Browsing by Author "Dissanayake, D.M."

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    Early identification of acute kidney injury in Russell's viper (Daboia russelii) envenoming using renal biomarkers
    (Public Library of Science, 2019) Ratnayake, I.; Mohamed, F.; Buckley, N.A.; Gawarammana, I.B.; Dissanayake, D.M.; Chathuranga, U.; Munasinghe, M.; Maduwage, K.; Jayamanne, S.; Endre, Z.H.; Isbister, G.K.
    BACKGROUND: Acute kidney injury (AKI) is a major complication of snake envenoming, but early diagnosis remains problematic. We aimed to investigate the time course of novel renal biomarkers in AKI following Russell's viper (Daboia russelii) bites. METHODOLOGY/PRINCIPAL FINDINGS: We recruited a cohort of patients with definite Russell's viper envenoming and collected serial blood and urine samples on admission (<4h post-bite), 4-8h, 8-16h, 16-24h, 1 month and 3 months post-bite. AKI stage (1-3) was defined using the Acute Kidney Injury Network criteria. AKI stages (1-3) were defined by the Acute Kidney Injury Network (AKIN) criteria. There were 65 Russell's viper envenomings and 49 developed AKI: 24 AKIN stage 1, 13 stage 2 and 12 stage 3. There was a significant correlation between venom concentrations and AKI stage (p = 0.007), and between AKI stage and six peak biomarker concentrations. Although most biomarker concentrations were elevated within 8h, no biomarker performed well in diagnosing AKI <4h post-bite. Three biomarkers were superior to serum creatinine (sCr) in predicting AKI (stage 2/3) 4-8h post-bite: serum cystatin C (sCysC) with an area under the receiver operating curve (AUC-ROC), 0.78 (95%CI:0.64-0.93), urine neutrophil gelatinase-associated lipocalin (uNGAL), 0.74 (95%CI:0.59-0.87) and urine clusterin (uClu), 0.81 (95%CI:0.69-0.93). No biomarker was better than sCr after 8h. Six other urine biomarkers urine albumin, urine beta2-microglobulin, urine kidney injury molecule-1, urine cystatin C, urine trefoil factor-3 and urine osteopontin either had minimal elevation, and/or minimal prediction for AKI stage 2/3 (AUC-ROC<0.7). CONCLUSIONS/SIGNIFICANCE: AKI was common and sometimes severe following Russell's viper bites. Three biomarkers uClu, uNGAL and sCysC, appeared to become abnormal in AKI earlier than sCr, and may be useful in early identification of envenoming.
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    Entrepreneurial Orientation and Growth: The Moderating Role of National Culture.
    (J Entrepren Organiz Manag, 2016) Semasinghe, D.M.; Dissanayake, D.M.
    Complementing to the inferences of previous research, this paper seeks to investigate the moderating impact on the relationship of Entrepreneurial Orientation (EO) and venture growth. This study conducted as a cross sectional survey and utilized the sample frame of the registry of Small Enterprises Development Division, Sri Lanka. 317 entrepreneurs were captured from varied districts of Sri Lanka and the data were collected by means of a structured questionnaire. The assessment of the moderating effects was subjected to multi-group analysis and the moderation effect was observed in the Chi-Square difference test. Findings of the study revealed that, EO acts as a predictor of venture growth suggesting a direct positive relationship. EO-growth relationship is strengthening under a low power distant organization. Uncertainty and ambiguity an entrepreneur faces is also weaken the relationship of EO-growth. Finally, individualism weakens the relationship of EO-growth.