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Ụzọ mma: Pathway to Intangible Cultural Heritage in Otobo Ugwu Dunoka Lejja, South-eastern Nigeria
Christian Chukwuma Opata,Apex Anselm Apeh 국립민속박물관 2016 International Journal of Intangible Heritage Vol.11 No.-
Heritage sites and their management remain an issue in Nigeria in general, and in South-eastern Nigeria in particular. These stem largely from the spate of wanton destruction of cultural heritage in Igboland, Eastern Nigeria by some Christian fundamentalists. Otobo Ugwu Dunoka Lejja, South-eastern Nigeria, is an open public square which serves as the traditional parliamentary, judicial and ritual square for the thirty-three villages in the Lejja community. It was also an iron smelting site and has the highest concentration of iron slag blocks in sub-Saharan Africa. Divided into four sections by rows of iron slag blocks, the square is full of monuments connected with iron smelting and community history. These monuments are linked to the rules and ethical values which form the intangible cultural heritage associated with iron smelting in the community. The approach in this study is multi- and interdisciplinary, as recourse is made to sociology, ethno-history, political economy, anthropology and the interface between these complementary disciplines. Based on extensive field work in the community, the researchers interrogate the meaning and essence of some of the values attached to the square and the monuments therein. These traditional values could help address the problems created by iconoclasts who pride themselves on destroying cultural heritage in Igboland, ostensibly in the name of Christianity.
Christian Albert,Michael Haase,Annemarie Albert,Siegfried Kropf,Rinaldo Bellomo,Sabine Westphal,Mark Westerman,Rüdiger Christian Braun-Dullaeus,Anja Haase-Fielitz 대한진단검사의학회 2020 Annals of Laboratory Medicine Vol.40 No.2
Background: The ability of urinary biomarkers to complement established clinical risk prediction models for postoperative adverse kidney events is unclear. We assessed the effect of urinary biomarkers linked to suspected pathogenesis of cardiac surgery-induced acute kidney injury (AKI) on the performance of the Cleveland Score, a risk assessment model for postoperative adverse kidney events. Methods: This pilot study included 100 patients who underwent open-heart surgery. We determined improvements to the Cleveland Score when adding urinary biomarkers measured using clinical laboratory platforms (neutrophil gelatinase-associated lipocalin [NGAL], interleukin-6) and those in the preclinical stage (hepcidin-25, midkine, alpha-1 microglobulin), all sampled immediately post-surgery. The primary endpoint was major adverse kidney events (MAKE), and the secondary endpoint was AKI. We performed ROC curve analysis, assessed baseline model performance (odds ratios [OR], 95% CI), and carried out statistical reclassification analyses to assess model improvement. Results: NGAL (OR [95% CI] per 20 concentration-units wherever applicable): (1.07 [1.01–1.14]), Interleukin-6 (1.51 [1.01–2.26]), midkine (1.01 [1.00–1.02]), 1-hepcidin-25 (1.08 [1.00–1.17]), and NGAL/hepcidin-ratio (2.91 [1.30–6.49]) were independent predictors of MAKE and AKI (1.38 [1.03–1.85], 1.08 [1.01–1.15], 1.01 [1.00–1.02], 1.09 [1.01–1.18], and 3.45 [1.54–7.72]). Category-free net reclassification improvement identified interleukin-6 as a model-improving biomarker for MAKE and NGAL for AKI. However, only NGAL/hepcidin-25 improved model performance for event- and event-free patients for MAKE and AKI. Conclusions: NGAL and interleukin-6 measured immediately post cardiac surgery may complement the Cleveland Score. The com
Biomarker-Guided Risk Assessment for Acute Kidney Injury: Time for Clinical Implementation?
Albert Christian,Haase Michael,Albert Annemarie,Zapf Antonia,Braun-Dullaeus Rüdiger Christian,Haase-Fielitz Anja 대한진단검사의학회 2021 Annals of Laboratory Medicine Vol.41 No.1
Acute kidney injury (AKI) is a common and serious complication in hospitalized patients, which continues to pose a clinical challenge for treating physicians. The most recent Kidney Disease Improving Global Outcomes practice guidelines for AKI have restated the importance of earliest possible detection of AKI and adjusting treatment accordingly. Since the emergence of initial studies examining the use of neutrophil gelatinase-associated lipocalin (NGAL) and cycle arrest biomarkers, tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein (IGFBP7), for early diagnosis of AKI, a vast number of studies have investigated the accuracy and additional clinical benefits of these biomarkers. As proposed by the Acute Dialysis Quality Initiative, new AKI diagnostic criteria should equally utilize glomerular function and tubular injury markers for AKI diagnosis. In addition to refining our capabilities in kidney risk prediction with kidney injury biomarkers, structural disorder phenotypes referred to as “preclinical-” and “subclinical AKI” have been described and are increasingly recognized. Additionally, positive biomarker test findings were found to provide prognostic information regardless of an acute decline in renal function (positive serum creatinine criteria). We summarize and discuss the recent findings focusing on two of the most promising and clinically available kidney injury biomarkers, NGAL and cell cycle arrest markers, in the context of AKI phenotypes. Finally, we draw conclusions regarding the clinical implications for kidney risk prediction.