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

Brand advertising competition across economic cycles’

This study investigates how brands’ responses to competitors’ advertising actions change over the business cycle. In an empirical analysis of advertising activity by 105 brands in six consumer packaged goods categories over 10 years in a market that experienced severe economic swings, we show that managers become more aggressive in contractions. Brands respond not only more often to competitors’ advertising but also more intensely. Different brands react in contractions. Brand leaders respond less often and intensely in bad times; by contrast, premium-tier brands seem to avoid competition in good times but aggressively defend their position in bad times, especially against cheaper competitors, which are more popular in contractions. We corroborate the validity of our findings through in-depth interviews with executives and introduce two useful metrics, aggressivity and receptivity, to map changes in brand competition in an industry when economic conditions change. Collectively, the findings show how managers can better anticipate competitive advertising reactions in good and bad economic times

Pollution reduction and biodegradability index improvement of tannery effluents

Al2 (SO4)3, 18H2O, FeCl3 and Ca (OH)2 were used for the treatment of tannery wastewaters. The influences of pH and coagulant dosages were studied. Conditions were optimised according to the pollutant removal efficiencies, the volume of decanted sludge and the biodegradability index improvement. The results indicate that 6771% of total COD, 76-92% of color and 79-97% of Cr can be removed using the optimum coagulant dosages at the optimum pH range. Al2 (SO4)3, 18H2O and Ca (OH)2 produced better results than FeCl3 in terms of COD, color and Cr removal as well as in terms of biodegradability improvement. Moreover, Al2 (SO4)3, 18H2O and FeCl3 produced the least amount of sludges for a given amounts of COD, color and Cr removed in comparison with Ca (OH)2. Al2 (SO4)3, 18H2O seems to be suitable for yielding high pollutant removals and corresponding low volumes of decanted sludges in addition to improving wastewaters biodegradability index

The 3' terminal sequence of the inosine monophosphate dehydrogenase gene encodes an active domain in the yeast Schizosaccharomyces pombe

The gua1 gene encoding inosine monophosphate dehydrogenase (IMPDH), which catalyses the first step in de novo biosynthesis of guanosine monophosphate (GMP), was cloned in the yeast Schizosaccharomyces pombe by functional complementation of a gua1ura4-D18 mutant strain from a S. pombe DNA genomic library. Complementation analysis revealed a 1.2 kb fragment which segregation analysis confirmed did not code for a suppressor gene. Only 446 nucleotides of the gua1 gene encoding the IMPDH C-terminal residues were found within this 1.2 kb sequence (GenBank, AJ293460). The comparison of this wild-type fragment with the same fragment from the gua1ura4-D18 mutant revealed that there was a point mutation at position 1261 (guanine -> adenine) from the 5' end, corresponding to the amino acid residue 421 (glycine -> serine) of the enzyme. Dot and Northern analyses showed that the gua1 gene was expressed in transformants as well as in the wild-type and the gua1ura4-D18 mutant, but enzyme activity was only detected in wild-type and transformant cells. It seems likely that a 446 bp fragment from the 3' end of the gua1 gene abolished the point mutation in the mutant strain, suggesting that this fragment participates in the sequences encoding the active domain of IMPDH in S. pombe