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Acute kidney injury (AKI) following hyperthermic intraperitoneal chemotherapy (HIPEC) is common. Identifying patients at risk could have implications for surgical and anesthetic management. We aimed to develop a predictive model that could predict AKI based on patients preoperative characteristics and intraperitoneal chemotherapy regimen. We retrospectively gathered data of adult patients undergoing HIPEC at our health system between November 2013 and April 2022. Next, we developed a model predicting postoperative AKI using multivariable logistic regression and calculated the performance of the model (area under the receiver operating characteristics curve [AUC]) via tenfold cross-validation. A total of 412 patients were included, of which 36 (8.7%) developed postoperative AKI. Based on our multivariable logistic regression model, multiple preoperative and intraoperative characteristics were associated with AKI. We included the total intraoperative cisplatin dose, body mass index, male sex, and preoperative hemoglobin level in the final model. The mean area under the receiver operating characteristics curve value was 0.82 (95% confidence interval 0.71-0.93). Our risk model predicted AKI with high accuracy in patients undergoing HIPEC in our institution. The external validity of our model should now be tested in independent and prospective patient cohorts.

Self-enrichment is one of the leading explanations for chemical anomalies in globular clusters. In this scenario, various candidate polluter stars have been proposed to eject gas with altered chemical composition during the self-enrichment process. Most of the proposed polluters will also eject radioactive |$^{26}$| Al into the surroundings. Hence, any detection of |$^{26}$| Al in young massive star clusters (YMCs) would support the self-enrichment scenario if YMCs were indeed the progenitors of globular clusters. Observations of gamma-ray data from COMPTEL and INTEGRAL, as well as detections of |$^{26}$| AlF molecules by the Atacama Large Millimeter-submillimeter Array (ALMA), indicate the maturing of |$^{26}$| Al detection methods. Detection possibilities will be enhanced in the short- to mid-term by the upcoming launch of the Compton Spectrometer and Imager (COSI). The Square Kilometre Array (SKA) could in principle also detect radio recombination lines of the positronium formed from the decay products of |$^{26}$| Al. Here, we show for a sample of YMCs in the nearby Universe, where self-enrichment could plausibly take place. For some nearby galaxies, this could enhance |$^{26}$| Al by an order of one magnitude. Detecting |$^{26}$| AlF with ALMA appears feasible for many candidate self-enrichment clusters, although significant challenges remain with other detection methods. The Large Magellanic Cloud, with its YMC R136, stands out as the most promising candidate. Detecting a 1.8 MeV radioactive decay line of |$^{26}$| Al here would require at least 15 months of targeted observation with COSI, assuming ongoing self-enrichment in R136. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of acute ischemia typically relies on evidence of ischemic lesions on magnetic resonance imaging (MRI), a limited diagnostic resource. We aimed to determine associations of clinical variables and acute infarcts on MRI in patients with suspected low-risk transient ischemic attack (TIA) and minor stroke and to assess their predictive ability., Methods: We conducted a post-hoc analysis of the Diagnosis of Uncertain-Origin Benign Transient Neurological Symptoms (DOUBT) study, a prospective, multicenter cohort study investigating the frequency of acute infarcts in patients with low-risk neurological symptoms. Primary outcome parameter was defined as diffusion-weighted imaging (DWI)-positive lesions on MRI. Logistic regression analysis was performed to evaluate associations of clinical characteristics with MRI-DWI-positivity. Model performance was evaluated by Harrel's c-statistic., Results: In 1028 patients, age (Odds Ratio (OR) 1.03, 95% Confidence Interval (CI) 1.01-1.05), motor (OR 2.18, 95%CI 1.27-3.65) or speech symptoms (OR 2.53, 95%CI 1.28-4.80), and no previous identical event (OR 1.75, 95%CI 1.07-2.99) were positively associated with MRI-DWI-positivity. Female sex (OR 0.47, 95%CI 0.32-0.68), dizziness and gait instability (OR 0.34, 95%CI 0.14-0.69), normal exam (OR 0.55, 95%CI 0.35-0.85) and resolved symptoms (OR 0.49, 95%CI 0.30-0.78) were negatively associated. Symptom duration and any additional symptoms/symptom combinations were not associated. Predictive ability of the model was moderate (c-statistic 0.72, 95%CI 0.69-0.77)., Conclusion: Detailed clinical information is helpful in assessing the risk of ischemia in patients with low-risk neurological events, but a predictive model had only moderate discriminative ability. Patients with clinically suspected low-risk TIA or minor stroke require MRI to confirm the diagnosis of cerebral ischemia.