Acute-on-chronic kidney injury at hospital discharge is associated with long-term dialysis and mortality

Existing chronic kidney disease (CKD) is among the most potent predictors of postoperative acute kidney injury (AKI). Here we quantified this risk in a multicenter, observational study of 9425 patients who survived to hospital discharge after major surgery. CKD was defined as a baseline estimated glomerular filtration rate <45ml/min per 1.73m2. AKI was stratified according to the maximum simplified RIFLE classification at hospitalization and unresolved AKI defined as a persistent increase in serum creatinine of more than half above the baseline or the need for dialysis at discharge. A Cox proportional hazard model showed that patients with AKI-on-CKD during hospitalization had significantly worse long-term survival over a median follow-up of 4.8 years (hazard ratio, 3.3) than patients with AKI but without CKD. The incidence of long-term dialysis was 22.4 and 0.17 per 100 person-years among patients with and without existing CKD, respectively. The adjusted hazard ratio for long-term dialysis in patients with AKI-on-CKD was 19.8 compared to patients who developed AKI without existing CKD. Furthermore, AKI-on-CKD but without kidney recovery at discharge had a worse outcome (hazard ratios of 4.6 and 213, respectively) for mortality and long-term dialysis as compared to patients without CKD or AKI. Thus, in a large cohort of postoperative patients who developed AKI, those with existing CKD were at higher risk for long-term mortality and dialysis after hospital discharge than those without. These outcomes were significantly worse in those with unresolved AKI at discharge

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

The Somatic Genomic Landscape of Glioblastoma

We describe the landscape of somatic genomic alterations based on multi-dimensional and comprehensive characterization of more than 500 glioblastoma tumors (GBMs). We identify several novel mutated genes as well as complex rearrangements of signature receptors including EGFR and PDGFRA. TERT promoter mutations are shown to correlate with elevated mRNA expression, supporting a role in telomerase reactivation. Correlative analyses confirm that the survival advantage of the proneural subtype is conferred by the G-CIMP phenotype, and MGMT DNA methylation may be a predictive biomarker for treatment response only in classical subtype GBM. Integrative analysis of genomic and proteomic profiles challenges the notion of therapeutic inhibition of a pathway as an alternative to inhibition of the target itself. These data will facilitate the discovery of therapeutic and diagnostic target candidates, the validation of research and clinical observations and the generation of unanticipated hypotheses that can advance our molecular understanding of this lethal cancer

Evaluating the Erosion Process from a Single-Stripe Laser-Scanned Topography: A Laboratory Case Study

Topographies during the erosion process obtained from the single-stripe laser-scanning method may provide an accurate, but affordable, soil loss estimation based on high-precision digital elevation model (DEM) data. In this study, we used laboratory erosion experiments with a sloping flume, a rainfall simulator, and a stripe laser apparatus to evaluate topographic changes of soil surface and the erosion process. In the experiments, six slope gradients of the flume (5&deg; to 30&deg; with an increment of 5&deg;) were used and the rainfall simulator generated a 30-min rainfall with the kinetic energy equivalent to 80 mm/h on average. The laser-scanned topography and sediment yield were collected every 5 min in each test. The difference between the DEMs from laser scans of different time steps was used to obtain the eroded soil volumes and the corresponding estimates of soil loss in mass. The results suggest that the collected sediment yield and eroded soil volume increased with rainfall duration and slope, and quantified equations are proposed for soil loss prediction using rainfall duration and slope. This study shows the applicability of the stripe laser-scanning method in soil loss prediction and erosion evaluation in a laboratory case study

Semantic Interoperability for Enhancing Sharing and Learning through E-Government Knowledge-Intensive Portal Services

E-Government emerges from web sites that offer static information, documents and forms for employees and citizens, enquiries, and process automations to many types of stakeholders. Increasingly, different layers of government services are being consolidated into a knowledge portal, providing on time and online services. Such knowledge portals not only provide a platform for integrating applications and information from all government sources, but also provide platforms for knowledge sharing and learning to the public with the objective to improve the efficiency and the quality of E-Government processes and services. However, due to the heterogeneity of applications and information across different levels of government agencies, a significant amount of work is needed to re-configure such applications and services into a new platform. However, semantics are often deficient, which results in problems establishing effective knowledge sharing and learning in E-Government. This paper confers how knowledge intensive portals can be used for enhancing sharing and learning in E-Government. The authors discuss innovative information on how the Semantic Web and Web 2.0 technologies can be applied in providing interoperability to leverage knowledge sharing and learning activities

Semantic Interoperability for Enhancing Sharing and Learning through E- Government Knowledge-Intensive Portal Services

E-Government emerges from the web sites that offer static information, documents and forms for employees and citizens to more advanced types of transactions, enquiries, and process automations to many types of stakeholders. Increasingly, different layers of government services are being consolidated into a knowledge portal providing on time and online services to the public. Such a knowledge portal not only provides a platform for integrating applications and information from all government sources, but also provides a platform for knowledge sharing and learning to the public with the objective to improve the efficiency and the quality of E-Government processes and services. However, due to the heterogeneity of applications and information across different levels of government agencies, a significant amount of work is usually needed to re-configure such applications and services into a new platform despite the progress made in service-oriented architectures. Semantics and in particular meta-knowledge about the nature and types of application services are often lacking. Semantic interoperability needs to be established for effective knowledge sharing and learning in E-Government. In this paper, we discuss how knowledge intensive portals can be used for enhancing sharing an

小尺度人工降雨試驗侵蝕量模擬研究-Hairsine-Rose 模式應用

The main purpose of this study is to establish a model of hillslope soil erosion based on Hairsine-Rose erosion equation, using the System Dynamics software, Stella. We applied the time-varied soil loss data from a small-scale rainfall simulator experiment to calibrate and verify the constructed model. For model calibration, the parameters were either obtained directly by laboratory experiments or by taking references to previous studies that focus on the application of Harisine-Rose equation. Comparing the simulated soil erosion quantity with the collected soil erosion data, we found good agreement between the simulated and collected data in the cases of steep slope erosion experiment, but a larger gap between the simulated and collected data for mild slope cases. Sensitivity analysis carried out for the parameters including J, F, threshold of stream power, detachability of the original soil, and detachability of the deposited layer, can indicate the degree of parameter effects on soil erosion quantity for the cases of different slopes. The influential parameters of all the slopes are found as J and F.本研究主要參考的土壤沖蝕理論為 Hairsine-Rose 沖蝕方程式，並根據系統動力學概念以 Stella 軟體建立土壤侵蝕模式，以小尺度人工降雨模擬試驗的資料進行率定和驗證，相關參數由 試驗直接取得或參考前人應用 Hairsine-Rose 侵蝕方程式研究之文獻值。將模式所計算出之土壤 沖蝕量與試驗收集的土壤沖蝕量進行比較，發現在高坡度下擬合的結果較為理想，至於低坡度時 則會有較大的誤差發生。再對參數 J (土壤基質對抗逕流對土壤產生捲起之能力)、F (超過門檻值 之河川功率實際對土壤造成捲起和再捲起的比率)、河川功率之門檻值和原始表土之離散能力及 沉積層之離散能力進行敏感度分析，可以得到各坡度之主要影響土壤沖蝕量的參數，在各坡度都 有一定影響力的參數為 J 和 F

Association of body mass index with all-cause mortality in the elderly population of Taiwan: A prospective cohort study.

[[abstract]]Background and aims The nutritional status of the elderly is different from that of young people. Body composition changes as people age, for example, fat mass increases, muscle mass decreases, and body fat distribution is changed. We aimed to investigate the association of body mass index (BMI) with cause-specific mortality in the elderly population. Methods and results The data of annual health examination for the older citizens (≥65 years old) from 2006 to 2011 in Taipei City Hospital were used. Information on baseline demographics, lifestyle behaviors, medical, and drug usage were collected by a self-administered questionnaire. Cause-specific mortality was ascertained from the National Registration of Death. Individuals were followed up until death or December 31, 2012, whichever was earlier. Univariable and multivariable Cox proportional hazard analyses were applied to investigate the association between BMI and all-cause mortality. Among 81,221 older people included in the analysis, 42,602 (52.45%) were men. The mean age was 73.85 ± 6.32 years. Among the 81,221 participants, 3398 (4.18%) were underweight, 36,476 (44.91%) were normal weight, 25,708 (31.65%) were overweight, and 15,639 (19.25%) were obese. Those in the BMI category 27 ≤ BMI<28 kg/m2 had the lowest all-cause mortality risk. The BMI of lowest cause-specific mortality was between 27 kg/m2 and 28 kg/m2 in infection mortality, between 28 kg/m2 and 29 kg/m2 in circulation mortality, between 29 kg/m2 and 30 kg/m2 in respiratory mortality, and between 31 kg/m2 and 32 kg/m2 in cancer mortality. Conclusions The current study found a J-shaped relation between BMI and cause-specific mortality in the elderly population of Taiwan

Association of body mass index with all-cause mortality in the elderly population of Taiwan: A prospective cohort study

[[abstract]]Background and aims The nutritional status of the elderly is different from that of young people. Body composition changes as people age, for example, fat mass increases, muscle mass decreases, and body fat distribution is changed. We aimed to investigate the association of body mass index (BMI) with cause-specific mortality in the elderly population. Methods and results The data of annual health examination for the older citizens (≥65 years old) from 2006 to 2011 in Taipei City Hospital were used. Information on baseline demographics, lifestyle behaviors, medical, and drug usage were collected by a self-administered questionnaire. Cause-specific mortality was ascertained from the National Registration of Death. Individuals were followed up until death or December 31, 2012, whichever was earlier. Univariable and multivariable Cox proportional hazard analyses were applied to investigate the association between BMI and all-cause mortality. Among 81,221 older people included in the analysis, 42,602 (52.45%) were men. The mean age was 73.85 ± 6.32 years. Among the 81,221 participants, 3398 (4.18%) were underweight, 36,476 (44.91%) were normal weight, 25,708 (31.65%) were overweight, and 15,639 (19.25%) were obese. Those in the BMI category 27 ≤ BMI<28 kg/m2 had the lowest all-cause mortality risk. The BMI of lowest cause-specific mortality was between 27 kg/m2 and 28 kg/m2 in infection mortality, between 28 kg/m2 and 29 kg/m2 in circulation mortality, between 29 kg/m2 and 30 kg/m2 in respiratory mortality, and between 31 kg/m2 and 32 kg/m2 in cancer mortality. Conclusions The current study found a J-shaped relation between BMI and cause-specific mortality in the elderly population of Taiwan