Diagnosis, evaluation, and management of acute kidney injury : a KDIGO summary (part 1)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided

Contrast-induced acute kidney injury and renal support for acute kidney injury : a KDIGO summary (part 2)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever international multidisciplinary clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. Two topics, contrast-induced AKI and management of renal replacement therapy, deserve special attention because of the frequency in which they are encountered and the availability of evidence. Recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided. This review is an abridged version of the guideline and provides additional rationale and commentary for those recommendation statements that most directly impact the practice of critical care

The robust selection of predictive genes via a simple classifier

Identifying genes that direct the mechanism of a disease from expression data is extremely useful in understanding how that mechanism works. This in turn may lead to better diagnoses and potentially can lead to a cure for that disease. This task becomes extremely challenging when the data are characterised by only a small number of samples and a high number of dimensions, as it is often the case with gene expression data. Motivated by this challenge, we present a general framework that focuses on simplicity and data perturbation. These are the keys for the robust identification of the most predictive features in such data. Within this framework, we propose a simple selective na¨ıve Bayes classifier discovered using a global search technique, and combine it with data perturbation to increase its robustness to small sample sizes. An extensive validation of the method was carried out using two applied datasets from the field of microarrays and a simulated dataset, all confounded by small sample sizes and high dimensionality. The method has been shown capable of identifying genes previously confirmed or associated with prostate cancer and viral infections

Hoarding Behavior in the Elderly

Educational Objectives 1. Identify the medical and mental health factors that contribute to hoarding behavior. 2. Describe the unique aspects of hoarding in the elderly. 3. Examine intervention and treatment strategies

Improving compliance with the VitalGo Total Lift Bed to improve patient outcomes: A quality improvement study

Background: Immobilization is frequently encountered in critically ill adult patients within the intensive care unit (ICU) leading to numerous, detrimental effects including increased hospital and ICU length of stay, increased ventilator days, and increased mortality. One measure to increase early mobility of critically ill patients at the University of Kentucky Chandler Medical Center (UKMC) is implementing the VitalGo Total Lift Bed (TLB). The TLB vertically tilts a secured patient upright from zero to 82 degrees, allowing immobile patients to benefit from early weight bearing therapy and early, progressive mobility in the confines of the bed. Despite implementation of the TLB, a discrepancy exists because the TLB protocol orders are placed for the patient however nursing does not adhere to the TLB protocol. Objectives: The objectives of this retrospective and prospective electronic medical record review were to examine adherence to the TLB protocol in the acute care, progressive care, and intensive care units at UKMC before and after a formal educational intervention; to examine the change in nursing knowledge of the TLB protocol before and after an educational intervention; and to identify associations between utilization of the TLB protocol and mobility, hospital length of stay, ICU length of stay, and ventilator days. Methods: A 6-month retrospective chart review was performed on patients receiving TLB therapy from January 1, 2019 through June 30, 2019. One electronic medical record was analyzed. Formal education via a web-based training module was administered to registered nurses in July 2019. After the WBT intervention was completed, a 6-month post-intervention chart review was completed from August 13, 2019 to February 13, 2020. Three electronic medical records were analyzed. Results: There was a statistically significant increase in nursing knowledge before and after an educational intervention (61.08% and 80.18%, respectively; p Conclusion:This project demonstrated that there is a need for further education on mobility devices for nurses and other healthcare providers. Nurses and other members of the multidisciplinary team have the opportunity to benefit from education on early mobility devices as it pertains to their role in caring for patients and ultimately improving patient outcomes

Television Violence Prevention Versus Juvenile Violence Prevention: Any Connections In Parental Control?

Animated features, like children\u27s cartoons, are considered by some to be the most violent shows on televi-sion, with approximately 25 to 50 acts of violence per hour (Dietz and Strasburger, 1991). Cartoons, unlike other shows that portray violence, present instances of violence to children in an acceptable way, which teaches children from zero to 17 years of age that hurting people is tolerable. Television violence has been linked to juvenile aggression, which has been linked to juvenile violence. In researching several studies, the author found that many of the preventions mentioned in the television violence studies were also mentioned in the research studies on juvenile violence. Parents were the primary source of control and prevention in both fields of juvenile justice and television media. The prevention connection found in both areas should help mental health professionals, law enforcement personnel, juvenile justice personnel, parents, and other interested persons curb violent behavior in children and adolescents

Is HP1 an RNA detector that functions both in repression and activation?

Heterochromatin is defined as regions of compact chromatin that persist throughout the cell cycle (Heitz, 1928). The earliest cytological observations of heterochromatin were followed by ribonucleotide labeling experiments that showed it to be transcriptionally inert relative to the more typical euchromatic regions that decondense during interphase. Genetic studies of rearrangements that place euchromatic genes next to blocks of heterochromatin also pointed out the repressive nature of heterochromatin (Grigliatti, 1991; and references therein). The discovery of the heterochromatin-enriched protein heterochromatin protein 1 (HP1)* by Elgin and co-workers in the mid-1980s suggested that the distinct cytological features of this chromatin may be related to its unique nucleoprotein composition (James and Elgin, 1986; James et al., 1989). HP1 immunostaining on polytene chromosomes from Drosophila larval salivary glands was used to show enrichment of the protein in pericentric heterochromatin. Since that initial discovery, HP1 homologues have been found in species ranging from fission yeast to humans where it is associated with gene silencing (Eissenberg and Elgin, 2000; and references therein). A number of euchromatic sites of localization were also reported in this original study. It has been generally assumed that these sites might constitute euchromatic sites of transcriptional repression by HP1. Indeed, several genes located at one of these sites (cytological region 31) have increased transcript levels in mutants for HP1 (Hwang et al., 2001)