EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Atlas of recent benthic foraminifera from Turkey

Benthic foraminifera are single-celled organisms abundantly found in all kind of marine environments from brackish estuaries to the deep ocean basins at all latitudes. Foraminifera are covered with an organic test which accumulate in the sediment and make up a significant amount of sedimentary rock. Many species have well defined salinity and temperature preferences making them particularly useful for reconstructing ecological changes occured in the past. The fossil tests not only used for paleoenvironmental interpretition, but also for biostratigraphy and age-dating. Anthropogenic pollution or environmental factors may cuase abnormal development of the test, such as aberrant chamber shape and size, twisted or distorted chamber arrangement, multiple apertures, twin, triplet and even quadruplet forms. These abnormalities are commonly used as indicators of pollution. Many researchers have studied the recent benthic and planktic foraminifera of the Mediterranean fauna. The studies have investigated the distribution and abundance of the species, composition of the foraminiferal assemblages, ecological factors and interractions of tests with the substrate. Recent studies, mainly focused on the alien species and their ecological impact. Despite the numerous researches, there is a lack of a comprehensive illustrated guide to the Mediterranean foraminifeal fauna, except the "Mediterranean Foraminifera" (Cimerman and Langer 1991), which included samples from Adriatic and Tyrrhenian Seas, representing mostly the western Mediterranean fauna. With the presented SEM photos of 299 species in 84 plates, the aim of the present Atlas is to fill the gap and provide an updated checklist of foraminiferal fauna of the Turkish coastline, representing the majority of the Levantine Basin

Twin, triplet and quadruplet teratogens in benthic foraminifera from Antalya

We report twin and triplet forms of Recent benthic foraminifers from the southwestern coasts of Antalya (SW Turkey). Biological influences are possibly the primary cause for abnormal morphologies During foraminifer reproduction, the number of individuals occupying the reproduction cyst, duration of the delay before the breaking of the cyst and the size of the cyst are all likely causes for the formation of twins, triplets and quadruplets. Thus, we assume that twins, triplets and quadruplet test formation in benthic foraminifers in our study area are caused by developmental accidents, and are not necessarily related to physical and chemical pressures from the environment

A review of benthic foraminifers and ostracodes of the Antalya coast

We studied benthic foraminifer and ostracod faunas from the Southwestern coasts of Antalya (Turkey) in 227 sediment samples collected by SCUBA divers in July and August, 2002. We identified 50 foraminifer genera and 96 species, some of which contained numerous large specimens. The large abundances of Indo-Pacific species, such as Peneroplis arietinus (Batsch), Amphisorus hemprichii Ehrenberg, Sorites variabilis Lacroix, Amphistegina lobifera Larsen, and Heterostegina depressa d'Orbigny is noteworthy. In some samples 75% of the sand is composed of Amphistegina lobifera Larsen tests. In contrast to this rich foraminifer fauna, ostracods are poorly represented by only 21 genera and 23 species

The importance of benthic foraminiferas in detecting features of ecological and geological structures in Edremit Bay and on coastal areas of Dikili Channel (NE Aegean Sea)

Benthic foraminiferal assemblages from the Gulf of Edremit, Lesbos Island, Alibey and Maden islands and Dikili Bay have been investigated and various morphological abnormalities, as well as, colored tests and large sizes have been observed. Besides, abundance of alien species originating from tropical seas attracts attention. Interesting togethernesses were found between different genera and species. Significant differences were observed between the assemblages from the northwest and southeast coasts of the Gulf of Edremit. 57 genera and 97 species were identified in the samples from the northwest coast, where as only 32 genera and 48 species were found on the southeast coast. A diverse foraminifer assemblage were observed around the Ayvalik-Alibey and Maden islands, with large individual sizes, colored tests and morphological abnomalities. Abnormal togethernesses between different genera and species were also observed in this locality. Togethernesses between Peneroplis pertusus (Forskal)-Coscinaspira hemprichii Ehrenberg and Peneroplis planatus (Fichtel and Moll)- Coscinaspira hemprichii Ehrenberg are important findings in the benthic foraminiferal assemblages of Ayvalik Alibey and Maden islands. Orange and brown coloration observed on many Peneroplis pertusus (Forskal) and P. planatus (Fichtel and Moll) individuals is another important finding in this region. Besides, many individuals of Peneroplis pertusus (Forskal), P. planatus (Fichtel and Moll), Lobatula lobatula (Walker and Jacob), Cibicidella variabilis (d'Orbigny), Ammonia compacta Hofker, A. parkinsoniana (d'Orbigny), Challengerella bradyi Billman, Hottinger and Oesterle, Elphidium complanatum (d'Orbigny) and E. crispum (Linné) were found. The presence of Laevipeneroplis karreri (Wiesner), Peneroplis pertusus (Forskal) and P. planatus (Fichtel and Moll) and Sorites orbiculus Ehrenberg on the east coast of Lesbos Island indicates the presence of hotwater springs. An abnormally large Peneroplis planatus (Fichtel and Moll) individual were found. Besides, many Peneroplis pertusus (Forskal) and P. planatus (Fichtel and Moll) individuals with orange-yellow tests, like the ones in Ayvalik, were found, suggesting the presence of submarine springs with Fe content. An abnormal Peneroplis planatus (Fichtel and Moll) individual with three different apertures was found in Dikili samples. One of the apertures was typical of the species, whereas the other two have the aperture characteristics of Coscinospira hemprichii Ehrenberg. The aim of our study is to figure out the factors leading to abnormal test morphologies. It is suggested that the benthic foraminiferal assemblages found in the study area are affected by the physical environmental conditions such as, temperature and salinity, as well as the chemical factors, such as radioactivity

First report of Pararotalia calcariformata from the Hatay coastline (Turkey - North-eastern Mediterranean)

Alien benthic foraminiferal assemblages of Samandag and Yayladagi coasts (Hatay, Turkey) have been investigated. 41 genera and 58 species of benthic foraminifers were identified and Indo-Pacific originated alien species were found to dominate the foraminiferal assemblage. Pararotalia calcariformata which shows distribution in the western Pacific is recorded for the first time in the Mediterranean Sea. © Marine Biological Association of the United Kingdom 2013

A dystroglycan mutation associated with limb-girdle muscular dystrophy.

Dystroglycan, which serves as a major extracellular matrix receptor in muscle and the central nervous system, requires extensive O-glycosylation to function. We identified a dystroglycan missense mutation (Thr192→Met) in a woman with limb-girdle muscular dystrophy and cognitive impairment. A mouse model harboring this mutation recapitulates the immunohistochemical and neuromuscular abnormalities observed in the patient. In vitro and in vivo studies showed that the mutation impairs the receptor function of dystroglycan in skeletal muscle and brain by inhibiting the post-translational modification, mediated by the glycosyltransferase LARGE, of the phosphorylated O-mannosyl glycans on α-dystroglycan that is required for high-affinity binding to laminin