The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Takayasu arteritis presenting with massive cerebral ischemic infarction in a 35-year-old woman: a case report

INTRODUCTION: Takayasu arteritis is a relatively rare type of large-vessel arteritis that primarily affects the aorta and its major branches, the coronary arteries, and the pulmonary arteries. Depending on the different groups of blood vessels involved in the disease process, the clinical presentation of Takayasu arteritis varies. Here we report a case of a woman presenting with a debilitating massive cerebral ischemic infarct that turned out to be a relatively rare first presentation of Takayasu arteritis. CASE PRESENTATION: A 35-year-old Chinese woman presented to the Emergency Department with left hemiparesis, pain and numbness of her arms and weak radial pulses. Her laboratory results showed an elevated C-reactive protein and erythrocyte sedimentation rate, and subsequent digital subtraction angiography demonstrated narrowing and occlusion of the major branches of her aortic arch. We report the case of a patient with Takayasu arteritis presenting with a massive cerebral ischemic infarct and review the current literature on this topic. CONCLUSION: Takayasu arteritis is a relatively rare disease with various and sometimes devastating clinical manifestations, such as massive cerebral ischemic infarction as in our case. Currently, there are multiple diagnostic tools and treatment options available, and more under investigation. Early, appropriate diagnosis and initiation of proper therapy could avoid further progression and reduce complications of the disease

LFVB-BioSLAM: A Bionic SLAM System with a Light-Weight LiDAR Front End and a Bio-Inspired Visual Back End

Simultaneous localization and mapping (SLAM) is one of the crucial techniques applied in autonomous robot navigation. The majority of present popular SLAM algorithms are built within probabilistic optimization frameworks, achieving high accuracy performance at the expense of high power consumption and latency. In contrast to robots, animals are born with the capability to efficiently and robustly navigate in nature, and bionic SLAM algorithms have received increasing attention recently. Current bionic SLAM algorithms, including RatSLAM, with relatively low accuracy and robustness, tend to fail in certain challenging environments. In order to design a bionic SLAM system with a novel framework and relatively high practicality, and to facilitate the development of bionic SLAM research, in this paper we present LFVB-BioSLAM, a bionic SLAM system with a light-weight LiDAR-based front end and a bio-inspired vision-based back end. We adopt a range flow-based LiDAR odometry as the front end of the SLAM system, providing the odometry estimation for the back end, and we propose a biologically-inspired back end processing algorithm based on the monocular RGB camera, performing loop closure detection and path integration. Our method is verified through real-world experiments, and the results show that LFVB-BioSLAM outperforms RatSLAM, a vision-based bionic SLAM algorithm, and RF2O, a laser-based horizontal planar odometry algorithm, in terms of accuracy and robustness

Deformation mechanism finite element analysis and die geometry optimization of magnesium alloys by equal channel angular processing

Magnesium alloys are one of the highly promising structural metals. hcp structure makes it less plastic at room temperature, which greatly limits the development of magnesium alloys. The problem of poor plastic deformation of magnesium alloy can be solved by grain refinement methods, and equal channel angle pressing is one of the more effective methods in grain refinement. In this paper, two-dimensional dynamic simulation of equal channel angle pressing of magnesium alloy is carried out by using finite element software DEFORM F2™. The deformation of magnesium alloy with different of die angles and die corner angles was analyzed. The results show that in the main deformation zone, when the die angles are different, the deformation of the workpiece in the horizontal direction is very uniform. However, in the longitudinal direction of the workpiece, the larger the die angle is, the more uniform the workpiece deformation is. The die corner angle has no significant effect on the uniformity of workpiece deformation in the longitudinal direction, but it has an effect on the dead zone area and workpiece warpage. The dead zone area and workpiece warpage increase with the increase of die angle

Dynamic Response Analysis of Rutting Resistance Performance of High Modulus Asphalt Concrete Pavement

In order to systematically study the rutting resistance performance of High-Modulus Asphalt Concrete (HMAC) pavements, a finite element method model of HMAC pavement was established using ABAQUS software. Based on the viscoelasticity theory of asphalt, the stress and deformation distribution characteristics of HMAC pavement were studied and compared to conventional asphalt pavement under moving loads. Then, the pavement temperature field model was established to study the temperature variation and the thermal stress in HMAC pavement. Finally, under the condition of continuous temperature variation, the creep behavior and permanent deformation of HMAC pavement were investigated. The results showed that under the action of moving loads, the strain and displacement generated in HMAC pavement were lower than those in conventional asphalt pavement. The upper surface layer was most obviously affected by outside air temperature, resulting in maximum thermal stress. Lastly, under the condition of continuous temperature change, HMAC pavement could greatly reduce the deformation of asphalt material in each surface layer compared to conventional asphalt pavement

Ginsenoside Rk3 Inhibits the Extramedullary Infiltration of Acute Monocytic Leukemia Cell via miR-3677-5p/CXCL12 Axis

Background. Acute monocytic leukemia belongs to type M5 of acute myeloid leukemia (AML) classified by FAB, which appears a high incidence of extramedullary infiltration (EMI) and poor prognosis. In this study, we observed the inhibitory effect of ginsenoside Rk3 on the EMI of monocytic leukemia cells and initially explored its related mechanism of targeting the miR-3677-5p/CXCL12 axis. Methods. The MTT assay and colony formation assay were used to detect the inhibitory effect of Rk3 on proliferation. Both cellular migration and invasion were observed by the Transwell assay. The expression levels of miR-3677-5p, CXCL12, and CXCR4 were detected by RT-qPCR and Western blot, as well as overexpression of miR-3677-5p by transfected with lentivirus and detection of a dual luciferase reporter gene. The expression of MMP2 and TIMP2 was detected by immunofluorescence. Results. Rk3 effectively inhibits the proliferation, migration, and invasion associated with EMI of leukemia. The leukemia cells of M5 patients with EMI showed low expression of miR-3677-5p but high expression of the mRNA of CXCL12 and CXCR4. Overexpression of miR-3677-5p or intervention of CXCL12 effectively inhibited the proliferation, migration, and invasion of SHI-1 cells. The luciferase assay showed that CXCL12 was the downstream target gene of miR-3677-5p. After overexpression of miR-3677-5p or intervention of CXCL12 in combination with Rk3, the inhibitory effect on the proliferation, migration, and invasion of SHI-1 cells was more obvious. Importantly, Rk3 significantly regulated the expression levels of miR-3677-5p, CXCL12, CXCR4, and EMI-related functional proteins including MMP2 and TIMP2. Overexpression of miR-3677-5p or intervention of CXCL12 also regulated the expression of MMP2 and TIMP2. Conclusions. The leukemia cells of M5 patients with EMI appeared to have low expression of miR-3677-5p and high expression of the mRNA of CXCL12 and CXCR4, which may be used as indicators of EMI and poor prognosis. Rk3 is effective in inhibiting the EMI of SHI-1 cells by targeting the miR-3677-5p/CXCL12 axis

Investigate the Glass Transition Temperature of Hyperbranched Copolymers with Segmented Monomer Sequence

Hyperbranched copolymers with segmented structures were synthesized using a chain-growth copper-catalyzed azide–alkyne cycloaddition (CuAAC) polymerization via sequential monomer addition in one pot. Three AB₂-type monomers that contained one alkynyl group (A), two azido groups (B), and one dangling group, either benzyl or oligo­(ethylene oxide) (EO_<i>x</i>, <i>x</i> = 3 and 7.5), were used in these CuAAC reactions. Varying the addition sequences and feed ratios of the monomers produced a variety of hyperbranched copolymers with tunable compositions, molecular weights, segmented structures, and consequently glass transition temperature (<i>T</i>_g). It was found that the <i>T</i>_g of hyperbranched copolymers was little affected by the polymer molecular weights when <i>M</i>_n ≥ 5000. However, the values of <i>T</i>_g were significantly determined by the compositions of the terminal groups and the outermost segment of the hyperbranched copolymers. The last added AB₂ monomer in the polymerization formed an outermost “shell” and shielded the contribution of inner segments to the glass transition of the copolymers, reflecting a chain sequence effect of hyperbranched polymers on the thermal properties

Homoharringtonine Combined with the Heat Shock Protein 90 Inhibitor IPI504 in the Treatment of FLT3-ITD Acute Myeloid Leukemia

As a heterogeneous group of clonal disorders, acute myeloid leukemia with internal tandem duplication of fms-like tyrosine kinase 3 (FLT3-ITD) mutation usually shows an inferior prognosis. In the present study, we found that homoharringtonine (HHT), a protein translation inhibitor of plant alkaloid in China, exhibited potent cytotoxic effect against FLT3-ITD (+) cell lines and primary leukemia cells, and a remarkable synergistic anti-leukemia action was demonstrated in vitro and in vivo in xenograft mouse models when co-treated with the heat shock protein 90 inhibitor IPI504. Mechanistically, HHT combined with IPI504 synergistically inhibited the growth of leukemia cells by inducing apoptosis and G1 phase arrest. This synergistic action resulted in a prominent reduction of total and phosphorylated FLT3 (p-FLT3) as well as inhibition of its downstream signaling molecules such as STAT5, AKT, ERK and 4E-BP1. Furthermore, co-treatment of HHT and IPI504 led to a synergistic or additive effect on 55.56%(10/18) of acute myeloid leukemia cases tested, including three relapsed/refractory patients. In conclusion, our findings indicate that the combination of HHT and HSP90 inhibitor provides an alternative way for the treatment of FLT3-ITD positive acute myeloid leukemia, especially for relapsed/refractory AML

Highly Selective and Permeable Microporous Polymer Membranes for Hydrogen Purification and CO₂ Removal from Natural Gas

This paper reports a new macromolecular design that incorporates hierarchical triptycene unit into thermally rearranged polybenzoxazole (TR-PBO) structures for highly selective and permeable gas separation membranes with great potential for H₂ purification and CO₂ removal from natural gas. We demonstrate that triptycene moieties not only effectively disrupt chain packing enabling microporous structure for fast mass transport, but also introduce ultrafine microporosity via the unique internal free volume intrinsic to triptycene unit that allows for superior molecular sieving capability in resulting PBO membranes. Consequently, these triptycene-based polybenzoxazole (TPBO) membranes display among the highest gas selectivities for H₂ separations (i.e., α­(H₂/N₂) = 96; α­(H₂/CH₄) = 203) and CO₂ removal from natural gas (i.e., α­(CO₂/CH₄) = 68) among existing glassy polymeric membranes. It is also demonstrated that microporous structure and gas transport properties of TPBO films are highly tailorable by adjusting the triptycene content and the <i>ortho</i>-functionality of the precursors. The highly diverse tunability, along with the excellent resistance toward membrane plasticization and physical aging, render the TPBO membranes with extremely versatile separation capability applicable for a wide range of important industrial processes to get clean or low carbon fuels and reduce carbon footprint