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

Measurement of the muon flux from 400 GeV/c protons interacting in a thick molybdenum/tungsten target

The SHiP experiment is proposed to search for very weakly interacting particles beyond the Standard Model which are produced in a 400 GeV/c proton beam dump at the CERN SPS. About 1011 muons per spill will be produced in the dump. To design the experiment such that the muon-induced background is minimized, a precise knowledge of the muon spectrum is required. To validate the muon flux generated by our Pythia and GEANT4 based Monte Carlo simulation (FairShip), we have measured the muon flux emanating from a SHiP-like target at the SPS. This target, consisting of 13 interaction lengths of slabs of molybdenum and tungsten, followed by a 2.4 m iron hadron absorber was placed in the H4 400 GeV/c proton beam line. To identify muons and to measure the momentum spectrum, a spectrometer instrumented with drift tubes and a muon tagger were used. During a 3-week period a dataset for analysis corresponding to (3.27±0.07) × 1011 protons on target was recorded. This amounts to approximatively 1% of a SHiP spill

Track reconstruction and matching between emulsion and silicon pixel detectors for the SHiP-charm experiment

In July 2018 an optimization run for the proposed charm cross section measurement for SHiP was performed at the CERN SPS. A heavy, moving target instrumented with nuclear emulsion films followed by a silicon pixel tracker was installed in front of the Goliath magnet at the H4 proton beam-line. Behind the magnet, scintillating-fibre, drift-tube and RPC detectors were placed. The purpose of this run was to validate the measurement's feasibility, to develop the required analysis tools and fine-tune the detector layout. In this paper, we present the track reconstruction in the pixel tracker and the track matching with the moving emulsion detector. The pixel detector performed as expected and it is shown that, after proper alignment, a vertex matching rate of 87% is achieved

Comparison of heat generation during implant drilling using stainless steel and ceramic drills

Purpose The purpose of this study was to compare the heat generated from implant drilling using stainless steel and ceramic drills. Materials and Methods A total of 40 fresh bovine femoral cortical bone samples were used in this study. A constant drill load of 2.0 kg was applied throughout the drilling procedures via a drilling rig at a speed of 1,500 rpm. Two different implant drill types (stainless steel and ceramic) were evaluated. Heat was measured with type K thermocouple from 3 different depths. Data were subjected to the independent-sample t test and Pearson correlation analysis. The ? level was set a priori at 0.05. Results The mean maximum temperatures at the depths of 3 mm, 6 mm, and 9 mm with the stainless steel drill were 32.15°C, 35.94°C, and 37.05°C, respectively, and those with the ceramic drill were 34.49°C, 36.73°C, and 36.52°C, respectively. A statistically significant difference was found at the depth of 3 mm (P = .014) whereas there was no significant difference at the depths of 6 and 9 mm (P > .05) between stainless steel and ceramic drills. Conclusion Within the limitations of the study, although more heat was generated in the superficial part of the drilling cavity with the ceramic drill, heat modifications seemed not to be correlated with the drill type, whether stainless steel or ceramic, in the deep aspect of the cavity. Further clinical studies are required to determine the effect of drill type on heat generation. © 2011 American Association of Oral and Maxillofacial Surgeons

Central Nervous System Infections In The Absence Of Cerebrospinal Fluid Pleocytosis

Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated.Scopu

A facility to Search for Hidden Particles (SHiP) at the CERN SPS

A new general purpose fixed target facility is proposed at the CERN SPS accelerator which is aimed at exploring the domain of hidden particles and make measurements with tau neutrinos. Hidden particles are predicted by a large number of models beyond the Standard Model. The high intensity of the SPS 400~GeV beam allows probing a wide variety of models containing light long-lived exotic particles with masses below ${\cal O}$(10)~GeV/c$^2$, including very weakly interacting low-energy SUSY states. The experimental programme of the proposed facility is capable of being extended in the future, e.g. to include direct searches for Dark Matter and Lepton Flavour Violation

Reconstruction of 400 GeV/c proton interactions with the SHiP-charm project

International audienceThe SHiP-charm project was proposed to measure the associated charm production induced by 400 GeV/c protons in a thick target, including the contribution from cascade production. An optimisation run was performed in July 2018 at CERN SPS using a hybrid setup. The high resolution of nuclear emulsions acting as vertex detector was complemented by electronic detectors for kinematic measurements and muon identification. Here we present first results on the analysis of nuclear emulsions exposed in the 2018 run, which prove the capability of reconstructing proton interaction vertices in a harsh environment, where the signal is largely dominated by secondary particles produced in hadronic and electromagnetic showers within the lead target