Acute kidney disease and renal recovery : consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of > 90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD

Early Spectroscopy and Dense Circumstellar Medium Interaction in SN~2023ixf

We present the optical spectroscopic evolution of SN~2023ixf seen in sub-night cadence spectra from 1.18 to 14 days after explosion. We identify high-ionization emission features, signatures of interaction with material surrounding the progenitor star, that fade over the first 7 days, with rapid evolution between spectra observed within the same night. We compare the emission lines present and their relative strength to those of other supernovae with early interaction, finding a close match to SN~2020pni and SN~2017ahn in the first spectrum and SN~2014G at later epochs. To physically interpret our observations we compare them to CMFGEN models with confined, dense circumstellar material around a red supergiant progenitor from the literature. We find that very few models reproduce the blended \NC{} emission lines observed in the first few spectra and their rapid disappearance thereafter, making this a unique diagnostic. From the best models, we find a mass-loss rate of $10^{-3}-10^{-2}$ \mlunit{}, which far exceeds the mass-loss rate for any steady wind, especially for a red supergiant in the initial mass range of the detected progenitor. These mass-loss rates are, however, similar to rates inferred for other supernovae with early circumstellar interaction. Using the phase when the narrow emission features disappear, we calculate an outer dense radius of circumstellar material $R_\mathrm{CSM, out}\sim5\times10^{14}~\mathrm{cm}$ and a mean circumstellar material density of $\rho=5.6\times10^{-14}~\mathrm{g\,cm^{-3}}$. This is consistent with the lower limit on the outer radius of the circumstellar material we calculate from the peak \Halpha{} emission flux, $R_\text{CSM, out}\gtrsim9\times10^{13}~\mathrm{cm}$.Comment: Submitted to ApJ

An Outcome Evaluation of Competency Based Training for Child Welfare

In response to the continuing need for competent child welfare professionals, a large mid-western university’s College of Social Work collaborated with a public child welfare agency to design and implement a one year,Title IV-E-funded training opportunity for second-year MSW students. Student outcomes, including knowledge acquisition, attitudes about child welfare, and field of post-graduation employment, were evaluated using a quasi-experimental pre-post comparison group design (n=28).Results indicated that there were statistically significant differences between the two groups concerning attitudes about child welfare practice. However, although trainees’ level of child welfare knowledge increased more than that of the comparison group, the difference did not reach statistical significance. Implications for practice and social work education are discussed

Early Spectroscopy and Dense Circumstellar Medium Interaction in SN 2023ixf

We present the optical spectroscopic evolution of SN 2023ixf seen in subnight cadence spectra from 1.18 to 15 days after explosion. We identify high-ionization emission features, signatures of interaction with material surrounding the progenitor star, that fade over the first 7 days, with rapid evolution between spectra observed within the same night. We compare the emission lines present and their relative strength to those of other supernovae with early interaction, finding a close match to SN 2020pni and SN 2017ahn in the first spectrum and SN 2014G at later epochs. To physically interpret our observations, we compare them to CMFGEN models with confined, dense circumstellar material around a red supergiant (RSG) progenitor from the literature. We find that very few models reproduce the blended N iii ( λλ 4634.0,4640.6)/C iii ( λλ 4647.5,4650.0) emission lines observed in the first few spectra and their rapid disappearance thereafter, making this a unique diagnostic. From the best models, we find a mass-loss rate of 10 ^−3 –10 ^−2 M _⊙ yr ^−1 , which far exceeds the mass-loss rate for any steady wind, especially for an RSG in the initial mass range of the detected progenitor. These mass-loss rates are, however, similar to rates inferred for other supernovae with early circumstellar interaction. Using the phase when the narrow emission features disappear, we calculate an outer dense radius of circumstellar material R _CSM,out ≈ 5 × 10 ^14 cm, and a mean circumstellar material density of ρ = 5.6 × 10 ^−14 g cm ^−3 . This is consistent with the lower limit on the outer radius of the circumstellar material we calculate from the peak H α emission flux, R _CSM,out ≳ 9 × 10 ^13 cm