HMG CoA reductase inhibitors (statins) for preventing acute kidney injury after surgical procedures requiring cardiac bypass.

BACKGROUND: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery among whom it is associated with poor outcomes, prolonged hospital stays and increased mortality. Statin drugs can produce more than one effect independent of their lipid lowering effect, and may improve kidney injury through inhibition of postoperative inflammatory responses. OBJECTIVES: This review aimed to look at the evidence supporting the benefits of perioperative statins for AKI prevention in hospitalised adults after surgery who require cardiac bypass. The main objectives were to 1) determine whether use of statins was associated with preventing AKI development; 2) determine whether use of statins was associated with reductions in in-hospital mortality; 3) determine whether use of statins was associated with reduced need for RRT; and 4) determine any adverse effects associated with the use of statins. SEARCH METHODS: We searched the Cochrane Renal Group's Specialised Register to 13 January 2015 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared administration of statin therapy with placebo or standard clinical care in adult patients undergoing surgery requiring cardiopulmonary bypass and reporting AKI, serum creatinine (SCr) or need for renal replacement therapy (RRT) as an outcome were eligible for inclusion. All forms and dosages of statins in conjunction with any duration of pre-operative therapy were considered for inclusion in this review. DATA COLLECTION AND ANALYSIS: All authors extracted data independently and assessments were cross-checked by a second author. Likewise, assessment of study risk of bias was initially conducted by one author and then by a second author to ensure accuracy. Disagreements were arbitrated among authors until consensus was reached. Authors from two of the included studies provided additional data surrounding post-operative SCr as well as need for RRT. Meta-analyses were used to assess the outcomes of AKI, SCr and mortality rate. Data for the outcomes of RRT and adverse effects were not pooled. Adverse effects taken into account were those reported by the authors of included studies. MAIN RESULTS: We included seven studies (662 participants) in this review. All except one study was assessed as being at high risk of bias. Three studies assessed atorvastatin, three assessed simvastatin and one investigated rosuvastatin. All studies collected data during the immediate perioperative period only; data collection to hospital discharge and postoperative biochemical data collection ranged from 24 hours to 7 days. Overall, pre-operative statin treatment was not associated with a reduction in postoperative AKI, need for RRT, or mortality. Only two studies (195 participants) reported postoperative SCr level. In those studies, patients allocated to receive statins had lower postoperative SCr concentrations compared with those allocated to no drug treatment/placebo (MD 21.2 µmol/L, 95% CI -31.1 to -11.1). Adverse effects were adequately reported in only one study; no difference was found between the statin group compared to placebo. AUTHORS' CONCLUSIONS: Analysis of currently available data did not suggest that preoperative statin use is associated with decreased incidence of AKI in adults after surgery who required cardiac bypass. Although a significant reduction in SCr was seen postoperatively in people treated with statins, this result was driven by results from a single study, where SCr was considered as a secondary outcome. The results of the meta-analysis should be interpreted with caution; few studies were included in subgroup analyses, and significant differences in methodology exist among the included studies. Large high quality RCTs are required to establish the safety and efficacy of statins to prevent AKI after cardiac surgery

Non-semisimple Hopf Algebras of Dimension p^2

Let H be a Hopf algebra of dimension pq over an algebraically closed field of characteristic 0, where p <= q are odd primes. Suppose that S is the antipode of H. If H is not semisimple, then S^{4p}=id_H and Tr(S^{2p}) is an integer divisible by p^2. In particular, if dim H = p^2, we prove that H is isomorphic to a Taft algebra. We then complete the classification for the Hopf algebras of dimension p^2

Hearing Loss and Retarded Cochlear Development in Mice Lacking Type 2 Iodothyronine Deiodinase

The later stages of cochlear differentiation and the developmental onset of hearing require thyroid hormone. Although thyroid hormone receptors (TRs) are a prerequisite for this process, it is likely that other factors modify TR activity during cochlear development. The mouse cochlea expresses type 2 deiodinase (D2), an enzyme that converts thyroxine, the main form of thyroid hormone in the circulation, into 3,5,3\u27-triiodothyronine (T3) the major ligand for TRs. Here, we show that D2-deficient mice have circulating thyroid hormone levels that would normally be adequate to allow hearing to develop but they exhibit an auditory phenotype similar to that caused by systemic hypothyroidism or TR deletions. D2-deficient mice have defective auditory function, retarded differentiation of the cochlear inner sulcus and sensory epithelium, and deformity of the tectorial membrane. The similarity of this phenotype to that caused by TR deletions suggests that D2 controls the T3 signal that activates TRs in the cochlea. Thus, D2 is essential for hearing, and the results suggest that this hormone-activating enzyme confers on the cochlea the ability to stimulate its own T3 response at a critical developmental period

Can Strong Gravitational Lensing Constrain Dark Energy?

We discuss the ratio of the angular diameter distances from the source to the lens, $D_{ds}$, and to the observer at present, $D_{s}$, for various dark energy models. It is well known that the difference of $D_s$s between the models is apparent and this quantity is used for the analysis of Type Ia supernovae. However we investigate the difference between the ratio of the angular diameter distances for a cosmological constant, $(D_{ds}/D_{s})^{\Lambda}$ and that for other dark energy models, $(D_{ds}/D_{s})^{\rm{other}}$ in this paper. It has been known that there is lens model degeneracy in using strong gravitational lensing. Thus, we investigate the model independent observable quantity, Einstein radius ($\theta_E$), which is proportional to both $D_{ds}/D_s$ and velocity dispersion squared, $\sigma_v^2$. $D_{ds}/D_s$ values depend on the parameters of each dark energy model individually. However, $(D_{ds}/D_s)^{\Lambda} - (D_{ds}/D_{s})^{\rm{other}}$ for the various dark energy models, is well within the error of $\sigma_v$ for most of the parameter spaces of the dark energy models. Thus, a single strong gravitational lensing by use of the Einstein radius may not be a proper method to investigate the property of dark energy. However, better understanding to the mass profile of clusters in the future or other methods related to arc statistics rather than the distances may be used for constraints on dark energy.Comment: 15 pages, 13 figures, Accepted in PR

Inference and Sampling of Point Processes from Diffusion Excursions

Point processes often have a natural interpretation with respect to a continuous process. We propose a point process construction that describes arrival time observations in terms of the state of a latent diffusion process. In this framework, we relate the return times of a diffusion in a continuous path space to new arrivals of the point process. This leads to a continuous sample path that is used to describe the underlying mechanism generating the arrival distribution. These models arise in many disciplines, such as financial settings where actions in a market are determined by a hidden continuous price or in neuroscience where a latent stimulus generates spike trains. Based on the developments in It\^o's excursion theory, we propose methods for inferring and sampling from the point process derived from the latent diffusion process. We illustrate the approach with numerical examples using both simulated and real data. The proposed methods and framework provide a basis for interpreting point processes through the lens of diffusions.Comment: In UAI 202

Heat shock induces rapid resorption of primary cilia

Primary cilia are involved in important developmental and disease pathways, such as the regulation of neurogenesis and tumorigenesis. They function as sensory antennae and are essential in the regulation of key extracellular signalling systems. We have investigated the effects of cell stress on primary cilia. Exposure of mammalian cells in vitro, and zebrafish cells in vivo, to elevated temperature resulted in the rapid loss of cilia by resorption. In mammalian cells loss of cilia correlated with a reduction in hedgehog signalling. Heat-shock-dependent loss of cilia was decreased in cells where histone deacetylases (HDACs) were inhibited, suggesting resorption is mediated by the axoneme-localised tubulin deacetylase HDAC6. In thermotolerant cells the rate of ciliary resorption was reduced. This implies a role for molecular chaperones in the maintenance of primary cilia. The cytosolic chaperone Hsp90 localises to the ciliary axoneme and its inhibition resulted in cilia loss. In the cytoplasm of unstressed cells, Hsp90 is known to exist in a complex with HDAC6. Moreover, immediately after heat shock Hsp90 levels were reduced in the remaining cilia. We hypothesise that ciliary resorption serves to attenuate cilia-mediated signalling pathways in response to extracellular stress, and that this mechanism is regulated in part by HDAC6 and Hsp90

Five new INTEGRAL unidentified hard X-Ray sources uncovered by Chandra

The IBIS imager on board INTEGRAL, with a sensitivity better than a mCrab in deep observations and a point source location accuracy of the order of few arcminutes, has localized so far 723 hard X-ray sources in the 17--100 keV energy band, of which a fraction of about 1/3 are still unclassified. The aim of this research is to provide sub-arcsecond localizations of the unidentified sources, necessary to pinpoint the optical and/or infrared counterpart of those objects whose nature is so far unknown. The cross-correlation between the new IBIS sources published within the fourth INTEGRAL/IBIS Survey catalogue and the CHANDRA/ACIS data archive resulted in a sample of 5 not yet identified objects. We present here the results of CHANDRA X-ray Observatory observations of these five hard X-ray sources discovered by the INTEGRAL satellite. We associated IGR J10447-6027 with IR source 2MASSJ10445192-6025115, IGR J16377-6423 with the cluster CIZA J1638.2-6420, IGR J14193-6048 with the pulsar with nebula PSR J1420-6048 and IGR J12562+2554 with the Quasar SDSSJ125610.42+260103.5. We suggest that the counterpart of IGR J12288+0052 may be an AGN/QSO type~2 at a confidence level of 90%.Comment: ApJ accepte

Meralgia paresthetica after “all-in-one” appendectomy

AbstractMinimally invasive approaches have become standard for pediatric appendectomy. The laparoscopic assisted single port approach, also known as the “all-in-one” appendectomy, has gained recent popularity [1]. We describe a child who suffered meralgia paresthetica (a neuropathy in the distribution of the lateral femoral cutaneous nerve) after a laparoscopic assisted single port appendectomy, perhaps secondary to mobilization of the cecum

A Computationally Efficient Model for Pedestrian Motion Prediction

We present a mathematical model to predict pedestrian motion over a finite horizon, intended for use in collision avoidance algorithms for autonomous driving. The model is based on a road map structure, and assumes a rational pedestrian behavior. We compare our model with the state-of-the art and discuss its accuracy, and limitations, both in simulations and in comparison to real data

Do We Have to Close Residual Patent Ductus Arteriosus After Surgery or Transcatheter Intervention?

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