A prospective study of incidence and outcome of acute kidney injury among hospitalised patients in Malaysia (My-AKI).

INTRODUCTION: The incidence of acute kidney injury (AKI) among hospitalised patients has not been well studied in Malaysia. MATERIALS AND METHODS: We conducted a prospective, multicentre study in seven hospitals in West Malaysia. All the adults admitted in March 2017 fulfilling Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI were included. RESULTS: Of the 34,204 patients screened, 2,457 developed AKI (7.18%), 13.1% of which occurred in intensive care unit (ICU). There were 60.2% males with a mean age of 57.8 (±17.5) years. The most common comorbidities were hypertension (55.0%), diabetes (46.6%), ischaemic heart disease (15.1%) and chronic kidney disease (12.0%). The commonest causes of AKI were sepsis (41.7%), pre-renal (24.2%) and cardiorenal syndrome (10.8%). Nephrotoxin exposure was reported in 31%. At diagnosis, the proportion of AKI stages 1, 2 and 3 were 79.1%, 9.7%, 11.2%, respectively. Referral to nephrologists was reported in 16.5%. Dialysis was required in 176 (7.2%) patients and 55.6% were performed in the ICU. Acidosis (46.2%), uraemia (31.6%) and electrolyte disturbance (11.1%) were the commonest indications. Continuous renal replacement therapy (CRRT) was required in 14%. The average length of hospital stay was 9.5 days. In-hospital mortality was 16.4%. Among survivors, full and partial renal recovery was seen in 74.7% and 16.4% respectively while 8.9% failed to recover. After a mean follow-up of 13.7 months, 593 (30.2%) of survivors died and 38 (1.9%) initiated chronic dialysis. Mortality was highest among those with malignancies (Hazard Ratio, HR 2.14), chronic liver disease (HR 2.13), neurological disease (HR 1.56) and cardiovascular disease (HR 1.17). CONCLUSION: AKI is common in hospitalised patients and is with associated high mortality during and after hospitalisation.

Generation of pronounced Fano resonances and tuning of subwavelength spatial light distribution in plasmonic pentamers.

Arrays of plasmonic pentamers consisting of five metallic nano-disks were designed and fabricated to achieve a pronounced Fano Resonance with polarization-independent far-field spectral response at normal incidence due to the structure symmetry of pentamers. A mass-spring coupled oscillator model was applied to study plasmon interactions among the nano-disks. It was found that the direction of the excitation light polarization can flexibly tune the spatial localization of near-field energy at sub-wavelength scales while the collective optical properties are kept constant. It can lead to a selective storage of excited energy down to sub-20 nm gap at a normal incident with a single light source.

Lattice resonances in antenna arrays for liquid sensing in the terahertz regime.

Terahertz antenna arrays supporting narrow lattice resonances are proposed as an alternative sensor-on-chip approach to liquid sensing. An array of metallic rectangular antennas fabricated on a polyethylene naphthalate (PEN) substrate is used to demonstrate the sensing of a number of fluids. Good agreement is shown between experiment and simulation with Q-factors of around 20 and a figure-of-merit (FOM) of 3.80 being achieved. Liquid sensing with antenna arrays is simple both in terms of fabrication and setup. The working frequency can be tuned with a suitable choice of substrates and array parameters. The nature of the lattice resonance means that the whole sample is used to provide the conditions required for resonance occurrence, eliminating the need to preferentially locate the sample in small areas of high field concentration. The antenna arrays could also potentially be coupled with a microfluidic system for in situ sensing or used in a reflection setup.

Nanolubrication: patterned lubricating films using ultraviolet (UV) irradiation on hard disks.

Nanolubrication is emerging to be the key technical barrier in many devices. One of the key attributes for successful device lubrication is self-sustainability using only several molecular layers. For single molecular species lubrication, one desires bonding strength and molecular mobility to repair the contact by diffusing back to the contact. One way to achieve this is the use of mask to shield the surface with a patterned surface texture, put a monolayer on the surface and induce bonding. Then re-deposit mobile molecules on the surface to bring the thickness back to the desired thickness. This paper describes the use of long wavelength UV irradiation (320-390 nm) to induce bonding of a perfluoropolyether (PFPE) on CN(x) disks for magnetic hard disk application. This allows the use of irradiation to control the degree of bonding on CN(x) coatings. The effect of induced bonding based on this wavelength was studied by comparing 100% mobile PFPE, 100% bonded PFPE, and a mixture of mobile and bonded PFPE in a series of laboratory tests. Using a lateral force microscope, a diamond-tipped atomic force microscope, and a ball-on-inclined plane apparatus, the friction and wear characteristics of these three cases were obtained. Results suggested that the mixed PFPE has the highest shear rupture strength.

Purification and characterization of the venom phospholipases A2 from Asian monotypic crotalinae snakes.

Phospholipases A2 were purified from the venoms of Asian monotypic crotalinae snakes including Callosellasma, Hypnale, Deinagkistrodon, and Tropidolaemus by a combination of gel filtration and reversed-phase chromatographic methods. One to four isoforms of the enzyme were found in each of the venoms. The venom enzymes were subjected to N-terminal sequencing up to the 30th amino acids, and their molecular weights were analyzed by electrospray-ionization mass spectrometry. Homologous antiplatelet phospholipase with a conserved Glu 6 residue was found in each of the venoms. Basic phospholipases with Trp 6 (W6) but without detectable enzyme activities were also isolated from the venom of C. rhodostoma, H. hypnale, and T. wagleri. These W6 enzymes showed strong heparin-binding affinity and capable of inducing edema in rat paws. The fact that the venoms of Callosellasma and Hypnale contain similar types of phospholipases is in accord with recent reports that these two taxa formed a clade. Deinagkistrodon venom does not contain phospholipase variants other than the Glu-6 subtype as Trimeresurus, Agkistrodon, and Protobothrops venoms do. Interestingly, the Glu-6 enzyme from T. wagleri venom has a molecular weight of 15,319 Daltons, higher than those of most other venom phospholipases. Our results show that new types of the enzyme are more likely to be found in the venom of monotypic species; the amino acid sequence data or the subtypes of venom-phospholipases are potentially useful as markers or a character system for studying higher-order systematics of venomous snakes.