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Our world tour : a photographic journey around the world
\"This book takes you on a journey around the world through the eyes of photographer Mario Dirks. In the fall of 2011, camera and lens manufacturer Sigma sent Mario on a yearlong adventure to photograph the most beautiful places on earth.\"-- Provided by publisher.
Book
The Dose Response Multicentre Investigation on Fluid Assessment (DoReMIFA) in critically ill patients
Background
The previously published “Dose Response Multicentre International Collaborative Initiative (DoReMi)” study concluded that the high mortality of critically ill patients with acute kidney injury (AKI) was unlikely to be related to an inadequate dose of renal replacement therapy (RRT) and other factors were contributing. This follow-up study aimed to investigate the impact of daily fluid balance and fluid accumulation on mortality of critically ill patients without AKI (N-AKI), with AKI (AKI) and with AKI on RRT (AKI-RRT) receiving an adequate dose of RRT.
Methods
We prospectively enrolled all consecutive patients admitted to 21 intensive care units (ICUs) from nine countries and collected baseline characteristics, comorbidities, severity of illness, presence of sepsis, daily physiologic parameters and fluid intake-output, AKI stage, need for RRT and survival status. Daily fluid balance was computed and fluid overload (FO) was defined as percentage of admission body weight (BW). Maximum fluid overload (MFO) was the peak value of FO.
Results
We analysed 1734 patients. A total of 991 (57 %) had N-AKI, 560 (32 %) had AKI but did not have RRT and 183 (11 %) had AKI-RRT. ICU mortality was 22.3 % in AKI patients and 5.6 % in those without AKI (
p
< 0.0001). Progressive fluid accumulation was seen in all three groups. Maximum fluid accumulation occurred on day 2 in N-AKI patients (2.8 % of BW), on day 3 in AKI patients not receiving RRT (4.3 % of BW) and on day 5 in AKI-RRT patients (7.9 % of BW). The main findings were: (1) the odds ratio (OR) for hospital mortality increased by 1.075 (95 % confidence interval 1.055–1.095) with every 1 % increase of MFO. When adjusting for severity of illness and AKI status, the OR changed to 1.044. This phenomenon was a continuum and independent of thresholds as previously reported. (2) Multivariate analysis confirmed that the speed of fluid accumulation was independently associated with ICU mortality. (3) Fluid accumulation increased significantly in the 3-day period prior to the diagnosis of AKI and peaked 3 days later.
Conclusions
In critically ill patients, the severity and speed of fluid accumulation are independent risk factors for ICU mortality. Fluid balance abnormality precedes and follows the diagnosis of AKI.
Journal Article
Cruising the Library
Cruising the Library examines the ways in which library classifications have organized sexuality and sexual perversion. The author studies the Library of Congress Subject Headings and Classification, as well as the Library of Congress's Delta Collection, a restricted collection of obscenity until 1964.
eBook
Photographs from the edge : a master photographer's insights on capturing an extraordinary world
\"Art Wolfe, one of the world's most celebrated nature photographers, recounts the stories behind the images of forty years of expeditionary photography capturing vanishing and rarely seen lands, creatures, and populations often at the edge of extinction. Legendary photographer Art Wolfe recounts the stories behind the images of forty years of expeditionary photography capturing vanishing lands, creatures, and peoples at the edge of extinction. Wolfe and co-author Rob Sheppard transportv readers, while carrying on a dialog about photography, technique & process, world travel, close calls and photographic opportunities both taken and missed. From the rich sights and smells of the Pushkar Camel Fair to the exact moment when a polar bear and her cubs leave their arctic den, Photographs from the Edge represents what Wolfe has lived for: the instances when circumstance, light, and subject miraculously collide to form an iconic image. Many of these photographs can never be duplicated as cultures and landscapes are transformed and wildlife diminishes or disappears all together. Whether discussing his photographs of endangered lands, peoples, or wildlife, Wolfe regales readers with the stories behind the photographs and helps them experience life on the world's most unique photo safari. Photographs from the Edge is a lifetime of experience distilled into a rich photographic education\"-- Provided by publisher.
Book
Artery Wall Assessment Helps Predict Kidney Transplant Outcome
Kidney transplant recipients have high cardiovascular risk, and vascular inflammation may play an important role. We explored whether the inflammatory state in the vessel wall was related to carotid intima-media thickness (c-IMT) and patient survival following kidney transplantation.
In this prospective observational cohort study we measured c-IMT and expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery in 115 kidney transplant candidates. Another c-IMT measurement was done 1-year post-transplantation in 107. By stepwise multiple regression analysis we explored factors associated with baseline c-IMT and their changes over time. Multivariate Cox regression analysis was constructed to identify risk factors for mortality.
A worse cardiovascular profile (older age, smoker, diabetic, carotid plaque, systolic blood pressure and vascular calcification) and higher VCAM-1 levels were found in patients in the highest baseline c-IMT tertile, who also had a worse survival. Factors independently related to baseline c-IMT were age (β=0.369, P<0.0001), fasting glucose (β=0.168, P=0.045), smoking (β=0.228, P=0.003) and VCAM-1 levels (β=0.244, P=0.002). Independent factors associated with c-IMT measurement 1-year post-transplantation were baseline c-IMT (β=-0.677, P<0.0001), post-transplant diabetes (β=0.225, P=0.003) and triglycerides (β=0.302, P=0.023). Vascular VCAM-1 levels were associated with increased risk of mortality in bivariate and multivariate Cox regression. Notably, nearly 50% of patients showed an increase or maintenance of high c-IMT 1 year post-transplantation and these patients experienced a higher mortality (13 versus 3.5%; P=0.021).
A worse cardiovascular profile and a higher vascular VCAM-1 protein levels at time of KT are related to subclinical atheromatosis. This could lead to a higher post-transplant mortality. Pre-transplant c IMT, post-transplant diabetes and triglycerides at 1-year post-transplantation may condition a high c-IMT measurement post-transplantation, which may decrease patient survival.
Journal Article
The art of movement
\"A collection of photographs by Ken Browar and Deborah Ory that capture the movement, flow, energy, and grace of many of the most accomplished dancers in the world. Featured are more than 70 dancers from companies including American Ballet Theatre, New York City Ballet, Alvin Ailey American Dance Theater, Martha Graham Dance Company, Boston Ballet, Royal Danish Ballet, The Royal Ballet, and many more. Accompanying the photographs are intimate and inspiring words from the dancers, as well as from choreographers and artistic directors, on what dance means to them\"--From publisher description.
Book
Structural analysis of the GPI glycan
Glycosylphosphatidylinositol (GPI) anchoring of proteins is an essential post-translational modification in all eukaryotes that occurs at the endoplasmic reticulum (ER) and serves to deliver GPI-anchored proteins (GPI-APs) to the cell surface where they play a wide variety of vital physiological roles. This paper describes a specialized method for purification and structural analysis of the GPI glycan of individual GPI-APs in yeast. The protocol involves the expression of a specific GPI-AP tagged with GFP, enzymatic release from the cellular membrane fraction, immunopurification, separation by electrophoresis and analysis of the peptides bearing GPI glycans by mass spectrometry after trypsin digestion. We used specifically this protocol to address the structural remodeling that undergoes the GPI glycan of a specific GPI-AP during its transport to the cell surface. This method can be also applied to investigate the GPI-AP biosynthetic pathway and to directly confirm predicted GPI-anchoring of individual proteins.
Journal Article