Effect of Rosuvastatin on Acute Kidney Injury in Sepsis-Associated Acute Respiratory Distress Syndrome.

Background:Acute kidney injury (AKI) commonly occurs in patients with sepsis and acute respiratory distress syndrome (ARDS). Objective:To investigate whether statin treatment is protective against AKI in sepsis-associated ARDS. Design:Secondary analysis of data from Statins for Acutely Injured Lungs in Sepsis (SAILS), a randomized controlled trial that tested the impact of rosuvastatin therapy on mortality in patients with sepsis-associated ARDS. Setting:44 hospitals in the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network. Patients:644 of 745 participants in SAILS who had available baseline serum creatinine data and who were not on chronic dialysis. Measurements:Our primary outcome was AKI defined using the Kidney Disease Improving Global Outcomes creatinine criteria. Randomization to rosuvastatin vs placebo was the primary predictor. Additional covariates include demographics, ARDS etiology, and severity of illness. Methods:We used multivariable logistic regression to analyze AKI outcomes in 511 individuals without AKI at randomization, and 93 with stage 1 AKI at randomization. Results:Among individuals without AKI at randomization, rosuvastatin treatment did not change the risk of AKI (adjusted odds ratio: 0.99, 95% confidence interval [CI]: 0.67-1.44). Among those with preexisting stage 1 AKI, rosuvastatin treatment was associated with an increased risk of worsening AKI (adjusted odds ratio: 3.06, 95% CI: 1.14-8.22). When serum creatinine was adjusted for cumulative fluid balance among those with preexisting stage 1 AKI, rosuvastatin was no longer associated worsening AKI (adjusted odds ratio: 1.85, 95% CI: 0.70-4.84). Limitations:Sample size, lack of urine output data, and prehospitalization baseline creatinine. Conclusion:Treatment with rosuvastatin in patients with sepsis-associated ARDS did not protect against de novo AKI or worsening of preexisting AKI

Letter from the Nuclear Security Women Editors

Letter from the Nuclear Security Women Editors for the IJNS and NSW Special Issue: Women in Nuclear Securit

Quality Child Care Supports the Achievement of Low-Income Children: Direct and Indirect Pathways Through Caregiving and the Home Environment

Existing studies of child care have not been able to determine whether higher quality child care protects children from the effects of poverty, whether poverty and lower quality child care operate as dual risk factors, or whether both are true. The objective of the current study was to test two pathways through which child care may serve as a naturally occurring intervention for low-income children: a direct pathway through child care quality to child outcomes, and an indirect pathway through improvements in the home environment. Children were observed in their homes and child care settings at 6, 15, 24, and 36 months. An interaction between family income-to-needs ratio and child care quality predicted School Readiness, Receptive Language, and Expressive Language, as well as improvements in the home environment. Children from low-income families profited from observed learning supports in the form of sensitive care and stimulation of cognitive development, and their parents profited from unobserved informal and formal parent supports. Policy implications are discussed

2013 Military Family Lifestyle Survey: Comprehensive Report

Despite the drawdown of the Iraq and Afghanistan wars, the United States will continue to rely on an all-volunteermilitary for global stability and security for the foreseeable future. The Blue Star Families Military Family Lifestyle Survey takes a proactive look at the current needs and priorities of military families and service members and what can be done to support them. The goal of the survey is to provide concrete data and information about prominent aspects of the military lifestyle so that decisionmakers can make informed choices on their behalf. After all, the first step in recognizing the unique and substantial contributions military families make to this nation's security and collective strength, is to understand their perspective and experiences while serving.Each year, Blue Star Families collects data and disseminates the results so that stakeholders can address military families with a timely and relevant perspective. In doing so, decision-makers may be able to target efforts for better reception, applicability, and successful outreach to military families in communities across the nation and around the world. This report details the results and analysis of the fourth annual Blue Star Families Military Family Lifestyle Survey.The survey, which was conducted online in November 2012 with more than 5,100 military family respondents, was designed to reveal key trends in today's military families by examining, among other things, feelings of stress, financialreadiness, spouse employment, effects of deployment, levels of communication, behavioral and mental health, wellbeing, and civic engagement. !e results provide clear insight into the unique lifestyles of modern-day military families after more than a decade of continuous war

Extending the Functionality of Behavioural Change-Point Analysis with k-Means Clustering: A Case Study with the Little Penguin (Eudyptula minor)

We present a simple framework for classifying mutually exclusive behavioural states within the geospatial lifelines of animals. This method involves use of three sequentially applied statistical procedures: (1) behavioural change point analysis to partition movement trajectories into discrete bouts of same-state behaviours, based on abrupt changes in the spatiotemporal autocorrelation structure of movement parameters; (2) hierarchical multivariate cluster analysis to determine the number of different behavioural states; and (3) k-means clustering to classify inferred bouts of same-state location observations into behavioural modes. We demonstrate application of the method by analysing synthetic trajectories of known ‘artificial behaviours’ comprised of different correlated random walks, as well as real foraging trajectories of little penguins (Eudyptula minor) obtained by global-positioning-system telemetry. Our results show that the modelling procedure correctly classified 92.5% of all individual location observations in the synthetic trajectories, demonstrating reasonable ability to successfully discriminate behavioural modes. Most individual little penguins were found to exhibit three unique behavioural states (resting, commuting/active searching, arearestricted foraging), with variation in the timing and locations of observations apparently related to ambient light, bathymetry, and proximity to coastlines and river mouths. Addition of k-means clustering extends the utility of behavioural change point analysis, by providing a simple means through which the behaviours inferred for the location observations comprising individual movement trajectories can be objectively classified

Using Video Modeling to Teach Complex Play Sequences to a Preschooler with

Abstract: The identification of efficient teaching procedures to address deficits in imaginative play skills, which are commonly seen in children with autism, is a challenge for professionals who are designing treatment programs. In the present study, video modeling was used to teach play skills to a preschool child with autism. Videotaped play sequences included both verbal and motor responses. A multiple-baseline procedure across three response categories (having a tea party, shopping, and baking) was implemented to demonstrate experimental control. No experimenter-implemented reinforcement or correction procedures were used during the intervention. Results indicated that the video modeling intervention led to the rapid acquisition of both verbal and motor responses for all play sequences. This procedure was shown to be an efficient technique for teaching relatively long sequences of responses in relatively few teaching sessions in the absence of chaining procedures. In addition, the complex sequences of verbal and motor responses were acquired without the use of error-correction procedures or explicit experimenter-implemented reinforcement contingencies

Recent advances in the application of stable isotope ratio analysis in forensic chemistry

This review paper updates the previous literature in relation to the continued and developing use of stable isotope ratio analysis in samples which are relevant to forensic science. Recent advances in the analysis of drug samples, explosive materials, and samples derived from human and animal samples are discussed. The paper also aims to put the use of isotope ratio mass spectrometry into a forensic context and discuss its evidential potential