10 research outputs found

    EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

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    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 MĂŒnster 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

    Produção animal e retorno econÎmico da suplementação em pastagem de aveia e azevém Animal production and economic return in a supplementated oats/ryegrass mixture

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    O experimento avaliou a resposta animal e o retorno econĂŽmico do uso da suplementação energĂ©tica em pastagem de aveia preta (Avena strigosa Schreb) + azevĂ©m anual (Lolium multiflorum Lam). Os tratamentos foram: STP - Suplementação, durante todo o perĂ­odo de utilização da pastagem; SAS- Suplementação atĂ© final de setembro; SS- Sem suplementação. O sistema de pastejo foi o contĂ­nuo com lotação variĂĄvel. O suplemento utilizado foi o grĂŁo de sorgo em quantidade variĂĄvel para manter a mesma quantidade de massa de forragem em todos os tratamentos. O ganhos de peso mĂ©dios diĂĄrios por animal (GMD) foram superiores nos tratamentos STP e SAS, 0,716 e 0,710 kg, respectivamente, em relação ao obtido no tratamento SS (0,580 kg). A suplementação possibilitou maior carga animal. A produção animal por hectare foi maior em STP, 627 kg ha-1 de PV, sendo 75% superior aos 359 kg ha-1 de PV do SS. A suplementação nĂŁo afetou a condição corporal dos animais. O custo total e a receita lĂ­quida foram de 775,42/165,08, 605,75/204,25 e 367,35/204,92 Rha−1paraSTP,SASeSS,respectivamente.Ousoexclusivodapastagemeasuplementac\ca~o,ateˊofinaldesetembro,resultaramemmaiorretornofinanceirodireto.<br>Theexperimentevaluatedtheanimalresponseandeconomicreturnofenergeticsupplementationinoat(AvenastrigosaSchreb)plusItalianryegrass(LoliummultiflorumLam)pasture.Thetreatmentswere:STP−Supplementationduringtheentirepasturecycle;SAS−SupplementationuntiltheendofSeptemberandSS−Nosupplement.Thecontinuousgrazingsystemwithvariablestockingratewasused.Thesupplementutilized,withdifferentquantities,wasgroundsorghuminordertomaintainthesameherbagemassforalltreatments.LiveweightdailygainwashigherinSTPandSAS,0.716and0.710kg,respectivelythan0.580kginSS.Thestockingratewasgreaterwithsupplements.ThehigherweightgainperhectarewasatSTP(627kg),75 ha-1 para STP, SAS e SS, respectivamente. O uso exclusivo da pastagem e a suplementação, atĂ© o final de setembro, resultaram em maior retorno financeiro direto.<br>The experiment evaluated the animal response and economic return of energetic supplementation in oat (Avena strigosa Schreb) plus Italian ryegrass (Lolium multiflorum Lam) pasture. The treatments were: STP- Supplementation during the entire pasture cycle; SAS- Supplementation until the end of September and SS- No supplement. The continuous grazing system with variable stocking rate was used. The supplement utilized, with different quantities, was ground sorghum in order to maintain the same herbage mass for all treatments. Live weight daily gain was higher in STP and SAS, 0.716 and 0.710 kg, respectively than 0.580 kg in SS. The stocking rate was greater with supplements. The higher weight gain per hectare was at STP (627 kg), 75% higher than no supplement treatment, 359 kgha of LW. No significant effects on body condition score of treatments was recorded. The total cost and the net income were 775.42/165.08, 605.75/204.25 and 333.58/204.92 Rha for STP, SAS and SS, respectively. No supplements and the use of supplementation until the end of September resulted in higher economic return

    Non-Invasive Coronary Imaging

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    Gaia Data Release 3: the Galaxy in your preferred colours: Synthetic photometry from Gaia low-resolution spectra

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    Stars and planetary system

    EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI): Study protocol for a multicentre, observational trial

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    Introduction 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. Methods and analysis 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. Ethics and dissemination EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University MĂŒnster 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.
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