Search results for: residual renal function

Authors: Shiva Naidoo, Kristena Yossef, Grimm Jimm, Mirza Wasique, Eric Kemmerer, Joshua Obuch, Anand Mahadevan

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Background: Fiducial markers effectively enhance tumor target visibility prior to Stereotactic Body Radiation Therapy or Proton therapy. To streamline clinical practice, fiducial placement guidelines from a robotic radiosurgery vendor were examined with the goals of optimizing and standardizing feasible geometries for each treatment indication. Clinical examples of prostate, renal, and pancreatic cases are presented. Methods: Vendor guidelines (Accuray, Sunnyvale, Ca) suggest implantation of 4–6 fiducials at least 20 mm apart, with at least a 15-degree angular difference between fiducials, within 50 mm or less from the target centroid, to ensure that any potential fiducial motion (e.g., from respiration or abdominal/pelvic pressures) will mimic target motion. Also recommended is that all fiducials can be seen in 45-degree oblique views with no overlap to coincide with the robotic radiosurgery imaging planes. For the prostate, a standardized geometry that meets all these objectives is a 2 cm-by-2 cm square in the coronal plane. The transperineal implant of two pairs of preloaded tandem fiducials makes the 2 cm-by-2 cm square geometry clinically feasible. This technique may be applied for renal cancer, except repositioned in a sagittal plane, with the retroperitoneal placement of the fiducials into the tumor. Pancreatic fiducial placement via endoscopic ultrasound (EUS) is technically more challenging, as fiducial placement is operator-dependent, and lesion access may be limited by adjacent vasculature, tumor location, or restricted mobility of the EUS probe in the duodenum. Fluoroscopically assisted fiducial placement during EUS can help ensure fiducial markers are deployed with optimal geometry and visualization. Results: Among the first 22 fiducial cases on a newly installed robotic radiosurgery system, live x-ray images for all nine prostatic cases had excellent fiducial visualization at the treatment console. Renal and pancreatic fiducials were not as clearly visible due to difficult target access and smaller caliber insertion needle/fiducial usage. The geometry of the first prostate case was used to ensure accurate geometric marker placement for the remaining 8 cases. Initially, some of the renal and pancreatic fiducials were closer than the 20 mm recommendation, and interactive feedback with the proceduralists led to subsequent fiducials being too far to the edge of the tumor. Further feedback and discussion of all cases are being used to help guide standardized geometries and achieve ideal fiducial placement. Conclusion: The ideal tradeoffs of fiducial visibility versus the thinnest possible gauge needle to avoid complications needs to be systematically optimized among all patients, particularly in regards to body habitus. Multidisciplinary collaboration among proceduralists and radiation oncologists can lead to improved outcomes.

Keywords: fiducial, prostate cancer, renal cancer, pancreatic cancer, radiotherapy

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Authors: S. Sreeja, Radhakrishnan R. Nair, Noble Gracious, Sreeja S. Nair, M. Radhakrishna Pillai

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Background: Tacrolimus is a potent immunosuppressant clinically used for the long term treatment of antirejection of transplanted organs in liver and kidney transplant recipients though dose optimization is poorly managed. However, So far no study has been carried out on the South Indian kidney transplant patients. The objective of this study is to evaluate the potential influence of a functional polymorphism in CYP3A5*3 gene on tacrolimus physiological availability/dose ratio in South Indian renal transplant patients. Materials and Methods: Twenty five renal transplant recipients receiving tacrolimus were enrolled in this study. Their body weight, drug dosage, and therapeutic concentration of Tacrolimus were observed. All patients were on standard immunosuppressive regime of Tacrolimus-Mycophenolate mofetil along with steroids on a starting dose of Tac 0.1 mg/kg/day. CYP3A5 genotyping was performed by PCR followed with RFLP. Conformation of RFLP analysis and variation in the nucleotide sequence of CYP3A5*3 gene were determined by direct sequencing using a validated automated generic analyzer. Results: A significant association was found between tacrolimus per dose/kg/d and CYP3A5 gene (A6986G) polymorphism in the study population. The CYP3A5 *1/*1, *1/*3 and *3/*3 genotypes were detected in 5 (20 %), 5 (20 %) and 15 (60 %) of the 25 graft recipients, respectively. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus Concentration/Dose ratio in kidney transplant recipients. Significantly higher L/D was observed among non-expressors 9.483 ng/mL(4.5- 14.1) as compared with the expressors 5.154 ng/mL (4.42-6.5 ) of CYP3A5. Acute rejection episodes were significantly higher for CYP3A5*1 homozygotes compared to patients with CYP3A5*1/*3 and CYP3A5*3/*3 genotypes (40 % versus 20 % and 13 %, respectively ). The dose normalized TAC concentration (ng/ml/mg/kg) was significantly lower in patients having CYP3A5*1/*3 polymorphism. Conclusion: This is the first study to extensively determine the effect of CYP3A5*3 genetic polymorphism on tacrolimus pharmacokinetics in South Indian renal transplant recipients and also shows that majority of our patients carry mutant allele A6986G in CYP3A5*3 gene. Identification of CYP3A5 polymorphism prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus for each patient.

Keywords: kidney transplant patients, CYP3A5 genotype, tacrolimus, RFLP

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Authors: Theena Thayalan, K. N. Ramesh Babu

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Machining induced residual stress (RS) is one of the most important surface integrity parameters that characterize the near surface layer of a mechanical component, which plays a crucial role in controlling the performance, especially its fatigue life. Since experimental determination of RS is expensive and time consuming, it would be of great benefit if they could be predicted. In such case, it would be possible to select the cutting parameters required to produce a favorable RS profile. In the present study, an effort has been made to develop a 'two dimensional finite element model (FEM)' to simulate orthogonal cutting process and to predict surface and sub-surface RS using the commercial FEA software DEFORM-2D. The developed finite element model has been validated through experimental investigation of RS. In the experimentation, the orthogonal cutting tests were carried out on AISI 4340 by varying the cutting speed (VC) and uncut chip thickness (f) at three levels and the surface & sub-surface RS has been measured using XRD and Electro polishing techniques. The comparison showed that the RS obtained using developed numerical model is in reasonable agreement with that of experimental data.

Keywords: FEM, machining, residual stress, XRF

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Authors: Oscar Corredor, Alexander Guzman, Adan Leon

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Density is a bulk physical property that indicates the quality of a petroleum fraction. It is also a useful property to estimate various physicochemical properties of fraction and petroleum fluids; however, the determination of density of extra heavy residual (EHR) fractions by standard methodologies, (ASTM D70) shows limitations for samples with higher densities than 1.0879 g/cm3. For this reason, a dilution methodology was developed in order to determinate density for those particular fractions, 87 (EHR) fractions were obtained as products of the fractionation of Colombian typical Vacuum Distillation Residual Fractions using molecular distillation (MD) and extraction with Solvent N-hexane in Supercritical Conditions (SFEF) pilot plants. The proposed methodology showed reliable results that can be demonstrated with the standard deviation of repeatability and reproducibility values of 0.0031 and 0.0061 g/ml respectively. In the same way, it was possible to determine densities in fractions EHR up to 1.1647g/cm3 and °API values obtained were ten times less than the water reference value.

Keywords: API, density, vacuum residual, molecular distillation, supercritical fluid extraction

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Authors: Baby Tabassum, Priya Bajaj

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Cadmium is the second most hazardous heavy metal occurring in both elemental as well as compound forms. It is a highly toxic metal with a very high bio-concentration factor (BCF>100). WHO permitted groundwater cadmium concentration is 0.005 mg/L only, but reality is far away from this limit. A number of natural and anthropogenic industrial activities contribute to the spread of cadmium into the environment. The present study had been designated to find out the renal changes at functional level after cadmium intoxication and protection against these changes offered by Mentha piperata. For the purpose, albino rats were selected as the model organism. Cadmium significantly increases the serum level of serum proteins and nitrogenous wastes showing reduced filtration rate of kidneys. Pretreatment with Mentha piperata leaf extract causes significant retention of these levels to normalcy. These findings conclude that Cadmium exposure affects renal functioning but Mentha could prevent it, proving its nephro-protective potential against heavy metal toxicity.

Keywords: albino rat, cadmium, Mentha piperata, nephrotoxicity

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Authors: Ashkan Golgoon, Souhayl Sadik, Arash Yavari

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Eigenstrains in nonlinear solids are created due to anelastic effects such as non-uniform temperature distributions, growth, remodeling, and defects. Eigenstrains understanding is indispensable, as they can generate residual stresses and strongly affect the overall response of solids. Here, we study the residual stress and deformation fields of an incompressible isotropic infinite wedge with a circumferentially-symmetric distribution of finite eigenstrains. We construct a material manifold, whose Riemannian metric explicitly depends on the eigenstrain distribution, thereby we turn the problem into a classical nonlinear elasticity problem, where we find an embedding of the Riemannian material manifold into the ambient Euclidean space. In particular, we find exact solutions for the residual stress and deformation fields of a neo-Hookean wedge having a symmetric inclusion with finite radial and circumferential eigenstrains. Moreover, we numerically solve a similar problem when a symmetric Mooney-Rivlin inhomogeneity with finite eigenstrains is placed in a neo-Hookean wedge. Generalization of the eigenstrain problem to other geometries are also discussed.

Keywords: finite eigenstrains, geometric mechanics, inclusion, inhomogeneity, nonlinear elasticity

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Authors: Zhiqiang Cheng, Qingliang He, Lu Li, Jie Ren

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The safety of pipelines in the condition of frost heave or thaw settlement is necessarily evaluated. A full-scale experiment pipe with the typical structure configuration in station pipeline is constructed, the residual stress is tested with X-ray residual stress device, and the residual stress field of pipe is analyzed. The evolution of pipe strain with pressure in the scope of maximum allowable operation pressure (MAOP) is investigated by both strain gauge and X-ray methods. Load caused by frost heave or thaw settlement is simulated by two ways of lifting jack. The relation of maximum stress of pipe and clearances between supporter and pipe is studied in case of frost heave. The relation of maximum stress of pipe and maximum deformation of pipe on the ground is studied in case of thaw settlement. The study methods and results are valuable for safety assessment of station pipeline according to clearances or deformation in the condition of frost heave or thaw settlement.

Keywords: frost heave, pipeline, stress analysis, thaw settlement

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Authors: Slobodan B. Tričković

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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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Authors: Rabitah Zakaria, Chan M. Luan, Nor Hakimah Ramly

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The extraction of vegetable oil using aqueous extraction process assisted by ionic extended surfactant has been investigated as an alternative to hexane extraction. However, the ionic extended surfactant has not been commercialised and its safety with respect to food processing is uncertain. Hence, food-grade non-ionic surfactants (Tween 20, Span 20, and Span 80) were proposed for the extraction of residual oil from palm-pressed mesocarp fibre. Palm-pressed mesocarp fibre contains a significant amount of residual oil ( 5-10 wt %) and its recovery is beneficial as the oil contains much higher content of vitamin E, carotenoids, and sterols compared to crude palm oil. In this study, the formulation of food-grade surfactants using a combination of high hydrophilic-lipophilic balance (HLB) surfactants and low HLB surfactants to produce micro-emulsion with very low interfacial tension (IFT) was investigated. The suitable surfactant formulation was used in the oil extraction process and the efficiency of the extraction was correlated with the IFT, droplet size and viscosity. It was found that a ternary surfactant mixture with a HLB value of 15 (82% Tween 20, 12% Span 20 and 6% Span 80) was able to produce micro-emulsion with very low IFT compared to other HLB combinations. Results suggested that the IFT and droplet size highly affect the oil recovery efficiency. Finally, optimization of the operating parameters shows that the highest extraction efficiency of 78% was achieved at 1:31 solid to liquid ratio, 2 wt % surfactant solution, temperature of 50˚C, and 50 minutes contact time.

Keywords: food-grade surfactants, aqueous extraction of residual oil, palm-pressed mesocarp fibre, interfacial tension

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Authors: Bárbara Durão, Pedro Almeida, David Ramilo, André Meneses, Rute Canejo-Teixeira

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The importance of quality of life (QoL) assessment in veterinary medicine is an integral part of patient care. This is especially true in cases of chronic diseases, such as chronic kidney disease (CKD), where the ever more advanced treatment options prolong the patient’s life. Whether this prolongment of life comes with an acceptable quality of life remains has been called into question. The aim of this study was to evaluate the relationship between CKD disease biomarkers and QoL in cats. Thirty-seven cats diagnosed with CKD and with no known concurrent illness were enrolled in an observational study. Through the course of several evaluations, renal biomarkers were assessed in blood and urine samples, and owners retrospectively described their cat’s quality of life using a validated instrument for this disease. Correlations between QoL scores (AWIS) and the biomarkers were assessed using Spearman’s rank test. Statistical significance was set at p-value < 0.05, and every serial sample was considered independent. Thirty-seven cats met the inclusion criteria, and all owners completed the questionnaire every time their pet was evaluated, giving a total of eighty-four questionnaires, and the average-weighted-impact-score was –0.5. Results showed there was a statistically significant correlation between the quality of life and most of 17 the studied biomarkers and confirmed that CKD has a negative impact on QoL in cats especially due to the management of the disease and secondary appetite disorders. To our knowledge, this is the attempt to assess the correlation between renal biomarkers and QoL in cats. Our results reveal a strong potential of this type of approach in clinical management, mainly in situations where it is not possible to measure biomarkers. Whilst health-related QoL is a reliable predictor of mortality and morbidity in humans; our findings can help improve the clinical practice in cats with CKD.

Keywords: chronic kidney disease, biomarkers, quality of life, feline

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Authors: Jianhong Xiang, Rui Sun, Linyu Wang

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In recent years, due to the continuous improvement of deep learning theory, Convolutional Neural Network (CNN) has played a great superior performance in the research of Hyperspectral Image (HSI) classification. Since HSI has rich spatial-spectral information, only utilizing a single dimensional or single size convolutional kernel will limit the detailed feature information received by CNN, which limits the classification accuracy of HSI. In this paper, we design a multi-scale CNN with MLP based on residual and attention modules (INRAM-3DCNN) for the HSI classification task. We propose to use multiple 3D convolutional kernels to extract the packet feature information and fully learn the spatial-spectral features of HSI while designing residual 3D convolutional branches to avoid the decline of classification accuracy due to network degradation. Secondly, we also design the 2D Inception module with a joint channel attention mechanism to quickly extract key spatial feature information at different scales of HSI and reduce the complexity of the 3D model. Due to the high parallel processing capability and nonlinear global action of the Multilayer Perceptron (MLP), we use it in combination with the previous CNN structure for the final classification process. The experimental results on two HSI datasets show that the proposed INRAM-3DCNN method has superior classification performance and can perform the classification task excellently.

Keywords: INRAM-3DCNN, residual, channel attention, hyperspectral image classification

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Authors: D. Jagath Kumari, K. Srinivasa Rao

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Quality assurance of the structures subjected to high temperatures is now enforcing measure for the Structural Engineers. The existing relations between strength and nondestructive measurements have been established under normal conditions are not suitable to concretes that have been exposed to high temperatures. The scope of the work is to investigate the influence of high temperatures of short durations on the residual properties of reinforced HVFA concrete columns that affect the strength by non-destructive tests (NDT). Fly ash concrete is increasingly used in the design of normal strength, high strength and high performance concretes. In this paper, the authors revealed the influence of high temperatures on HVFA concrete columns. These columns are heated from 100oC to 800oC with increments of 100oC and allowed to cool to room temperature by two methods one is air cooling method and the other immediate water quenching method. All the specimens were tested identically, before heating and after heating for compressive strength and material integrity by rebound hammer and ultrasonic pulse velocity (UPV) meter respectively. HVFA concrete retained more residual strength by water quenching method than air-cooling method.

Keywords: HVFA concrete, NDT methods, residual strength, non-destructive tests

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Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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Authors: Sasiporn Rattanasupha, Settapat Chinviriyasit

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The treatment function adopts a continuous and differentiable function which can describe the effect of delayed treatment when the number of infected individuals increases and the medical condition is limited. In this paper, the SEIR epidemic model with treatment function is studied to investigate the dynamics of the model due to the effect of treatment. It is assumed that the treatment rate is proportional to the number of infective patients. The stability of the model is analyzed. The model is simulated to illustrate the analytical results and to investigate the effects of treatment on the spread of infection.

Keywords: basic reproduction number, local stability, SEIR epidemic model, treatment function

Procedia PDF Downloads 486

Authors: F. Pottmeyer, M. Weispfenning, K. A. Weidenmann

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Continuous carbon fiber reinforced plastics (CFRP) exhibit a high application potential for lightweight structures due to their outstanding specific mechanical properties. Embedded metal elements, so-called inserts, can be used to join structural CFRP parts. Drilling of the components to be joined can be avoided using inserts. In consequence, no bearing stress is anticipated. This is a distinctive benefit of embedded inserts, since continuous CFRP have low shear and bearing strength. This paper aims at the investigation of the load bearing capacity after preinduced damages from impact tests and thermal-cycling. In addition, characterization of mechanical properties during dynamic high speed pull-out testing under different loading velocities was conducted. It has been shown that the load bearing capacity increases up to 100% for very high velocities (15 m/s) in comparison with quasi-static loading conditions (1.5 mm/min). Residual strength measurements identified the influence of thermal loading and preinduced mechanical damage. For both, the residual strength was evaluated afterwards by quasi-static pull-out tests. Taking into account the DIN EN 6038 a high decrease of force occurs at impact energy of 16 J with significant damage of the laminate. Lower impact energies of 6 J, 9 J, and 12 J do not decrease the measured residual strength, although the laminate is visibly damaged - distinguished by cracks on the rear side. To evaluate the influence of thermal loading, the specimens were placed in a climate chamber and were exposed to various numbers of temperature cycles. One cycle took 1.5 hours from -40 °C to +80 °C. It could be shown that already 10 temperature cycles decrease the load bearing capacity up to 20%. Further reduction of the residual strength with increasing number of thermal cycles was not observed. Thus, it implies that the maximum damage of the composite is already induced after 10 temperature cycles.

Keywords: composite, joining, inserts, dynamic loading, thermal loading, residual strength, impact

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Authors: M. Ndaw, G. Mendy, S. Ouya

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Risk management in banking sector is a key issue linked to financial system stability and its importance has been elevated by technological developments and emergence of new financial instruments. In this paper, we improve the model previously defined for quantifying internal control impact on banking risks by automatizing the residual criticality estimation step of FMECA. For this, we defined three equations and a maturity coefficient to obtain a mathematical model which is tested on all banking processes and type of risks. The new model allows an optimal assessment of residual criticality and improves the correlation rate that has become 98%.

Keywords: risk, control, banking, FMECA, criticality

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Authors: Naga Velamakuri, Jyothi K. Reddy

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Quality must be designed into a product and not inspected has become the main motto of all the companies globally. Due to the rapidly increasing technology in the past few decades, the nature of demands from the consumers has become more sophisticated. To sustain this global revolution of innovation in production systems, companies have to take steps to accommodate this technology growth. In this process of understanding the customers' expectations, all the firms globally take steps to deliver a perfect output. Most of these techniques also concentrate on the consistent development and optimization of the product to exceed the expectations. Quality Function Deployment(QFD) and Modular Function Deployment(MFD) are such techniques which rely on the voice of the customer and help deliver the needs. In this paper, Quality Function Deployment and Modular Function Deployment techniques which help in converting the quantitative descriptions to qualitative outcomes are discussed. The area of interest would be to understand the scope of each of the techniques and the application range in product development when these are applied together to any problem. The research question would be mainly aimed at comprehending the limitations using modularity in product development.

Keywords: quality function deployment, modular function deployment, house of quality, methodology

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Authors: Eun Hui Bae, Sang Yeob Lim, Bongseong Kim, Tae Ryom Oh, Su Hyun Song, Sang Heon Suh, Hong Sang Choi, Eun Mi Yang, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, Soo Wan Kim

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Background: Recent hypertension guidelines have recommended lower blood pressure (BP) targets in high-risk patients. However, there are no specific guidelines based on age or systolic and diastolic blood pressure (SBP and DBP, respectively). We aimed to assess the effects of age-related BP on the development of end-stage renal disease (ESRD) in patients with diabetes. Methods: A total of 2,563,870 patients with DM aged >20 years were selected from the Korean National Health Screening Program from 2009 to 2012 and followed up until the end of 2019. Participants were categorized into age and BP groups, and the hazard ratios (HRs) for ESRD were calculated. Results: During a median follow-up of 7.15 years, the incidence rates of ESRD increased with increasing SBP and DBP. The HR for ESRD was the highest in patients younger than 40 years of age with DBP ≥ 100 mmHg. The effect of SBP and DBP on ESRD development was attenuated with age (interaction p-value was <0.0001 for age and SBP and 0.0022 for age and DBP). The subgroup analysis for sex, anti-hypertension medication, and history of chronic kidney disease (CKD) showed higher HRs for ESRD among males younger than 40 years, not taking anti-hypertension medications and CKD compared to those among females older than 40 years, anti-hypertension medication and non-CKD groups. Conclusions: Higher SBP and DBP increase the risk of developing ESRD in patients with diabetes, and in particular, younger individuals face greater risk. Therefore, intensive BP management is warranted in younger patients to prevent ESRD.

Keywords: hypertension, young adult, end-stage renal disease, diabetes mellitus, chronic kidney disease, blood pressure

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Authors: Yungtai Lo

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Two-part random effects models have been used to fit semi-continuous longitudinal data where the response variable has a point mass at 0 and a continuous right-skewed distribution for positive values. We review methods proposed in the literature for analyzing data with excess zeros. A two-part logit-log-normal random effects model, a two-part logit-truncated normal random effects model, a two-part logit-gamma random effects model, and a two-part logit-skew normal random effects model were used to examine effects of a bottle-weaning intervention on reducing bottle use and daily milk intake from bottles in toddlers aged 11 to 13 months in a randomized controlled trial. We show in all four two-part models that the intervention promoted bottle-weaning and reduced daily milk intake from bottles in toddlers drinking from a bottle. We also show that there are no differences in model fit using either the logit link function or the probit link function for modeling the probability of bottle-weaning in all four models. Furthermore, prediction accuracy of the logit or probit link function is not sensitive to the distribution assumption on daily milk intake from bottles in toddlers not off bottles.

Keywords: two-part model, semi-continuous variable, truncated normal, gamma regression, skew normal, Pearson residual, receiver operating characteristic curve

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Authors: Ayesha Waqar Khan, Mariam Altaf, Jamil Ahmad, Shaheen Shahzad

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Kidney fibrosis is an anticipated outcome of possibly all types of progressive chronic kidney disease (CKD). Epithelial-mesenchymal transition (EMT) signaling pathway is responsible for production of matrix-producing fibroblasts and myofibroblasts in diseased kidney. In this study, a discrete model of TGF-beta (transforming growth factor) and CTGF (connective tissue growth factor) was constructed using Rene Thomas formalism to investigate renal fibrosis turn over. The kinetic logic proposed by Rene Thomas is a renowned approach for modeling of Biological Regulatory Networks (BRNs). This modeling approach uses a set of constraints which represents the dynamics of the BRN thus analyzing the pathway and predicting critical trajectories that lead to a normal or diseased state. The molecular connection between TGF-beta, Smad 2/3 (transcription factor) phosphorylation and CTGF is modeled using GenoTech. The order of BRN is CTGF, TGF-B, and SMAD3 respectively. The predicted cycle depicts activation of TGF-B (TGF-β) via cleavage of its own pro-domain (0,1,0) and presentation to TGFR-II receptor phosphorylating SMAD3 (Smad2/3) in the state (0,1,1). Later TGF-B is turned off (0,0,1) thereby activating SMAD3 that further stimulates the expression of CTGF in the state (1,0,1) and itself turns off in (1,0,0). Elevated CTGF expression reactivates TGF-B (1,1,0) and the cycle continues. The predicted model has generated one cycle and two steady states. Cyclic behavior in this study represents the diseased state in which all three proteins contribute to renal fibrosis. The proposed model is in accordance with the experimental findings of the existing diseased state. Extended cycle results in enhanced CTGF expression through Smad2/3 and Smad4 translocation in the nucleus. The results suggest that the system converges towards organ fibrogenesis if CTGF remains constructively active along with Smad2/3 and Smad 4 that plays an important role in kidney fibrosis. Therefore, modeling regulatory pathways of kidney fibrosis will escort to the progress of therapeutic tools and real-world useful applications such as predictive and preventive medicine.

Keywords: CTGF, renal fibrosis signaling pathway, system biology, qualitative modeling

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Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

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Authors: Chanchai Wimon, Polin Muangngam, Thannapat Nimsumram, Chanin Prombutra, Prasert Aengchuan, Perawat Boonpuek

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Cleaning water containers is essential for drinking water production to prevent contamination and residual chemicals from washing liquid. Water distribution divisions in Thailand are facing a critical problem with residual contamination in 15-liter drinking water containers due to dust and residual chemicals (TDS value > 200) after normal washing. A thorough washing process is required before filling the purified water into each container. Unfortunately, the washing procedure and frequency do not align with the work instructions provided by the health department. The measured Total Dissolved Solids (TDS) value of the remaining water was found to range between 195–202, exceeding the standard TDS for excellent drinking water (50-190 ppm). This research uses the design of experiment technique in statistics to improve the washing process and reduce such contamination. Statistical data from our survey of the cleaning process is collected to identify affecting factors. Washing time and water volume are varied to test the efficiency of the washing process in reducing residual sediment in the water. The result indicates that cleaning the 15-liter container with 2 liters of tap water mixed with 15 milliliters of dishwashing liquid for 3.12 minutes per container is optimal, as the resulting TDS reduces to 189.75, falling within the standard value for good drinking water. This study result would benefit the drinking water industry in implementing a statistically evaluated cleaning procedure without conducting multiple trials, thus saving takt time and production costs.

Keywords: design of experiment, drinking water purification, quality management, production process reliability

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Authors: Myunggon Yoon, Jung-Ho Moon

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In this paper, we present a transfer function representation of a general one-dimensional combustor. The input of the transfer function is a heat rate perturbation of a burner and the output is a flow velocity perturbation at the burner. This paper considers a general combustor model composed of multiple cans with different cross sectional areas, along with a non-zero flow rate.

Keywords: combustor, dynamics, thermoacoustics, transfer function

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Authors: Boonsiri Dandumrongsin, Halis Simsek, Chaiwat Rongsayamanont

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Dissolved organic nitrogen (DON) is known as one of the persistence nitrogenous pollutant being originated from secondary treated effluent of municipal sewage treatment plant. However, effect of key system operating condition on the fate and behavior of residual DON in the treated effluent is still not known. This study aims to investigate effect of organic loading rate (OLR) on the residual level of DON in the biofilm reactor effluent. Synthetic municipal wastewater was fed into moving bed biofilm reactors at OLR of 1.6x10-3 and 3.2x10-3 kg SCOD/m3-d. The results showed higher organic removal efficiency was found in the reactor operating at higher OLR. However, DON was observed at higher value in the effluent of the higher OLR reactor than that of the lower OLR reactor evidencing a clear influence of OLR on the residual DON level in the treated effluent of the biofilm reactors. It is possible that the lower DON being observed in the reactor at lower OLR is likely to be a result of providing the microbe with the additional period for utilizing the refractory DON molecules during operation at lower organic loading. All the experiments were repeated using raw wastewaters and similar trend was obtained.

Keywords: dissolved organic nitrogen, hydraulic retention time, moving bed biofilm reactor, soluble microbial products

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Authors: I. D. Laryushin, V. A. Kostin, A. A. Silaev, N. V. Vvedenskii

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Generation of broadband intense terahertz (THz) radiation attracts reasonable interest due to various applications, such as the THz time-domain spectroscopy, the probing and control of various ultrafast processes, the THz imaging with subwavelength resolution, and many others. One of the most promising methods for generating powerful and broadband terahertz pulses is based on focusing two-color femtosecond ionizing laser pulses in gases, including ambient air. For this method, the amplitudes of terahertz pulses are determined by the free-electron current density remaining in a formed plasma after the passage of the laser pulse. The excitation of this residual current density can be treated as multi-wave mixing: Аn effective generation of terahertz radiation is possible only when the frequency ratio of one-color components in the two-color pulse is close to irreducible rational fraction a/b with small odd sum a + b. This work focuses on the optimal parameters (polarizations and intensities) of laser components for the strongest THz generation. The optimal values of parameters are found numerically and analytically with the use of semiclassical approach for calculating the residual current density. For frequency ratios close to a/(a ± 1) with natural a, the strongest THz generation is shown to take place when the both laser components have circular polarizations and equal intensities. For this optimal case, an analytical formula for the residual current density was derived. For the frequency ratios such as 2/5, the two-color ionizing pulses with circularly polarized components practically do not excite the residual current density. However, the optimal parameters correspond generally to specific elliptical (not linear) polarizations of the components and intensity ratios close to unity.

Keywords: broadband terahertz radiation, ionization, laser plasma, ultrashort two-color pulses

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Authors: Dongjoo Kim

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Effective control of sloshing in a liquid container is an important issue to be resolved in many applications. In this study, numerical simulations are performed to design the velocity profile of rectangular container and investigate the effectiveness of input shaping for sloshing control. Trapezoidal profiles of container velocity are chosen to be reference commands and they are convolved with a series of impulses to generate shaped ones that induce minimal residual oscillations. The performances of several input shapers are compared from the viewpoint of transient peak and residual oscillations of sloshing. Results show that sloshing can be effectively controlled by input shaping (Supported by the NRF programs, NRF-2015R1D1A1A01059675, of Korean government).

Keywords: input shaping, rectangular container, sloshing, trapezoidal profile

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Authors: İbrahim Aktaş, Árpád Baricz

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In this paper, the radii of star likeness of the Jackson and Hahn-Exton q-Bessel functions are considered, and for each of them three different normalizations is applied. By applying Euler-Rayleigh inequalities for the first positive zeros of these functions tight lower, and upper bounds for the radii of starlikeness of these functions are obtained. The Laguerre-Pólya class of real entire functions plays an important role in this study. In particular, we obtain some new bounds for the first positive zero of the derivative of the classical Bessel function of the first kind.

Keywords: bessel function, lommel function, radius of starlikeness and convexity, Struve function

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Authors: Christian Lavault

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In this paper, the generalized fractional integral operators of two generalized Mittag-Leffler type functions are investigated. The special cases of interest involve the generalized M-series and K-function, both introduced by Sharma. The two pairs of theorems established herein generalize recent results about left- and right-sided generalized fractional integration operators applied here to the M-series and the K-function. The note also results in important applications in physics and mathematical engineering.

Keywords: Fox–Wright Psi function, generalized hypergeometric function, generalized Riemann– Liouville and Erdélyi–Kober fractional integral operators, Saigo's generalized fractional calculus, Sharma's M-series and K-function

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Authors: Harshadkumar Rajgor, Jeff Butterworth

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Background: Barretts oesophagus increases the risk of developing oesophageal adenocarcinoma. Over the last 40 years, there has been a 6 fold increase in the incidence of oesophageal adenocarcinoma in the western world and the incidence rates are increasing at a greater rate than cancers of the colon, breast and lung. Endoscopic mucosal resection (EMR) is a relatively new technique being used by 2 centres in the greater midlands cancer network. EMR can be used for curative or staging purposes, for high-grade dysplasia’s and T1 tumours of the oesophagus. EMR is also suitable for those who are deemed high risk for oesophagectomy. EMR has a recurrence rate of 21% according to the Wiesbaden data. Method: A retrospective study of prospectively collected data was carried out involving 24 patients who had EMR for curative or staging purposes. Complications of residual or recurrent disease following EMR that required further treatment were investigated. Results: In 54% of cases residual or recurrent disease was suspected. 96% of patients were given clear and concise information regarding their diagnosis of high-grade dysplasia or T1 tumours. All 24 patients consulted the same specialist healthcare team. Conclusion: EMR is a safe and effective treatment for patients who have high-grade dysplasia and T1NO tumours. In 54% of cases residual or recurrent disease was suspected. Initially, only single resections were undertaken. Multiple resections are now being carried out to reduce the risk of recurrence. Complications from EMR remain low in this series and consisted of a single episode of post procedural bleeding.

Keywords: endoscopic mucosal resection, oesophageal dysplasia, T1 tumours, cancer network

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Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Bookun

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Introduction: Dialysis access is a key component of the care of patients with end stage renal failure. In our institution, a combined service of vascular surgeons and nephrologists are responsible for the creation and maintenance of arteriovenous fisultas (AVF), tenckhoff cathethers and Hickman/permcath lines. This poster investigates the last 10 years of dialysis access surgery conducted at St. Vincent’s Hospital Melbourne. Method: A cross-sectional retrospective analysis was conducted of patients of St. Vincent’s Hospital Melbourne (Victoria, Australia) utilising data collection from the Australasian Vascular Audit (Australian and New Zealand Society for Vascular Surgery). Descriptive demographic analysis was carried out as well as operation type, length of hospital stays, postoperative deaths and need for reoperation. Results: 2085 patients with renal failure were operated on between the years of 2011 and 2020. 1315 were male (63.1%) and 770 were female (36.9%). The mean age was 58 (SD 13.8). 92% of patients scored three or greater on the American Society of Anesthiologiests classification system. Almost half had a history of ischaemic heart disease (48.4%), more than half had a history of diabetes (64%), and a majority had hypertension (88.4%). 1784 patients had a creatinine over 150mmol/L (85.6%), the rest were on dialysis (14.4%). The most common access procedure was AVF creation, with 474 autologous AVFs and 64 prosthetic AVFs. There were 263 Tenckhoff insertions. We performed 160 cadeveric renal transplants. The most common location for AVF formation was brachiocephalic (43.88%) followed by radiocephalic (36.7%) and brachiobasilic (16.67%). Fistulas that required re-intervention were most commonly angioplastied (n=163), followed by thrombectomy (n=136). There were 107 local fistula repairs. Average length of stay was 7.6 days, (SD 12). There were 106 unplanned returns to theatre, most commonly for fistula creation, insertion of tenckhoff or permacath removal (71.7%). There were 8 deaths in the immediately postoperative period. Discussion: Access to dialysis is vital for patients with end stage kidney disease, and requires a multidisciplinary approach from both nephrologists, vascular surgeons, and allied health practitioners. Our service provides a variety of dialysis access methods, predominately fistula creation and tenckhoff insertion. Patients with renal failure are heavily comorbid, and prolonged hospital admission following surgery is a source of significant healthcare expenditure. AVFs require careful monitoring and maintenance for ongoing utility, and our data reflects a multitude of operations required to maintain usable access. The requirement for dialysis is growing worldwide and our data demonstrates a local experience in access, with preferred methods, common complications and the associated surgical interventions.

Keywords: dialysis, fistula, nephrology, vascular surgery

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