A Measurement of Rb using a Double Tagging Method

The fraction of Z to bbbar events in hadronic Z decays has been measured by the OPAL experiment using the data collected at LEP between 1992 and 1995. The Z to bbbar decays were tagged using displaced secondary vertices, and high momentum electrons and muons. Systematic uncertainties were reduced by measuring the b-tagging efficiency using a double tagging technique. Efficiency correlations between opposite hemispheres of an event are small, and are well understood through comparisons between real and simulated data samples. A value of Rb = 0.2178 +- 0.0011 +- 0.0013 was obtained, where the first error is statistical and the second systematic. The uncertainty on Rc, the fraction of Z to ccbar events in hadronic Z decays, is not included in the errors. The dependence on Rc is Delta(Rb)/Rb = -0.056*Delta(Rc)/Rc where Delta(Rc) is the deviation of Rc from the value 0.172 predicted by the Standard Model. The result for Rb agrees with the value of 0.2155 +- 0.0003 predicted by the Standard Model.Comment: 42 pages, LaTeX, 14 eps figures included, submitted to European Physical Journal

Getting the Grip on Nonspecific Treatment Effects: Emesis in Patients Randomized to Acupuncture or Sham Compared to Patients Receiving Standard Care

Background: It is not known whether or not delivering acupuncture triggers mechanisms cited as placebo and if acupuncture or sham reduces radiotherapy-induced emesis more than standard care. Methodology/Principal Findings: Cancer patients receiving radiotherapy over abdominal/pelvic regions were randomized to verum (penetrating) acupuncture (n = 109; 99 provided data) in the alleged antiemetic acupuncture point PC6 or sham acupuncture (n = 106; 101 provided data) performed with a telescopic non-penetrating needle at a sham point 2-3 times/week during the whole radiotherapy period. The acupuncture cohort was compared to a reference cohort receiving standard care (n = 62; 62 provided data). The occurrence of emesis in each group was compared after a mean dose of 27 Gray. Nausea and vomiting were experienced during the preceding week by 37 and 8% in the verum acupuncture group, 38 and 7% in the sham acupuncture group and 63 and 15% in the standard care group, respectively. The lower occurrence of nausea in the acupuncture cohort (verum and sham) compared to patients receiving standard care (37% versus 63%, relative risk (RR) 0.6, 95 % confidence interval (CI) 0.5-0.8) was also true after adjustment for potential confounding factors for nausea (RR 0.8, CI 0.6 to 0.9). Nausea intensity was lower in the acupuncture cohort (78% no nausea, 13% a little, 8% moderate, 1% much) compared to the standard care cohort (52% no nausea, 32% a little, 15% moderate, 2% much) (p = 0.002). The acupuncture cohort expected antiemetic effects from their treatment (95%). Patients who expected nausea had increased risk for nausea compared to patients who expected low risk for nausea (RR 1.6; Cl 1.2-2.4). Conclusions/Significance: Patients treated with verum or sham acupuncture experienced less nausea and vomiting compared to patients receiving standard care, possibly through a general care effect or due to the high level of patient expectancy.Original Publication:Anna Enblom, Mats Lekander, Mats Hammar, Anna Johnsson, Erik Onelov, Martin Ingvar, Gunnar Steineck and Sussanne Börjeson, Getting the Grip on Nonspecific Treatment Effects: Emesis in Patients Randomized to Acupuncture or Sham Compared to Patients Receiving Standard Care, 2011, PLOS ONE, (6), 3, .http://dx.doi.org/10.1371/journal.pone.0014766Licensee: Public Library of Science (PLoS)http://www.plos.org

Measurement of the B+ and B-0 lifetimes and search for CP(T) violation using reconstructed secondary vertices

The lifetimes of the B+ and B-0 mesons, and their ratio, have been measured in the OPAL experiment using 2.4 million hadronic Z(0) decays recorded at LEP. Z(0) --> b (b) over bar decays were tagged using displaced secondary vertices and high momentum electrons and muons. The lifetimes were then measured using well-reconstructed charged and neutral secondary vertices selected in this tagged data sample. The results aretau(B+) = 1.643 +/- 0.037 +/- 0.025 pstau(Bo) = 1.523 +/- 0.057 +/- 0.053 pstau(B+)/tau(Bo) = 1.079 +/- 0.064 +/- 0.041,where in each case the first error is statistical and the second systematic.A larger data sample of 3.1 million hadronic Z(o) decays has been used to search for CP and CPT violating effects by comparison of inclusive b and (b) over bar hadron decays, No evidence fur such effects is seen. The CP violation parameter Re(epsilon(B)) is measured to be Re(epsilon(B)) = 0.001 +/- 0.014 +/- 0.003and the fractional difference between b and (b) over bar hadron lifetimes is measured to(Delta tau/tau)(b) = tau(b hadron) - tau((b) over bar hadron)/tau(average) = -0.001 +/- 0.012 +/- 0.008

Biochar: pyrogenic carbon for agricultural use: a critical review.

O biocarvão (biomassa carbonizada para uso agrícola) tem sido usado como condicionador do solo em todo o mundo, e essa tecnologia é de especial interesse para o Brasil, uma vez que tanto a ?inspiração?, que veio das Terras Pretas de Índios da Amazônia, como o fato de o Brasil ser o maior produtor mundial de carvão vegetal, com a geração de importante quantidade de resíduos na forma de finos de carvão e diversas biomassas residuais, principalmente da agroindústria, como bagaço de cana, resíduos das indústrias de madeira, papel e celulose, biocombustíveis, lodo de esgoto etc. Na última década, diversos estudos com biocarvão têm sido realizados e atualmente uma vasta literatura e excelentes revisões estão disponíveis. Objetivou-se aqui não fazer uma revisão bibliográfica exaustiva, mas sim uma revisão crítica para apontar alguns destaques na pesquisa sobre biochar. Para isso, foram selecionados alguns temaschave considerados críticos e relevantes e fez-se um ?condensado? da literatura pertinente, mais para orientar as pesquisas e tendências do que um mero olhar para o passad

Measurement of the W+W−γW^{+}W^{-} \gamma Cross-section and First direct Limits on Anomalous Electroweak Quartic Gauge Couplings

A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W+W- events accompanied by hard photon radiation produced in e+e- collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183pb^-1 of data recorded at root{s}=189GeV. From these data, 17 W+W-gamma candidates are selected with photon energy greater than 10GeV, consistent with the Standard Model expectation. These events are used to measure the e+e- to W+W-gamma cross-section within a set of geometric and kinematic cuts; sigma{W+W-gamma} = 136+-37+-8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the {W+ W- gamma gamma} and {W+ W- gamma Z0} vertices: -0.070GeV^{-2} < a_0/Lambda^2 < 0.070GeV^{-2}, -0.13GeV^{-2} < a_c/Lambda^2 < 0.19GeV^{-2}, -0.61GeV^{-2} < a_n/Lambda^2 < 0.57GeV^{-2}, where Lambda represents the energy scale for new physics.A study of W + W − events accompanied by hard photon radiation produced in e + e − collisions at LEP is presented. Events consistent with two on-shell W-bosons and an isolated photon are selected from 183 pb −1 of data recorded at s =189 GeV. From these data, 17 W + W − γ candidates are selected with photon energy greater than 10 GeV, consistent with the Standard Model expectation. These events are used to measure the e + e − →W + W − γ cross-section within a set of geometric and kinematic cuts, σ ̂ WW γ =136±37±8 fb, where the first error is statistical and the second systematic. The photon energy spectrum is used to set the first direct, albeit weak, limits on possible anomalous contributions to the W + W − γγ and W + W − γ Z 0 vertices: −0.070 GeV −

τ\tau decays with neutral kaons

The branching ratio of the tau lepton to a neutral K meson is measured from a sample of approximately 200,000 tau decays recorded by the OPAL detector at centre-of-mass energies near the Z0 resonance. The measurement is based on two samples which identify one-prong tau decays with KL and KS mesons. The combined branching ratios are measured to be B(tau- -->pi- K0bar nutau) = (9.33+-0.68+-0.49)x10^-3 B(tau- -->pi- K0bar [>=1pi0] nutau) = (3.24+-0.74+-0.66)x10^-3 B(tau- -->K- K0bar [>=0pi0] nutau) = (3.30+-0.55+-0.39)x10^-3 where the first error is statistical and the second systematic.The branching ratio of the tau lepton to a neutral K meson is measured from a sample of approximately 200,000 tau decays recorded by the OPAL detector at centre-of-mass energies near the Z0 resonance. The measurement is based on two samples which identify one-prong tau decays with KL and KS mesons. The combined branching ratios are measured to be B(tau- -->pi- K0bar nutau) = (9.33+-0.68+-0.49)x10^-3 B(tau- -->pi- K0bar [>=1pi0] nutau) = (3.24+-0.74+-0.66)x10^-3 B(tau- -->K- K0bar [>=0pi0] nutau) = (3.30+-0.55+-0.39)x10^-3 where the first error is statistical and the second systematic

Transverse and Longitudinal Bose Einstein Correlations in hadronic Z0Z^0 Decays

Bose-Einstein correlations in pairs of identical charged pions produced in asample of 4.3 million Z0 hadronic decays are studied as a function of the threecomponents of the momentum difference, transverse ("out" and "side") andlongitudinal with respect to the thrust direction of the event. A significantdifference between the transverse, r_t_side, and longitudinal, r_l, dimensionsis observed, indicating that the emitting source of identical pions, asobserved in the Longitudinally CoMoving System, has an elongated shape. This isobserved with a variety of selection techniques. Specifically, the values ofthe parameters obtained by fitting the extended Goldhaber parametrisation tothe correlation function C'= C^{DATA}}/C^{MC} for two-jet events, selected withthe Durham algorithm and resolution parameter ycut=0.04, arer_t_out=(0.647+-0.011(stat})+0.022-0.124(syst)) fm,r_t_side=(0.809+-0.009(stat)+0.019-0.032}(syst)) fm, r_l=(0.989+-0.011(stat)+0.030-0.015(syst})) fm andr_l/r_t_side=1.222+- 0.027(stat})+0.075-0.012(syst). The results are discussedin the context of a recent model of Bose-Einstein correlations based on stringfragmentation.Bose-Einstein correlations in pairs of identical charged pions produced in a sample of 4.3 million Z0 hadronic decays are studied as a function of the three components of the momentum difference, transverse ("out" and "side") and longitudinal with respect to the thrust direction of the event. A significant difference between the transverse, r_t_side, and longitudinal, r_l, dimensions is observed, indicating that the emitting source of identical pions, as observed in the Longitudinally CoMoving System, has an elongated shape. This is observed with a variety of selection techniques. Specifically, the values of the parameters obtained by fitting the extended Goldhaber parametrisation to the correlation function C'= C^{DATA}}/C^{MC} for two-jet events, selected with the Durham algorithm and resolution parameter ycut=0.04, are r_t_out=(0.647+-0.011(stat})+0.022-0.124(syst)) fm, r_t_side=(0.809+-0.009(stat)+0.019-0.032}(syst)) fm, r_l=(0.989+-0.011(stat)+0.030-0.015(syst})) fm and r_l/r_t_side=1.222+-0.027(stat})+0.075-0.012(syst). The results are discussed in the context of a recent model of Bose-Einstein correlations based on string fragmentation

Experimental properties of gluon and quark jets from a point source

Gluon jets are identified in hadronic Z0 decays as all the particles in a hemisphere opposite to a hemisphere containing two tagged quark jets. Gluon jets defined in this manner are equivalent to gluon jets produced from a color singlet point source and thus correspond to the definition employed for most theoretical calculations. In a separate stage of the analysis, we select quark jets in a manner to correspond to calculations, as the particles in hemispheres of flavor tagged light quark (uds) events. We present the distributions of rapidity, scaled energy, the logarithm of the momentum, and transverse momentum with respect to the jet axes, for charged particles in these gluon and quark jets. We also examine the charged particle multiplicity distributions of the jets in restricted intervals of rapidity. For soft particles at large transverse momentum, we observe the charged particle multiplicity ratio of gluon to quark jets to be 2.29 +- 0.09 +- 0.15 in agreement with the prediction that this ratio should approximately equal the ratio of QCD color factors, CA/CF = 2.25. The intervals used to define soft particles and large transverse momentum for this result, p<4 GeV/c and 0.8<p_t<3.0 GeV/c, are motivated by the predictions of the Herwig Monte Carlo multihadronic event generator. Additionally, our gluon jet data allow a sensitive test of the phenomenon of non-leading QCD terms known as color reconnection. We test the model of color reconnection implemented in the Ariadne Monte Carlo multihadronic event generator and find it to be disfavored by our data.Gluon jets are identified in hadronic Z0 decays as all the particles in a hemisphere opposite to a hemisphere containing two tagged quark jets. Gluon jets defined in this manner are equivalent to gluon jets produced from a color singlet point source and thus correspond to the definition employed for most theoretical calculations. In a separate stage of the analysis, we select quark jets in a manner to correspond to calculations, as the particles in hemispheres of flavor tagged light quark (uds) events. We present the distributions of rapidity, scaled energy, the logarithm of the momentum, and transverse momentum with respect to the jet axes, for charged particles in these gluon and quark jets. We also examine the charged particle multiplicity distributions of the jets in restricted intervals of rapidity. For soft particles at large transverse momentum, we observe the charged particle multiplicity ratio of gluon to quark jets to be 2.29 +- 0.09 +- 0.15 in agreement with the prediction that this ratio should approximately equal the ratio of QCD color factors, CA/CF = 2.25. The intervals used to define soft particles and large transverse momentum for this result, p<4 GeV/c and 0.8<p_t<3.0 GeV/c, are motivated by the predictions of the Herwig Monte Carlo multihadronic event generator. Additionally, our gluon jet data allow a sensitive test of the phenomenon of non-leading QCD terms known as color reconnection. We test the model of color reconnection implemented in the Ariadne Monte Carlo multihadronic event generator and find it to be disfavored by our data.Gluon jets are identified in hadronic Z0 decays as all the particles in a hemisphere opposite to a hemisphere containing two tagged quark jets. Gluon jets defined in this manner are equivalent to gluon jets produced from a color singlet point source and thus correspond to the definition employed for most theoretical calculations. In a separate stage of the analysis, we select quark jets in a manner to correspond to calculations, as the particles in hemispheres of flavor tagged light quark (uds) events. We present the distributions of rapidity, scaled energy, the logarithm of the momentum, and transverse momentum with respect to the jet axes, for charged particles in these gluon and quark jets. We also examine the charged particle multiplicity distributions of the jets in restricted intervals of rapidity. For soft particles at large transverse momentum, we observe the charged particle multiplicity ratio of gluon to quark jets to be 2.29 +- 0.09 +- 0.15 in agreement with the prediction that this ratio should approximately equal the ratio of QCD color factors, CA/CF = 2.25. The intervals used to define soft particles and large transverse momentum for this result, p<4 GeV/c and 0.8<p_t<3.0 GeV/c, are motivated by the predictions of the Herwig Monte Carlo multihadronic event generator. Additionally, our gluon jet data allow a sensitive test of the phenomenon of non-leading QCD terms known as color reconnection. We test the model of color reconnection implemented in the Ariadne Monte Carlo multihadronic event generator and find it to be disfavored by our data.Gluon jets are identified in hadronic Z0 decays as all the particles in a hemisphere opposite to a hemisphere containing two tagged quark jets. Gluon jets defined in this manner are equivalent to gluon jets produced from a color singlet point source and thus correspond to the definition employed for most theoretical calculations. In a separate stage of the analysis, we select quark jets in a manner to correspond to calculations, as the particles in hemispheres of flavor tagged light quark (uds) events. We present the distributions of rapidity, scaled energy, the logarithm of the momentum, and transverse momentum with respect to the jet axes, for charged particles in these gluon and quark jets. We also examine the charged particle multiplicity distributions of the jets in restricted intervals of rapidity. For soft particles at large transverse momentum, we observe the charged particle multiplicity ratio of gluon to quark jets to be 2.29 +- 0.09 +- 0.15 in agreement with the prediction that this ratio should approximately equal the ratio of QCD color factors, CA/CF = 2.25. The intervals used to define soft particles and large transverse momentum for this result, p<4 GeV/c and 0.8<p_t<3.0 GeV/c, are motivated by the predictions of the Herwig Monte Carlo multihadronic event generator. Additionally, our gluon jet data allow a sensitive test of the phenomenon of non-leading QCD terms known as color reconnection. We test the model of color reconnection implemented in the Ariadne Monte Carlo multihadronic event generator and find it to be disfavored by our data

Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: A randomised controlled trial

Background:Sleep disturbances and poor rest-activity rhythms, which can reduce the quality of life, are highly prevalent among patients with lung cancer.Methods:This trial investigated the effects of a 12-week exercise intervention including home-based walking exercise training and weekly exercise counseling on 111 lung cancer patients. Participants were randomly allocated to receive the intervention or usual-care. Outcomes included objective sleep (total sleep time, TST; sleep efficiency, SE; sleep onset latency, SOL; and wake after sleep onset, WASO), subjective sleep (Pittsburgh Sleep Quality Index, PSQI), and rest-activity rhythms (r24 and I<O). Outcomes were assessed at baseline and 3 and 6 months after intervention.Results:The PSQI (Wald χ 2 =15.16, P=0.001) and TST (Wald χ 2 =7.59, P=0.023) of the patients in the exercise group significantly improved 3 and 6 months after intervention. The moderating effect of I<O on TST was significant (β of group × I<O=3.70, P=0.032).Conclusions:The walking program is an effective intervention for improving the subjective and objective sleep quality of lung cancer patients and can be considered an optional component of lung cancer rehabilitation.Link_to_subscribed_fulltex

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