What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis.

OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures. INTERVENTIONS: Temporary discontinuation of any of the medications of interest. PRIMARY AND SECONDARY OUTCOME MEASURES: Risk of AKI. Secondary outcome measures were estimated glomerular filtration rate and creatinine post-AKI, urea, systolic and diastolic blood pressure, death, clinical outcomes and biomarkers. RESULTS: 6 studies were included (1663 participants), 3 randomised controlled trials (RCTs) and 3 prospective cohort studies. The mean age ranged from 65 to 73 years, and the proportion of women ranged from 31% to 52%. All studies were in hospital settings; 5 evaluated discontinuation of medication prior to coronary angiography and 1 prior to cardiac surgery. 5 studies evaluated discontinuation of ACEI and ARBs and 1 small cohort study looked at discontinuation of non-steroidal anti-inflammatory drugs. No studies evaluated discontinuation of medication in the community following an acute intercurrent illness. There was an increased risk of AKI of around 15% in those in whom medication was continued compared with those in whom it was discontinued (relative risk (RR) 1.17, 95% CI 0.99 to 1.38; 5 studies). When only results from RCTs were pooled, the increase in risk was almost 50% (RR 1.48, 95% CI 0.84 to 2.60; 3 RCTs), but the CI was wider. There was no difference between groups for any secondary outcomes. CONCLUSIONS: There is low-quality evidence that withdrawal of ACEI/ARBs prior to coronary angiography and cardiac surgery may reduce the incidence of AKI. There is no evidence of the impact of drug cessation interventions on AKI incidence during intercurrent illness in primary or secondary care. TRIAL REGISTRATION NUMBER: PROSPERO CRD42015023210

Convergence in the classroom : expanding new media delivery and content in journalism and broadcast courses

Thesis (M.A.)--Michigan State University. Telecommunication, Information Studies and Media, 2010Includes bibliographical references (pages 67-70

Design of a Deployment and Retrieval System for Submerged Open-Ocean Aquaculture Structures

Increasing demand for seafood globally is pushing capture fisheries to their limits. Aquaculture is a viable, sustainable alternative to capture fisheries that is seeing significant growth worldwide. As near- shore sites are limited, new infrastructure is needed to support aquaculture further offshore in the open ocean. While several countries have developed large-scale structures to enable this open-ocean aquaculture, New Zealand is uniquely placed in that its aquaculture production is predominantly bivalves (shellfish); this provides the need for infrastructure to expand New Zealand’s bivalve aquaculture into the open ocean. Cawthron Institute has been conducting research into enabling this expansion, which produced a farm structure named the Shellfish Tower. While the Shellfish tower was proven to be a viable structure for open-ocean farming of shellfish, it lacked an efficient deployment and retrieval method. Unlike near-shore aquaculture, the Shellfish Tower was required to be submerged at significant depths to survive the high-energy environment of the open ocean. Therefore, there existed a need for a system to deploy and retrieve the Shellfish Tower. A deployment and retrieval system was designed through a structured design process, resulting in a capstan-winch climber device and a releasable wedge clamp. The climber was a novel application of existing marine technology by extending a capstan-style device into a submerged rope tensioner. All other commercial-scale aquaculture depth management systems currently use a ballasting system, which is of limited use in the application of the Shellfish Tower due to design criteria such as speed of deployment. The clamp design was less successful than the climber, as it required significant geometry optimisation of the clamp jaw cleat after production to enable correct grip and release functionality. It was recommended that alternative concepts be evaluated for future design developments of the clamp. Ocean force modelling was undertaken to determine the loads acting on the deployment and retrieval system. This modelling was completed using the Ansys AQWA package, which provided many tools ideal for ocean modelling. However, the analysis was complex, and the results were not as accurate as desired. The model provided a considerable understanding of the dynamics of the deployment and retrieval process, where it was discovered that snap loading caused peak loads during high sea states, which was in agreement with previous experimental research. This system was tested both on land and in the ocean, where it successfully submerged and retrieved a 1200 kg positively buoyant structure similar to the Shellfish Tower, proving the viability of the design. While significant design improvements remained before the system could be used commercially, the design was still a successful deployment and retrieval system that allowed for further development of the Shellfish Tower into a unique commercial solution that could further open-ocean aquaculture in New Zealand and globally

MRI atlas of a lizard brain

Magnetic resonance imaging (MRI) is an established technique for neuroanatomical analysis, being particularly useful in the medical sciences. However, the application of MRI to evolutionary neuroscience is still in its infancy. Few magnetic resonance brain atlases exist outside the standard model organisms in neuroscience and no magnetic resonance atlas has been produced for any reptile brain. A detailed understanding of reptilian brain anatomy is necessary to elucidate the evolutionary origin of enigmatic brain structures such as the cerebral cortex. Here, we present a magnetic resonance atlas for the brain of a representative squamate reptile, the Australian tawny dragon (Agamidae: Ctenophorus decresii), which has been the subject of numerous ecological and behavioral studies. We used a high-field 11.74T magnet, a paramagnetic contrasting-enhancing agent and minimum-deformation modeling of the brains of thirteen adult male individuals. From this, we created a high-resolution three-dimensional model of a lizard brain. The 3D-MRI model can be freely downloaded and allows a better comprehension of brain areas, nuclei, and fiber tracts, facilitating comparison with other species and setting the basis for future comparative evolution imaging studies. The MRI model and atlas of a tawny dragon brain (Ctenophorus decresii) can be viewed online and downloaded using the Wiley Biolucida Server at wiley.biolucida.net.Government of Australia, Grant/Award Numbers: APA#31/2011, IPRS#1182/2010; National Science and Engineering Research Council of Canada, Grant/Award Number: PGSD3-415253-2012; Quebec Nature and Technology Research Fund, Grant/AwardNumber: 208332; National Imaging Facility of Australia; Spanish Ministerio de Economía y Competitividad and Fondo Europeo de Desarrollo Regional, Grant/Award Number:BFU2015-68537-

Corrected and Republished from: "A Novel, Multiple-Antigen Pneumococcal Vaccine Protects against Lethal Streptococcus pneumoniae Challenge"

Current vaccination against Streptococcus pneumoniae uses vaccines based on capsular polysaccharides from selected serotypes and has led to nonvaccine serotype replacement disease. We have investigated an alternative serotype-independent approach, using multiple-antigen vaccines (MAV) prepared from S. pneumoniae TIGR4 lysates enriched for surface proteins by a chromatography step after culture under conditions that induce expression of heat shock proteins (Hsp; thought to be immune adjuvants). Proteomics and immunoblot analyses demonstrated that, compared to standard bacterial lysates, MAV was enriched with Hsps and contained several recognized protective protein antigens, including pneumococcal surface protein A (PspA) and pneumolysin (Ply). Vaccination of rodents with MAV induced robust antibody responses to multiple serotypes, including nonpneumococcal conjugate vaccine serotypes. Homologous and heterologous strains of S. pneumoniae were opsonized after incubation in sera from vaccinated rodents. In mouse models, active vaccination with MAV significantly protected against pneumonia, while passive transfer of rabbit serum from MAV-vaccinated rabbits significantly protected against sepsis caused by both homologous and heterologous S. pneumoniae strains. Direct comparison of MAV preparations made with or without the heat shock step showed no clear differences in protein antigen content and antigenicity, suggesting that the chromatography step rather than Hsp induction improved MAV antigenicity. Overall, these data suggest that the MAV approach may provide serotype-independent protection against S. pneumoniae

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

The FLASH pilot survey: an HI absorption search against MRC 1-Jy radio sources

We report an ASKAP search for associated HI 21-cm absorption against bright radio sources from the Molonglo Reference Catalogue (MRC) 1-Jy sample. The search uses pilot survey data from the ASKAP First Large Absorption Survey in \hi (FLASH) covering the redshift range $0.42 < z < 1.00$. From a sample of 62 MRC 1-Jy radio galaxies and quasars in this redshift range we report three new detections of associated HI 21-cm absorption, yielding an overall detection fraction of $1.8\%^{+4.0\%}_{-1.5\%}$. The detected systems comprise two radio galaxies (MRC 2216$-$281 at $z=0.657$ and MRC 0531$-$237 at $z=0.851$) and one quasar (MRC 2156$-$245 at $z=0.862$). The MRC 0531$-$237 absorption system is the strongest found to date, with a velocity integrated optical depth of $\rm 143.8 \pm 0.4 \ km \ s^{-1}$. All three objects with detected HI 21-cm absorption are peaked-spectrum or compact steep-spectrum (CSS) radio sources, classified based on our SED fits to the spectra. Two of them show strong interplanetary scintillation at 162 MHz, implying that the radio continuum source is smaller than 1 arcsec in size even at low frequencies. Among the class of peaked-spectrum and compact steep-spectrum radio sources, the HI detection fraction is $23\%^{+22\%}_{-13\%}$. This is consistent within $1\sigma$ with a detection fraction of $\approx 42\%^{+21\%}_{-15\%}$ in earlier reported GPS and CSS samples at intermediate redshifts ($0.4 < z < 1.0$). All three detections have a high 1.4 GHz radio luminosity, with MRC 0531$-$237 and MRC 2216$-$281 having the highest values in the sample, $\rm > 27.5 \ W \ Hz^{-1}$. The preponderance of extended radio sources in our sample could partially explain the overall low detection fraction, while the effects of a redshift evolution in gas properties and AGN UV luminosity on the neutral gas absorption still need to be investigated.Comment: 28 pages, 9 figures and 7 Tables. Submitted to MNRA

The Journal of Microelectronic Research 2009

https://scholarworks.rit.edu/meec_archive/1017/thumbnail.jp

Tackling immunosuppression by Neisseria gonorrhoeae to facilitate vaccine design.

Gonorrhoea, caused by Neisseria gonorrhoeae, is a common sexually transmitted infection. Increasing multi-drug resistance and the impact of asymptomatic infections on sexual and reproductive health underline the need for an effective gonococcal vaccine. Outer membrane vesicles (OMVs) from Neisseria meningitidis induce modest cross-protection against gonococcal infection. However, the presence of proteins in OMVs derived from N. gonorrhoeae that manipulate immune responses could hamper their success as a vaccine. Here we modified two key immunomodulatory proteins of the gonococcus; RmpM, which can elicit 'blocking antibodies', and PorB, an outer membrane porin which contributes to immunosuppression. As meningococcal PorB has adjuvant properties, we replaced gonococcal PorB with a meningococcal PorB. Immunisation with OMVs from N. gonorrhoeae lacking rmpM and expressing meningococcal porB elicited higher antibody titres against model antigens in mice compared to OMVs with native PorB. Further, a gonococcal protein microarray revealed stronger IgG antibody responses to a more diverse range of antigens in the Nm PorB OMV immunised group. Finally, meningococcal PorB OMVs resulted in a Th1-skewed response, exemplified by increased serum IgG2a antibody responses and increased IFNɣ production by splenocytes from immunised mice. In summary, we demonstrate that the replacement of PorB in gonococcal OMVs enhances immune responses and offers a strategy for gonococcal vaccine development

Contributions and perspectives of Indigenous Peoples to the study of mercury in the Arctic

Arctic Indigenous Peoples are among the most exposed humans when it comes to foodborne mercury (Hg). In response, Hg monitoring and research have been on-going in the circumpolar Arctic since about 1991; this work has been mainly possible through the involvement of Arctic Indigenous Peoples. The present overview was initially conducted in the context of a broader assessment of Hg research organized by the Arctic Monitoring and Assessment Programme. This article provides examples of Indigenous Peoples' contributions to Hg monitoring and research in the Arctic, and discusses approaches that could be used, and improved upon, when carrying out future activities. Over 40 mercury projects conducted with/by Indigenous Peoples are identified for different circumpolar regions including the U.S., Canada, Greenland, Sweden, Finland, and Russia as well as instances where Indigenous Knowledge contributed to the understanding of Hg contamination in the Arctic. Perspectives and visions of future Hg research as well as recommendations are presented. The establishment of collaborative processes and partnership/co-production approaches with scientists and Indigenous Peoples, using good communication practices and transparency in research activities, are key to the success of research and monitoring activities in the Arctic. Sustainable funding for community-driven monitoring and research programs in Arctic countries would be beneficial and assist in developing more research/ monitoring capacity and would promote a more holistic approach to understanding Hg in the Arctic. These activities should be well connected to circumpolar/international initiatives to ensure broader availability of the information and uptake in policy development