AKI occurred in 40% of very low birth weight infants and was concentrated in the most premature and severely ill infants. One in six infants experienced multiple episodes of AKI, and a small number of infants was discharged with an elevated serum creatinine. Reporting a history of AKI in the discharge summary occurred infrequently, and referral to a nephrologist for AKI follow-up did not occur, highlighting areas for quality improvement.

In the 2020-2021 academic year, more than 40 000 medical students and physicians will apply for residency positions in the United States. Yet due to the effects of the novel coronavirus disease 2019 (COVID-19) pandemic, the experience will be distinctly different for applicants and programs than in previous years. How will the residency application process be affected by COVID-19? While the pandemic will stress the residency selection process, it will also provide the opportunity for change and systemic improvements.Even before COVID-19, calls to reform the residency selection process were becoming more frequent. 1,2 Many issues are related to the increasing number of programs to which applicants apply. In 2019-2020, applicants from US medical schools applied to an average of 65 programs, and international medical graduates (IMGs) applied to an average of 137 programs. 3 This number of applications likely does not improve match rates and imposes a substantial cost on applicants and a potentially unmanageable load on program directors.

Thanks to remarkable advances in neonatal intensive care, infants who once had little chance for survival can now enter adulthood. Yet the consequences of premature birth or low birth weight (LBW) on nephrogenesis, final nephron number, and long-term kidney function are unclear. This review focuses on the theory, experimental evidence, and observational data that suggest an increased risk of chronic kidney disease (CKD) for infants born prematurely. Many premature and LBW infants begin life with an incomplete complement of immature nephrons. They are then exposed to a variety of external stressors that can hinder ongoing kidney development or cause additional nephron loss such as hemodynamic alterations, nephrotoxic medications, infections, and suboptimal nutrition. Acute kidney injury, in particular, may be a significant risk factor for the development of CKD. According to Brenner' s hypothesis, patients with decreased nephron number develop hyperfiltration that results in sodium retention, hypertension, nephron loss, and CKD due to secondary focal segmental glomerulosclerosis. Because the risk of CKD in premature and LBW infants has not been accurately determined, there are no evidence-based recommendations for screening or management. Yet with the first generation of infants from the surfactant era only now reaching adulthood, it is possible that there is already an unrecognized epidemic of CKD. We suggest individualized, risk-based assessments of premature and LBW infants due to the increased risk of CKD and call for additional research into the long-term risk for CKD these infants face.

Dynamic photonic structures can be tuned by changing the periodic structure and/or the index of refraction. [ 1 ] These dynamic photonic structures allow optically responsive capability to control the properties of light and act as optical transducers to sense external stimuli. [ 2 ] Tunable optical systems operating in the visible and near-infrared region offer great promise for designing adaptive optical materials, telecommunication devices and sensors. Such sensors have been prepared by various methods, including microfabrication, self-assembly or a combination of both. [ 3 ] However, achieving the attributes of a narrow-band response with a high-tunability range to construct off-axis optical sensors still remains a signifi cant challenge.We recently developed an optical sensing platform [ 4 ] based on Denisyuk refl ection holography [ 5 ] and in situ size reduction of metallic nanoparticles in polymers through laser ablation, where an intense laser pulse produces Bragg gratings in a fraction of the time, cost and complexity compared to silver-halide chemistry-based fabrication techniques. [ 6 ] This technique allows the fabrication of holographic sensors that display improved versatility and scalability. The platform utilizes an effi cient approach to produce off-axis chemical-stimuli responsive holographic sensors with a large, reversible narrow-band tunability, using metallic nanoparticles that can be organized in densityconcentrated 3D regions.The present work employs a hologram fabricated by laser ablation comprising of a functionalized hydrophilic host polymer. The optical characteristics of the system were investigated by analyzing the distribution of the mean diameter of Ag 0 nanoparticles, effective refractive indices of ablated and non-ablated polymer-nanoparticle regions, along with angular-resolved measurements. Furthermore, the system was characterized through computational modeling and diffraction simulations. The putative clinical utility of the sensor for the quantifi cation of pH was demonstrated with large wavelength shifts in the entire visible spectrum.Our sensor employs a simultaneous lateral and vertical periodic diffraction grating of silver nanoparticles dispersed within a poly (hydroxyethyl methacrylate)-based (pHEMA) matrix with a dry thickness of approximately 10 µm. The diffracted light is spectrally concentrated at a specifi c narrowband color due to the vertically-ordered periodicity. We use 6 ns-pulsed laser (λ = 532 nm, 240 mJ) standing waves to order the density of silver nanoparticles (mean diameter of 13 ± 9 nm) into regions with a periodicity of approximately half of the wavelength distributed throughout the cross section of the polymer matrix (see Supporting Information). The fabrication of the holographic sensors begins with UV-initiated free radical polymerization of the pHEMA-based hydrogel on an O 2 -plasma-treated poly (methyl methacrylate) (PMMA) substrate ( Figure 1 (a)). Subsequently, Ag + ions are perfused into the pHEMA polymer matrix (Figure 1 (b)), and reduc...

Developing noninvasive and accurate diagnostics that are easily manufactured, robust, and reusable will provide monitoring of high-risk individuals in any clinical or point-of-care environment. We have developed a clinically relevant optical glucose nanosensor that can be reused at least 400 times without a compromise in accuracy. The use of a single 6 ns laser (λ = 532 nm, 200 mJ) pulse rapidly produced off-axis Bragg diffraction gratings consisting of ordered silver nanoparticles embedded within a phenylboronic acid-functionalized hydrogel. This sensor exhibited reversible large wavelength shifts and diffracted the spectrum of narrow-band light over the wavelength range λpeak ≈ 510-1100 nm. The experimental sensitivity of the sensor permits diagnosis of glucosuria in the urine samples of diabetic patients with an improved performance compared to commercial high-throughput urinalysis devices. The sensor response was achieved within 5 min, reset to baseline in ∼10 s. It is anticipated that this sensing platform will have implications for the development of reusable, equipment-free colorimetric point-of-care diagnostic devices for diabetes screening.