Survival and recovery modeling of acute kidney injury in critically ill adults

Objectives: Acute kidney injury is common among the critically ill. However, the incidence, medication use, and outcomes of acute kidney injury have been variably described. We conducted a single-center, retrospective cohort study to examine the risk factors and correlates associated with acute kidney injury in critically ill adults with a particular focus on medication class usage. Methods: We reviewed the electronic medical records of all adult patients admitted to an intensive care unit between 1 February and 30 August 2020. Acute kidney injury was defined by the 2012 Kidney Disease: Improving Global Outcomes guidelines. Data included were demographics, comorbidities, symptoms, laboratory parameters, interventions, and outcomes. The primary outcome was acute kidney injury incidence. A Least Absolute Shrinkage and Selection Operator regression model was used to determine risk factors associated with acute kidney injury. Secondary outcomes including acute kidney injury recovery and intensive care unit mortality were analyzed using a Cox regression model. Results: Among 226 admitted patients, 108 (47.8%) experienced acute kidney injury. 37 (34.3%), 39 (36.1%), and 32 patients (29.6%) were classified as acute kidney injury stages I–III, respectively. Among the recovery and mortality cohorts, analgesics/sedatives, anti-infectives, and intravenous fluids were significant (p-value \u3c 0.05). The medication classes IV-fluid electrolytes nutrition (96.7%), gastrointestinal (90.2%), and anti-infectives (81.5%) were associated with an increased odds of developing acute kidney injury, odd ratios: 1.27, 1.71, and 1.70, respectively. Cox regression analyses revealed a significantly increased time-varying mortality risk for acute kidney injury-stage III, hazard ratio: 4.72 (95% confidence interval: 1–22.33). In the recovery cohort, time to acute kidney injury recovery was significantly faster in stage I, hazard ratio: 9.14 (95% confidence interval: 2.14–39.06) cohort when compared to the stage III cohort. Conclusion: Evaluation of vital signs, laboratory, and medication use data may be useful to determine acute kidney injury risk stratification. The influence of particular medication classes further impacts the risk of developing acute kidney injury, necessitating the importance of examining pharmacotherapeutic regimens for early recognition of renal impairment and prevention

Measured Sensitivity of the First Mark II Phased Array Feed on an ASKAP Antenna

This paper presents the measured sensitivity of CSIRO's first Mk. II phased array feed (PAF) on an ASKAP antenna. The Mk. II achieves a minimum system-temperature-over-efficiency $T_\mathrm{sys}/\eta$ of 78 K at 1.23 GHz and is 95 K or better from 835 MHz to 1.8 GHz. This PAF was designed for the Australian SKA Pathfinder telescope to demonstrate fast astronomical surveys with a wide field of view for the Square Kilometre Array (SKA).Comment: 5 pages, 2 figures, accepted for publication in Electromagnetics in Advanced applications (ICEAA), 2015 International Conference o

The Effect of a High Fat Meal on Cerebral Vascular Function

It is well known that a single high fat meal (HFM) causes a robust and transient elevation in serum triglycerides (TG). This elevation in serum TG is a primary contributor to the post-prandial attenuation of peripheral vascular endothelial function, as assessed by flow-mediated dilation in the brachial artery. Whether a similar impairment in vascular reactivity can be observed in the cerebral circulation remains unknown, and was the focus of this investigation. PURPOSE: To test the hypothesis that cerebral vascular function is impaired following a HFM. METHODS: End-tidal carbon dioxide partial pressure (PETCO2), middle cerebral artery blood velocity (MCAVmean), calculated cerebral vascular conductance index (CVCI; MCAVmean/mean arterial pressure) and cerebral vasodilator response to rebreathing induced hypercapnia (% increase in CVC from baseline at common maximal ΔPETCO2) were assessed in 6 healthy young men (27 ±5 years). Measures were assessed during fasted baseline and again at 2 and 4 h post meal consumption (HFM day) or at a similar time point in the fasted state (TC day). The two visits were separated by 2-7 days and were conducted in a randomized order. Blood lipids were assessed at baseline and at the 2 h time point into each respective condition. RESULTS: As expected, consumption of the HFM significantly elevated serum TG concentrations relative to TC at 2 h (HFM: 101±38 to 169±77mg/dl, TC: 107±32 to 92±31mg/dl, P=0.007). However, the HFM had no effect of cerebral vasodilator capacity during rebreathing induced hypercapnia. The maximal increase in %CVC achieved at the highest common ΔPETCO2 during all conditions within each subject was unchanged during 2hr and 4hr post HFM or TC (condition x time interaction: P=0.96). Similarly, the slope of the change in %CVC per change in ΔPETCO2 was unaffected by HFM across time (P=0.49). CONCLUSION: Contrary to our hypothesis, and unlike the peripheral vasculature, our preliminary data suggest that the cerebral circulation appears to be protected from the acute negative effects of a high fat meal

Deformation of the Pacific/North America plate boundary at Queen Charlotte Fault : the possible role of rheology

Published 2018. This article is a U.S. Government work and is in the public domain in the USA. The definitive version was published in Journal of Geophysical Research: Solid Earth 123 (2018): 4223-4242, doi:10.1002/2017JB014770.The Pacific/North America (PA/NA) plate boundary between Vancouver Island and Alaska is similar to the PA/NA boundary in California in its kinematic history and the rate and azimuth of current relative motion, yet their deformation styles are distinct. The California plate boundary shows a broad zone of parallel strike slip and thrust faults and folds, whereas the 49‐mm/yr PA/NA relative plate motion in Canada and Alaska is centered on a single, narrow, continuous ~900‐km‐long fault, the Queen Charlotte Fault (QCF). Using gravity analysis, we propose that this plate boundary is centered on the continent/ocean boundary (COB), an unusual location for continental transform faults because plate boundaries typically localize within the continental lithosphere, which is weaker. Because the COB is a boundary between materials of contrasting elastic properties, once a fault is established there, it will probably remain stable. We propose that deformation progressively shifted to the COB in the wake of Yakutat terrane's northward motion along the margin. Minor convergence across the plate boundary is probably accommodated by fault reactivation on Pacific crust and by an eastward dipping QCF. Underthrusting of Pacific slab under Haida Gwaii occurs at convergence angles >14°–15° and may have been responsible for the emergence of the archipelago. The calculated slab entry dip (5°–8°) suggests that the slab probably does not extend into the asthenosphere. The PA/NA plate boundary at the QCF can serve as a structurally simple site to investigate the impact of rheology and composition on crustal deformation and the initiation of slab underthrusting

Effect of Acute Antioxidant Consumption on Cardiac Baroreflex Sensitivity in Young Healthy Adults

There is an emerging body of evidence in animals indicating that elevated oxidative stress impairs baroreflex sensitivity (BRS) function, however studies in healthy humans have yielded equivocal results. One potential reason for this discrepancy is that previous studies have used individual antioxidant treatments (e.g., Vitamin C only) to investigate the effect of oxidative stress on BRS. Recent studies in healthy humans have demonstrated significant reductions in reactive oxygen species using an antioxidant cocktail (AOC; Vitamin C, Vitamin E, and Co-enzyme Q10) suggesting the effectiveness of this treatment. Whether this AOC induced reduction in oxidative species affects BRS in young, healthy adults remains unknown. PURPOSE: We tested the hypothesis that AOC will improve cardiac BRS in young healthy adults. METHODS: Five young men were studied on two separate days: placebo (sugar pills) and AOC (2000 mg Vitamin C, 150 IU Vitamin E and 100 mg Co-enzyme Q10) performed in random order. Resting heart rate (ECG) and arterial blood pressure (automated sphygmomanometer and finger photoplethysmography) were measured 90 minutes after AOC or placebo (a time period this AOC has been shown to have peak effects on oxidative stress). Spontaneous cardiac BRS was determined for all sequences combined (overall BRS), and also separately for up (increase systolic blood pressure: increase R-R interval) and down (decrease systolic blood pressure: decrease R-R interval) sequences. RESULTS: Systolic blood pressure on AOC day tended to be lower relative to the placebo day (127 ± 4 vs. 131 ± 5; p=0.098). However, no differences in overall cardiac BRS were found between placebo and AOC (18.0 ± 2.7 vs.17.3 ± 2.6 ms/mmHg; p=0.59). Likewise, up sequences (17.02 ± 2.9 vs 14.04 ± 4.0 ms/mmHg; p=0.51) and down sequences (18.0 ± 2.7 placebo vs. 18.0 ± 2.6 ms/mmHg AOC; p=0.98) were not different between conditions. Equal number of sequences were found between the placebo and AOC days. CONCLUSION: These preliminary data suggest that antioxidant treatment does not affect resting cardiac BRS in young, healthy men

Seabird Bycatch in Pelagic Longline Fisheries Is Grossly Underestimated when Using Only Haul Data

Hundreds of thousands of seabirds are killed each year as bycatch in longline fisheries. Seabirds are predominantly caught during line setting but bycatch is generally recorded during line hauling, many hours after birds are caught. Bird loss during this interval may lead to inaccurate bycatch information. In this 15 year study, seabird bycatch was recorded during both line setting and line hauling from four fishing regions: Indian Ocean, Southern Ocean, Coral Sea and central Pacific Ocean. Over 43,000 albatrosses, petrels and skuas representing over 25 species were counted during line setting of which almost 6,000 seabirds attempted to take the bait. Bait-taking interactions were placed into one of four categories. (i) The majority (57%) of bait-taking attempts were “unsuccessful” involving seabirds that did not take the bait nor get caught or hooked. (ii) One-third of attempts were “successful” with seabirds removing the bait while not getting caught. (iii) One-hundred and seventy-six seabirds (3% of attempts) were observed being “caught” during line setting, with three albatross species – Laysan (Phoebastria immutabilis), black-footed (P. nigripes) and black-browed (Thalassarche melanophrys)– dominating this category. However, of these, only 85 (48%) seabird carcasses were retrieved during line hauling. Most caught seabirds were hooked through the bill. (iv) The remainder of seabird-bait interactions (7%) was not clearly observed, but likely involved more “caught” seabirds. Bait taking attempts and percentage outcome (e.g. successful, caught) varied between seabird species and was not always related to species abundance around fishing vessels. Using only haul data to calculate seabird bycatch grossly underestimates actual bycatch levels, with the level of seabird bycatch from pelagic longline fishing possibly double what was previously thought

What we observe is biased by what other people tell us: beliefs about the reliability of gaze behavior modulate attentional orienting to gaze cues

For effective social interactions with other people, information about the physical environment must be integrated with information about the interaction partner. In order to achieve this, processing of social information is guided by two components: a bottom-up mechanism reflexively triggered by stimulus-related information in the social scene and a top-down mechanism activated by task-related context information. In the present study, we investigated whether these components interact during attentional orienting to gaze direction. In particular, we examined whether the spatial specificity of gaze cueing is modulated by expectations about the reliability of gaze behavior. Expectations were either induced by instruction or could be derived from experience with displayed gaze behavior. Spatially specific cueing effects were observed with highly predictive gaze cues, but also when participants merely believed that actually non-predictive cues were highly predictive. Conversely, cueing effects for the whole gazed-at hemifield were observed with non-predictive gaze cues, and spatially specific cueing effects were attenuated when actually predictive gaze cues were believed to be non-predictive. This pattern indicates that (i) information about cue predictivity gained from sampling gaze behavior across social episodes can be incorporated in the attentional orienting to social cues, and that (ii) beliefs about gaze behavior modulate attentional orienting to gaze direction even when they contradict information available from social episodes