80 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 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

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    Intrinsic brittleness origination of micro-scale phase-separating metallic glasses: Based on mechanical relaxations and theoretical analysis

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    cited By 0Pronounced slow β-relaxation in metallic glasses (MGs) has been proven to be closely related to macroscopic plasticity especially around 0.6–0.8Tg. However, the micro-scale phase-separating (ZrxLa1-x)57Co27Al16 (x = 0.2, 0.3, and 0.4) MGs obviously display brittleness around 0.7Tg even though an obvious slow β-relaxation peak is observed based on the dynamic mechanical analysis (DMA). In order to probe their intrinsic brittleness, the slow β-relaxation processes of the (ZrxLa1-x)57Co27Al16 (x = 0, 0.2, 0.3, 0.4, and 1) MGs were observed together with their mechanical performances. The results demonstrated that the La57Co27Al16 and Zr57Co27Al16 MGs show obvious ductility around 0.7Tg. Based on DMA results, the La57Co27Al16 MG displays an evident slow β-relaxation peak while the Zr57Co27Al16 MG presents an excess wing. When the phase-separating Zr–La–Co–Al MGs consisting of La-rich and Zr-rich components were heated up to 0.7Tg, only the β-relaxation behavior originating from La-rich components rather than from Zr-rich components is preferentially thermal-activated. In addition, the slow β-relaxation is well described by the Cole-Cole (CC) model, which becomes more obvious with increasing phase-separating degree. Then only partial but not all of potential structural units in whole samples can be activated, leading to the whole intrinsic brittleness of the micro-scale phase-separating MGs. These findings suggests that the large compositional difference between components is harmful to design ductile phase-separating MGs. © 2019 Elsevier B.V
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