Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Cross-cultural deception detection

The cultural diversity of people encountered by front-line investigators has increased substantially over the last decade. Increasingly, investigators must try to resolve their suspicions by evaluating a person's behaviour through the lens of that person's social and cultural norms. In this chapter, we consider what is known about cross-cultural deception and deception detection. In the first section, we examine cultural differences in perceptions of deception and review evidence suggesting that the accuracy of deception judgements deteriorates when made across cultures. We examine the roots of this poor performance, showing how eight cultural norms lead to behaviours that appear suspicious to judges from other cultures. In the second section, we review evidence suggesting that verbal and non-verbal cues to deception vary across cultures. In particular, we show that the observed variation in cues is consistent with, and can be predicted by, what is known about cultural differences in fundamental interpersonal and cognitive processes. In our conclusion, we speculate about likely areas of development in this line of researc

Development and Operation of the Harwell Small Counter Facility for the Measurement of 14C in Very Small Samples

From the 11th International Radiocarbon Conference held in Seattle, Washington, June 20-26, 1982.The Harwell system for measuring milligram size samples using Brookhaven miniature gas counters is fully operative. It comprises 12 counters of different sizes which operate simultaneously within a single NaI crystal (300mm diameter x 300mm long) acting as an anti-coincidence guard counter. Brief details are given of the construction and commissioning of the system, including counter assembly, shield design, electronics, data capture, data analysis, and chemical processing and filling procedures. The performance of the system and an overall view of the fields of application for which the counters have important applications are discussed.This material was digitized as part of a cooperative project between Radiocarbon and the University of Arizona Libraries.The Radiocarbon archives are made available by Radiocarbon and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform February 202