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.     

Exploring Animal-Assisted Programs with Children in School and Therapeutic Contexts

Animal-Assisted programs with children are becoming increasingly popular in school and therapeutic settings. This article provides an overview of the benefits accrued by children as well as the concerns with programs which involve animals, and therapy dogs in particular, in these environments. Research over the past 30 years indicates that therapy dogs may offer physiological, emotional, social, and physical support for children. The distinguishing features of Animal-Assisted Therapy (AAT) are characterized by the supplemental inclusion of a trained therapy dog in reaching an intervention goal in therapeutic environments, and as a supplement to an educational objective in school contexts. The general assumptions underlying AAT with children are that although therapy dogs are interactive, children seem to perceive them as non-judgemental participants who are outside of the complications and expectations of human relationships. This unique interaction may offer children a valuable form of social and emotional support in educational and therapeutic settings.     

Early Childhood Educators’ Use of Language-Support Practices with 4-Year-Old Children in Child Care Centers

The importance of encouraging language skills in early childhood has been well documented. Educators who are responsible for children in daycare services have many opportunities to use rich and stimulating educational practices that support language acquisition. The purpose of this study was to assess the language-support practices used by 22 educators in ECE centers with 174 children (87 girls and 87 boys) aged 55.7 months on average (SD = 4.2). The Teacher Interaction and Language Rating Scale developed by Girolametto et al. (Teacher interaction and language rating scale, Hanen Centre, Toronto, 2000) was translated and adapted for use in French. Analyses reveal the heterogeneity of language support provided to 4-year-old children attending early childhood education centers in Québec (Canada). Results are discussed in relation to the importance of the educational setting and specific training on language skill development provided to educators around promoting language skills in children, a fundamental prerequisite for educational success.     

The challenge of continuation: Schools’ continuation of the Respect program

The Respect program is a whole school approach to prevent and reduce problem behavior. The purpose of this study was to investigate which conditions in schools helped them to continue the program successfully after the end of the 1-year implementation period. The study also looked at the actual continuation after the program end. Especially, we looked at which strategies and structures promoted change beyond the implementation phase. The project groups at four Norwegian schools implementing the program were interviewed at the end of the implementation period and again 2? years later. The main findings suggest that involvement in the Respect program enables schools to implement change. However, it is challenging for the schools to continue the work afterwards. The one school that successfully continued the work after the program was characterized by strong and supportive leadership, leadership at many levels, they made plans and saw them through, renewed activities and new members of staff were introduced to and included in the work according to the program principles. These elements were more or less lacking at the other three schools, at least after the active program period. A main finding is that a 1-year program period is not long enough for most schools to implement and continue an extensive whole school program like Respect.