Nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study: Design and methods.

AIM: Acute kidney injury (AKI) carries an increasing incidence rate worldwide and increases the risk of developing end-stage renal disease (ESRD) as well as the medical expenses during the post-AKI course. The Taiwan Consortium for Acute Kidney Injury and Renal Diseases (CAKs) has thus launched a nationwide epidemiology and prognosis of dialysis-requiring acute kidney injury (NEP-AKI-D) study, which prospectively enrols critically ill patients with AKI. Through thoroughly evaluating the risk and prognostic factors of AKI, we hope to lower the incidence of AKI and ESRD from the perspective of AKI-ESRD interaction. METHODS: The CAKs includes 30 hospitals which distribute widely through the four geographical regions (north, middle, south, and east) of Taiwan, and have a 1:1 ratio of medical centres to regional hospitals in each region. The NEP-AKI-D study enrols intensive care unit-based AKI patients who receive dialysis in the four seasonal sampled months (October 2014, along with January, April, and July 2015) in the included hospitals. The collected data include demographic information, pertaining laboratory results, dialysis settings and patient outcomes. The data are uploaded in a centre website and will be audited by on-site principal investigators, computer logic gates, and the CAKs staffs. The outcomes of interest are in-hospital mortality, dialysis-dependency and readmission rate within 90 days after discharge. CONCLUSION: The NEP-AKI-D study enrols a large number of representative AKI patients throughout Taiwan. The results of the current study are expected to provide more insight into the risk and prognostic factors of AKI and further attenuated further chronic kidney disease transition.

The size and concentration of droplets generated by coughing in human subjects.

This work investigated the size distribution of the droplet nuclei and coughed droplets by test subjects. The size distributions of droplet nuclei coughed by test subjects were determined with an aerodynamic particle sizer (APS) and scanning mobility particle sizer (SMPS) system (system 1). Coughed droplets were only sampled with the APS system (system 2). Two different schemes were employed in system 2. Furthermore, the size distribution of coughed droplets of different ages and gender was investigated to identify the effects of age and gender on droplet size distribution. Results indicated the total average size distribution of the droplet nuclei was 0.58-5.42 microm, and 82% of droplet nuclei centered in 0.74-2.12 microm. The entire average size distribution of the coughed droplets was 0.62-15.9 microm, and the average mode size was 8.35 microm. The size distribution of the coughed droplets was multimodal. The size distribution of coughed droplets showed three peaks at approximately 1 microm, 2 microm, and 8 microm. These analytical findings indicate that variation for average droplet size among the three age groups was insignificant (p > 0.1). Moreover, the variation in average droplet size between males and females was also insignificant (p > 0.1). Also, the variation in droplet concentration between males and females was significant (p > 0.1). Droplet nuclei concentrations from male subjects were considerably higher than that from females. Comparison of the droplet concentrations for subjects in different age groups demonstrated that subjects in the 30-50-year age group have the largest droplet concentrations.