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

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Not AvailableIncreased edible oil demand in the country propel to probe the production constraints in oilseeds cultivation. Andhra Pradesh is one of the major states in India in terms of area and production of important oilseed crops. Present study investigates the production constraints faced by the farmers in groundnut, sesame and sunflower cultivation in the state. Stratified multistage random sampling technique was adopted for the sample design encompassing the sample size of 440 oilseed farmers. Sampled farmers were personally interviewed with the help of pre-tested schedules. Garrett’s ranking technique was used to rank the intensity indicated by the respondents among different constraints. To conclude, factors viz., the lower spread of suitable high yielding varieties/hybrids, moisture stress, high costs of production; untimely availability of inputs; low and fluctuating prices were found to be some of the key production constraints confronted at the farm level for the cultivation of all the three important oilseed crops in the state.Not Availabl

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Wintertime spatial characteristics of boundary layer aerosols over peninsular India

During an intense field campaign for generating a spatial composite of aerosol characteristics over peninsular India, collocated measurements of the mass concentration and size distribution of near-surface aerosols were made onboard instrumented vehicles along the road network during the dry, winter season (February-March) of 2004. The study regions covered coastal, industrial, urban, village, remote, semiarid, and vegetated forestlands. The results showed (1) comparatively high aerosol (mass) concentrations (exceeding 50 &mu; g m(-3)), in general, along the coastal regions (east and west) and adjacent to urban locations, and (2) reduced mass concentration (<30 &mu; g m(-3)) over the semiarid interior continental regions. Fine, accumulation-mode particles (<1 &mu; m) contribute more than 50% to the total aerosol mass concentration in the coastal regions, which is more conspicuous along the east coast than the west coast, while the interior regions showed abundance (>50% of the total) of coarse-mode aerosols (>1 &mu; m). The spatial composite of accumulation-mode share to the total aerosol mass concentration agreed very well with the monthly mean spatial composite of aerosol fine-mode fraction for February 2004, deduced from Moderate-Resolution Imaging Spectroradiometer data for the study region, while a point by point comparison yielded a linear association with a slope of 1.09 and correlation coefficient of 0.79 for 76 independent data pairs. Pockets of enhanced aerosol concentration were observed around the industrialized and urban centers along the coast as well as inland. Aerosol size distributions were parameterized using a power law. Spatial variation of the retrieved aerosol size index shows relatively high values (>4) along the coast compared to interior continental regions except at a few locations. Urban locations showed steeper size spectra than the remote locations