Management of Pain in Autosomal Dominant Polycystic Kidney Disease and Anatomy of Renal Innervation

Purpose Chronic pain is a prominent feature of autosomal dominant polycystic kidney disease that is difficult to treat and manage, often resulting in a decrease in quality of life. Understanding the underlying anatomy of renal innervation and the various etiologies of pain that occur in autosomal dominant polycystic kidney disease can help guide proper treatments to manage pain. Reviewing previously studied treatments for pain in autosomal dominant polycystic kidney disease can help characterize treatment in a stepwise fashion. Materials and Methods We performed a literature search of the etiology and management of pain in autosomal dominant polycystic kidney disease and the anatomy of renal innervation using PubMed® and Embase® from January 1985 to April 2014 with limitations to human studies and English language. Results Pain occurs in the majority of patients with autosomal dominant polycystic kidney disease due to renal, hepatic and mechanical origins. Patients may experience different types of pain which can make it difficult to clinically confirm its etiology. An anatomical and histological evaluation of the complex renal innervation helps in understanding the mechanisms that can lead to renal pain. Understanding the complex nature of renal innervation is essential for surgeons to perform renal denervation. The management of pain in autosomal dominant polycystic kidney disease should be approached in a stepwise fashion. Acute causes of renal pain must first be ruled out due to the high incidence in autosomal dominant polycystic kidney disease. For chronic pain, nonopioid analgesics and conservative interventions can be used first, before opioid analgesics are considered. If pain continues there are surgical interventions such as renal cyst decortication, renal denervation and nephrectomy that can target pain produced by renal or hepatic cysts. Conclusions Chronic pain in patients with autosomal dominant polycystic kidney disease is often refractory to conservative, medical and other noninvasive treatments. There are effective surgical procedures that can be performed when more conservative treatments fail. Laparoscopic cyst decortication has been well studied and results in the relief of chronic renal pain in the majority of patients. In addition, renal denervation has been used successfully and could be performed concurrently with cyst decortication. Nephrectomy should be reserved for patients with intractable pain and renal failure when other modalities have failed

Effect of Live Yeast Saccharomyces cerevisiae on Post-weaning Performance, Diarrhea and Immune Parameters with an Environmental Challenge

Weaning imposes multiple stressors that reduce feed intake and impair intestinal integrity. Furthermore, poor environmental management could compound the high stress period increasing morbidity and mortality of postweaning piglets. The objective of this research was to investigate the effect of supplemental Saccharomyces cerevisiae on postweaning growth performance, fecal scores and immune parameters in a clean or dirty nursery environment. The experiment was a 2 X 2 factorial design with two dietary treatments fed in a sanitized (following barn SOP) and unsanitized (pits flushed, feeders and pens scraped) nursery environment. Weaned piglets (n=260 and 5pigs/pen; 20.8 day of age) were allotted to the following dietary treatments: 1) control or 2) Saccharomyces cerevisiae (0.1% in phase 1 and 2 and 0.05% phase 3 diets) for 5-wks postweaning. On days 3, 7, 14, 21 and 35 fecal scores/pen and blood samples were collected for monitoring diarrhea and measurement of cytokines. Overall, pigs fed Saccharomyces cerevisiae had greater ADG compared to control fed pigs regardless of environment (P= 0.09; 379 vs. 357 g/d, Saccharomyces cerevisiae vs control, respectively), and final pen weights at d35 were greater in Saccharomyces cerevisiae vs. control fed pigs (101 vs. 97 kg/pen; P < 0.05). Pigs reared in the dirty environment vs the clean environment had reduced overall ADG (352 vs 384 g/d, respectively; P = 0.01), and pigs raised in the dirty environment had an overall greater F:G ratio compared to pigs raised in clean environments; 1.87 vs. 1.76 g/g (P = 0.09). Diarrhea scores were increased in the dirty environment compared to the clean environment on days 3 and 7 (P < 0.01). Serum tumor necrosis factor alpha (TNF-α) concentrations were not significantly affected by diet or environment. In conclusion, Saccharomyces cerevisiae increased overall ADG in weaned pigs regardless of environment and environmental challenge reduced growth and efficiency parameters in the nursery pigs.A one-year embargo was granted for this item.Academic Major: Animal Science

The Effectiveness of a New Mole Repellent for Preventing Damage to Lawns by Eastern Moles

A new product containing 65% castor oil with the trade name Mole-Med was evaluated for its effectiveness in repelling eastern moles (Scalopus aquaticus) from lawns. Seven lawns in southern Michigan during September, 1993 were selected as preliminary test sites, and the ridges over mole tunnels in the lawns were flattened each day for 3 days. If some existing and new ridges were raised each day, the site was classified as having mole activity and continuing damage. The repellent was then applied according to label directions, and ridges above mole tunnels were flattened as described previously. If no tunnels were raised on the test lawn after one week, the repellent was considered to be effective. The repellent was classified as effective on all 7 test lawns. In May-July, 1994, 17 additional lawns were selected in the same way as preliminary test sites and classified as having or not having mole damage. Eleven received repellent treatment, while 6 were considered control, 3 adjacent to a treated area, 3 not adjacent to treated areas. Raised mole produced ridges were flattened on all test sites. On any site where ridges remained flattened and no new ridges were created for one week, moles were considered repelled. Mole activity as indicated by raised ridges ceased on eleven treated sites but continued on 5 of 6 control sites. The effectiveness of the repellent as indicated by the lack of new ridges continued for 65 days on one treatment site and for 30 days on the remaining treatment sites

Using Disaster Outcomes to Validate Components of Social Vulnerability to Floods: Flood Deaths and Property Damage across the USA

Social vulnerability indicators seek to identify populations susceptible to hazards based on aggregated sociodemographic data. Vulnerability indices are rarely validated with disaster outcome data at broad spatial scales, making it difficult to develop effective national scale strategies to mitigate loss for vulnerable populations. This paper validates social vulnerability indicators using two flood outcomes: death and damage. Regression models identify sociodemographic factors associated with variation in outcomes from 11,629 non-coastal flood events in the USA (2008–2012), controlling for flood intensity using stream gauge data. We compare models with (i) socioeconomic variables, (ii) the composite social vulnerability index (SoVI), and (iii) flood intensity variables only. The SoVI explains a larger portion of the variance in death (AIC = 2829) and damage (R2 = 0.125) than flood intensity alone (death—AIC = 2894; damage—R2 = 0.089), and models with individual sociodemographic factors perform best (death—AIC = 2696; damage—R2 = 0.229). Socioeconomic variables correlated with death (rural counties with a high proportion of elderly and young) differ from those related to property damage (rural counties with high percentage of Black, Hispanic and Native American populations below the poverty line). Results confirm that social vulnerability influences death and damage from floods in the USA. Model results indicate that social vulnerability models related to specific hazards and outcomes perform better than generic social vulnerability indices (e.g., SoVI) in predicting non-coastal flood death and damage. Hazard- and outcome-specific indices could be used to better direct efforts to ameliorate flood death and damage towards the people and places that need it most. Future validation studies should examine other flood outcomes, such as evacuation, migration and health, across scales

Inferring the past: a combined CNN-LSTM deep learning framework to fuse satellites for historical inundation mapping

Mapping floods using satellite data is crucial for managing and mitigating flood risks. Satellite imagery enables rapid and accurate analysis of large areas, providing critical information for emergency response and disaster management. Historical flood data derived from satellite imagery can inform long-term planning, risk management strategies, and insurance-related decisions. The Sentinel-1 satellite is effective for flood detection, but for longer time series, other satellites such as MODIS can be used in combination with deep learning models to accurately identify and map past flood events. We here develop a combined CNN--LSTM deep learning framework to fuse Sentinel-1 derived fractional flooded area with MODIS data in order to infer historical floods over Bangladesh. The results show how our framework outperforms a CNN-only approach and takes advantage of not only space, but also time in order to predict the fractional inundated area. The model is applied to historical MODIS data to infer the past 20 years of inundation extents over Bangladesh and compared to a thresholding algorithm and a physical model. Our fusion model outperforms both models in consistency and capacity to predict peak inundation extents.Comment: CVPR 2023: Earthvision Worksho