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

Efeitos do manejo pós-parto de vacas primíparas no desempenho de bezerros de corte até um ano de idade Effects of post-partum management of primiparous cows on growth of beef calves up to one year of age

Os efeitos no desenvolvimento de bezerros submetidos a: a) três tratamentos, consitindo de cargas animais pós-parto (CA) de 240 kg de peso vivo (PV)/ha (tratamento 1, T1), de 320 kg de PV/ha (T2), ambas em campo nativo, e de 400 kg de PV/ha em pastagem melhorada de azevém (Lolium multiflorum L.) por 80 dias pós-parto e, posteriormente, em CA igual à do T2 em campo nativo (T3); b) duas idades de desmame, consistindo de desmame aos 100 (DP) ou 180 (DC) dias de idade, foram avaliados utilizando 92 bezerros filhos de vacas primíparas Hereford e Braford. O sexo dos bezerros influenciou significativamente o peso ao nascer, não sendo observado efeito da raça da vaca. Os tratamentos e a raça da vaca não influenciaram o ganho médio diário (GMD) dos bezerros do nascimento ao desmame precoce. Bezerros filhos de vacas Braford tiveram maiores pesos no DP (PDP) que os filhos de vacas Hereford, enquanto os tratamentos não influenciaram o PDP. Os bezerros filhos de vacas Braford no T2 tiveram GMD até os 180 dias (GMD180) e PV aos 180 dias (PAJ180) superiores aos bezerros filhos de vacas Braford no T1 e Hereford no T2. Os bezerros do DP tiveram GMD180 e PAJ180 significativamente inferiores aos bezerros do DC. Entretanto, não se verificaram efeitos de tratamentos e idade de desmame sobre o GMD até os 365 dias e o peso ajustado aos 365 dias de idade. Portanto, os três manejos pós-parto das vacas e as duas idades de desmame dos bezerros avaliados não influenciaram o desenvolvimento dos bezerros a um ano de idade.<br>The effects on the performance of calves submitted to: a) three treatments, consisted of post-partum stocking rates (CA) of 240 kg of live weight (LW)/ha (treatment 1, T1), of 320 kg of LW/ha (T2), both on natural pastures, and of 400 kg of LW/ha on improved pasture of Italian ryegrass (Lolium multiflorum L.) during the first 80 days post-partum, and after on natural pasture at the same stocking rate as T2 afterwards (T3); b) two weaning ages, consisted of weaning at 100 (EW) and at 180 (CW) days of age, were evaluated using 92 beef calves from Hereford and Braford primiparous cows. The sex of the calves affected significantly the birth weight, and no effect was observed for the breed of cow. The treatments and breed of cow did not affect the average daily gain (ADG) of the calves from birth to early weaning (GEW). Calves born from Braford cows had higher LW at EW (WEW) than calves born from Hereford cows, while the WEW was not affected by the treatments. Calves born from Braford cows on T2 had ADG up to 180 days (ADG180) and LW at 180 days (LW180) greater than calves born from Braford cows on T1 and Hereford cows on T2. Calves from CW had greater LW180 and ADG180 than calves from EW. However, treatments and weaning ages did not affect the LW at 365 days and the ADG up to 365 days of age. The three cows post-partum management schemes and the two calves weaning ages evaluated did not affect the calves performance up to one year of age

Influência das taxas de ganho de peso pré-desmame das vacas e do tipo de pastagem no período pós-parto sobre a eficiência biológica de vacas e de bezerros de corte Effects of different preweaning rates of body weight gain and type of pasture during the postpartum on biological efficiency of beef cows and calves

Objetivou-se com este estudo avaliar a influência de duas taxas de ganho de peso de bezerras (baixa: 340 &plusmn; 32 g/dia ou moderada: 490 &plusmn; 29 g/dia) do nascimento aos 7 meses de idade e do tipo de pastagem no período pós-parto, quando vacas, sobre sua eficiência biológica e de seus bezerros até o desmame (aos 217 dias). Quando vacas e após o parto, os animais foram mantidos em pastagem nativa (PN) ou em pastagem cultivada (PC). Durante a lactação, vacas com baixa taxa de ganho de peso pré-desmame apresentaram maior produção de leite. Houve similaridade entre as taxas de ganho de peso baixa e moderada para a conversão de litros de leite (7,32 e 6,44 L/kg, respectivamente) e de kg de MS de leite produzido pelas vacas (1,00 e 0,86 kg/kg, respectivamente) em kg de ganho de peso dos bezerros; a exigência total de energia líquida para mantença (mantença + gestação + produção de leite) (TOTELm) (2.733,7 e 2.316,7 Mcal, respectivamente); TOTELm por kg de bezerro desmamado (14,7 e 14,7 Mcal/kg, respectivamente); e kg de bezerro desmamado por 100 kg de vaca ao desmame (42,0 e 38,7 kg/100 kg, respectivamente). No entanto, vacas com baixa taxa de ganho de peso pré-desmame desmamaram mais kg de bezerros por unidade de peso metabólico da vaca ao desmame (1,89 vs 1,73 kg/g).<br>The objective of this experiment was to evaluate the influence of different rates of weight gain (low: 340 &plusmn; 32 g/day or moderate: 490 &plusmn; 29 g/day) of heifers, from birth until seven months of age, and the type of pasture after calving, as cows, on the biologic efficiency of cows and their calves until weaning at 217 days. After calving, the animals were maintained on native pasture (NP) or cultivated pasture (CP). During lactation, cows with low preweaning rate of weight gain showed higher milk production. Similarity between low and moderate rates of weight gain was verified for conversion of litres of milk (7.32 and 6.44 L/kg, respectively) and kg of dry matter of milk produced by cows (1.00 and 0.86 kg/kg, respectively) into kg of calves weight gain, total requirements of net energy for maintenance (maintenance plus gestation plus milk production) of cows (TOTNEm) (2733.7 and 2316.7 Mcal, respectively), TOTNEm per kg of weaned calve (14.7 and 14.7 Mcal/kg, respectively) and kg of weaned calve per 100 kg of cow at weaning (42.0 and 38.7 kg/100 kg, respectively). However, cows with low preweaning rate of weight gain weaned more kg of calves per unit of cow metabolic weight at weaning (1.89 vs. 1.73 kg/g)

Diverse anthropogenic disturbances shift Amazon forests along a structural spectrum

Amazon forests are being degraded by myriad anthropogenic disturbances, altering ecosystem and climate function. We analyzed the effects of a range of land-use and climate-change disturbances on fine-scale canopy structure using a large database of profiling canopy lidar collected from disturbed and mature Amazon forest plots. At most of the disturbed sites, surveys were conducted 10–30 years after disturbance, with many exhibiting signs of recovery. Structural impacts differed in magnitude more than in character among disturbance types, producing a gradient of impacts. Structural changes were highly coordinated in a manner consistent across disturbance types, indicating commonalities in regeneration pathways. At the most severely affected site – burned igapó (seasonally flooded forest) – no signs of canopy regeneration were observed, indicating a sustained alteration of microclimates and consequently greater vulnerability to transitioning to a more open-canopy, savanna-like state. Notably, disturbances rarely shifted forests beyond the natural background of structural variation within mature plots, highlighting the similarities between anthropogenic and natural disturbance regimes, and indicating a degree of resilience among Amazon forests. Studying diverse disturbance types within an integrated analytical framework builds capacity to predict the risk of degradation-driven forest transitions. © 2023 The Authors. Frontiers in Ecology and the Environment published by Wiley Periodicals LLC on behalf of The Ecological Society of America.Immediate accessThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]