Acute Kidney Injury in the Intensive Care Unit

Acute kidney injury (AKI) is defined as an abrupt decrease in glomerular filtration rate (GFR). Incidence varies from 20% to as high as 70% in critically ill patients. Classically, AKI has been divided into three broad pathophysiologic categories: prerenal AKI, intrinsic AKI, and postrenal (obstructive) AKI. The clinical manifestations of AKI vary among a wide range of symptoms and metabolic abnormalities. A sudden decrease in GFR will result in rising concentrations of solutes in the blood, which are normally excreted by the kidneys. Recently, new urinary and serum biomarkers have gained a place in the diagnosis, classification, and prognosis prediction of AKI. The best treatment for AKI is prevention. Patients with prerenal azotemia should have intravascular volume deficits corrected and cardiac function optimized. Obstructive (postrenal) kidney disease is treated by mechanical relief of the block. The primary management of acute interstitial nephritis is discontinuation of the inciting agent. Renal replacement therapy (RRT) has emerged as a supportive mechanism rather than just as a lifesaving measure. Continuous techniques are preferable in treating critically ill patients, although every modality has its benefits, indications, and contraindications

Impact of Astaxanthin Supplementation on Postprandial Oxidative Stress

Astaxanthin is a naturally occurring carotenoid found in salmon and microalgae that has antioxidative properties. Previous research shows dietary supplementation may result in increased endogenous antioxidant status and reduced markers of oxidative stress (OS). Research suggests OS causes increased risk for cardiometabolic and other chronic diseases, making it important to find interventions that can decrease occurrence of OS. While astaxanthin has been shown to be antioxidative, most studies observing the impact of astaxanthin has on OS has involved rodent models, therefore human trials are needed. PURPOSE: The purpose of this study was to assess whether four weeks of astaxanthin supplementation (6mg/day) can decrease blood markers of oxidative stress following the consumption of a high fat meal in healthy, young men. METHODS: Participants (n=13) were healthy, young men (mean ±SD; Age: 23.7 ±2.7 yrs; Weight: 79.8 ±12.6 kg; Height: 171.7 ±5.9 cm) that completed a randomized, double blinded crossover counterbalanced study. All participants completed 4 weeks of 6 mg of astaxanthin supplementation in addition to 4 weeks of placebo supplementation with a one-week washout period between treatments. After each supplementation period, participants consumed a high fat milkshake (milkshake; 1g fat/kg body weight, 1g carbohydrate/kg body weight, 0.25g protein/kg body weight) to induce postprandial OS. Blood samples were taken immediately before, as well as two, and four hours post milkshake consumption. The following were analyzed from each blood sample: triglycerides (TAG), glutathione (GSH), hydrogen peroxide (H2O2), malondialdehyde (MDA), and advanced oxidation protein products (AOPP). RESULTS: Participant compliance on average was 98%. Regarding AOPP, there was no treatment x timepoint interaction or a significant main effect for treatment, while there was a main effect for time (F = 17.14, p \u3c 0.01) with significantly higher levels of AOPP at two and four hours postprandial compared to pre ingestion (p \u3c 0.01). In regard to MDA, there was no treatment x timepoint interaction or a significant main effect for treatment but a main effect for time was noted (F= 24.66, p \u3c 0.01) with significantly higher (p \u3c 0.01) MDA levels 2 and 4 hours post ingestion when compared to pre ingestion levels. In terms of GSH, while there was no treatment x timepoint interaction or main effect for time, the main effect for treatment did approach significance (F = 3.67, p = 0.06). There was no treatment x timepoint interaction for TAG nor a main effect for treatment, while there was a significant increase in TAG levels over time noted by a main effect (F = 15.80, p \u3c 0.01) with 2 and 4 hours post ingestion being significantly higher than pre ingestion TAG levels (p \u3c 0.01). Furthermore, with H2O2, a treatment x timepoint interaction (F = 5.94, p \u3c 0.01) was noted. H2O2 levels were significantly lower (p \u3c 0.05) 2 and 4 hours post ingestion following astaxanthin supplementation when compared to the placebo treatment. CONCLUSION: The high fat meal induced significant OS, reflected by increased levels of MDA, AOPP, and H2O2.Despite postprandial hyperlipidemia, astaxanthin was able to significantly decrease H2O2, suggesting astaxanthin is a desirable exogenous antioxidant for mitigating OS

Male and female immediate fear reaction to white noise in a semi-natural environment: A detailed behavioural analysis of the role of sex and oestrogen receptors

In classical rodent anxiety models, females usually display lower anxiety than males, whereas anxiety disorders are more prevalent in women. Perhaps this contradiction is caused by the use of behavioural models with low external validity. Therefore, we analysed immediate reactions to a sudden 90-dB white noise in a semi-natural environment. We observed mixed-sex groups of rats for the 60 seconds preceding noise onset and the first 60 seconds of exposure. White noise elicited fear-specific behaviours hiding alone and huddling. It also increased exploratory and ambulatory behaviours, although only in the burrow zone farthest from the open area. Thus, in a semi-natural environment, white noise enhanced motor activity as a product of fear-induced general arousal. Then, we compared male and female sexual, social, exploratory and anxiety-related behaviour, and found little sex difference. This absence of behavioural effect, also observed in other studies, might be a result of our study design, a familiar environment with an ecologically relevant social context. Fear and anxiety responses are modulated by oestrogens through the activation of oestrogen receptors α and β. Thus, in a third part of out study, we analysed how treatment with either oil, oestradiol benzoate (EB), an agonist to the oestrogen receptor α (propylpyrazoletriol [PPT]) or β (diarylpropionitrile [DPN]) influenced female behaviour. The effect of treatment was limited, both EB and PPT stimulated motor activity in the open area before white noise, probably because of sexual activity. PPT increased the probability of fleeing from the noise, and decreased the latency to do so, which is consistent with a pattern of anxiogenic properties found in previous studies. Contrary to reports in classical procedures, we failed to detect any effect of DPN on immediate fear reactions in a semi-natural environment

Automated Construction Progress and Quality Monitoring for Commercial Buildings with Unmanned Aerial Systems: An Application Study from Switzerland

Unmanned Aerial Systems (UASs), which have become a key tool in remote sensing in recent years, have also rapidly entered the practice of Architecture, Engineering, Construction, and Operations (AECO). This paper presents an application study of a methodology for monitoring construction progress and quality using real-time data from a commercial building during the execution phase and the results of an analysis of the costs and benefits of monitoring construction progress and quality with and without a UAS. The methodology used consists of three parts: (1) automated data collection at the construction site, (2) data processing, in which the collected data are processed to generate the outputs necessary for the data analysis, and (3) data analysis to monitor construction progress and quality. The method is based on the detection of structural elements, combined with four principles: the sectional approach, the calculation of the concrete volume, the height-distance measurement, and the detection of defects by visual comparisons. The cost-benefit analysis considers three cases: monitoring of progress (1) by the construction company using the UAS, (2) by external contractors using the UAS, and (3) by the construction company without using the UAS. We show that the in-house operation of the UAS is associated with medium costs. However, a return on investment can be achieved quickly if the strategy for the operation of the UAS is clearly defined. In summary, the use of a UAS for the automated monitoring of the construction progress and quality of commercial buildings is practicable, which can quickly lead to a return on investment. We also show that there is great potential for further improvements.</p