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  • 1
    In: BJS Open, Oxford University Press (OUP), Vol. 6, No. 1 ( 2022-01-06)
    Abstract: Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multicentre cohort studies. Methods The Outcomes After Kidney injury in Surgery (OAKS) prognostic model was developed to predict risk of AKI in the 7 days after surgery using six routine datapoints (age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker). Validation was performed within two independent cohorts: a prospective multicentre, international study (‘IMAGINE’) of patients undergoing elective colorectal surgery (2018); and a retrospective regional cohort study (‘Tayside’) in major abdominal surgery (2011–2015). Multivariable logistic regression was used to predict risk of AKI, with multiple imputation used to account for data missing at random. Prognostic accuracy was assessed for patients at high risk (greater than 20 per cent) of postoperative AKI. Results In the validation cohorts, 12.9 per cent of patients (661 of 5106) in IMAGINE and 14.7 per cent (106 of 719 patients) in Tayside developed 7-day postoperative AKI. Using the OAKS model, 558 patients (9.6 per cent) were classified as high risk. Less than 10 per cent of patients classified as low-risk developed AKI in either cohort (negative predictive value greater than 0.9). Upon external validation, the OAKS model retained an area under the receiver operating characteristic (AUC) curve of range 0.655–0.681 (Tayside 95 per cent c.i. 0.596 to 0.714; IMAGINE 95 per cent c.i. 0.659 to 0.703), sensitivity values range 0.323–0.352 (IMAGINE 95 per cent c.i. 0.281 to 0.368; Tayside 95 per cent c.i. 0.253 to 0.461), and specificity range 0.881–0.890 (Tayside 95 per cent c.i. 0.853 to 0.905; IMAGINE 95 per cent c.i. 0.881 to 0.899). Conclusion The OAKS prognostic model can identify patients who are not at high risk of postoperative AKI after gastrointestinal surgery with high specificity. Presented to Association of Surgeons in Training (ASiT) International Conference 2018 (Edinburgh, UK), European Society of Coloproctology (ESCP) International Conference 2018 (Nice, France), SARS (Society of Academic and Research Surgery) 2020 (Virtual, UK).
    Type of Medium: Online Resource
    ISSN: 2474-9842
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2902033-5
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  • 2
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 2 ( 2020-01-05), p. e161-e169
    Abstract: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P & lt; 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2006309-X
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  • 3
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 3 ( 2019-02-05)
    Abstract: See Editorial by Ding et al .
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2653953-6
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  • 4
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2011
    In:  Clinical Kidney Journal Vol. 4, No. suppl 2 ( 2011-06-01), p. 4.s2.16-4.s2.16
    In: Clinical Kidney Journal, Oxford University Press (OUP), Vol. 4, No. suppl 2 ( 2011-06-01), p. 4.s2.16-4.s2.16
    Type of Medium: Online Resource
    ISSN: 2048-8505 , 2048-8513
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2011
    detail.hit.zdb_id: 2656786-6
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  • 5
    In: Science, American Association for the Advancement of Science (AAAS), Vol. 334, No. 6055 ( 2011-10-28), p. 521-524
    Type of Medium: Online Resource
    ISSN: 0036-8075 , 1095-9203
    RVK:
    RVK:
    Language: English
    Publisher: American Association for the Advancement of Science (AAAS)
    Publication Date: 2011
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  • 6
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 107, No. 5 ( 2020-03-18), p. 552-559
    Abstract: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P & lt; 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 7
    Online Resource
    Online Resource
    Wiley ; 1983
    In:  Soil Science Society of America Journal Vol. 47, No. 4 ( 1983-07), p. 810-817
    In: Soil Science Society of America Journal, Wiley, Vol. 47, No. 4 ( 1983-07), p. 810-817
    Abstract: Efficient N applications are necessary to maximize bermudagrass ( Cynodon dactylon L.) dry matter yield and N uptake in forage. Significant losses of NH 3 from surface applications of urea and NH 4 ‐N fertilizers by volatilization have been reported. Field experiments were conducted over a three‐year period under a wide range of climatic and soil conditions in Oklahoma to determine the efficiency of N applications for dry matter production and N uptake in bermudagrass forage. Four locations were selected in 1978 and one each in 1979 and 1980, representing four typical soil types for bermudagrass production with a pH range of 4.7 to 6.9. Anhydrous ammonia (AA) and ammonia passed through a Cold‐Flo adapter (ACF) were injected into bermudagrass sod and urea‐ammonium‐nitrate (UAN), urea, and (NH 4 ) 2 SO 4 (AS) were broadcast. Rates of N were 0, 112, 224, and 448 kg·ha −1 initially as well as 224, 336, and 448 kg·ha −1 in split applications. An additional experiment was established in 1980 to evaluate the effect of S on yield and N uptake. Rates of S were 0 and 64 kg · ha −1 and sources were elemental S, CaSO 4 · 2H 2 0, MgSO 4 , and AS. There were two harvests at each location in 1978, three in 1979, and two in 1980. Yield and N uptake from AA and ACF applications were not significantly different, but generally were lower than with broadcast UAN, urea, and AS. Yield and N uptake generally were lower from urea than UAN and AS. Relative efficiency of N sources obtained from averaging across N response experiments were in the order of AS 〉 UAN 〉 urea 〉 AA 〉 ACF. Split application of N in 1978 and 1980 did not increase yield, but in 1979 an increase in yield was obtained with more even rainfall distribution during the growing season. Sulfur fertilization decreased N:S ratios in forage, but did not increase yield or N uptake or improve N efficiency. Potential losses of NH 3 by volatilization from broadcast urea, UAN, and AS in these experiments were considered minimal.
    Type of Medium: Online Resource
    ISSN: 0361-5995 , 1435-0661
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 1983
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    detail.hit.zdb_id: 2239747-4
    detail.hit.zdb_id: 196788-5
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    SSG: 13
    SSG: 21
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  • 8
    Online Resource
    Online Resource
    Acoustical Society of America (ASA) ; 1984
    In:  The Journal of the Acoustical Society of America Vol. 76, No. S1 ( 1984-10-01), p. S4-S4
    In: The Journal of the Acoustical Society of America, Acoustical Society of America (ASA), Vol. 76, No. S1 ( 1984-10-01), p. S4-S4
    Abstract: Changes in sound intensity generally produce dynamic or transient changes in the responses of auditory neurons in addition to sustained or steady-state changes. These dynamic components appear to enhance the response to changes in intensity and potentially play an important role in intensity discrimination. The distinction between dynamic and steady-state responsiveness appears to be minimal in responses of hair cells, significant in responses of auditory nerve fibers, and still greater in some units of the cochlear nucleus. Results will be reviewed comparing responses in the three regions to step, ramp, and sinusoidally modulated changes in intensity. Underlying mechanisms will be discussed that may be responsible for producing the observed increases in both the magnitude and operating range of the dynamic response components.
    Type of Medium: Online Resource
    ISSN: 0001-4966 , 1520-8524
    RVK:
    Language: English
    Publisher: Acoustical Society of America (ASA)
    Publication Date: 1984
    detail.hit.zdb_id: 1461063-2
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  • 9
    Online Resource
    Online Resource
    Wiley ; 1972
    In:  Soil Science Society of America Journal Vol. 36, No. 1 ( 1972-01), p. 82-86
    In: Soil Science Society of America Journal, Wiley, Vol. 36, No. 1 ( 1972-01), p. 82-86
    Abstract: Urea and oxamide, each labeled with 15 N, were compared as fertilizers in two field experiments in adjacent locations in successive years with ‘Sudax SX11’ Sorghum‐sudan hybrid ( Sorghum sudanense ) as the test crop. Four cuttings were harvested during the first experiment and three during the second. Patterns of uptake of fertilizer N were in accord with the characteristics of the two carriers. In the first harvests in both experiments the amounts of N taken up from urea were markedly greater than from oxamide; but by the third harvests, yield responses and N uptake from oxamide were greater than from urea. Total recoveries of fertilizer N from the two carriers during the entire growing season were similar as greater recoveries of urea‐N in the early summer were compensated for by greater recoveries of oxamide‐N in the late summer. Of the N added in urea in the first experiment, 51% was recovered in the crops and 28% was still in the soil (0–25cm) at the end of the growing season. Corresponding figures for oxamide were 52% in the crops and 31% in the soil. In the second experiment, when fertilizer applications and planting operations were delayed until more favorable growing weather, 93% and 99% of the urea‐ and oxamide‐N, respectively, were estimated as recovered in the crops, and measurements of the amounts of fertilizer remaining in the soil were not attempted.
    Type of Medium: Online Resource
    ISSN: 0361-5995 , 1435-0661
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 1972
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    detail.hit.zdb_id: 196788-5
    detail.hit.zdb_id: 1481691-X
    SSG: 13
    SSG: 21
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  • 10
    Online Resource
    Online Resource
    American Physiological Society ; 1988
    In:  Journal of Neurophysiology Vol. 59, No. 4 ( 1988-04-01), p. 1083-1097
    In: Journal of Neurophysiology, American Physiological Society, Vol. 59, No. 4 ( 1988-04-01), p. 1083-1097
    Abstract: 1. The neurophysiological basis for the sensation of prickle evoked by contact of some fabrics with the skin is reported. 2. Single-unit sensory nerve recordings from the rabbit saphenous nerve were used to identify the receptors responsible for fabric-evoked prickle. These recordings showed that all low-threshold mechanoreceptors were activated by fabric, but they did not show differential response to prickly and nonprickly fabrics. 3. However, the response of some nociceptors, both A delta and polymodal C, differed according to the prickliness of fabrics. Some of these receptors responded to fine von Frey hairs with buckling loads of at least 75 mgf. This suggested that the prickle stimuli on the fabric surface were protruding fiber ends that exerted loads of 75 mgf, or more, against the skin. 4. A Teflon replication technique was devised for estimating the density of these fiber ends. Estimates of the sensation magnitude of prickle from graded fabric sets by a panel of 55 subjects correlated (coefficient 0.91) with this measure of fiber end density. 5. We conclude from these results that fabric-evoked prickle is the result of low-grade activity in nociceptors and that the stimuli are protruding fiber ends exerting loads of approximately 75 mgf or more against the skin.
    Type of Medium: Online Resource
    ISSN: 0022-3077 , 1522-1598
    RVK:
    Language: English
    Publisher: American Physiological Society
    Publication Date: 1988
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    detail.hit.zdb_id: 1467889-5
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