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

Doxycycline for Malaria Chemoprophylaxis and Treatment: Report from the CDC Expert Meeting on Malaria Chemoprophylaxis

Doxycycline, a synthetically derived tetracycline, is a partially efficacious causal prophylactic (liver stage of Plasmodium) drug and a slow acting blood schizontocidal agent highly effective for the prevention of malaria. When used in conjunction with a fast acting schizontocidal agent, it is also highly effective for malaria treatment. Doxycycline is especially useful as a prophylaxis in areas with chloroquine and multidrug-resistant Plasmodium falciparum malaria. Although not recommended for pregnant women and children < 8 years of age, severe adverse events are rarely reported for doxycycline. This report examines the evidence behind current recommendations for the use of doxycycline for malaria and summarizes the available literature on its safety and tolerability

Data from: Culture moderates changes in linguistic self-presentation and detail provision when deceiving others

Change in our language when deceiving is attributable to differences in the affective and cognitive experience of lying compared to truth telling, yet these experiences are also subject to substantial individual differences. On the basis of previous evidence of cultural differences in self-construal and remembering, we predicted and found evidence for cultural differences in the extent to which truths and lies contained self (versus other) references and perceptual (versus social) details. Participants (N = 320) of Black African, South Asian, White European and White British ethnicity completed a catch-the-liar task in which they provided genuine and fabricated statements about either their past experiences or an opinion and counter-opinion. Across the four groups we observed a trend for using more/fewer first-person pronouns and fewer/more third-person pronouns when lying, and a trend for including more/fewer perceptual details and fewer/more social details when lying. Contrary to predicted cultural differences in emotion expression, all participants showed more positive affect and less negative affect when lying. Our findings show that liars deceive in ways that are congruent with their cultural values and norms, and that this may result in opposing changes in behaviour

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