Comparison of risk factors for contrast‐induced acute kidney injury between patients with and without diabetes

Although it is well known that diabetics are at a higher risk of contrast‐induced acute kidney injury (CI‐AKI) than nondiabetic patients, the reason for this discrepancy is not well known. Thus, in this study, we compared the predisposing factors for CI‐AKI between patients with and without diabetes. We prospectively studied 290 consecutive in‐hospital patients including 88 diabetics undergoing coronary angiography or a percutaneous coronary intervention in Kowsar hospital, and we compared risk factors for CI‐AKI between diabetic and nondiabetic patients. CI‐AKI was defined as RIFLE criteria within 48 hours after contrast exposure. The incidence of CR‐AKI was significantly higher in diabetic patients compared with nondiabetics (P<0.05). The incidence of CI‐AKI was significantly higher in patients with diabetes and left‐ventricular ejection fraction ≤40%, hypercholesterolemia, serum creatinine ≥1.1 mg/dL, estimated glomerular filtration rate (eGFR) <90 mL/min, Contrast volume ≥80 (mL), maximum safe contrast volume factor of 1.5, and dehydration, while in nondiabetics, a significantly higher incidence of CR‐AKI was observed in those with serum creatinine ≥1.1 mg/dL (P=0.02) and/or eGFR<60 mL/min (P=0.01). Multiple logistic regression analysis showed hyperchlosteremia to be the strongest predictor of AKI (P=0.01, B:14.5) in diabetics, followed by eGFR<90 (P=0.05, B:12.4) but, in nondiabetics, only eGFR<60 predicted the occurrence of CI‐AKI (P=0.04, B:2.3). It seems that the predisposing factors to CI‐AKI differ in diabetics and nondiabetics. In patients with diabetes, hypercholesterolemia is the strongest predictor of CI‐AKI, followed by eGFR and diabetics are at risk for CI‐AKI in the early stage of chronic kidney disease (stage 2), accounting for the higher incidence of CI‐AKI in them.     

Can dialyzer membrane selection affect outcomes in patients with acute kidney injury requiring dialysis?

The choice of dialyzer membrane may potentially affect not only solute clearances but also blood-dialyzer interactions. Although on one hand alteration of the dialyzer surface or pore size to increase inflammatory mediator loss may potentially be beneficial for patients with acute kidney injury (AKI), dialyzer membrane interactions, which precipitate intradialytic hypotension, may worsen AKI. Several years ago cellulosic membrane dialyzers were shown to reduce both patient survival and renal recovery in patients with AKI. This review looks at the earlier studies of dialyzer membrane choice and outcomes in AKI, besides discussing the newer developments in membrane technology for patients with AKI.     

Preparation of magnetic mesoporous silica nanoparticles as a multifunctional platform for potential drug delivery and hyperthermia

We report the preparation of magnetic mesoporous silica (MMS) nanoparticles with the potential multifunctionality of drug delivery and magnetic hyperthermia. Carbon-encapsulated magnetic colloidal nanoparticles (MCN@C) were used to coat mesoporous silica shells for the formation of the core-shell structured MMS nanoparticles (MCN@C/mSiO₂), and the rattle-type structured MMS nanoparticles (MCN/mSiO₂) were obtained after the removal of the carbon layers from MCN@C/mSiO₂ nanoparticles. The morphology, structure, magnetic hyperthermia ability, drug release behavior, in vitro cytotoxicity and cellular uptake of MMS nanoparticles were investigated. The results revealed that the MCN@C/mSiO₂ and MCN/mSiO₂ nanoparticles had spherical morphology and average particle sizes of 390 and 320 nm, respectively. The MCN@C/mSiO₂ nanoparticles exhibited higher magnetic hyperthermia ability compared to the MCN/mSiO₂ nanoparticles, but the MCN/mSiO₂ nanoparticles had higher drug loading capacity. Both MCN@C/mSiO₂ and MCN/mSiO₂ nanoparticles had similar drug release behavior with pH-controlled release and temperature-accelerated release. Furthermore, the MCN@C/mSiO₂ and MCN/mSiO₂ nanoparticles showed low cytotoxicity and could be internalized into HeLa cells. Therefore, the MCN@C/mSiO₂ and MCN/mSiO₂ nanoparticles would be promising for the combination of drug delivery and magnetic hyperthermia treatment in cancer therapy.     

Structurally ordered mesoporous carbon nanoparticles as transmembrane delivery vehicle in human cancer cells

A structurally ordered, CMK-1 type mesoporous carbon nanoparticle (MCN) material was successfully synthesized by using a MCM-48 type mesoporous silica nanoparticle as template. The structure of MCN was analyzed by a series of different techniques, including the scanning and transmission electron microscopy, powder X-ray diffraction, and N2 sorption analysis. To the best of our knowledge, no study has been reported prior to our investigation on the utilization of these structurally ordered mesoporous carbon nanoparticles for the delivery of membrane impermeable chemical agents inside of eukaryotic cells. The cellular uptake efficiency and biocompatibility of MCN with human cervical cancer cells (HeLa) were investigated. Our results show that the inhibitory concentration (IC50) value of MCN is very high (>50 microg/mL per million cells) indicating that MCN is fairly biocompatible in vitro. Also, a membrane impermeable fluorescence dye, Fura-2, was loaded to the mesoporous matrix of MCN. We demonstrated that the MCN material could indeed serve as a transmembrane carrier for delivering Fura-2 through the cell membrane to release these molecules inside of live HeLa cells. We envision that further developments of this MCN material will lead to a new generation of nanodevices for transmembrane delivery and intracellular release applications.     

Experimental evaluation and prediction of forming limit of FSW blanks made of AA 6061 T6 sheets at different weld orientations and weld locations

The main objective of the present work is to predict the forming limit of friction stir welded (FSW) sheets made of AA 6061T6, having different weld orientations, weld locations, and made at two different welding speeds. The predicted forming limit curves (FLCs) are validated with experimental FLCs. The thickness gradient based necking criterion (TGNC) and major strain‐rate ratio based necking criterion (MSRC) are used to predict the forming limit. The significance of single zone model and double zone model in FLC prediction is discussed. A decrease in hardness is witnessed in the weld zone as compared to base material. With increase in shoulder diameter and decrease in rotational speed, hardness has improved in the weld zone. The forming limit predictions of un‐welded sheets and FSW sheets coincide well with experimental results. The predicted FLCs of FSW sheets from TGNC and MSRC are equally accurate as compared to experimental FLCs in all the weld locations. Both TGNC and MSRC predict almost the same forming limit in 90° weld orientation, while TGNC showed better prediction in 45° weld orientation. FSW sheets with double zone models show better prediction accuracy than single zone models in most of the cases, except in the case of weld at centre location and at longitudinal orientation. There is only slight deviation between single zone and double zone model predictions. The failure location and failure pattern predictions are also agreeing well with the experimental FLCs.     

Biomarkers upon discontinuation of renal replacement therapy predict 60‐day survival and renal recovery in critically ill patients with acute kidney injury

Introduction: There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60‐day survival and renal recovery in an effort to add knowledge to the decision‐making process regarding RRT withdrawal. Methods: We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit. Serum osteopontin (sOPN), serum interleukin 6 (sIL‐6), serum cystatin C (sCysC), sIL‐18, serum neutrophil gelatinase‐associated lipocalin and urinary IL‐18 and urinary neutrophil gelatinase‐associated lipocalin were measured upon discontinuation of RRT. Patients were followed up at 60 days for survival and renal recovery. Findings: Patients who survived showed lower levels of all serum and urinary biomarkers. Serum OPN (OR 1.029, 95% CI 1.013–1.047, P = 0.001), diabetes (OR 23.157, 95% CI 4.507–118.981, P < 0.001) and APACHE II score (OR 1.308, 95% CI 1.121–1.527, P = 0.001) were independent predictors of 60‐day mortality. Patients whose sOPN values fell within the highest and middle tertiles showed 5.25‐ and 2.31‐fold increased risks of mortality, respectively, compared with that of patients in the lowest tertile. The addition of sOPN to the clinical model resulted in significant net reclassification improvement of 0.453 (P = 0.026) and an integrated discriminative index of 0.155 (P = 0.032). Lower levels of sOPN and sIL‐6 were associated with greater odds of 60‐day survival (AUC 0.812 and 0.741). The AUC value for predicting survival reached its highest level when all biomarkers were combined with urine output (UO) and urinary and serum creatinine upon discontinuation of RRT (0.882). Lower sCysC performed as well as higher UO in predicting 60‐day renal recovery with the greatest AUC of 0.743. Discussion: Upon discontinuation of RRT, serum and urinary biomarkers, particularly sOPN, may predict 60‐day survival and renal recovery in critically ill patients with AKI. The serum levels of OPN, IL‐6 and CysC may be useful when considering withdrawal of RRT on the basis of conventional indicators.     

Who may not benefit from continuous renal replacement therapy in acute kidney injury?

This study aimed to identify factors that may predict early kidney recovery (less than 48 hours) or early death (within 48 hours) after initiating continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) patients. This is a multicenter retrospective observational study of 14 Japanese Intensive care units (ICUs) in 12 tertiary hospitals. Consecutive adult patients with severe AKI requiring CRRT admitted to the participating ICUs in 2010 (n = 343) were included. Patient characteristics, variables at CRRT initiation, settings, and outcomes were collected. Patients were grouped into early kidney recovery group (CRRT discontinuation within 48 hours after initiation, n = 52), early death group (death within 48 hours after CRRT initiation, n = 52), and the rest as the control group (n = 239). The mean duration of CRRT in the early kidney recovery group and early death group was 1.3 and 0.9 days, respectively. In multivariable regression analysis, in comparison with the control group, urine output (mL/h) (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03), duration between ICU admission to CRRT initiation (days) (OR: 0.65, 95% CI: 0.43–0.87), and the sepsis‐related organ failure assessment score (OR: 0.87, 95% CI; 0.78–0.96) were related to early kidney recovery. Serum lactate (mmol/L) (OR: 1.19, 95% CI: 1.11–1.28), albumin (g/dL) (OR: 0.52, 95% CI: 0.28–0.92), vasopressor use (OR: 3.68, 95% CI: 1.37–12.16), and neurological disease (OR: 9.64, 96% CI: 1.22–92.95) were related to early death. Identifying AKI patients who do not benefit from CRRT and differentiating such patients from the study cohort may allow previous and future studies to effectively evaluate the indication and role of CRRT.     

Anodic stripping voltammetry coupled on-line with inductively coupled plasma mass spectrometry: optimization of a thin-layer flow cell system for analyte signal enhancement

Parameters affecting analyte signal enhancement in anodic stripping voltammetry-inductively coupled plasma mass spectrometry (ASV-ICP-MS), using a thin-layer ASV cell and microconcentric nebulization (MCN), have been examined. Silver was used as a test analyte and was deposited at a glassy carbon working electrode. The MCN allowed use of solution flow rates that were beneficial to optimum electrolytic performance of the thin-layer cell. High analyte deposition efficiencies obtained with the thin-layer cell, combined with minimal sample consumption of the MCN, allowed substantial signal enhancement (>400 times higher than continuous nebulization level) to be obtained with 2-3 mL of sample and deposition times of less than 30 min. Signal enhancement was strongly influenced by the opposing effect of flow rate on the electrolytic deposition efficiency (deposition efficiency decreases with increasing flow rate) and on the quantity of analyte delivered to the cell (analyte mass throughput increases with increasing flow rate). Excellent linearity for stripping peak heights was demonstrated for a wide range of analyte deposition times and for peak heights and peak areas (r > 0.999) over a wide concentration range (25 ng/L-20 μg/L). Precision was good (RSD typically <3% for n = 3-6) except for a high Ag blank contributed to by corrosion of the counter electrode and by Ag diffusion from the reference electrode into the cell. Details of the flow manifold and ASV cells are discussed, along with relevant performance characteristics of the MCN.     

Effects of annealing temperature on microstructure and electrical properties of Mn-Co-Ni-O thin films

Mn_1.85Co_0.3Ni_0.85O₄ (MCN) thin films were prepared on Al₂O₃ substrates by chemical solution deposition method at different annealing temperature (650, 700, 750 and 800 °C). Effects of annealing temperature on microstructure and electrical properties of MCN thin films were investigated. The MCN thin film annealed at 750 °C is of good crystallization and compact surface. It shows lower resistance (4.8 MΩ) and higher sensitivity (3720.6 K) than those of other prepared films. It also has small aging coefficient (3.7%) after aging at 150 °C for 360 h. The advantages of good properties make MCN thin film very promising for integrated devices.     

Predictors of post‐hospitalization recovery of renal function among patients with acute kidney injury requiring dialysis

Introduction: Acute kidney injury (AKI) requiring dialysis complicates 1% of all hospital admissions, and up to 30% of survivors will still require dialysis at hospital discharge. There is a paucity of data to describe the postdischarge outcomes or to guide evidence‐based dialysis management of this vulnerable population. Methods: Single‐center, retrospective analysis of 100 consecutive patients with AKI who survived to hospital discharge and required outpatient dialysis. Data collection included baseline characteristics, hospitalization characteristics, and outpatient dialysis treatment variables. Primary outcome was dialysis independence 90 days after discharge. Findings: Overall, 43% of patients recovered adequate renal function to discontinue dialysis, with the majority recovering within 30 days post discharge. Worse baseline renal function was associated with lower likelihood of renal recovery. In the first week postdischarge, patients with subsequent nonrecovery of renal function had greater net fluid removal (5.3 vs. 4.1 L, P = 0.037), higher ultrafiltration rates (6.0 vs. 4.7 mL/kg/h, P = 0.041) and more frequent intradialytic hypotension (24.6% vs. 9.3% with 3 or more episodes, P = 0.049) compared to patients that later recovered. Discussion: A significant proportion of AKI survivors will recover renal function following discharge. Outpatient intradialytic factors may influence subsequent renal function recovery.     

微乳液原位制备磁性壳聚糖纳米粒子及其对染料的吸附性能

利用环己烷/正己醇、壳聚糖、Fe2+/Fe3+盐和Triton X-100组成的W/O微乳体系中加NaOH溶液沉淀剂,原位制备磁性壳聚糖纳米粒子,并经乙二胺改性(EMCN),用于吸附酸性橙12(AO12)和酸性橙10(AO10)。利用透射电镜、X-射线衍射、红外等对产物进行了表征。结果表明,EMCN分散良好,粒径15 nm~40 nm,饱和磁化强度25.6 emu/g。AO12和AO10最佳pH值分别为4.0和3.0;吸附速率很快,平衡时间40 min~60 min。吸附平衡用Langmuir模型拟合最好,饱和吸附容量分别为AO12 2.81 mmol/g,AO10 1.82 mmol/g。由D-R模型计算E值(14.95 kJ/mol~18.54 kJ/mol)表明以化学吸附为主。EMCN可用NH4OH/NH4Cl(pH10.0)溶液再生。     

Comparison of mass discrimination correction methods and sample introduction systems for the determination of lead isotopic composition using a multicollector inductively coupled plasma mass spectrometer

The influence of sample introduction system on Neptune MC-ICPMS lead isotopic ratio measurements was tested on dilute solutions of the lead certified material NIST SRM 981 ([Pb] = 0.2-170 ng g(-1)) using (1) a SIS spray chamber, (2) a MCN 6000 desolvating system, or (3) an Apex inlet system. The impact of using a high-efficiency X-cone in place of a standard H-cone with the MCN and Apex was also investigated. Performance of the sample introduction systems varied with lead concentration. Over 10 ng g(-1), no system was significantly more precise or accurate. As lead concentrations decreased, both accuracy and precision diminished, and below 1 ng g(-1), use of an X-cone in combination with the Apex and particularly with the MCN system notably improved the quality of the measurements. Various mathematical methods of mass bias correction using thallium additions were tested. Selection of (205)Tl/(203)Tl for NIST SRM 997 to optimize data (1) daily, (2) for each introduction system, and (3) over all sessions significantly improved the data, with no major difference in the output between the three methods. Consistency of the (205)Tl/(203)Tl ratio (2.3888) optimized over all data with previous observations by others supports the use of this value for future measurements.     

Evidence of Microporous Carbon Nanosheets Showing Fast Kinetics in both Gas Phase and Liquid Phase Environments

Despite the great advantages of microporous carbons for applications in gas phase separation, liquid phase enrichment, and energy storage devices, direct experiment data and theoretical calculations on the relevance of properties and structures are quite limited. Herein, two model carbon materials are designed and synthesized, i.e., microporous carbon nanosheets (MCN) and microporous carbon spheres (MCS). They both have nearly same composition, surface chemistry, and specific surface area, known morphology, but distinguishable diffusion paths. Based on these two types of materials, a reliable relationship between the morphology with different diffusion paths and adsorption kinetics in both gas phase and liquid phase environments is established. When used for CO₂ capture, MCN shows a high saturated CO₂ capacity of 8.52 μmol m⁻² and 18.4 mmol cm⁻³ at 273 K and ambient pressure, and its calculated first‐order rate constant is ≈7.4 times higher than that of MCS. Moreover, MCN shows a quick and high uptake of Cr (VI) and a higher‐rate performance for supercapacitors than MCS does. These results strongly confirm that MCN exhibits improved kinetics in gas phase separation, liquid phase enrichment, and energy storage devices due to its shorter diffusion paths and larger exposed geometrical area resulting from the nanosheet structure.     

Fluoro-Photoacoustic Polymeric Renal Reporter for Real-Time Dual Imaging of Acute Kidney Injury

Photoacoustic (PA) imaging agents detect disease tissues and biomarkers with increased penetration depth and enhanced spatial resolution relative to traditional optical imaging, and thus hold great promise for clinical applications. However, existing PA imaging agents often encounter the issues of slow body excretion and low-signal specificity, which compromise their capability for in vivo detection. Herein, a fluoro-photoacoustic polymeric renal reporter (FPRR) is synthesized for real-time imaging of drug-induced acute kidney injury (AKI). FPRR simultaneously turns on both near-infrared fluorescence (NIRF) and PA signals in response to an AKI biomarker (γ-glutamyl transferase) with high sensitivity and specificity. In association with its high renal clearance efficiency (78% at 24 h post-injection), FPRR can detect cisplatin-induced AKI at 24 h post-drug treatment through both real-time imaging and optical urinalysis, which is 48 h earlier than serum biomarker elevation and histological changes. More importantly, the deep-tissue penetration capability of PA imaging results in a signal-to-background ratio that is 2.3-fold higher than NIRF imaging. Thus, the study not only demonstrates the first activatable PA probe for real-time sensitive imaging of kidney function at molecular level, but also highlights the polymeric probe structure with high renal clearance.     

Ferroelectric Liquid Crystals with an alkanoyl group

Recent studies on ferroelectric liquid crystals (FLCs) with an alkanoyl group are reviewed in this article. The FLCs exhibit large spontaneous polarization, especially when another chiral group is introduced at the opposite side of the core. The maximum value reaches 1130 nC/cm², which is almost the same as the total transverse dipole in the molecule. Fastswitching FLC mixtures can be obtained by using these compounds. The synthesis and properties of FLC polymers having the same mesogen and chiral group are also described, and some applications of the FLC mixtures in devices for optical communication reported.     

Photocatalytic removal of phenol under visible light irradiation on zinc phthalocyanine/mesoporous carbon nitride nanocomposites

A series of zinc phthalocyanine/mesoporous carbon nitride (ZnPc/MCN) nanocomposites was prepared successfully by an impregnation method. The addition of ZnPc (0.05–1.5 wt%) extended the absorption of MCN to longer visible light region without affected its structure. It was found that the photocatalytic activity of the nanocomposites for phenol removal depended on the loading amount of ZnPc. The photocatalytic activity of the MCN increased as the amount of ZnPc increased to 0.05 wt%, but further increase in the loading amount decreased the activity. It was suggested that the optimum amount of ZnPc acted as a good photosensitiser that effectively induced electron charge transfer and reduced the electron-hole recombination.     

On the performance of time division multiple access-based multihop fixed cellular networks with respect to available frequency carriers

In multihop cellular networks (MCN), the user nodes can act as relays and forward other nodes' traffic to/from base stations. There are several advantages of MCN such as the improved signal quality and higher coverage. However, it is known that multihop relaying networks require extra radio resources. Therefore the performance of MCN depends to a great extent on the availability of adequate radio resources. The performance of a time division multiple access (TDMA)-based multihop fixed cellular network is analysed with highlighting the dependence of the system performance on the amount of available radio resources, namely, the number of frequency carriers. Results show that in a fixed cellular network, the multihop architecture significantly outperforms the traditional single-hop architecture in terms of the outage probability and throughput if an adequate amount of frequency carriers is available in the network. Otherwise, the multihop fixed cellular networks architecture loses its superiority and might even lead to performance degradation, particularly at high loading levels.     

Long-term effect of chronic intravenous and inhaled nephrotoxic antibiotic treatment on the renal function of patients with cystic fibrosis

Cystic fibrosis (CF) patients have numerous infectious exacerbations requiring prolonged antibiotic treatments, some of which are nephrotoxic. Inhaled antibiotics can reach detectable serum levels. We studied the impact of chronic nephrotoxic antibiotic exposure on kidney function in CF population. We collected data retrospectively for 113 adult CF patients followed for 8.5 years. Fifty‐seven (50.4%) were males and 56 (49.5%) females (mean age 31.7 years [SD 9.9]), of which 31% had diabetes and 9.7% had hypertension. Over 8.5 years follow up, there were no significant changes in blood urea nitrogen (BUN; P = 0.92) or creatinine (P = 0.2) in the whole group. 22% of patients had ≥1 episodes of acute kidney injury (AKI). The presence of AKI was associated with increased BUN (P = 0.002) and creatinine (P = 0.056) at the end of follow up. Use of intravenous colistin, gentamicin, tobramycin, or vancomycin did not correlate with increased BUN (P = 0.64; P = 0.49; P = 0.51; P = 0.47) or creatinine (P = 0.43; P = 0.49; P = 0.17; P = 0.2) after 8.5 years. Elevated tobramycin peak and trough levels did not correlate with increased BUN or creatinine. Inhaled colistin and gentamicin correlated with increased BUN (P = 0.009; P = 0.02) but not creatinine (P = 0.45; P = 0.46). Inhaled tobramycin did not correlate with increased BUN (P = 0.17) or creatinine (P = 0.58). Only inhaled colistin correlated with AKI episodes (P = 0.03). Chronic inhaled colistin and gentamicin are associated with an increase in BUN but not creatinine at the end of follow up. Inhaled colistin was associated with episodes of AKI. Well‐managed intravenous use of nephrotoxic antibiotics in CF population is associated with no major long‐term renal toxicity.     

Annealing effect on the structural,electrical and 1/f noise properties of Mn–Co–Ni–O thin films

Thin films of Mn_1.4Co_1.0Ni_0.6O₄ (MCN) spinel oxide are grown by radio frequency (RF) magnetron sputtering method on amorphous Al₂O₃ substrate. We investigate the annealing effect on the micro structural and electrical properties of RF sputtered MCN films. It is found that the crystallinity of MCN film is improved with increasing annealing time at 750 °C, and the annealed films present excellent cubic spinel (220) preferred orientation in X-ray diffraction patterns. Comparing to as-sputtered thin film, the annealed films show a decrease of 60 to 70 % in resistivity at 300 K. The annealed samples with post annealing time longer than 18 min acquire a negative temperature coefficient of resistance of about ?3.73 %K^?1 and resistivity of about 210–220 Ω cm at 300 K. 1/f noise of MCN films are also studied and the Hooge’s parameters (γ/n) are calculated. After annealing for 18 to 90 min, the γ/n values of the films are on the order of 10^?21 cm³, which ranks about two orders lower than that of amorphous silicon.