo (PP), heterocigosidad observada y esperada (Ho y He), índice relativo de heterocigosidad (IRH) e índice de Shannon (IS). Para NPAL y PP, el promedio para las 30 accesiones fue de 2,03 y 59,8%, respectivamente. El análisis de Ho y He mostró variación genética en el complejo infraespecífico de Sechium, con valores promedio de 0,05 y 0,26, respectivamente. El IRH mostró una deficiencia de individuos heterocigotos (promedio de ‑0,75). El IS mostró gran diversidad en las 30 accesiones (0,41). Las poblaciones con mayor diversidad fueron Negrito, Verde liso, Negro xalapa, Verde espinoso y Negro cónico; con una variación intermedia fueron Castilla blanco, Caldero y Blanco pequeño; y, con poca variación, Castilla verde, Cambray y los parientes silvestres.The objective of this work was to estimate the degree of genetic variation in an infraspecific complex of Sechium using isoenzymatic systems. For this purpose, 23 loci were codified by 12 isoenzimatic systems and analyzed in starch gels, in 10 individuals from each of the 30 accesions of Sechium (27 cultivated and three wild relatives). The estimation of genetic variation was based on the average number of alleles per locus (NPAL), polymorphism percentage (PP), observed and expected heterozygosity (Ho and He), relative heterozygosity index (RHI) and Shannon´s index (IS). For NPAL and PP, the average for the 30 accesions was 2.03 and 59.8%, respectively. The analysis of Ho and He showed genetic variation in the infraspecific complex of Sechium, with 0.05 and 0.26 average values, respectively. The RHI showed a deficiency of heterozygote individuals (average of ‑0.75). The IS showed a great diversity in the 30 accesions (0.41). The populations with the greatest genetic variations were Negrito, Verde liso, Negro xalapa, Verde espinoso and Negro cónico; with intermediate variation were Castilla blanco, Caldero and Blanco pequeño; and with little variation were Castilla verde, Cambray and wild relatives.Para estimar el grado de variación genética dentro del complejo infraespecífico de Sechium, se analizaron 23 loci isoenzimáticos codificados por doce sistemas isoenzimáticos, en geles de almidón, en diez individuos de cada una de 30 accesiones (27 cultivadas y tres silvestres). La variación genética se estimó con base en el número promedio de alelos por locus (NPAL), porcentaje de porlimorfismo (PP), heterocigosidad observada y esperada (Ho y HE), índice relativo de heterocigotos (IRH) e índice de Shannon (IS). Los resultados mostraron que para NPAL y PP el promedio para las 30 accesiones fue de 2.03 y 59.8 %, respectivamente.  El análisis de Ho y HE reveló que la variación genética en el complejo infraespecífico de Sechium es alta, con valores promedio de 0.05 y 0.26, respectivamente.  El IRH reveló una deficiencia de individuos heterocigotos (promedio de 0.75). El IS mostró gran diversidad en las 30 accesiones (0.41).  Las poblaciones con mayor diversidad  fueron: negrito, verde liso, negro xalapa, verde espinoso y negro cónico; con una variación intermedia fueron: castilla blanco, caldero y blanco pequeño, y con poca variación: castilla verde, castilla blanco, cambray y los parientes silvestres

Una nota sobre las fuentes del crecimiento industrial en España

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