Search results for: renal functions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2782

Search results for: renal functions

2602 Closed Forms of Trigonometric Series Interms of Riemann’s ζ Function and Dirichlet η, λ, β Functions or the Hurwitz Zeta Function and Harmonic Numbers

Authors: Slobodan B. Tričković

Abstract:

We present the results concerned with trigonometric series that include sine and cosine functions with a parameter appearing in the denominator. We derive two types of closed-form formulas for trigonometric series. At first, for some integer values, as we know that Riemann’s ζ function and Dirichlet η, λ equal zero at negative even integers, whereas Dirichlet’s β function equals zero at negative odd integers, after a certain number of members, the rest of the series vanishes. Thus, a trigonometric series becomes a polynomial with coefficients involving Riemann’s ζ function and Dirichlet η, λ, β functions. On the other hand, in some cases, one cannot immediately replace the parameter with any positive integer because we shall encounter singularities. So it is necessary to take a limit, so in the process, we apply L’Hospital’s rule and, after a series of rearrangements, we bring a trigonometric series to a form suitable for the application of Choi-Srivastava’s theorem dealing with Hurwitz’s zeta function and Harmonic numbers. In this way, we express a trigonometric series as a polynomial over Hurwitz’s zeta function derivative.

Keywords: Dirichlet eta lambda beta functions, Riemann's zeta function, Hurwitz zeta function, Harmonic numbers

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2601 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

Abstract:

Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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2600 The Functions of “Question” and Its Role in Education Process: Quranic Approach

Authors: Sara Tusian, Zahra Salehi Motaahed, Narges Sajjadie, Nikoo Dialame

Abstract:

One of the methods which have frequently been used in Quran is the “question”. In the Quran, in addition to the content, methods are also important. Using analysis-interpretation method, the present study has investigated Quranic questions, and extracted its functions from educational perspective. In so doing, it has first investigated all the questions in Quran and then taking the three-stage classification of education into account, it has offered question functions. The results obtained from this study suggest that question functions in Quran are presented in three categories: the preparation stage (including preparation of the audience, revising the insights, and internal Evolution); main body (including the granting the insight, and elimination of intellectual negligence and the question of innate and logical axioms, the introducting of the realm of thinking, creating emotional arousal and alleged in the claim) and the third stage as modification and revision (including invitation to move in the framework of tasks using the individual beliefs to reveal the contradictions and, Error detection and contribution to change the function) that each of which has a special role in the education process.

Keywords: education, question, Quranic questions, Quran

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2599 A Genre Analysis of University Lectures

Authors: Lee Kok Yueh, Fatin Hamadah Rahman, David Hassell, Au Thien Wan

Abstract:

This work reports on a genre based study of lectures at a University in Brunei, Universiti Teknologi Brunei to explore the communicative functions and to gain insight into the discourse. It explores these in three different domains; Social Science, Engineering and Computing. Audio recordings from four lecturers comprising 20 lectures were transcribed and analysed, with the duration of each lecture varying between 20 to 90 minutes. This qualitative study found similar patterns and functions of lectures as those found in existing research amongst which include greetings, housekeeping, or recapping of previous lectures in the lecture introductions. In the lecture content, comprehension check and use of examples or analogies are very prevalent. However, the use of examples largely depend on the lecture content; and the more technical the content, the harder it was for lecturers to provide examples or analogies. Three functional moves are identified in the lecture conclusions; announcement, summary and future plan, all of which are optional. Despite the relatively small sample size, the present study shows that lectures are interactive and there are some consistencies with the delivery of lecture in relation to the communicative functions and genre of lecture.

Keywords: communicative functions, genre analysis, higher education, lectures

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2598 Correlation between Microalbuminuria and Hypertension in Type 2 Diabetic Patients

Authors: Alia Ali, Azeem Taj, Muhammed Joher Amin, Farrukh Iqbal, Zafar Iqbal

Abstract:

Background: Hypertension is commonly found in patients with Diabetic Kidney Disease (DKD). Microalbuminuria is the first clinical sign of involvement of kidneys in patients with type 2 diabetes. Uncontrolled hypertension induces a higher risk of cardiovascular events, including death, increasing proteinuria and progression to kidney disease. Objectives: To determine the correlation between microalbuminuria and hypertension and their association with other risk factors in type 2 diabetic patients. Methods: One hundred and thirteen type 2 diabetic patients were screened for microalbuminuria and raised blood pressure, attending the diabetic clinic of Shaikh Zayed Hospital, Lahore, Pakistan. The study was conducted from November 2012 to June 2013. Results: Patients were divided into two groups. Group 1, those with normoalbuminuria (n=63) and Group 2, those having microalbuminuria (n=50). Group 2 patients showed higher blood pressure values as compared to Group 1. The results were statistically significant and showed poor glycemic control as a contributing risk factor. Conclusion: The study concluded that there is high frequency of hypertension among type 2 diabetics but still much higher among those having microalbuminuria. So, early recognition of renal dysfunction through detection of microalbuminuria and to start treatment without any delay will confer future protection from end-stage renal disease as well as hypertension and its complications in type 2 diabetic patients.

Keywords: hypertension, microalbuminuria, diabetic kidney disease, type 2 Diabetes mellitus

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2597 Two Cases of VACTERL Association in Pregnancy with Lymphocyte Therapy

Authors: Seyed Mazyar Mortazavi, Masod Memari, Hasan Ali Ahmadi, Zhaleh Abed

Abstract:

Introduction: VACTERL association is a rare disorder with various congenital malformations. The aetiology remains unknown. Combination of at least three congenital anomalies of the following criteria is required for diagnosis: vertebral defects, anal atresia, cardiac anomalies, tracheo-esophageal fistula, renal anomalies, and limb defects. Case presentation: The first case was 1-day old male neonate with multiple congenital anomalies was bore from 28 years old mother. The mother had history of pregnancy with lymphocyte therapy. His anomalies included: defects in thoracic and lumbar vertebral, anal atresia, bilateral hydronephrosis, atrial septal defect, and lower limb abnormality. Other anomalies were cryptorchidism and nasal canal narrowing. The second case was born with 32 weeks gestational age from mother with history of pregnancy with lymphocyte therapy. He had thoracic vertebral defect, cardiac anomalies and renal defect. Conclusion: diagnosis based on clinical finding is VACTERL association. Early diagnosis is very important to investigation and treatment of other coexistence anomalies. VACTERL association in mothers with history of pregnancy with lymphocyte therapy has suggested possibly of relationship between VACTERL association and this method of pregnancy.

Keywords: anal atresia, tracheo-esophageal fistula, atrial septal defect, lymphocyte therapy

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2596 The Importance of Working Memory, Executive and Attention Functions in Attention Deficit Hyperactivity Disorder and Learning Disabilities Diagnostics

Authors: Dorottya Horváth, Tímea Harmath-Tánczos

Abstract:

Attention deficit hyperactivity disorder (ADHD) and learning disabilities are common neurocognitive disorders that can have a significant impact on a child's academic performance. ADHD is characterized by inattention, hyperactivity, and impulsivity, while learning disabilities are characterized by difficulty with specific academic skills, such as reading, writing, or math. The aim of this study was to investigate the working memory, executive, and attention functions of neurotypical children and children with ADHD and learning disabilities in order to fill the gaps in the Hungarian mean test scores of these cognitive functions in children with neurocognitive disorders. Another aim was to specify the neuropsychological differential diagnostic toolkit in terms of the relationships and peculiarities between these cognitive functions. The research question addressed in this study was: How do the working memory, executive, and attention functions of neurotypical children compare to those of children with ADHD and learning disabilities? A self-administered test battery was used as a research tool. Working memory was measured with the Non-Word Repetition Test, the Listening Span Test, the Digit Span Test, and the Reverse Digit Span Test; executive function with the Letter Fluency, Semantic Fluency, and Verb Fluency Tests; and attentional concentration with the d2-R Test. The data for this study was collected from 115 children aged 9-14 years. The children were divided into three groups: neurotypical children (n = 44), children with ADHD without learning disabilities (n = 23), and children with ADHD with learning disabilities (n = 48). The data was analyzed using a variety of statistical methods, including t-tests, ANOVAs, and correlational analyses. The results showed that the performance of children with neurocognitive involvement in working memory, executive functions, and attention was significantly lower than the performance of neurotypical children. However, the results of children with ADHD and ADHD with learning disabilities did not show a significant difference. The findings of this study are important because they provide new insights into the cognitive profiles of children with ADHD and learning disabilities and suggest that working memory, executive functions, and attention are all impaired in children with neurocognitive involvement, regardless of whether they have ADHD or learning disabilities. This information can be used to develop more effective diagnostic and treatment strategies for these disorders.

Keywords: ADHD, attention functions, executive functions, learning disabilities, working memory

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2595 MHD Equilibrium Study in Alborz Tokamak

Authors: Maryamosadat Ghasemi, Reza Amrollahi

Abstract:

Plasma equilibrium geometry has a great influence on the confinement and magnetohydrodynamic stability in tokamaks. The poloidal field (PF) system of a tokamak should be able to support this plasma equilibrium geometry. In this work the prepared numerical code based on radial basis functions are presented and used to solve the Grad–Shafranov (GS) equation for the axisymmetric equilibrium of tokamak plasma. The radial basis functions (RBFs) which is a kind of numerical meshfree method (MFM) for solving partial differential equations (PDEs) has appeared in the last decade and is developing significantly in the last few years. This technique is applied in this study to obtain the equilibrium configuration for Alborz Tokamak. The behavior of numerical solution convergences show the validation of this calculations.

Keywords: equilibrium, grad–shafranov, radial basis functions, Alborz Tokamak

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2594 A Fuzzy Nonlinear Regression Model for Interval Type-2 Fuzzy Sets

Authors: O. Poleshchuk, E. Komarov

Abstract:

This paper presents a regression model for interval type-2 fuzzy sets based on the least squares estimation technique. Unknown coefficients are assumed to be triangular fuzzy numbers. The basic idea is to determine aggregation intervals for type-1 fuzzy sets, membership functions of whose are low membership function and upper membership function of interval type-2 fuzzy set. These aggregation intervals were called weighted intervals. Low and upper membership functions of input and output interval type-2 fuzzy sets for developed regression models are considered as piecewise linear functions.

Keywords: interval type-2 fuzzy sets, fuzzy regression, weighted interval

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2593 Nephroprotective Effect of Aqueous Extract of Plectranthus amboinicus (Roxb.) Leaves in Adriamycin Induced Acute Renal Failure in Wistar Rats: A Biochemical and Histopathological Assessment

Authors: Ampe Mohottige Sachinthi Sandaruwani Amarasiri, Anoja Priyadarshani Attanayake, Kamani Ayoma Perera Wijewardana Jayatilaka, Lakmini Kumari Boralugoda Mudduwa

Abstract:

The search for alternative pharmacological therapies based on natural extracts for renal failure has become an urgent need, due to paucity of effective pharmacotherapy. The current study was undertaken to evaluate the acute nephroprotective effect of aqueous leaf extract of Plectranthus amboinicus (Roxb.) (Family: Lamiaceae), a medicinal plant used in traditional Ayurvedic medicine for the management of renal diseases in Sri Lanka. The study was performed in adriamycin (ADR) induced nephrotoxic in Wistar rats. Wistar rats were randomly divided into four groups each with six rats. A single dose of ADR (20 mg/kg body wt., ip) was used for the induction of nephrotoxicity in all groups of rats except group one. The treatments were started 24 hours after induction of nephrotoxicity and continued for three days. Group one and two served as healthy and nephrotoxic control rats and were administered equivalent volumes of normal saline (0.9% NaCl) orally. Group three and four nephrotoxic rats were administered the lyophilized powder of the aqueous extract of P. amboinicus (400 mg/ kg body wt.; equivalent human therapeutic dose) and the standard drug, fosinopril sodium (0.09 mg/ kg body wt.) respectively. Urine and blood samples were collected from rats in each group at the end of the period of intervention for the estimation of selected renal parameters. H and E stained sections of the kidney tissues were examined for histopathological changes. Rats treated with the plant extract showed significant improvement in biochemical parameters and histopathological changes compared to ADR induced nephrotoxic group. The elevation of serum concentrations of creatinine and β2-microglobulin were decreased by 38%, and 66% in plant extract treated nephrotoxic rats respectively (p < 0.05). In addition, serum concentrations of total protein and albumin were significantly increased by 25% and 14% in rats treated with P. amboinicus respectively (p < 0.05). The results of β2 –microglobulin and serum total protein demonstrated a significant reduction in the elevated values in rats administered with the plant extract (400 mg/kg) compared to that of fosinopril (0.09 mg/kg). Urinary protein loss in 24hr urine samples was significantly decreased in rats treated with both fosinopril (86%) and P. ambonicus (56%) at the end of the intervention (p < 0.01). Accordingly, an attenuation of morphological destruction was observed in the H and E stained sections of the kidney with the treatments of plant extract and fosinopril. The results of the present study revealed that the aqueous leaf extract of P. amboinicus possesses significant nephroprotective activity at the equivalent therapeutic dose of 400 mg/ kg against adriamycin induced acute nephrotoxicity.

Keywords: biochemical assessment, histopathological assessment, nephroprotective activity, Plectranthus amboinicus

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2592 Attribute Selection for Preference Functions in Engineering Design

Authors: Ali E. Abbas

Abstract:

Industrial Engineering is a broad multidisciplinary field with intersections and applications in numerous areas. When designing a product, it is important to determine the appropriate attributes of value and the preference function for which the product is optimized. This paper provides some guidelines on appropriate selection of attributes for preference and value functions for engineering design.

Keywords: decision analysis, industrial engineering, direct vs. indirect values, engineering management

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2591 The Impact of Transformational Leadership and Interpersonal Interaction on Mentoring Function

Authors: Ching-Yuan Huang, Rhay-Hung Weng, Yi-Ting Chen

Abstract:

Mentoring functions will improve new nurses' job performance, provide support with new nurses, and then reduce the turnover rate of them. This study explored the impact of transformational leadership and interpersonal interaction on mentoring functions. We employed a questionnaire survey to collect data and selected a sample of new nurses from three hospitals in Taiwan. A total of 306 valid surveys were obtained. Multiple regression model analysis was conducted to test the study hypothesis. Inspirational motivation, idealized influence, and individualized consideration had a positive influence on overall mentoring function, but intellectual stimulation had a positive influence on career development function only. Perceived similarity and interaction frequency also had positive influences on mentoring functions. When the shift overlap rate exceeded 80%, mentoring function experienced a negative result. The transformational leadership of mentors actually would improve the mentoring functions among new staff nurses. Perceived similarity and interaction frequency between mentees and mentors also had a positive influence on mentoring functions. Managers should enhance the transformational leadership of mentors by designing leadership training and motivation programs. Furthermore, nursing managers should promote the interaction between new staff nurses and their mentors, but the shift overlap rate should not exceed 80%.

Keywords: interpersonal interaction, mentoring function, mentor, new nurse, transformational leadership

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2590 Solving Weighted Number of Operation Plus Processing Time Due-Date Assignment, Weighted Scheduling and Process Planning Integration Problem Using Genetic and Simulated Annealing Search Methods

Authors: Halil Ibrahim Demir, Caner Erden, Mumtaz Ipek, Ozer Uygun

Abstract:

Traditionally, the three important manufacturing functions, which are process planning, scheduling and due-date assignment, are performed separately and sequentially. For couple of decades, hundreds of studies are done on integrated process planning and scheduling problems and numerous researches are performed on scheduling with due date assignment problem, but unfortunately the integration of these three important functions are not adequately addressed. Here, the integration of these three important functions is studied by using genetic, random-genetic hybrid, simulated annealing, random-simulated annealing hybrid and random search techniques. As well, the importance of the integration of these three functions and the power of meta-heuristics and of hybrid heuristics are studied.

Keywords: process planning, weighted scheduling, weighted due-date assignment, genetic search, simulated annealing, hybrid meta-heuristics

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2589 Seismic Loss Assessment for Peruvian University Buildings with Simulated Fragility Functions

Authors: Jose Ruiz, Jose Velasquez, Holger Lovon

Abstract:

Peruvian university buildings are critical structures for which very little research about its seismic vulnerability is available. This paper develops a probabilistic methodology that predicts seismic loss for university buildings with simulated fragility functions. Two university buildings located in the city of Cusco were analyzed. Fragility functions were developed considering seismic and structural parameters uncertainty. The fragility functions were generated with the Latin Hypercube technique, an improved Montecarlo-based method, which optimizes the sampling of structural parameters and provides at least 100 reliable samples for every level of seismic demand. Concrete compressive strength, maximum concrete strain and yield stress of the reinforcing steel were considered as the key structural parameters. The seismic demand is defined by synthetic records which are compatible with the elastic Peruvian design spectrum. Acceleration records are scaled based on the peak ground acceleration on rigid soil (PGA) which goes from 0.05g to 1.00g. A total of 2000 structural models were considered to account for both structural and seismic variability. These functions represent the overall building behavior because they give rational information regarding damage ratios for defined levels of seismic demand. The university buildings show an expected Mean Damage Factor of 8.80% and 19.05%, respectively, for the 0.22g-PGA scenario, which was amplified by the soil type coefficient and resulted in 0.26g-PGA. These ratios were computed considering a seismic demand related to 10% of probability of exceedance in 50 years which is a requirement in the Peruvian seismic code. These results show an acceptable seismic performance for both buildings.

Keywords: fragility functions, university buildings, loss assessment, Montecarlo simulation, latin hypercube

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2588 Development of an Information System Based Airport Evaluation Method

Authors: Eniko Nagy, Csaba Csiszar

Abstract:

Satisfaction of air transportation passengers is significantly affected by the perceived quality of airport information services. The development potential of ICT is considerable. The traditional and new functions of ‘smart’ airports are realized by complex services aiding seamless, comfortable and less time-consuming travel. Based on the elements of the transportation chain the information management functions, their relationships and the technical solutions have been identified. The functions have been categorized by their development level and evaluation scores have been assigned to each category. Correction factors influencing the usefulness of the technology or the service have been introduced. A method for the calculation of ‘smart’ index in order to compare the airports in objective way has been developed; thus facilitating further developments. The method has been applied for the case study of Budapest.

Keywords: air transportation informatics, evaluation, information service, smart airport

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2587 Assessment of Sex Differences in Serum Urea and Creatinine Level in Response to Spinal Cord Injury Using Albino Rat Models

Authors: Waziri B. I., Elkhashab M. M.

Abstract:

Background: One of the most serious consequences of spinal cord injury (SCI) is progressive deterioration of renal function mostly as a result of urine stasis and ascending infection of the paralyzed bladder. This necessitates for investigation of early changes in serum urea and creatinine and associated sex related differences in response to SCI. Methods: A total of 24 adult albino rats weighing above 150g were divided equally into two groups, a control and experimental group (n = 12) each containing an equal number of male and female rats. The experimental group animals were paralyzed by complete transection of spinal cord below T4 level after deep anesthesia with ketamine 75mg/kg. Blood samples were collected from both groups five days post SCI for analysis. Mean values of serum urea (mmol/L) and creatinine (µmol/L) for both groups were compared. P < 0.05 was considered as significant. Results: The results showed significantly higher levels (P < 0.05) of serum urea and creatinine in the male SCI models with mean values of 92.12 ± 0.98 and 2573 ± 70.97 respectively compared with their controls where the mean values for serum urea and creatinine were 6.31 ± 1.48 and 476. 95 ± 4.67 respectively. In the female SCI models, serum urea 13.11 ± 0.81 and creatinine 519.88 ± 31.13 were not significantly different from that of female controls with serum urea and creatinine levels of 11.71 ± 1.43 and 493.69 ± 17.10 respectively (P > 0.05). Conclusion: Spinal cord injury caused a significant increase in serum Urea and Creatinine levels in the male models compared to the females. This indicated that males might have higher risk of renal dysfunction following SCI.

Keywords: albino rats, creatinine, spinal cord injury (SCI), urea

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2586 The Uniting Control Lyapunov Functions in Permanent Magnet Synchronous Linear Motor

Authors: Yi-Fei Yang, Nai-Bao He, Shao-Bang Xing

Abstract:

This study investigates the permanent magnet synchronous linear motor (PMSLM) chaotic motion under the specific physical parameters, the stability and the security of motor-driven system will be unavoidably influenced. Therefore, it is really necessary to investigate the methods of controlling or suppressing chaos in PMSLM. Firstly, we derive a chaotic model of PMSLM in the closed-loop system. Secondly, in order to realize the local asymptotic stabilization of the mechanical subsystem and the global stabilization of the motor-driven system including electrical subsystem, we propose an improved uniting control lyapunov functions by introducing backstepping approach. Finally, an illustrated example is also given to show the electiveness of the obtained results.

Keywords: linear motor, lyapunov functions, chao control, hybrid controller

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2585 Case Report of Left Atrial Myxoma Diagnosed by Bedside Echocardiography

Authors: Anthony S. Machi, Joseph Minardi

Abstract:

We present a case report of left atrial myxoma diagnosed by bedside transesophageal (TEE) ultrasound. Left atrial myxoma is the most common benign cardiac tumor and can obstruct blood flow and cause valvular insufficiency. Common symptoms consist of dyspnea, pulmonary edema and other features of left heart failure in addition to thrombus release in the form of tumor fragments. The availability of bedside ultrasound equipment is essential for the quick diagnosis and treatment of various emergency conditions including cardiac neoplasms. A 48-year-old Caucasian female with a four-year history of an untreated renal mass and anemia presented to the ED with two months of sharp, intermittent, bilateral flank pain radiating into the abdomen. She also reported intermittent vomiting and constipation along with generalized body aches, night sweats, and 100-pound weight loss over last year. She had a CT in 2013 showing a 3 cm left renal mass and a second CT in April 2016 showing a 3.8 cm left renal mass along with a past medical history of diverticulosis, chronic bronchitis, dyspnea on exertion, uncontrolled hypertension, and hyperlipidemia. Her maternal family history is positive for breast cancer, hypertension, and Type II Diabetes. Her paternal family history is positive for stroke. She was a current everyday smoker with an 11 pack/year history. Alcohol and drug use were denied. Physical exam was notable for a Grade II/IV systolic murmur at the right upper sternal border, dyspnea on exertion without angina, and a tender left lower quadrant. Her vitals and labs were notable for a blood pressure of 144/96, heart rate of 96 beats per minute, pulse oximetry of 96%, hemoglobin of 7.6 g/dL, hypokalemia, hypochloremia, and multiple other abnormalities. Physicians ordered a CT to evaluate her flank pain which revealed a 7.2 x 8.9 x 10.5 cm mixed cystic/solid mass in the lower pole of the left kidney and a filling defect in the left atrium. Bedside TEE was ordered to follow up on the filling defect. TEE reported an ejection fraction of 60-65% and visualized a mobile 6 x 3 cm mass in the left atrium attached to the interatrial septum extending into the mitral valve. Cardiothoracic Surgery and Urology were consulted and confirmed a diagnosis of left atrial myxoma and clear cell renal cell carcinoma. The patient returned a week later due to worsening nausea and vomiting and underwent emergent nephrectomy, lymph node dissection, and colostomy due to a necrotic colon. Her condition declined over the next four months due to lung and brain metastases, infections, and other complications until she passed away.

Keywords: bedside ultrasound, echocardiography, emergency medicine, left atrial myxoma

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2584 Evaluation of the Pain of Patients with Chronic Renal Disease in Hemodialysis

Authors: Fabiana Souza Orlandi, Izabel Cristina Chavez Gomes, Barbara Isabela De Paula Morais, Ana Carolina Ottaviani

Abstract:

Chronic Kidney Disease (CKD) is considered a public health problem. Patients who present CKD in their more advanced stages usually present several biopsychosocial changes, which may include pain. Pain can be considered subjective and personal, and its perception is characterized as a multidimensional experience. The objective of this study was to evaluate the level and descriptors of pain of adults and elderly patients with chronic kidney disease, through the Multidimensional Pain Evaluation Scale (EMADOR). This is a descriptive cross-sectional study with a quantitative approach. The sample consisted of 100 subjects with CKD in hemodialysis treatment at a Renal Replacement Therapy Service in the interior of the state of São Paulo. Data were collected through an individual interview, using a Sociodemographic Characterization and Multidimensional Pain Evaluation Scale (EMADOR). All ethical precepts were respected. The majority of the respondents were men (61.0%), white (56.0%) and with a high school education (34.0%). Regarding the pain of the individuals, 89 patients reported pain, with Chronic Pain predominating (50.0%, n = 50), followed by Acute Pain (39.0%, n = 39). Of the subjects who presented acute pain most of the 89.0% described the pain felt as unbearable, and of those who presented chronic pain, 35.0% described the pain felt as painful, unbearable and uncomfortable. It was concluded that there was a significant presence of pain, being the chronic pain dominant in the studied population. Faced with such factors, the present study motivates researches in this population, in order to establish interventions with the objective of improving the quality of life of these individuals.

Keywords: pain, chronic kidney disease, dialysis, evaluation

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2583 Bayesian Using Markov Chain Monte Carlo and Lindley's Approximation Based on Type-I Censored Data

Authors: Al Omari Moahmmed Ahmed

Abstract:

These papers describe the Bayesian Estimator using Markov Chain Monte Carlo and Lindley’s approximation and the maximum likelihood estimation of the Weibull distribution with Type-I censored data. The maximum likelihood method can’t estimate the shape parameter in closed forms, although it can be solved by numerical methods. Moreover, the Bayesian estimates of the parameters, the survival and hazard functions cannot be solved analytically. Hence Markov Chain Monte Carlo method and Lindley’s approximation are used, where the full conditional distribution for the parameters of Weibull distribution are obtained via Gibbs sampling and Metropolis-Hastings algorithm (HM) followed by estimate the survival and hazard functions. The methods are compared to Maximum Likelihood counterparts and the comparisons are made with respect to the Mean Square Error (MSE) and absolute bias to determine the better method in scale and shape parameters, the survival and hazard functions.

Keywords: weibull distribution, bayesian method, markov chain mote carlo, survival and hazard functions

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2582 Solving Process Planning and Scheduling with Number of Operation Plus Processing Time Due-Date Assignment Concurrently Using a Genetic Search

Authors: Halil Ibrahim Demir, Alper Goksu, Onur Canpolat, Caner Erden, Melek Nur

Abstract:

Traditionally process planning, scheduling and due date assignment are performed sequentially and separately. High interrelation between these functions makes integration very useful. Although there are numerous works on integrated process planning and scheduling and many works on scheduling with due date assignment, there are only a few works on the integration of these three functions. Here we tested the different integration levels of these three functions and found a fully integrated version as the best. We applied genetic search and random search and genetic search was found better compared to the random search. We penalized all earliness, tardiness and due date related costs. Since all these three terms are all undesired, it is better to penalize all of them.

Keywords: process planning, scheduling, due-date assignment, genetic algorithm, random search

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2581 Optimal Mother Wavelet Function for Shoulder Muscles of Upper Limb Amputees

Authors: Amanpreet Kaur

Abstract:

Wavelet transform (WT) is a powerful statistical tool used in applied mathematics for signal and image processing. The different mother, wavelet basis function, has been compared to select the optimal wavelet function that represents the electromyogram signal characteristics of upper limb amputees. Four different EMG electrode has placed on different location of shoulder muscles. Twenty one wavelet functions from different wavelet families were investigated. These functions included Daubechies (db1-db10), Symlets (sym1-sym5), Coiflets (coif1-coif5) and Discrete Meyer. Using mean square error value, the significance of the mother wavelet functions has been determined for teres, pectorals, and infraspinatus around shoulder muscles. The results show that the best mother wavelet is the db3 from the Daubechies family for efficient classification of the signal.

Keywords: Daubechies, upper limb amputation, shoulder muscles, Symlets, Coiflets

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2580 VHL, PBRM1, and SETD2 Genes in Kidney Cancer: A Molecular Investigation

Authors: Rozhgar A. Khailany, Mehri Igci, Emine Bayraktar, Sakip Erturhan, Metin Karakok, Ahmet Arslan

Abstract:

Kidney cancer is the most lethal urological cancer accounting for 3% of adult malignancies. VHL, a tumor-suppressor gene, is best known to be associated with renal cell carcinoma (RCC). The VHL functions as negative regulator of hypoxia inducible factors. Recent sequencing efforts have identified several novel frequent mutations of histone modifying and chromatin remodeling genes in ccRCC (clear cell RCC) including PBRM1 and SETD2. The PBRM1 gene encodes the BAF180 protein, which involved in transcriptional activation and repression of selected genes. SETD2 encodes a histone methyltransferase, which may play a role in suppressing tumor development. In this study, RNAs of 30 paired tumor and normal samples that were grouped according to the types of kidney cancer and clinical characteristics of patients, including gender and average age were examined by RT-PCR, SSCP and sequencing techniques. VHL, PBRM1 and SETD2 expressions were relatively down-regulated. However, statistically no significance was found (Wilcoxon signed rank test, p > 0.05). Interestingly, no mutation was observed on the contrary of previous studies. Understanding the molecular mechanisms involved in the pathogenesis of RCC has aided the development of molecular-targeted drugs for kidney cancer. Further analysis is required to identify the responsible genes rather than VHL, PBRM1 and SETD2 in kidney cancer.

Keywords: kidney cancer, molecular biomarker, expression analysis, mutation screening

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2579 A Comparitive Study of the Effect of Stress on the Cognitive Parameters in Women with Increased Body Mass Index before and after Menopause

Authors: Ramesh Bhat, Ammu Somanath, A. K. Nayanatara

Abstract:

Background: The increasing prevalence of overweight and obesity is a critical public health problem for women. The negative effect of stress on memory and cognitive functions has been widely explored for decades in numerous research projects using a wide range of methodology. Deterioration of memory and other brain functions are hallmarks of Alzheimer’s disease. Estrogen fluctuations and withdrawal have myriad direct effects on the central nervous system that have the potential to influence cognitive functions. Aim: The present study aims to compare the effect of stress on the cognitive functions in overweight/obese women before and after menopause. Material and Methods: A total of 142 female subjects constituting women before menopause between the age group of 18–44 years and women after menopause between the age group of 45–60 years were included in the sample. Participants were categorized into overweight/obese groups based on the body mass index. The Perceived Stress Scale (PSS) the major tool was used for measuring the perception of stress. Based on the stress scale measurement each group was classified into with stress and without stress. Addenbrooke’s cognitive Examination-III was used for measuring the cognitive functions. Results: Premenopausal women with stress showed a significant (P<0.05) decrease in the cognitive parameters such as attention and orientation Fluency, language and visuospatial ability. Memory did not show any significant change in this group. Whereas, in the postmenopausal stressed women all the cognitive functions except fluency showed a significant (P<0.05) decrease after menopause stressed group. Conclusion: Stress is a significant factor on the cognitive functions of obese and overweight women before and after menopause. Practice of Yoga, Encouragement in activities like gardening, embroidery, games and relaxation techniques should be recommended to prevent stress. Insights into the neurobiology before and after menopause can be gained from future studies examining the effect on the HPA axis in relation to cognition and stress.

Keywords: cognition, stress, premenopausal, body mass index

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2578 Deep Learning Approach for Chronic Kidney Disease Complications

Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

Abstract:

Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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2577 Profile of the Renal Failure Patients under Haemodialysis at B. P. Koirala Institute of Health Sciences Nepal

Authors: Ram Sharan Mehta, Sanjeev Sharma

Abstract:

Introduction: Haemodialysis (HD) is a mechanical process of removing waste products from the blood and replacing essential substances in patients with renal failure. First artificial kidney developed in Netherlands in 1943 AD First successful treatment of CRF reported in 1960AD, life-saving treatment begins for CRF in 1972 AD. In 1973 AD Medicare took over financial responsibility for many clients and after that method become popular. BP Koirala institute of health science is the only center outside the Kathmandu, where HD service is available. In BPKIHS PD started in Jan.1998, HD started in August 2002 till September 2003 about 278 patients received HD. Day by day the number of HD patients is increasing in BPKIHS as with institutional growth. No such type of study was conducted in past hence there is lack of valid & reliable baseline data. Hence, the investigators were interested to conduct the study on " Profile of the Renal Failure patients under Haemodialysis at B.P. Koirala Institute of Health Sciences Nepal". Objectives: The objectives of the study were: to find out the Socio-demographic characteristics of the patients, to explore the knowledge of the patients regarding disease process and Haemodialysis and to identify the problems encountered by the patients. Methods: It is a hospital-based exploratory study. The population of the study was the clients under HD and the sampling method was purposive. Fifty-four patients undergone HD during the period of 17 July 2012 to 16 July 2013 of complete one year were included in the study. Structured interview schedule was used for collect data after obtaining validity and reliability. Results: Total 54 subjects had undergone for HD, having age range of 5-75 years and majority of them were male (74%) and Hindu (93 %). Thirty-one percent illiterate, 28% had agriculture their occupation, 80% of them were from very poor community, and about 30% subjects were unaware about the disease they suffering. Majority of subjects reported that they had no complications during dialysis (61%), where as 20% reported nausea and vomiting, 9% Hypotension, 4% headache and 2%chest pain during dialysis. Conclusions: CRF leading to HD is a long battle for patients, required to make major and continuous adjustment, both physiologically and psychologically. The study suggests that non-compliance with HD regimen were common. The socio-demographic and knowledge profile will help in the management and early prevention of disease and evaluate aspects that will influence care and patients can select mode of treatment themselves properly.

Keywords: profile, haemodialysis, Nepal, patients, treatment

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2576 Detection of Leptospira interrogans in Kidney and Urine of water Buffalo and its Relationship with Histopathological and Serological Findings

Authors: M. R. Haji Hajikolaei, A. A. Nikvand, A. R. Ghadrdan, M. Ghorbanpoor, B. Mohammadian

Abstract:

This study was carried out on water buffalo for detection of Leptospira interrogans in kidney and urine and its relationship with serological findings. Blood, urine and kidney samples were taken immediately after slaughter from 353 water buffalos at Ahvaz abattoir in Khouzestan province, Iran. Sera were initially screened at serum dilution of 1:100 against seven live antigens of Leptospira interrogans: pomona, hardjo, ballum, icterohemorrhagiae, tarasovi, australis and grippotyphosa using the microscopic agglutination test (MAT) and sera with positive results were titrated against reacting antigens in serial twofold dilution from 1:100 to 1:800. The samples of kidney were embedded in paraffin wax and 5µm thick sections were stained routinely with Haematoxylin and Eosin (H&E). Polymerase chain reaction (PCR) examination was done on urine and kidney by using LipL32 gene primers. Antibodies against one or more serovars at dilution >:100 were detected in sera. The most frequent reactor was hardjo (56.2%), followed by pomona (52.3%), australis (9.8%), tarassovi (5.9%), grippotyphosa (4.5%) and icterohaemorrhagiae (3.9%). The L. interrogans were detected in 43 (12.2%) of examined buffaloes, so that 26 (8.2%) of kidney tissues, 14 (4.8%) of urine samples separately and 3 (0.84%) of both kidney and urine samples were positive in PCR. From 153 (43.3%) buffaloes with positive MAT, 24 cases were positive by PCR of kidney and/or urine samples, synchronously. Renal lesions such as interstitial nephritis, acute tubular necrosis (ATN), pyelonephritis, glomerolonephritis, renal fibrosis and hydronephrosis were found in 128 (36.3%) cases. Statistical analysis indicated that there was no significant association between results of MAT, PCR and interstitial nephritis.

Keywords: leptospiral infection, PCR, MAT, histopathology, river buffalo

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2575 Directional Implicit Functions in Nonsmooth Analysis

Authors: Murzabekova Gulden

Abstract:

Directional implicit functions for underdetermined nonsmooth systems in terms of the new tool of the Nonsmooth analysis - exhausters are considered. A method for finding an implicit function for underdetermined nonsmooth systems is proposed.

Keywords: implicit function, exhauster, nonsmooth systems

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2574 Discourse Markers in Chinese University Students and Native English Speakers: A Corpus-Based Study

Authors: Dan Xie

Abstract:

The use of discourse markers (DMs) can play a crucial role in representing discourse interaction and pragmatic competence. Learners’ use of DMs and differences between native speakers (NSs) and non-native speakers (NNSs) in the use of various DMs have been the focus of considerable research attention. However, some commonly used DMs, such as you know, have not received as much attention in comparative studies, especially in the Chinese context. This study analyses data in two corpora (COLSEC and Spoken BNC 2014 (14-25)) to investigate how Chinese learners differ from NNSs in their use of the DM you know and its functions in speech. The results show that there is a significant difference between the two corpora in terms of the frequency of use of you know. In terms of the functions of you know, the study shows that six functions can all be present in both corpora, although there are significant differences between the five functional dimensions, especially in introducing a claim linked to the prior discourse and highlighting particular points in the discourse. It is hoped to show empirically how Chinese learners and NSs use DMs differently.

Keywords: you know, discourse marker, native speaker, Chinese learner

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2573 Frequency of Surgical Complications in Diabetic Patients after Kidney Transplantation

Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.

Keywords: kidney transplantation, diabetes mellitus, surgery, complication

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