EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

The Role of Digital Humanities in the Democratization of Knowledge

Arguably, the recognition that the printed word is no longer the main medium for knowledge production and distribution and the increasing importance of digital and web-based media rendered it necessary for contemporary academia to seek alternative outlets for knowledge production and dissemination. This paper builds on the interesting developments and advances in the publishing industry in humanities in particular and knowledge, in general, to argue that the digitalization/digitization of humanities set the stage for the emergence of alternative publishing media and techniques to the conventional print and subscription publishing. The paper argues that the newly emergent digital web-based technology empowered the democratization of knowledge within the relatively novel Open Access Publishing. Two major values and practices signal the democratic mood of digital humanities and digital publishing. Those values are access and participation. The author draws on his relative experience in editing and publishing within the electronic Open Access tradition to argue that digitalized and web-based dissemination of knowledge/humanities empowered the “subaltern” to speak and expressed the views and perspectives of postcolonial authors within/versus a largely Western hegemonic publishing industry