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

Analysis of the impact of sex and age on the variation in the prevalence of antinuclear autoantibodies in Polish population: a nationwide observational, cross-sectional study

The detection of antinuclear autoantibody (ANA) is dependent on many factors and varies between the populations. The aim of the study was first to assess the prevalence of ANA in the Polish adult population depending on age, sex and the cutoff threshold used for the results obtained. Second, we estimated the occurrence of individual types of ANA-staining patterns. We tested 1731 patient samples using commercially available IIFA using two cutoff thresholds of 1:100 and 1:160. We found ANA in 260 participants (15.0%), but the percentage of positive results strongly depended on the cutoff level. For a cutoff threshold 1:100, the positive population was 19.5% and for the 1:160 cutoff threshold, it was 11.7%. The most prevalent ANA-staining pattern was AC-2 Dense Fine speckled (50%), followed by AC-21 Reticular/AMA (14.38%) ANA more common in women (72%); 64% of ANA-positive patients were over 50 years of age. ANA prevalence in the Polish population is at a level observed in other highly developed countries and is more prevalent in women and elderly individuals. To reduce the number of positive results released, we suggest that Polish laboratories should set 1:160 as the cutoff threshold

A systematic approach to plant-wide control based on thermodynamics

15 pages, 23 figures.-- ESCAPE-15 - Selected Papers from the 15th European Symposium on Computer Aided Process Engineering held in Barcelona, Spain, May 29-June 1, 2005.-- Available online 26 December 2006.In this work, a systematic approach to plant-wide control design is proposed. The method combines ingredients from process networks, thermodynamics and systems theory to derive robust decentralized controllers that will ensure complete plant stability. As a first step, the considered process system is decomposed into abstract mass and energy inventory networks. In this framework, conceptual inventory control loops are then designed for the mass and energy layers to guarantee that the states of the plant, both in terms of extensive and intensive properties, will converge to a compact convex region defined by constant inventories. This result by itself does not ensure the convergence of intensive variables to a desired operation point as complex dynamic phenomena such as multiplicities may appear in the invariant set. In order to avoid these phenomena, thermodynamics naturally provides the designer, in these convex regions, with a legitimate storage or Lyapunov function candidate, the entropy, that can be employed to ensure global stability. Based on this, the control structure design procedure is completed with the realization of the conceptual inventory and intensive variable control loops over the available degrees of freedom in the system. To that purpose, both PI and feedback linearization control are employed. The different aspects of the proposed methodology will be illustrated on a non-isothermal chemical reaction network.The authors acknowledge the financial support received from the Spanish Government (MCyT Projects PPQ2001-3643), Xunta de Galicia (PGIDIT02-PXIC40209PN) and “PRIMS” Marie Curie Action (MRTN-CT-2004-512233).Peer reviewe

A thermodynamic based plant-wide control dsign procedure of the tennessee eastman process

6 páginas, 8 figurasIn this work, we apply the systematic approach to plant-wide control design presented in [1], based on the fundamentals of process networks, thermodynamics and systems theory, to the Tennessee Eastman (TE) Challenge Process, deriving robust decentralized controllers that will ensure the stability of the complete plant. We take one step further in the control design procedure by completing it with the realization of the controllers. The inventory control laws proposed are derived from a set of control loops over the available degrees of freedom in the process.The authors acknowledge the financial support received from the Spanish Government (MCyT Projects PPQ2001-3643) and Xunta de Galicia (PGIDIT02-PXIC40209PN).Peer reviewe

Contributing to fisheries sustainability by making the best possible use of their resources: the BEFAIR initiative

4 figuras, 2 tablasThe global harvesting of marine products has increased from around 17 million tons in the 1950s to a current average amount of 85 million tons. The Food and Agriculture Organization (FAO) estimates that an annual average of 27 million tons of non-targeted species are caught and thrown back into the sea, what means that near third of the fish volume captured every year is wasted. This in itself represents a purposeless waste of valuable living resources, but in addition, the large amounts of organic waste thrown into the sea may produce severe adverse effects on the ecological equilibrium of marine communities. In this context, the BEFAIRinitiative1 (www.befairproject.com) -co-founded under the LIFE Environment Program of the European Union- was devised in the intention to contribute to a responsible and sustainable management of fisheries by making the bestpossible use of the captured resources avoiding its waste. This paper discusses the main actions taken in the project, which in the purpose of reducing the costs associated to the implementation of that so-called zero-discard and zero-waste policy, were directed to the development and implementation of integral management and novel processing practices. The aim of these actions is to upgrade captured resources (by-catch and wastes produced by fish processing) and thus to obtain added value products of interest in the food industryFinancial support received from the European Union through the LIFE Environment Program of the European Union (LIFE05 ENV/E000267-BE FAIR).Peer reviewe