Detection of acute kidney injury in premature asphyxiated neonates by serum neutrophil gelatinase-associated lipocalin (sNGAL) – sensitivity and specificity of a potential new biomarker

Introduction

Acute kidney injury (AKI) is common in neonatal intensive care units (NICU). In recent years, every effort is made for early detection of AKI. Our hypothesis was that serum neutrophil gelatinase-associated lipocalin (sNGAL) may be a reliable screening test for early diagnosis of AKI in premature neonates after perinatal asphyxia. Therefore, our aim was to assess the diagnostic accuracy of sNGAL for AKI in premature asphyxiated neonates.

Materials and methods

AKI was defined in the third day of life (DOL 3) as a serum creatinine (sCr) increase ≥ 26.5 μmol/L from baseline (the lowest previous sCr). According to the increase of sCr, AKI patients were divided in AKIN1 (sCr increase up to 1.9 baseline) and AKIN2 (sCr increase from 2.0 to 2.9 baseline). sNGAL levels were measured on DOL 1, 3 and 7.

Results

AKI was diagnosed in 73 (0.676) of 108 enrolled premature asphyxiated neonates. Sixty one patients (0.836) were classified in AKIN1 and 12 patients (0.164) in AKIN2. sNGAL reached the maximal concentrations on DOL 1 within 4 hours after admission to NICU, being higher in AKI compared with no-AKI group (160.8 ± 113.1 vs. 87.1 ± 81.6; P < 0.001) as well as in AKIN2 compared with AKIN1 group (222.8 ± 112.9 vs. 147.8 ± 109.9; P < 0.001). The best areas under the receiver operating characteristic curves (AUC) for prediction of AKI were 0.72 [95% (0.62-0.80) P < 0.001] on DOL1 at 2h and 0.72 [95% (0.63-0.80) P < 0.001] at 4th hour after admission respectively. The corresponding sNGAL cutoff concentrations were 84.87 ng/mL (sensitivity 69.0% and specificity 71.9%) and 89.43 ng/mL (sensitivity 65.7% and specificity 74.3%).

Conclusions

In premature asphyxiated neonates sNGAL measured within the first 4 hours of DOL 1 is predictive of the occurrence and severity of AKI. Therefore, plasma levels of NGAL may be used for early diagnosis of AKI in these patients.Key words: serum neutrophil gelatinase-associated lipocalin, acute kidney injury, premature neonates, biomarker     

Effect of 12-week-long aerobic training programme on body composition,aerobic capacity,complete blood count and blood lipid profile among young women

Background

Numerous data suggest that aerobic-type exercise improves lipoprotein-lipid profiles, cardiorespiratory fitness and body composition in young women. The aim of this study was to evaluate the biological response to high-low impact aerobic fitness among young women.

Materials and methods

Thirty-four young women aged 22 (19-24) years were divided into three groups: underweight (N = 10), normal weight (N = 12) and overweight (N = 12). Aerobic capacity, anthropometry and body composition together with complete blood count and lipid profile were determined before and after completion of a 12-week-long training period.

Results

The training programme caused a significant decrease in weight (by 4.3 kg, P = 0.003), body mass index (by 1.3 kg/m², P = 0.003), free fat mass (by 2.1 kg, P = 0.002), total body water (by 0.4 kg, P = 0.036), percentage of fat (by 3 percent points, P = 0.002), all analyzed skinfolds thicknesses, as well as the lipid profile in overweight group, and no changes in normal weight group. Significant changes in weight (by 4.2 kg, P = 0.005), body mass index (by 0.9 kg/m², P = 0.005), crus skinfold thickness (by 3.3 mm, P = 0.028), and in maximum oxygen uptake (by 2.49 mL/kg/min; P = 0.047) were observed among underweight women. No change in total blood count was observed in all groups.

Conclusion

Twelve-week-long fitness training programme of two alternating styles (low and high impact) has a beneficial effect on overweight young women.Key words: body composition, physical fitness, overweight, women     

Organizational commitment,knowledge sharing and organizational citizenship behaviour: the case of the Taiwanese semiconductor industry

The semiconductor industry has made great contributions to Taiwan’s economy in the past 20 years. Because of competitive salaries and generous fringe benefits, some famous semiconductor manufacturers have become the best choice for students right after graduation. However, such magnetic effect has gradually faded away in the face of implementation of expensive employee bonuses. In a changeable environment, sharing knowledge will maintain organizational competitiveness and improve employees’ cohesion. As the semiconductor industry is characterized by a low-wage and high-turnover rate, the incurred job insecurities and career uncertainties have begun to force employees to change their cohesion, loyalty to organizations and even to reduce their willingness to share knowledge with others. This study aims to explore the relationships among organizational commitment (OC), knowledge sharing (KS) and organizational citizenship behavior (OCB) in the Taiwanese semiconductor industry. On the basis of 428 subjects, the results show that KS has a partial mediating effect on the OC–OCB relationship.     

Unravelling knowledge creation and management in educational organisations: barriers and enablers

Knowledge Creation and Management (KCM) is one of the main strategies for fostering improvement in any kind of organisation, including educational organisations, on which this paper is focused. While KCM is being widely studied, little attention has been given to KCM in organisations supplying education, training and/or assessment services to learners (i.e., primary and secondary schools or higher education institutions, among others). From an educational management approach, the aim of this paper is to describe and analyse the factors that foster or inhibit KCM processes conducted within educational organisations. Professionals (n=84), moderators and managers or institutional leaders of four selected cases were surveyed and interviewed. Results show the importance of the main organisational and procedural factors (i.e., organisational values and goals, leadership, structure, culture, dynamics, Information and Communications Technologies, KCM processes and people) to improve KCM results in educational organisations.     

Factors shaping organizational dynamics in strategic knowledge management

Knowledge as a valuable asset of organizations is increasingly incorporated into thinking about strategy. Studies of knowledge management (KM) suggest that executives engaged in decision making often have a slender understanding of the strategic significance of knowledge. When addressing the challenge of explicating and designing a knowledge strategy, logics of codification and personalization have been differentiated and commended. The paper draws upon evidence from four case studies to identify factors that shape the evolving contexts of knowledge strategies. It is in these contexts that the challenge of continuously reviewing and revising the mix of codifying and personalizing aspects of strategic KM is practically accomplished. The cases are analysed with reference to external competition, leadership, organizational politics, culture and technology as a basis for advancing a more dynamic framework for the analysis of knowledge strategies.     

Issues in the management of embedded knowledge in project-based organizations: the project actor’s role

Knowledge management (KM) in project-based organizations has received substantial attention in recent years, as knowledge processes are insufficiently supported within the organization as a whole. This study specifically focuses on the project actor’s role in managing knowledge. From an actor’s perspective, the problems raised by knowledge embeddedness are identified as a key issue to link project knowledge and organizational knowledge. A conceptual framework is developed that addresses three different aspects of knowledge embeddedness: a relational dimension, a temporal dimension and a structural dimension. Three cases are studied, covering varying forms of organizations in different areas (a consulting firm, an R&D department and an industrial business unit). The results concerning the relational dimension indicate that project actors re-build the network of relationships supporting knowledge. Regarding the temporal dimension, and specifically in their professional field, actors frame professional knowledge related to their project experience. However, actors fail to surmount the problems raised by the structural dimension of knowledge embeddedness. The resulting recommendations for KM concern both Human Resource Management practices and organizational design.     

挂胶履带板底板的热处理工艺改进

传统的挂胶履带底板冷冲压成形-热处理-人工矫直工艺,底板的氧化、脱碳、变形、开裂和硬度离散度大,矫平的工作量大,底板的寿命参差不齐.改进工艺为底板感应加热热压成型-压床淬火,固定集中回火,解决了传统工艺底板质量不稳定质量差的问题.     

关于嵌入式构件模型研究

构件是复用程度很高的软件成分,被认为是现阶段解决软件危机的有效方法.为了提高嵌入式系统的开发效率,时嵌入式构建模型的时间和空间因素做了深入的研究.分析了嵌入式软件模型结构,并提出了基于Java平台的嵌入式构件模型,为Java实践提供有力指导.     

网络环境下远程协同支教的阶段性探索

传统的现场支教方式,忽视了城市学校本身的困难及发展需要,在时空上都受到了限制。作为对传统支教模式的有益改革与探索,笔者在《网络带来的校际校本教研的新突破》一文首次提出了网络环境下远程化孙同校本教研形式。实现了远程化实时支教,以“足不出户”、省时、耗资低微的特点引起了众多关注。本文以发展的视野,对上文作了进一步的探索．并以阶段性的细分目标之形式来探讨如何实现上文中所提的远程支教模式。     

南宋马纲水运考述

南宋孝宗时期,政府曾尝试将川秦马纲沿嘉陵江和长江东运,这是中国古代马政和交通史上的一个重要事件.以往研究者对此多有关注,但一般所据史料不足,介绍也嫌简略.本文对有关史料进行了较为广泛地收集和梳理,对这一事件经过重新进行考述,并认为南宋马纲水运实际上运送的马匹数量有限,弊端重重,且遭到地方官员的反对,因此对水运在马纲运送中的意义不能高估.