Mouse invariant chain γ exhibits structural homology to both polymorphic subunits of the α,β-core complex of I-Ak antigens

AbstractThe 3 major constituents of the I-Ak subregion-associated complex α, β and γ were obtained from splenocytes in homogeneous form by differential isolation methods. α, β and γ were compared on the primary structural level by enzymatic fragmentation procedures and tryptic peptide map analysis of radiolabeled proteins. The data indicate that the invariant chain γ exhibits extensive structural homology to the polymorphic β-light and the α-heavy chain. Thus, although not being encoded within the MHC γ appears to belong structurally to the MHC-encoded class II proteins

Demographic, clinical, and epidemiologic characteristics of persons under investigation for Coronavirus Disease 2019-United States, January 17-February 29, 2020.

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), evolved rapidly in the United States. This report describes the demographic, clinical, and epidemiologic characteristics of 544 U.S. persons under investigation (PUI) for COVID-19 with complete SARS-CoV-2 testing in the beginning stages of the pandemic from January 17 through February 29, 2020.MethodsIn this surveillance cohort, the U.S. Centers for Disease Control and Prevention (CDC) provided consultation to public health and healthcare professionals to identify PUI for SARS-CoV-2 testing by quantitative real-time reverse-transcription PCR. Demographic, clinical, and epidemiologic characteristics of PUI were reported by public health and healthcare professionals during consultation with on-call CDC clinicians and subsequent submission of a CDC PUI Report Form. Characteristics of laboratory-negative and laboratory-positive persons were summarized as proportions for the period of January 17-February 29, and characteristics of all PUI were compared before and after February 12 using prevalence ratios.ResultsA total of 36 PUI tested positive for SARS-CoV-2 and were classified as confirmed cases. Confirmed cases and PUI testing negative for SARS-CoV-2 had similar demographic, clinical, and epidemiologic characteristics. Consistent with changes in PUI evaluation criteria, 88% (13/15) of confirmed cases detected before February 12, 2020, reported travel from China. After February 12, 57% (12/21) of confirmed cases reported no known travel- or contact-related exposures.ConclusionsThese findings can inform preparedness for future pandemics, including capacity for rapid expansion of novel diagnostic tests to accommodate broad surveillance strategies to assess community transmission, including potential contributions from asymptomatic and presymptomatic infections

Critical Conversations and A Call to Action!: A collective report from the June 2020 virtual gathering

Paul Kadetz - ORCID: 0000-0002-2824-1856 https://orcid.org/0000-0002-2824-1856Critical Conversations are held by members of the greater Engineering, Social Justice, and Peace network in the activist tradition of reflecting on our public engagement and collectively discovering ways of deepening our action. The particpants are selected based on their submissions (Expressions of Interest) in response to the Call for Participation in the Critcial Conversations disseminated through the ESJP website (esjp.org). For years, we have gathered in locations immersed in nature. In 2018 and 2019, the gathering took place in Cala Munda, organized by Caroline Baillie and Eric Feinblatt, in the beautiful Catskills mountains in upstate New York in the U.S.A. We want to feel our connection with the land while we engage in critical conversations on the intersection of the engineering field with social justice and peace. Caroline Baillie facilitates these conversations employing forest pedagogy. Through this pedagogy, we open our hearts to the forest for seeking guidance on how our profession can help restore, heal, and serve people, planet, and life instead of its current practice of destroying, pillaging, and harming nature. In the throes of the coronavirus pandemic, the urgency of action was evident in 2020 like never before. On June 26 and 27, 2020, a group of up to 40 educators, researchers, activists, and field practitioners, from 4 continents, met virtually for the 4th Annual Critical Conversations – almost thrice as large as the 2018 and 2019 groups that met in-person. The virtual format allowed for broader participation – both in numbers as well as geographical locations. Though we were physically separated in the online gathering, situated in our respective modern, often disconnected-from-nature enclaves, our hearts and minds were engaged in envisioning transition to a just and egalitarian society. In keeping with the need of the moment, our focus was on brainstorming action projects that we can implement in the near future. The retreat facilitated the formation of action teams, which spent the summer discussing possible action items moving forward. These teams are now looking for a more permanent structure with team leaders, team members, an infrastructure, and social media presence. This is a call to action! We carried out these deliberations in an open-space format, wherein the agenda for the two days was set by the participants. In the two sessions on day one, using this participatory approach, we were able to sift six main themes that participants were interested in exploring in-depth. On day two, we divided ourselves into six teams and each team took a deeper dive into their theme of choice. Five of these teams have written summaries of their deliberations and proposed their Calls to Action for the engineering community, which we report below.https://doi.org/10.24908/ijesjp.v8i2.151578pubpub

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Acute kidney disease beyond day 7 after major surgery: a secondary analysis of the EPIS-AKI trial

Purpose: Acute kidney disease (AKD) is a significant health care burden worldwide. However, little is known about this complication after major surgery. Methods: We conducted an international prospective, observational, multi-center study among patients undergoing major surgery. The primary study endpoint was the incidence of AKD (defined as new onset of estimated glomerular filtration rate (eCFR) < 60 ml/min/1.73 m2 present on day 7 or later) among survivors. Secondary endpoints included the relationship between early postoperative acute kidney injury (AKI) (within 72 h after major surgery) and subsequent AKD, the identification of risk factors for AKD, and the rate of chronic kidney disease (CKD) progression in patients with pre-existing CKD. Results: We studied 9510 patients without pre-existing CKD. Of these, 940 (9.9%) developed AKD after 7 days of whom 34.1% experiencing an episode of early postoperative-AKI. Rates of AKD after 7 days significantly increased with the severity (19.1% Kidney Disease Improving Global Outcomes [KDIGO] 1, 24.5% KDIGO2, 34.3% KDIGO3; P < 0.001) and duration (15.5% transient vs 38.3% persistent AKI; P < 0.001) of early postoperative-AKI. Independent risk factors for AKD included early postoperative-AKI, exposure to perioperative nephrotoxic agents, and postoperative pneumonia. Early postoperative-AKI carried an independent odds ratio for AKD of 2.64 (95% confidence interval [CI] 2.21-3.15). Of 663 patients with pre-existing CKD, 42 (6.3%) had worsening CKD at day 90. In patients with CKD and an episode of early AKI, CKD progression occurred in 11.6%. Conclusion: One in ten major surgery patients developed AKD beyond 7 days after surgery, in most cases without an episode of early postoperative-AKI. However, early postoperative-AKI severity and duration were associated with an increased rate of AKD and early postoperative-AKI was strongly associated with AKD independent of all other potential risk factors