Descending aortic calcification increases renal dysfunction and in-hospital mortality in cardiac surgery patients with intraaortic balloon pump counterpulsation placed perioperatively : a case control study

Introduction: Acute kidney injury (AKI) after cardiac surgery increases length of hospital stay and in-hospital mortality. A significant number of patients undergoing cardiac surgical procedures require perioperative intra-aortic balloon pump (IABP) support. Use of an IABP has been linked to an increased incidence of perioperative renal dysfunction and death. This might be due to dislodgement of atherosclerotic material in the descending thoracic aorta (DTA). Therefore, we retrospectively studied the correlation between DTA atheroma, AKI and in-hospital mortality. Methods: A total of 454 patients were retrospectively matched to one of four groups: -IABP/-DTA atheroma, +IABP/-DTA atheroma, -IABP/+DTA atheroma, +IABP/+DTA atheroma. Patients were then matched according to presence/absence of DTA atheroma, presence/absence of IABP, performed surgical procedure, age, gender and left ventricular ejection fraction (LVEF). DTA atheroma was assessed through standard transesophageal echocardiography (TEE) imaging studies of the descending thoracic aorta. Results: Basic patient characteristics, except for age and gender, did not differ between groups. Perioperative AKI in patients with -DTA atheroma/+IABP was 5.1% versus 1.7% in patients with -DTA atheroma/-IABP. In patients with +DTA atheroma/+IABP the incidence of AKI was 12.6% versus 5.1% in patients with +DTA atheroma/-IABP. In-hospital mortality in patients with +DTA atheroma/-IABP was 3.4% versus 8.4% with +DTA atheroma/+IABP. In patients with +DTA atheroma/+IABP in hospital mortality was 20.2% versus 6.4% with +DTA atheroma/-IABP. Multivariate logistic regression identified DTA atheroma > 1 mm (P = *0.002, odds ratio (OR) = 4.13, confidence interval (CI) = 1.66 to 10.30), as well as IABP support (P = *0.015, OR = 3.04, CI = 1.24 to 7.45) as independent predictors of perioperative AKI and increased in-hospital mortality. DTA atheroma in conjunction with IABP significantly increased the risk of developing acute kidney injury (P = 0.0016) and in-hospital mortality (P = 0.0001) when compared to control subjects without IABP and without DTA atheroma. Conclusions: Perioperative IABP and DTA atheroma are independent predictors of perioperative AKI and in-hospital mortality. Whether adding an IABP in patients with severe DTA calcification increases their risk of developing AKI and mortality postoperatively cannot be clearly answered in this study. Nevertheless, when IABP and DTA are combined, patients are more likely to develop AKI and to die postoperatively in comparison to patients without IABP and DTA atheroma

Pengaruh Pemahaman Wajib Pajak Orang Pribadi Terhadap Penerapan Self Assessment System Pada Kpp Pratama Gorontalo

This research aims to determine the influence of an individual taxpayer understanding of the Self Assessment System implementation on STO Gorontalo. The data in this study were taken from primary data through questionnaires. The number of samples used as subjects in this study were 100 individual taxpayer and using Convenience Sampling techniques. This study uses regression analysis simple. The results showed that the understanding of the individual taxpayer has a significant effect on the implementation of Self Assessment System. The determination coefficient show that 19.8% understanding of individual taxpayers influence the application of the Self Assessment System and the remaining 80.2% is influenced by other variables outside this study

Studi Metodologis Fikih Zakat Profesi dalam Perspektif Yusuf Al-Qardhawi

The purpose of this study was to determine the method, foundation and reasoning of Yusuf al-Qardhawi's law on professional zakat. This research is a library research with data collection methods in the form of quoting, adapting and analyzing using content analysis. The results showed that according to Yusuf al-Qardhawi, ijtihad is a serious effort by exerting all abilities by those who have the authority in order to find answers to religious law through istinbât both done hourly (collective) or fardi (individual) by involving other experts . The results of the ijtihad are based on the maqâsid al-syarî‘ah using the qiyas method. On the basis of this principle Yusuf al-Qardhawi stipulates that in determining the obligatory zakat from the profession does not wait a year. The determination of the law does not stand alone, but is supported by the Qur'anic texts, hadith, and analogies. The aspect of justice in determining the obligation of professional zakat for every Muslim is because zakat is essentially worship related to property. A person who has fulfilled his requirements is required to fulfill it, not solely on the basis of his generosity, but if necessary even under pressure from the authorities

Highly charged ions in Penning traps, a new tool for resolving low lying isomeric states

The use of highly charged ions increases the precision and resolving power, in particular for short-lived species produced at on-line radio-isotope beam facilities, achievable with Penning trap mass spectrometers. This increase in resolving power provides a new and unique access to resolving low-lying long-lived ($T_{1/2} > 50$ ms) nuclear isomers. Recently, the $111.19(22)$ keV (determined from $\gamma$-ray spectroscopy) isomeric state in $^{78}$Rb has been resolved from the ground state, in a charge state of $q=8+$ with the TITAN Penning trap at the TRIUMF-ISAC facility. The excitation energy of the isomer was measured to be $108.7(6.4)$ keV above the ground state. The extracted masses for both the ground and isomeric states, and their difference, agree with the AME2003 and Nuclear Data Sheet values. This proof of principle measurement demonstrates the feasibility of using Penning trap mass spectrometers coupled to charge breeders to study nuclear isomers and opens a new route for isomer searches.Comment: 8 pages, 6 figure

Using a spike-in experiment to evaluate analysis of LC-MS data

BACKGROUND: Recent advances in liquid chromatography-mass spectrometry (LC-MS) technology have led to more effective approaches for measuring changes in peptide/protein abundances in biological samples. Label-free LC-MS methods have been used for extraction of quantitative information and for detection of differentially abundant peptides/proteins. However, difference detection by analysis of data derived from label-free LC-MS methods requires various preprocessing steps including filtering, baseline correction, peak detection, alignment, and normalization. Although several specialized tools have been developed to analyze LC-MS data, determining the most appropriate computational pipeline remains challenging partly due to lack of established gold standards. RESULTS: The work in this paper is an initial study to develop a simple model with "presence" or "absence" condition using spike-in experiments and to be able to identify these "true differences" using available software tools. In addition to the preprocessing pipelines, choosing appropriate statistical tests and determining critical values are important. We observe that individual statistical tests could lead to different results due to different assumptions and employed metrics. It is therefore preferable to incorporate several statistical tests for either exploration or confirmation purpose. CONCLUSIONS: The LC-MS data from our spike-in experiment can be used for developing and optimizing LC-MS data preprocessing algorithms and to evaluate workflows implemented in existing software tools. Our current work is a stepping stone towards optimizing LC-MS data acquisition and testing the accuracy and validity of computational tools for difference detection in future studies that will be focused on spiking peptides of diverse physicochemical properties in different concentrations to better represent biomarker discovery of differentially abundant peptides/proteins

Population of isomers in decay of the giant dipole resonance

The value of an isomeric ratio (IR) in N=81 isotones ($^{137}$Ba, $^{139}$Ce, $^{141}$Nd and $^{143}$Sm) is studied by means of the ($\gamma, n)$ reaction. This quantity measures a probability to populate the isomeric state in respect to the ground state population. In ($\gamma, n)$ reactions, the giant dipole resonance (GDR) is excited and after its decay by a neutron emission, the nucleus has an excitation energy of a few MeV. The forthcoming $\gamma$ decay by direct or cascade transitions deexcites the nucleus into an isomeric or ground state. It has been observed experimentally that the IR for $^{137}$Ba and $^{139}$Ce equals about 0.13 while in two heavier isotones it is even less than half the size. To explain this effect, the structure of the excited states in the energy region up to 6.5 MeV has been calculated within the Quasiparticle Phonon Model. Many states are found connected to the ground and isomeric states by $E1$, $E2$ and $M1$ transitions. The single-particle component of the wave function is responsible for the large values of the transitions. The calculated value of the isomeric ratio is in very good agreement with the experimental data for all isotones. A slightly different value of maximum energy with which the nuclei rest after neutron decay of the GDR is responsible for the reported effect of the A-dependence of the IR.Comment: 16 pages, 4 Fig

Decay modes of 250No

The Fragment Mass Analyzer at the ATLAS facility has been used to unambiguously identify the mass number associated with different decay modes of the nobelium isotopes produced via 204Pb(48Ca,xn)(252-x)No reactions. Isotopically pure (>99.7%) 204Pb targets were used to reduce background from more favored reactions on heavier lead isotopes. Two spontaneous fission half-lives (t_1/2 = 3.7+1.1-0.8 us and 43+22-15 us) were deduced from a total of 158 fission events. Both decays originate from 250No rather than from neighboring isotopes as previously suggested. The longer activity most likely corresponds to a K-isomer in this nucleus. No conclusive evidence for an alpha branch was observed, resulting in upper limits of 2.1% for the shorter lifetime and 3.4% for the longer activity.Comment: RevTex4, 10 pages, 5 figures, submitted to PR

Coherent photonuclear reactions for isotope transmutation

Coherent photonuclear isotope transmutation (CPIT) produces exclusively radioactive isotopes (RIs) by coherent photonuclear reactions via E1 giant resonances. Photons to be used are medium energy photons produced by laser photons backscattered off GeV electrons. The cross sections are as large as 0.2 - 0.6 b, being independent of individual nuclides. A large fraction of photons is effectively used for the photonuclear reactions, while the scattered GeV electrons remain in the storage ring to be re-used. CPIT with medium energy photons provides specific/desired RIs with the high rate and the high density for nuclear science, molecular biology and for nuclear medicines.Comment: 8 pages, 2 figure