Solar Coronal Plumes

Polar plumes are thin long ray-like structures that project beyond the limb of the Sun polar regions, maintaining their identity over distances of several solar radii. Plumes have been first observed in white-light (WL) images of the Sun, but, with the advent of the space era, they have been identified also in X-ray and UV wavelengths (XUV) and, possibly, even in in situ data. This review traces the history of plumes, from the time they have been first imaged, to the complex means by which nowadays we attempt to reconstruct their 3-D structure. Spectroscopic techniques allowed us also to infer the physical parameters of plumes and estimate their electron and kinetic temperatures and their densities. However, perhaps the most interesting problem we need to solve is the role they cover in the solar wind origin and acceleration: Does the solar wind emanate from plumes or from the ambient coronal hole wherein they are embedded? Do plumes have a role in solar wind acceleration and mass loading? Answers to these questions are still somewhat ambiguous and theoretical modeling does not provide definite answers either. Recent data, with an unprecedented high spatial and temporal resolution, provide new information on the fine structure of plumes, their temporal evolution and relationship with other transient phenomena that may shed further light on these elusive features

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability