Search results for: renal failure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2562

Search results for: renal failure

2352 Efficacy of Heart Failure Reversal Treatment Followed by 90 Days Follow up in Chronic Heart Failure Patients with Low Ejection Fraction

Authors: Rohit Sane, Snehal Dongre, Pravin Ghadigaonkar, Rahul Mandole

Abstract:

The present study was designed to evaluate efficacy of heart failure reversal therapy (HFRT) that uses herbal procedure (panchakarma) and allied therapies, in chronic heart failure (CHF) patients with low ejection fraction. Methods: This efficacy study was conducted in CHF patients (aged: 25-65 years, ejection fraction (EF) < 30%) wherein HFRT (60-75 minutes) consisting of snehana (external oleation), swedana (passive heat therapy), hrudaydhara(concoction dripping treatment) and basti(enema) was administered twice daily for 7 days. During this therapy and next 30 days, patients followed the study dinarcharya and were prescribed ARJ kadha in addition to their conventional treatment. The primary endpoint of this study was evaluation of maximum aerobic capacity uptake (MAC) as assessed by 6-minute walk distance (6MWD) using Cahalins equation from baseline, at end of 7 day treatment, follow-up after 30 days and 90 days. EF was assessed by 2D Echo at baseline and after 30 days of follow-up. Results: CHF patients with < 30% EF (N=52, mean [SD] age: 58.8 [10.8], 85% men) were enrolled in the study. There was a 100% compliance to study therapy. A significant improvement was observed in MAC levels (7.11%, p =0.029), at end of 7 day therapy as compared to baseline. This improvement was maintained at two follow-up visits. Moreover, ejection fraction was observed to be increased by 6.38%, p=0,012 as compared to baseline at day 7 of the therapy. Conclusions: This 90 day follow up study highlights benefit of HFRT, as a part of maintenance treatment for CHF patients with reduced ejection fraction.

Keywords: chronic heart failure, functional capacity, heart failure reversal therapy, oxygen uptake, panchakarma

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2351 Myroides Bacteremia: A Case Report

Authors: Jamie Lynn Co, Mary Shiela Ariola-Ramos

Abstract:

Myroides are aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods. They are commonly found in the environment such as water and soil. Although found in the environment, Myroides are rare pathogens of humans. Myroides spp. primarily infect immunocompromised patients, often with diabetes mellitus, liver cirrhosis, chronic kidney disease, chronic obstructive pulmonary disease or prolonged corticosteroid therapy. We present a case of a 70-year-old immunocompromised patient with diabetes mellitus, chronic renal failure, diagnosed with sepsis caused by Myroides spp. The primary portal and source of infection were the pustules and boils found on the lower extremities of the patient. Susceptibility testing showed that our isolate was only susceptible to ciprofloxacin and meropenem; and following the treatment, the patient recovered. Myroides continues to be a rare pathogen of humans that is prevalent in our environment. It primarily affects immunocompromised patients such as those with uncontrolled diabetes mellitus, chronic kidney disease, etc. Despite their low virulence, physicians should consider this opportunistic pathogen as possible etiologic agent especially in cases wherein there is lack of response to commonly used antibiotics.

Keywords: bacteremia, immunocompromised, gram negative rods, Myroides

Procedia PDF Downloads 152
2350 Simplified Ultimate Strength Assessment of Ship Structures Based on Biro Klasifikasi Indonesia Rules for Hull

Authors: Sukron Makmun, Topan Firmandha, Siswanto

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Ultimate Strength Assessment on ship cross section in accordance with Biro Klasifikasi Indonesia (BKI) Rules for Hull, follows step by step incremental iterative approach. In this approach, ship cross section is divided into plate-stiffener combinations and hard corners element. The average stress-strain relationship (σ-ε) for all structural elements will be defined, where the subscript k refers to the modes 0, 1, 2, 3 or 4. These results would be verified with a commercial software calculation in similar cases. The numerical calculations of buckling strength are in accordance with the commercial software (GL Rules ND). Then the comparison of failure behaviours of stiffened panels and hard corners are presented. Where failure modes 3 are likely to occur first follows the failure mode 4 and the last one is the failure mode 1.

Keywords: ultimate strength assessment, BKI rules, incremental, plate-stiffener combination and hard corner, commercial software

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2349 Investigation of Soil Slopes Stability

Authors: Nima Farshidfar, Navid Daryasafar

Abstract:

In this paper, the seismic stability of reinforced soil slopes is studied using pseudo-dynamic analysis. Equilibrium equations that are applicable to the every kind of failure surface are written using Horizontal Slices Method. In written equations, the balance of the vertical and horizontal forces and moment equilibrium is fully satisfied. Failure surface is assumed to be log-spiral, and non-linear equilibrium equations obtained for the system are solved using Newton-Raphson Method. Earthquake effects are applied as horizontal and vertical pseudo-static coefficients to the problem. To solve this problem, a code was developed in MATLAB, and the critical failure surface is calculated using genetic algorithm. At the end, comparing the results obtained in this paper, effects of various parameters and the effect of using pseudo - dynamic analysis in seismic forces modeling is presented.

Keywords: soil slopes, pseudo-dynamic, genetic algorithm, optimization, limit equilibrium method, log-spiral failure surface

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2348 The Implication of Augmentation Cystoplasty with Mitrofanoff Channel on Reproduction Age Group and Outcome of Pregnancy

Authors: Amal A. Qedrah, Sofia A. Malik, Madiha Akbar

Abstract:

The aim of this article is to share a rare clinical case of pregnancy and surgical delivery in a patient who has undergone augmentation cystoplasty with mitrofanoff channel in the past. Methods: This case report is about a woman who conceived naturally at the age of 27, previously underwent augmentation cystoplasty at the age of 10 years with mitrofanoff procedure using self-clean intermittent catheterization. Furthermore, this pregnancy was complicated by the presence of preeclampsia diagnosed at term and PROM. Following the failure of induction for intrapartum preeclampsia, the patient delivered a healthy baby via low transverse cesarean section at 38 weeks done at Latifa Hospital, Dubai. Conclusion: The procedure is done at a pediatric or young age, after which most patients reach reproductive age. There is no contraindication to pregnancy vaginally or surgically; however, this case was complicated by preeclampsia, due to which this patient was taken for a cesarean section. It is advisable to consult a urologist frequently along with taking regular bacteriological urine samples and blood samples with renal ultrasonography for the evaluation of the kidney. Antibacterial treatment or prophylaxis should be used during pregnancy if necessary and intermittent self-catherization is mostly performed routinely. It is also important to have a urologist on standby during the surgery in order to avoid and/or fix any complications that might come forth.

Keywords: augmentation cystoplasty, cesarean section, delivery, mitrofanoff channel

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2347 Comparison of Wind Fragility for Window System in the Simplified 10 and 15-Story Building Considering Exposure Category

Authors: Viriyavudh Sim, WooYoung Jung

Abstract:

Window system in high rise building is occasionally subjected to an excessive wind intensity, particularly during typhoon. The failure of window system did not affect overall safety of structural performance; however, it could endanger the safety of the residents. In this paper, comparison of fragility curves for window system of two residential buildings was studied. The probability of failure for individual window was determined with Monte Carlo Simulation method. Then, lognormal cumulative distribution function was used to represent the fragility. The results showed that windows located on the edge of leeward wall were more susceptible to wind load and the probability of failure for each window panel increased at higher floors.

Keywords: wind fragility, window system, high rise building, wind disaster

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2346 Application of Failure Mode and Effects Analysis (FMEA) on the Virtual Process Hazard Analysis of Acetone Production Process

Authors: Princes Ann E. Prieto, Denise F. Alpuerto, John Rafael C. Unlayao, Neil Concibido, Monet Concepcion Maguyon-Detras

Abstract:

Failure Mode and Effects Analysis (FMEA) has been used in the virtual Process Hazard Analysis (PHA) of the Acetone production process through the dehydrogenation of isopropyl alcohol, for which very limited process risk assessment has been published. In this study, the potential failure modes, effects, and possible causes of selected major equipment in the process were identified. During the virtual FMEA mock sessions, the risks in the process were evaluated and recommendations to reduce and/or mitigate the process risks were formulated. The risk was estimated using the calculated risk priority number (RPN) and was classified into four (4) levels according to their effects on acetone production. Results of this study were also used to rank the criticality of equipment in the process based on the calculated criticality rating (CR). Bow tie diagrams were also created for the critical hazard scenarios identified in the study.

Keywords: chemical process safety, failure mode and effects analysis (FMEA), process hazard analysis (PHA), process safety management (PSM)

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2345 Nephroprotective Effect of Asparagus falcatus Leaf Extract on Adriamycin Induced Nephrotoxicity in Wistar Rats: A Dose Response Study

Authors: A. M. S. S. Amarasiri, A. P. Attanayake, K. A. P. W. Jayatilaka, L. K. B. Mudduwa

Abstract:

Adriamycin (ADR) is an effective anthracyclin antitumor drug, but its clinical use is limited due to renal toxicity. The leaves of Asparagus falcatus (Family: Liliaceae) have been used in the management of renal diseases since antiquity. In the present investigation, the aqueous leaf extract of A. falcatus was evaluated for acute nephroprotective activity in ADR induced nephrotoxic rats. Nephrotoxicity was induced in healthy male Wistar rats by intraperitoneal administration of ADR 20 mg/kg. The lyophilized powder of the aqueous refluxed (4h) leaf extract of A. falcatus was administered orally at three selected doses; 200, 400 and 600 mg/kg for three consecutive days. Fosinopril sodium (0.09 mg/kg) was used as the standard drug. Administration of the plant extract and the standard drug was commenced 24 hours after the induction of nephrotoxicity to rats. The nephroprotective effect was determined by selected biochemical parameters and by the assessment of histopathology on H and E stained kidney sections. The results were compared to a group of control rats with ADR induced nephrotoxicity. A group of rats administered with the equivalent volume of normal saline served as the healthy control. Administration of ADR 20 mg/kg produced a significant increase in the concentrations of serum creatinine (61%) and urine protein (73%) followed by a significant decrease in serum total protein (21%) and albumin (44%) of the plant extract treated animals compared to the healthy control group (p < 0.05). The aqueous extract of Asparagus falcatus at the three doses; 200, 400 and 600 mg/kg and the standard drug were found to decrease the elevation of concentrations of serum creatinine (33%, 51%, 54% and 42%) and urine protein (8%, 63%, 80% and 86%) respectively. The serum concentrations of total protein (12%, 17%, 29% and 12%) and albumin (3%, 17%, 17% and 16%) were significantly increased compared to the nephrotoxic control group respectively. Assessment of histopathology on H and E stained kidney sections demonstrated that ADR induced renal injury, as evidenced by loss of brush border, cytoplasmic vacuolization, pyknosis in renal tubular epithelial cells, haemorrhages, glomerular congestion and presence of hyaline casts. Treatment with the plant extract and the standard drug resulted in attenuation of the morphological destruction in rats. The results of the present study revealed that the aqueous leaf extract of A. falcatus possesses significant nephroprotective activity against adriamycin induced acute nephrotoxicity. The improved kidney functions were supported with the results of selected biochemical parameters and histological changes observed on H and E stained sections of the kidney tissues in Wistar rats.

Keywords: adriamycin induced nephrotoxicity, asparagus falcatus, biochemical assessment, histopathological assessment, nephroprotective activity

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2344 Calculating Shear Strength Parameter from Simple Shear Apparatus

Authors: G. Nitesh

Abstract:

The shear strength of soils is a crucial parameter instability analysis. Therefore, it is important to determine reliable values for the accuracy of stability analysis. Direct shear tests are mostly performed to determine the shear strength of cohesionless soils. The major limitation of the direct shear test is that the failure takes place through the pre-defined failure plane but the failure is not along pre-defined plane and is along the weakest plane in actual shearing mechanism that goes on in the field. This leads to overestimating the strength parameter; hence, a new apparatus called simple shear is developed and used in this study to determine the shear strength parameter that simulates the field conditions.

Keywords: direct shear, simple shear, angle of shear resistance, cohesionless soils

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2343 Reliability and Maintainability Optimization for Aircraft’s Repairable Components Based on Cost Modeling Approach

Authors: Adel A. Ghobbar

Abstract:

The airline industry is continuously challenging how to safely increase the service life of the aircraft with limited maintenance budgets. Operators are looking for the most qualified maintenance providers of aircraft components, offering the finest customer service. Component owner and maintenance provider is offering an Abacus agreement (Aircraft Component Leasing) to increase the efficiency and productivity of the customer service. To increase the customer service, the current focus on No Fault Found (NFF) units must change into the focus on Early Failure (EF) units. Since the effect of EF units has a significant impact on customer satisfaction, this needs to increase the reliability of EF units at minimal cost, which leads to the goal of this paper. By identifying the reliability of early failure (EF) units with regards to No Fault Found (NFF) units, in particular, the root cause analysis with an integrated cost analysis of EF units with the use of a failure mode analysis tool and a cost model, there will be a set of EF maintenance improvements. The data used for the investigation of the EF units will be obtained from the Pentagon system, an Enterprise Resource Planning (ERP) system used by Fokker Services. The Pentagon system monitors components, which needs to be repaired from Fokker aircraft owners, Abacus exchange pool, and commercial customers. The data will be selected on several criteria’s: time span, failure rate, and cost driver. When the selected data has been acquired, the failure mode and root cause analysis of EF units are initiated. The failure analysis approach tool was implemented, resulting in the proposed failure solution of EF. This will lead to specific EF maintenance improvements, which can be set-up to decrease the EF units and, as a result of this, increasing the reliability. The investigated EFs, between the time period over ten years, showed to have a significant reliability impact of 32% on the total of 23339 unscheduled failures. Since the EFs encloses almost one-third of the entire population.

Keywords: supportability, no fault found, FMEA, early failure, availability, operational reliability, predictive model

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2342 Additive Weibull Model Using Warranty Claim and Finite Element Analysis Fatigue Analysis

Authors: Kanchan Mondal, Dasharath Koulage, Dattatray Manerikar, Asmita Ghate

Abstract:

This paper presents an additive reliability model using warranty data and Finite Element Analysis (FEA) data. Warranty data for any product gives insight to its underlying issues. This is often used by Reliability Engineers to build prediction model to forecast failure rate of parts. But there is one major limitation in using warranty data for prediction. Warranty periods constitute only a small fraction of total lifetime of a product, most of the time it covers only the infant mortality and useful life zone of a bathtub curve. Predicting with warranty data alone in these cases is not generally provide results with desired accuracy. Failure rate of a mechanical part is driven by random issues initially and wear-out or usage related issues at later stages of the lifetime. For better predictability of failure rate, one need to explore the failure rate behavior at wear out zone of a bathtub curve. Due to cost and time constraints, it is not always possible to test samples till failure, but FEA-Fatigue analysis can provide the failure rate behavior of a part much beyond warranty period in a quicker time and at lesser cost. In this work, the authors proposed an Additive Weibull Model, which make use of both warranty and FEA fatigue analysis data for predicting failure rates. It involves modeling of two data sets of a part, one with existing warranty claims and other with fatigue life data. Hazard rate base Weibull estimation has been used for the modeling the warranty data whereas S-N curved based Weibull parameter estimation is used for FEA data. Two separate Weibull models’ parameters are estimated and combined to form the proposed Additive Weibull Model for prediction.

Keywords: bathtub curve, fatigue, FEA, reliability, warranty, Weibull

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2341 Study of Mechanical Behavior of Unidirectional Composite Laminates According

Authors: Deliou Adel, Saadalah Younes, Belkaid Khmissi, Dehbi Meriem

Abstract:

Composite materials, in the most common sense of the term, are a set of synthetic materials designed and used mainly for structural applications; the mechanical function is dominant. The mechanical behaviors of the composite, as well as the degradation mechanisms leading to its rupture, depend on the nature of the constituents and on the architecture of the fiber preform. The profile is required because it guides the engineer in designing structures with precise properties in relation to the needs. This work is about studying the mechanical behavior of unidirectional composite laminates according to different failure criteria. Varying strength parameter values make it possible to compare the ultimate mechanical characteristics obtained by the criteria of Tsai-Hill, Fisher and maximum stress. The laminate is subjected to uniaxial tensile membrane forces. Estimates of their ultimate strengths and the plotting of the failure envelope constitute the principal axis of this study. Using the theory of maximum stress, we can determine the various modes of damage of the composite. The different components of the deformation are presented for different orientations of fibers.

Keywords: unidirectional kevlar/epoxy composite, failure criterion, membrane stress, deformations, failure envelope

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2340 Experimental Investigation of the Failure Behavior of a Retaining Wall Constructed with Soil Bags

Authors: Kewei Fan, Sihong Liu, Yi Pik Cheng

Abstract:

This paper aims to analyse the failure behaviour of the retaining wall constructed with soil bags that are formed by filling river sand into woven bags (geosynthetics). Model tests were conducted to obtain the failure mode of the wall, and shear tests on two-layers and five-layers of soil bags were designed to investigate the mechanical characteristics of the interface of soil bags. The test results show that the slip surface in the soil bags-constructed retaining wall is ladder-like due to the inter-layer insertion of soil bags, and the wall above the ladder-like surface undergoes a rigid body translation. The insertion strengthens the shear strength of two-layer staggered-stacked soil bags. Meanwhile, it affects the shape of the slip surface of the five-layer staggered-stacked soil bags. Finally, the interlayer resisting friction of soil bags is found to be related to the shape of the slip surface.

Keywords: geosynthetics, retaining wall, soil bag, failure mode, interface, shear strength

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2339 The Assessment of Nephrotoxic Effects of Peganum Harmala In Rat

Authors: Amal Yamani, Jaber Elgtou, Aziz Mohammed, Lazaar Jamila, Elachouri Mostafa

Abstract:

Peganum harmala used traditionally as an emenagogue and abortifacient agent in Morocco phytotherapy. Even thought its benefits effects, Peganum harmala remained severely toxic for the organism especially in strong doses. The present study was initiated to evaluate the nephrotoxic effects of aqueous extract of Peganum harmala seeds (PHS). The solution containing aqueous extract of PHS was administered orally by gavage at the dose of 2g/kg body weight during twenty days. Rats were used in this study, two groups were considered, a treated group received an extract of PHS at dose 2g/kg bodyweight and control group received an amount of tap water equivalent to the volume of the vehicle used for the dose of PHS extract. The data we collected showed that aqueous extracts of PHS administered during twenty days induced a significant changes in renal function expressed in decreases of diuresis (from 10 ± 0,58 to 5,33 ± 0,33 ml/24 hours) and the same profile for mean arterial blood pressure (from 125 ± 2,89 to 96,67 ± 6,01 mmHg). The histopathological study showed an alteration of kidney cells in treated group with regard the control group which is not affected. In conclusion: our results indicate that the aqueous extract of PHS induces toxicity may affect severely kidney function and causes renal histopathology.

Keywords: peganum harmala seeds, nephrotoxic, diuresi, histpathology, kidney

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2338 An Experimental Investigation of Rehabilitation and Strengthening of Reinforced Concrete T-Beams Under Static Monotonic Increasing Loading

Authors: Salem Alsanusi, Abdulla Alakad

Abstract:

An experimental investigation to study the behaviour of under flexure reinforced concrete T-Beams. Those Beams were loaded to pre-designated stress levels as percentage of calculated collapse loads. Repairing these beans by either reinforced concrete jacket, or by externally bolted steel plates were utilized. Twelve full scale beams were tested in this experimental program scheme. Eight out of the twelve beams were loaded under different loading levels. Tests were performed for the beams before and after repair with Reinforced Concrete Jacket (RCJ). The applied Load levels were 60%, 77% and 100% of the calculated collapse loads. The remaining four beams were tested before and after repair with Bolted Steel Plate (BSP). Furthermore, out previously mentioned four beams two beams were loaded to the calculated failure load 100% and the remaining two beams were not subjected to any load. The eight beams recorded for the RCJ test were repaired using reinforced concrete jacket. The four beams recorded for the BSP test were all repaired using steel plate at the bottom. All the strengthened beams were gradually loaded until failure occurs. However, in each loading case, the beams behaviour, before and after strengthening, were studied through close inspection of the cracking propagation, and by carrying out an extensive measurement of deformations and strength. The stress-strain curve for reinforcing steel and the failure strains measured in the tests were utilized in the calculation of failure load for the beams before and after strengthening. As a result, the calculated failure loads were close to the actual failure tests in case of beams before repair, ranging from 85% to 90% and also in case of beams repaired by reinforced concrete jacket ranging from 70% to 85%. The results were in case of beams repaired by bolted steel plates ranging from (50% to 85%). It was observed that both jacketing and bolted steel plate methods could effectively restore the full flexure capacity of the damaged beams. However, the reinforced jacket has increased the failure load by about 67%, whereas the bolted steel plates recovered the failure load.

Keywords: rehabilitation, strengthening, reinforced concrete, beams deflection, bending stresses

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2337 Influence of Spirituality on Health Outcomes and General Well-Being in Patients with End-Stage Renal Disease

Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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2336 Compliance Of Dialysis patients With Nutrition Guidelines: Insights From A Questionnaire

Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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2335 Shame and Pride in Moral Self-Improvement

Authors: Matt Stichter

Abstract:

Moral development requires learning from one’s failures, but that turnsout to be especially challenging when dealing with moral failures. The distress prompted by moral failure can cause responses ofdefensiveness or disengagement rather than attempts to make amends and work on self-change. The most potentially distressing response to moral failure is a shame. However, there appears to be two different senses of “shame” that are conflated in the literature, depending on whether the failure is appraised as the result of a global and unalterable self-defect, or a local and alterable self-defect. One of these forms of shame does prompt self-improvement in response to moral failure. This occurs if one views the failure as indicating only a specific (local) defect in one’s identity, where that’s something repairable, rather than asanoverall(orglobal)defectinyouridentity that can’t be fixed. So, if the whole of one’s identity as a morally good person isn’t being called into question, but only a part, then that is something one could work on to improve. Shame, in this sense, provides motivation for self-improvement to fix this part oftheselfinthe long run, and this would be important for moral development. One factor that looks to affect these different self-attributions in the wake of moral failure can be found in mindset theory, as reactions to moral failure in these two forms of shame are similar to how those with a fixed or growth mindset of their own abilities, such as intelligence, react to failure. People fall along a continuum with respect to how they view abilities – it is more of a fixed entity that you cannot do much to change, or it is malleable such that you can train to improve it. These two mindsets, ‘fixed’ versus ‘growth’, have different consequences for how we react to failure – a fixed mindset leads to maladaptive responses because of feelings of helplessness to do better; whereas a growth mindset leads to adaptive responses where a person puts forth effort to learn how to act better the next time. Here we can see the parallels between a fixed mindset of one’s own (im)morality, as the way people respond to shame when viewed as indicating a global and unalterable self-defect parallels the reactions people have to failure when they have a fixed mindset. In addition, it looks like there may be a similar structure to pride. Pride is, like shame, a self-conscious emotion that arises from internal attributions about the self as being the cause of some event. There are also paradoxical results from research on pride, where pride was found to motivate pro-social behavior in some cases but aggression in other cases. Research suggests that there may be two forms of pride, authentic and hubristic, that are also connected to different self-attributions, depending on whether one is feeling proud about a particular (local) aspect of the self versus feeling proud about the whole of oneself (global).

Keywords: emotion, mindset, moral development, moral psychology, pride, shame, self-regulation

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2334 Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Syndrome Presenting as Multi-Organ Failure

Authors: Keshari Shrestha, Philip Vatterott

Abstract:

Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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2333 Fatigue Behavior of Dissimilar Welded Monel400 and SS316 by FSW

Authors: Aboozar Aghaei

Abstract:

In the present work, the dissimilar Monel400 and SS316 were joined by friction stir welding (FSW). The applied rotating speed was 400 rpm, whereas the traverse speed varied between 50 and 150 mm/min. At a constant rotating speed, the sound welds were obtained at the welding speeds of 50 and 100 mm/min. However, a groove-like defect was formed when the welding speed exceeded 100 mm/min. The mechanical properties of the joints were evaluated using tensile and fatigue tests. The fatigue strength of dissimilar FSWed specimen was higher than that of both Monel400 and SS316. To study the failure behavior of FSWed specimens, the fracture surfaces were analyzed using scanning electron microscope (SEM). The failure analysis indicates that different mechanisms may contribute to the fracture of welds. This was attributed to the dissimilar characteristics of dissimilar materials exhibiting different failure behaviors.

Keywords: mechanical properties, stainless steel, frictions, monel

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2332 Reliability Analysis of Glass Epoxy Composite Plate under Low Velocity

Authors: Shivdayal Patel, Suhail Ahmad

Abstract:

Safety assurance and failure prediction of composite material component of an offshore structure due to low velocity impact is essential for associated risk assessment. It is important to incorporate uncertainties associated with material properties and load due to an impact. Likelihood of this hazard causing a chain of failure events plays an important role in risk assessment. The material properties of composites mostly exhibit a scatter due to their in-homogeneity and anisotropic characteristics, brittleness of the matrix and fiber and manufacturing defects. In fact, the probability of occurrence of such a scenario is due to large uncertainties arising in the system. Probabilistic finite element analysis of composite plates due to low-velocity impact is carried out considering uncertainties of material properties and initial impact velocity. Impact-induced damage of composite plate is a probabilistic phenomenon due to a wide range of uncertainties arising in material and loading behavior. A typical failure crack initiates and propagates further into the interface causing de-lamination between dissimilar plies. Since individual crack in the ply is difficult to track. The progressive damage model is implemented in the FE code by a user-defined material subroutine (VUMAT) to overcome these problems. The limit state function is accordingly established while the stresses in the lamina are such that the limit state function (g(x)>0). The Gaussian process response surface method is presently adopted to determine the probability of failure. A comparative study is also carried out for different combination of impactor masses and velocities. The sensitivity based probabilistic design optimization procedure is investigated to achieve better strength and lighter weight of composite structures. Chain of failure events due to different modes of failure is considered to estimate the consequences of failure scenario. Frequencies of occurrence of specific impact hazards yield the expected risk due to economic loss.

Keywords: composites, damage propagation, low velocity impact, probability of failure, uncertainty modeling

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2331 Modeling of Historical Lime Masonry Structure in Abaqus

Authors: Ram Narayan Khare, Adhyatma Khare, Aradhna Shrivastava

Abstract:

In this study, numerical modeling of ‘Lime Surkhi’ masonry building has been carried out for a prototype ancient building situated at seismic zone III using the Finite Element Method by Abaqus software. The model is designed in order to get the failure envelope and then decide the best method of retrofitting the structure so that the structure is made to withstand more decades, given its historical background. Previously, due to a lack of technologies, it was difficult to determine the mode of failure. Present technological development can predict the mode of failure, and subsequently, the structure can be refabricated accordingly. The study makes an important addition to the understanding of retrofitting ancient and old buildings based on the results of FEM modeling.

Keywords: seismic retrofitting, Abaqus, FEM, historic building, Lime Surkhi masonry

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2330 Time-Dependent Reliability Analysis of Corrosion Affected Cast Iron Pipes with Mixed Mode Fracture

Authors: Chun-Qing Li, Guoyang Fu, Wei Yang

Abstract:

A significant portion of current water networks is made of cast iron pipes. Due to aging and deterioration with corrosion being the most predominant mechanism, the failure rate of cast iron pipes is very high. Although considerable research has been carried out in the past few decades, most are on the effect of corrosion on the structural capacity of pipes using strength theory as the failure criterion. This paper presents a reliability-based methodology for the assessment of corrosion affected cast iron pipe cracking failures. A nonlinear limit state function taking into account all three fracture modes is proposed for brittle metal pipes with mixed mode fracture. A stochastic model of the load effect is developed, and time-dependent reliability method is employed to quantify the probability of failure and predict the remaining service life. A case study is carried out using the proposed methodology, followed by sensitivity analysis to investigate the effects of the random variables on the probability of failure. It has been found that the larger the inclination angle or the Mode I fracture toughness is, the smaller the probability of pipe failure is. It has also been found that the multiplying and exponential coefficients k and n in the power law corrosion model and the internal pressure have the most influence on the probability of failure for cast iron pipes. The methodology presented in this paper can assist pipe engineers and asset managers in developing a risk-informed and cost-effective strategy for better management of corrosion-affected pipelines.

Keywords: corrosion, inclined surface cracks, pressurized cast iron pipes, stress intensity

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2329 Dynamic Damage Analysis of Carbon Fiber Reinforced Polymer Composite Confinement Vessels

Authors: Kamal Hammad, Alexey Fedorenko, Ivan Sergeichev

Abstract:

This study uses analytical modeling, experimental testing, and explicit numerical simulations to evaluate failure and spall damage in Carbon Fiber-Reinforced Polymer (CFRP) composite confinement vessels. It investigates the response of composite materials to explosive loading dynamic impact, revealing varied failure modes. Hashin damage was used to model inplane failure, while the Virtual Crack Closure Technique (VCCT) modeled inter-laminar damage. Results show moderate agreement between simulations and experiments regarding free surface velocity and failure stresses, with discrepancies due to wire alignment imperfections and wave reverberations in the experimental test. The findings can improve design and risk-reduction strategies in high-risk scenarios, leading to enhanced safety and economic efficiency in material assessment and structural design processes.

Keywords: explicit, numerical, spall, damage, CFRP, composite, vessels, explosive, dynamic, impact, Hashin, VCCT

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2328 Ductility of Slab-Interior Column Connections Transferring Shear and Moment

Authors: Omar M. Ben-Sasi

Abstract:

Ductility of slab-column connections of flat slab structures is a desirable property that should be considered when designing such connections which are susceptible to punching failure around their columns. Tests to failure on six half-scale specimens were conducted for slab-interior column connections transferring shear force and unbalanced moment. The influences on connection ductility of four parameters; namely, the moment to shear force ratio, the ratio of column side length to slab effective depth, the aspect ratio of the column cross section, and the presence of four square openings located next to column corners were investigated. The study revealed marked effects of these parameters on connection ductility. Increasing the first and second parameters, were found to be in favor of increasing connection ductility, while the third and fourth parameters were found to have negative effects on the connection ductility. These findings should, hopefully, help in designing interior connections of flat slab structures.

Keywords: ductility, flat slab, failure, shear force, moment, unbalanced moment, punching failure, connection, interior-column connection

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2327 Association of AGT (M268T) Gene Polymorphism in Diabetes and Nephropathy in Pakistan

Authors: Syed M. Shahid, Rozeena Shaikh, Syeda N. Nawab, Abid Azhar

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Diabetes mellitus (DM) is a prevalent non-communicable disease worldwide. DM may lead to many vascular complications like hypertension, nephropathy, retinopathy, neuropathy and foot infections. Pathogenesis of diabetic nephropathy (DN) is implicated by the polymorphisms in genes encoding the specific components of renin angiotensin aldosterone system (RAAS) which include angiotensinogen (AGT), angiotensin-II receptor and angiotensin converting enzyme (ACE) genes. This study was designed to explore the possible association of AG (M268T) polymorphism in the patients of diabetes and nephropathy in Pakistan. Study subjects included 100 controls, 260 diabetic patients without renal insufficiency and 190 diabetic nephropathy patients with persistent albuminuria. Fasting blood samples were collected from all the subjects after getting institutional ethical approval and informed consent. The biochemical estimations, PCR amplification and direct sequencing for the specific region of AGT gene was carried out. A significantly high frequency of TT genotype and T allele of AGT (M268T) was observed in the patients of diabetes with nephropathy as compared to controls and diabetic patients without any known renal impairment. The TT genotype and T allele of AGT (M268T) polymorphism may be considered as a genetic risk factor for the development and progression of nephropathy in diabetes. Further cross sectional population studies would be of help to establish and confirm the observed possible association of AGT gene variations with development of nephropathy in diabetes.

Keywords: RAAS, AGT (M268T), diabetes, nephropathy

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2326 The Influence of Design Complexity of a Building Structure on the Expected Performance

Authors: Ormal Lishi

Abstract:

This research presents a computationally efficient probabilistic method to assess the performance of compartmentation walls with similar Fire Resistance Levels (FRL) but varying complexity. Specifically, a masonry brick wall and a light-steel framed (LSF) wall with comparable insulation performance are analyzed. A Monte Carlo technique, employing Latin Hypercube Sampling (LHS), is utilized to quantify uncertainties and determine the probability of failure for both walls exposed to standard and parametric fires, following ISO 834 and Eurocodes guidelines. Results show that the probability of failure for the brick masonry wall under standard fire exposure is estimated at 4.8%, while the LSF wall is 7.6%. These probabilities decrease to 0.4% and 4.8%, respectively, when subjected to parametric fires. Notably, the complex LSF wall exhibits higher variability in predicting time to failure for specific criteria compared to the less complex brick wall, especially at higher temperatures. The proposed approach highlights the need for Probabilistic Risk Assessment (PRA) to accurately evaluate the reliability and safety levels of complex designs.

Keywords: design complexity, probability of failure, monte carlo analysis, compartmentation walls, insulation

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2325 Failure Criterion for Mixed Mode Fracture of Cracked Wood Specimens

Authors: Mahdi Fakoor, Seyed Mohammad Navid Ghoreishi

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Investigation of fracture of wood components can prevent from catastrophic failures. Created fracture process zone (FPZ) in crack tip vicinity has important effect on failure of cracked composite materials. In this paper, a failure criterion for fracture investigation of cracked wood specimens under mixed mode I/II loading is presented. This criterion is based on maximum strain energy release rate and material nonlinearity in the vicinity of crack tip due to presence of microcracks. Verification of results with available experimental data proves the coincidence of the proposed criterion with the nature of fracture of wood. To simplify the estimation of nonlinear properties of FPZ, a damage factor is also introduced for engineering and application purposes.

Keywords: fracture criterion, mixed mode loading, damage zone, micro cracks

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2324 Psychological Compatibility of Football Players According to Success Achievement and Failure Avoidance Motivation

Authors: Konstantin A. Bochaver, Alexandra O. Savinkina

Abstract:

The study analyzed the relationship between the homogeneity-heterogeneity of players in a football team and their efficiency. Compatible players were examined in terms of level of socio-psychological development of the team for which they act. It was shown that in teams of high level of socio-psychological development more compatible were athletes with different levels of failure avoidance motivation. But in low-level teams – bucking the trend. The homogeneity of success achievement motivation was not a factor in the effectiveness of the football team.

Keywords: compatibility, failure avoidance motivation, football, heterogeneity, homogeneity, soccer, sport team, success achievement motivation

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2323 Pragmatic Competence of Jordanian EFL Learners

Authors: Dina Mahmoud Hammouri

Abstract:

The study investigates the Jordanian EFL learners’ pragmatic competence through their production of the speech acts of responding to requests, making suggestions, making threats and expressing farewells. The sample of the study consists of 130 Jordanian EFL learners and native speakers. 2600 responses were collected through a Discourse Completion Test (DCT). The findings of the study revealed that the tested students showed similarities and differences in performing the strategies of four speech acts. Differences in the students’ performances led to pragmatic failure instances. The pragmatic failure committed by students refers to a lack of linguistic competence (i.e., pragmalinguistic failure), sociocultural differences and pragmatic transfer (i.e., sociopragmatic failure). EFL learners employed many mechanisms to maintain their communicative competence; the analysis of the test on speech acts showed learners’ tendency towards using particular strategies, resorting to modify strategies and relating them to their grammatical competence, prefabrication, performing long forms, buffing and transfer. The results were also suggestive of the learners’ lack of pragmalinguistic and sociopragmatic knowledge. The implications of this study are for language teachers to teach interlanguage pragmatics explicitly in EFL contexts to draw learners’ attention to both pragmalinguistic and sociopragmatic features, pay more attention to these areas and allocate more time and practice to solve learners’ problems in these areas. The implication of this study is also for pedagogical material designers to provide sufficient and well-organized pragmatic input.

Keywords: pragmatic failure, Jordanian EFL learner, sociopragmatic competence, pragmalinguistic competence

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