The accuracy of diagnostic coding for acute kidney injury in England - A single centre study

This is the final version. Available on open access from BMC via the DOI in this recordBackground: Acute kidney injury (AKI) is an independent risk factor for mortality and is responsible for a significant burden of healthcare expenditure, so accurate measurement of its incidence is important. Administrative coding data has been used for assessing AKI incidence, and shows an increasing proportion of hospital bed days attributable to AKI. However, the accuracy of coding for AKI and changes in coding over time have not been studied in England. Methods. We studied a random sample of admissions from 2005 and 2010 where ICD-10 code N17 (acute renal failure) was recorded in the administrative coding data at one acute NHS Foundation Trust in England. Using the medical notes and computerised records we examined the demographic and clinical details of these admissions. Results: Against a 6.3% (95% CI 4.8-7.9%) increase in all non-elective admissions, we found a 64% increase in acute renal failure admissions (95% CI 41%-92%, p<0.001) in 2010 compared to 2005. Median age was 78 years (IQR 72-87), 11-25% had a relevant pre-admission co-morbidity and 64% (55-73%) were taking drugs known to be associated with AKI. Over both years, 95% (91-99%) of cases examined met the Kidney Disease: Improving Global Outcomes criteria for AKI. Conclusions: Patients with hospital admissions where AKI has been coded are elderly with multiple co-morbidities. Our results demonstrate a high positive predictive value of coding data for a clinical diagnosis of AKI, with no suggestion of marked changes in coding of AKI between 2005 and 2010. © 2013 Tomlinson et al; licensee BioMed Central Ltd.Cambridge Biomedical Research InstituteBritish Heart Foundatio

A template for an improved rock-based subdivision of the pre-Cryogenian timescale

The geological timescale before 720 Ma uses rounded absolute ages rather than specific events recorded in rocks to subdivide time. This has led increasingly to mismatches between subdivisions and the features for which they were named. Here we review the formal processes that led to the current timescale, outline rock-based concepts that could be used to subdivide pre-Cryogenian time and propose revisions. An appraisal of the Precambrian rock record confirms that purely chronostratigraphic subdivision would require only modest deviation from current chronometric boundaries, removal of which could be expedited by establishing event-based concepts and provisional, approximate ages for eon-, era- and period-level subdivisions. Our review leads to the following conclusions: (1) the current informal four-fold Archean subdivision should be simplified to a tripartite scheme, pending more detailed analysis, and (2) an improved rock-based Proterozoic Eon might comprise a Paleoproterozoic Era with three periods (early Paleoproterozoic or Skourian, Rhyacian, Orosirian), Mesoproterozoic Era with four periods (Statherian, Calymmian, Ectasian, Stenian) and a Neoproterozoic Era with four periods (pre-Tonian or Kleisian, Tonian, Cryogenian and Ediacaran). These proposals stem from a wide community and could be used to guide future development of the pre-Cryogenian timescale by international bodies

Bovine immunoprotection against Rhipicephalus (Boophilus) microplus with recombinant Bm86-Campo Grande antigen Imunoproteção de bovinos contra Rhipicephalus (Boophilus) microplus com antígeno recombinante Bm86-Campo Grande

The southern cattle fever tick, Rhipicephalus (Boophilus) microplus, is no doubt the most economically important ectoparasite of cattle globally. The inappropriate use of chemical acaricides has driven the evolution of resistance in populations of R. (B.) microplus. Anti-tick vaccines represent a technology that can be combined with acaricides in integrated control programs to mitigate the impact of R. (B.) microplus. The recombinant form of Bm86 antigen from the Campo Grande (rBm86-CG) strain of R. (B.) microplus was produced using the Pichiapastoris expression system to test its ability to immunoprotect cattle against tick infestation. Secretion of rBm86-CG by P. pastoris through the bioprocess reported here simplified purification of the antigen. A specific humoral immune response was detected by ELISA in vaccinated cattle. Immunoblot results revealed that polyclonal antibodies from vaccinated cattle recognized a protein in larval extracts with a molecular weight corresponding to Bm86. The rBm86-CG antigen showed 31% efficacy against the Campo Grande strain of R. (B.) microplus infesting vaccinated cattle. The rBm86-CG is an antigen that could be used in a polyvalent vaccine as part of an integrated program for the control of R. (B.) microplus in the region that includes Mato Grosso do Sul.<br>O carrapato Rhipicephalus (Boophilus) microplus é, sem dúvidas, o ectoparasito economicamente mais importante para o gado a nível mundial. A utilização inadequada de acaricidas tem impulsionado a evolução da resistência em populações de R. (B.) microplus. Vacinas contra o carrapato representam uma tecnologia que pode ser combinada com acaricidas em programas de controle integrado para diminuir o impacto de R. (B.) microplus. A forma recombinante da Bm86 da cepa Campo Grande (rBm86-CG) de R. (B.) microplus foi produzido utilizando o sistema de expressão em Pichia pastoris para testar sua capacidade de imunoproteção ao gado contra a infestação de carrapatos. A secreção de rBm86-CG em P. pastoris pelo bioprocesso, simplificou a purificação do antígeno. A resposta imune humoral específica foi detectada por ELISA em soros de bovinos vacinados. Resultados de "imunoblot" revelaram que anticorpos policlonais de bovinos vacinados reconheceram uma proteína em extratos de larvas com um peso molecular correspondente à Bm86. O antígeno rBm86-CG mostrou eficácia de 31% contra a amostra CG de R. (B.) microplus utilizada para infestar os bovinos vacinados. Pelos resultados obtidos, concluímos que a rBm86-CG é um antígeno que pode ser usado em uma vacina polivalente, como parte de um programa integrado para o controle de R. (B.) microplus no estado do Mato Grosso do Sul, Brasil

Facies characteristics of Jurassic–Lower Cretaceous successions at Kösrelik–Kösrelikızığı (North of Ankara, Turkey)

Jurassic-Lower Cretaceous rocks in the Kosrelik and KosrelikA +/- zA +/- k areas (North of Ankara, Central Turkey) which were deposited in a tectonically controlled basin have outcrops in a very restricted area but they carry very important evidences for elucidating the Late Jurassic paleogeography of the Ankara region subjected to heavy tectonic activities during Hettangian-Oxfordian, especially during Sinemurian. Detailed facies analysis of sequences in the study area indicates that the deposition took place in two different tectonically controlled depositional settings, 3 km apart from each other. At the east of the study area, the succession is represented by Hettangian-Sinemurian aged basin sediments lying on the basement rocks with angular unconformity, but succession at the west comprises sediments of Oxfordian pelagic carbonate platform (PCP) overlying the basement rocks with angular unconformity. The PCP sediments were overlapped by radiolaria bearing pelagic limestone, Oxfordian-early Cretaceous in age, under relatively calm environmental conditions. Anomalies in C and O isotopes, trace elements and rare earth element values coincide with the periods of fast changes in the environmental conditions. The sedimentological and geochemical data indicated that the area was deepened and shallowed several times until early Cretaceous.Selcuk University Scientific Research Found (BAP) [10201116]This work was supported by Selcuk University Scientific Research Found (BAP, Project Number: 10201116). The authors thank Prof. Dr. Fusun ALKAYA for determining the taxonomy of ammonites in the study area. We thank Prof. Dr. Hukmu Orhan for constructive comments that improved the manuscript. We also thank anonymous reviewers for their valuable comments