KDIGO-based acute kidney injury criteria operate differently in hospitals and the community—findings from a large population cohort

ACKNOWLEDGEMENTS We acknowledge the data management support of Grampian Data Safe Haven (DaSH) and the associated financial support of NHS Research Scotland, through NHS Grampian investment in the Grampian DaSH. S.S. is supported by a Clinical Research Training Fellowship from the Wellcome Trust (Ref 102729/Z/13/Z). We also acknowledge the support from The Farr Institute of Health Informatics Research. The Farr Institute is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates) and the Wellcome Trust (MRC Grant Nos: Scotland MR/K007017/1).

Inoculação com leveduras e exposição ao ar modificam o valor nutritivo de silagem de milho para vacas leiteiras

Silagens de milho são mais propensas à deterioração quando expostas ao ar. As leveduras assimiladoras de ácido lático são frequentemente os primeiros microrganismos a iniciar a deterioração aeróbia nas silagens. Alguns estudos reportam que silagem de milho aerobicamente instável está associada à redução no consumo, na produção de leite e depressão no teor de gordura do leite. Portanto, o objetivo deste estudo foi avaliar a influência de inoculação de leveduras (Pichia norvegensis) e a exposição ao ar por 48 horas sobre o valor nutritivo das silagens e o desempenho de vacas leiteiras. O milho foi colhido com 34% de MS, tratado sem (Controle) ou com P. norvegensis, na dose 1×105 ufc/g MV (Levedura) e armazenado silos tipo bolsa (40 t/silo). Após 123 dias de armazenamento, os silos foram abertos e a silagem foi fornecida para vacas leiteiras. Diariamente, as silagens foram retiradas e fornecidas imediatamente (Fresca) ou após 48 horas de exposição (Exposta). Vinte vacas Holandesas foram distribuídas em 5 quadrados latinos replicados 4×4, com períodos de 21 dias (15 d para adaptação + 6 d para amostragem). As dietas foram formuladas para conter: 53% silagem de milho, 8% caroço de algodão, 18% farelo de soja, 9,5% polpa cítrica, 9% milho seco moído e 2,5% premix vitamínico e mineral. Os quatro tratamentos foram assim constituídos: silagem controle fresca (CF), silagem controle exposta (CE), silagem inoculada com levedura fresca (LF) e silagem inoculada com levedura exposta (LE). A inoculação com levedura aumentou as perdas de matéria seca (P<0,001) e reduziu o tempo de estabilidade aeróbia (P=0,03) das silagens de milho. No ensaio de desempenho animal, reduziu a produção de leite corrigida para 3,5% de gordura (P=0,03) e a eficiência alimentar (ELL leite/CMS) (P<0,01), porém não alterou o teor de gordura do leite. Quanto aos efeitos da exposição ao ar por 48 horas, estes reduziram a concentração de ácido lático (P<0,001), que consequentemente aumentou o pH (P=0,004) das silagens, além de reduzir outros produtos de fermentação. A exposição também reduziu a produção de leite corrigido para gordura (P=0,02) e a eficiência alimentar (P=0,10). Nenhum tratamento alterou o consumo de MS. Houve tendência para redução da digestibilidade da MS e FDN e do NDT, quando as silagens foram expostas ao ar. A inoculação com leveduras e a exposição ao ar por 48 horas deprimem o desempenho animal através da redução no valor nutritivo das silagens de milho.

Impaired renal endothelial nitric oxide synthase and reticulocyte production as modulators of hypertension induced by recombinant human erythropoietin in the rat

INTRODUCTION AND AIMS: Hypertension is a common side effect of recombinant human erythropoietin (rHuEPO) therapy; however, the exact pathways remain to be elucidated. The discovery of non-hematopoietic actions of rHuEPO increased the number of patients that could putatively benefit from this therapy; however, to achieve those effects higher doses are usually needed, which increase the risk and incidence of adverse events. Our aim was to study the effect of a broad range of rHuEPO doses on hematological and biochemical parameters, blood pressure and renal function and damage in the rat, focusing on endothelial nitric oxide synthase (eNOS) and hypoxia-inducible factors (HIFs). METHODS: Male Wistar rats were divided in 5 groups receiving different doses of rHuEPO (100, 200, 400 and 600 IU/kg body weight (BW)/week) and saline solution (control), during 3 weeks. Blood and 24h urine were collected to perform hematological and biochemical analysis. Blood pressure (BP) was measured by the tail-cuff method. The kidney tissue was collected to mRNA and protein expression assays and to characterize renal lesions. RESULTS: A dose-dependent increase in red blood cells count, hematocrit and hemoglobin levels was found with rHuEPO therapy, in rHuEPO200, rHuEPO400 and rHuEPO600 groups. Increased reticulocyte count was found in the rHuEPO400 and rHuEPO600 groups. BP raised in all groups receiving rHuEPO. The rHuEPO200 and rHuEPO600 groups presented increased kidney protein levels of HIF2α and a reduction in kidney protein levels of eNOS, along with the highest grade of vascular and tubular renal lesions. CONCLUSIONS: Our study showed that rHuEPO-induced hypertension might involve indirect (hematological) and direct (renal) effects which varies according to the dose used. Thus, rHuEPO therapy should be performed rationally and under adequate surveillance, as hypertension develops even with lower doses. Especial caution with higher doses should be taken, as rHuEPO-induced hypertension leads to early renal damage without alterations in traditional markers of renal function, thus masking the serious adverse effects and risks.

Metodi di indagine acustica per l'integrità strutturale

Questa tesi ha lo scopo di indagare lo stato interno di materiali e strutture di diverso tipo tramite sollecitazione acustica o vibrazionale. Si sono sottoposte le strutture in esame a sollecitazione acustica (mediante speaker) o meccanica (mediante martello strumentato o altro percussore), acquisendo le onde meccaniche di ritorno con trasduttori microfonici, array microfonici, ed accelerometri. Si è valutato, di caso in caso, quale fosse la strumentazione più adeguata e quale il parametro da prendere in considerazione per effettuare una discriminazione tra oggetto integro ed oggetto danneggiato o contenente vuoti o inclusioni. Si è riflettuto sui dati raccolti allo scopo di capire quali caratteristiche accomunino strutture apparentemente diverse tra loro, e quali differenzino in realtà - rispetto alla possibilità di una efficace diagnosi acustica - strutture apparentemente simili. Si è sviluppato uno script su piattaforma MatLab® per elaborare i dati acquisiti. Tutte le analisi effettuate si basano sull'osservazione dello spettro acustico del segnale di ritorno dall'oggetto sollecitato. Ove necessario, si sono osservati la funzione di trasferimento del sistema (per il calcolo della quale si crosscorrelano i segnali di output e di input) o il waterfall. Da questa base, si sono sviluppati parametri specifici per i vari casi. Gli esami più proficui si sono effettuati sui solai, per la verifica dello sfondellamento dei laterizi. Anche lo studio su prodotti dell'industria alimentare (salami) si è rivelato molto soddisfacente, tanto da gettare le basi per la produzione di un tester da utilizzare in stabilimento per il controllo di qualità dei pezzi.

Signal processing techniques for ultrasonic inspection

This thesis discusses the need for nondestructive testing and highlights some of the limitations in present day techniques. Special interest has been given to ultrasonic examination techniques and the problems encountered when they are applied to thick welded plates. Some suggestions are given using signal processing methods. Chapter 2 treats the need for nondestructive testing as seen in the light of economy and safety. A short review of present day techniques in nondestructive testing is also given. The special problems using ultrasonic techniques for welded structures is discussed in Chapter 3 with some examples of elastic wave propagation in welded steel. The limitations in applying sophisticated signal processing techniques to ultrasonic NDT~ mainly found in the transducers generating or receiving the ultrasound. Chapter 4 deals with the different transducers used. One of the difficulties with ultrasonic testing is the interpretation of the signals encountered. Similar problems might be found with SONAR/RADAR techniques and Chapter 5 draws some analogies between SONAR/RADAR and ultrasonic nondestructive testing. This chapter also includes a discussion on some on the techniques used in signal processing in general. A special signal processing technique found useful is cross-correlation detection and this technique is treated in Chapter 6. Electronic digital compute.rs have made signal processing techniques easier to implement -Chapter 7 discusses the use of digital computers in ultrasonic NDT. Experimental equipment used to test cross-correlation detection of ultrasonic signals is described in Chapter 8. Chapter 9 summarises the conclusions drawn during this investigation.

Composite materials impact damage detection using neural networks

This thesis considers two basic aspects of impact damage in composite materials, namely damage severity discrimination and impact damage location by using Acoustic Emissions (AE) and Artificial Neural Networks (ANNs). The experimental work embodies a study of such factors as the application of AE as Non-destructive Damage Testing (NDT), and the evaluation of ANNs modelling. ANNs, however, played an important role in modelling implementation. In the first aspect of the study, different impact energies were used to produce different level of damage in two composite materials (T300/914 and T800/5245). The impacts were detected by their acoustic emissions (AE). The AE waveform signals were analysed and modelled using a Back Propagation (BP) neural network model. The Mean Square Error (MSE) from the output was then used as a damage indicator in the damage severity discrimination study. To evaluate the ANN model, a comparison was made of the correlation coefficients of different parameters, such as MSE, AE energy, AE counts, etc. MSE produced an outstanding result based on the best performance of correlation. In the second aspect, a new artificial neural network model was developed to provide impact damage location on a quasi-isotropic composite panel. It was successfully trained to locate impact sites by correlating the relationship between arriving time differences of AE signals at transducers located on the panel and the impact site coordinates. The performance of the ANN model, which was evaluated by calculating the distance deviation between model output and real location coordinates, supports the application of ANN as an impact damage location identifier. In the study, the accuracy of location prediction decreased when approaching the central area of the panel. Further investigation indicated that this is due to the small arrival time differences, which defect the performance of ANN prediction. This research suggested increasing the number of processing neurons in the ANNs as a practical solution.

Acoustic emission detection using optical fibre sensors for aerospace applications

Structural Health Monitoring (SHM) ensures the structural health and safety of critical structures covering a wide range of application areas. This thesis presents novel, low-cost and good-performance fibre Bragg grating (FBG) based systems for detection of Acoustic Emission (AE) in aircraft structures, which is a part of SHM. Importantly a key aim, during the design of these systems, was to produce systems that were sufficiently small to install in an aircraft for lifetime monitoring. Two important techniques for monitoring high frequency AE that were developed as a part of this research were, Quadrature recombination technique and Active tracking technique. Active tracking technique was used extensively and was further developed to overcome the limitations that were observed while testing it at several test facilities and with different optical fibre sensors. This system was able to eliminate any low frequency spectrum shift due to environmental perturbation and keeps the sensor always working at optimum operation point. This is highly desirable in harsh industrial and operationally active environments. Experimental work carried out in the laboratory has proved that such systems can be used for high frequency detection and have capability to detect up to 600 kHz. However, the range of frequency depends upon the requirement and design of the interrogation system as the system can be altered accordingly for different applications. Several optical fibre configurations for wavelength detection were designed during the course of this work along with industrial partners. Fibre Bragg grating Fabry-Perot (FBG-FP) sensors have shown higher sensitivity and usability than the uniform FBGs to be used with such system. This was shown experimentally. The author is certain that further research will lead to development of a commercially marketable product and the use of active tracking systems can be extended in areas of healthcare, civil infrastructure monitoring etc. where it can be deployed. Finally, the AE detection system has been developed to aerospace requirements and was tested at NDT & Testing Technology test facility based at Airbus, Filton, UK on A350 testing panels.

Traffic Offered Behaviour Regarding Target QOS Parameters in Network Dimensioning

We consider a model of overall telecommunication network with virtual circuits switching, in stationary state, with Poisson input flow, repeated calls, limited number of homogeneous terminals and 8 types of losses. One of the main problems of network dimensioning/redimensioning is estimation of traffic offered in network because it reflects on finding of necessary number of circuit switching lines on the basis of the consideration of detailed users manners and target Quality of Service (QoS). In this paper we investigate the behaviour of the traffic offered in a network regarding QoS variables: “probability of blocked switching” and “probability of finding B-terminals busy”. Numerical dependencies are shown graphically. A network dimensioning task (NDT) is formulated, solvability of the NDT and the necessary conditions for analytical solution are researched as well. International Journal "Information Technologies and Knowledge" Vol.2 / 2008 174 The received results make the network dimensioning/redimensioning, based on QoS requirements easily, due to clearer understanding of important variables behaviour. The described approach is applicable directly for every (virtual) circuit switching telecommunication system e.g. GSM, PSTN, ISDN and BISDN. For packet - switching networks, at various layers, proposed approach may be used as a comparison basis and when they work in circuit switching mode (e.g. VoIP).

Dimensioning of Telecommunication Network Based on Quality of Services Demand and Detailed Behaviour of Users

The aim of this paper is to be determined the network capacity (number of necessary internal switching lines) based on detailed users’ behaviour and demanded quality of service parameters in an overall telecommunication system. We consider detailed conceptual and its corresponded analytical traffic model of telecommunication system with (virtual) circuit switching, in stationary state with generalized input flow, repeated calls, limited number of homogeneous terminals and losses due to abandoned and interrupted dialing, blocked and interrupted switching, not available intent terminal, blocked and abandoned ringing (absent called user) and abandoned conversation. We propose an analytical - numerical solution for finding the number of internal switching lines and values of the some basic traffic parameters as a function of telecommunication system state. These parameters are requisite for maintenance demand level of network quality of service (QoS). Dependencies, based on the numericalanalytical results are shown graphically. For proposed conceptual and its corresponding analytical model a network dimensioning task (NDT) is formulated, solvability of the NDT and the necessary conditions for analytical solution are researched as well. It is proposed a rule (algorithm) and computer program for calculation of the corresponded number of the internal switching lines, as well as corresponded values of traffic parameters, making the management of QoS easily.

The use of treatment theories and procedures for postural control in adult with hemiplegia: A national survey

This study investigated the use of treatment theories and procedures for postural control training used by Occupational Therapists (OTs) when working with hemiplegic adults who have had cerebrovascular accident (CVA) or traumatic brain injury (TBI). The method of data collection was a national survey of 400 randomly selected physical disability OTs with 127 usable surveys returned. Results showed that the most common used treatment theory was neurodevelopmental treatment (NDT), followed by motor relearning program (MRP), proprioceptive neuromuscular facilitation (PNF), Brunnstrom's approach, and the approach of Rood. The most common treatment posture used was sitting, followed by standing, mat activity, equilibrium reaction training, and walking. The factors affecting the use of various treatment theories procedures were years certified, years of clinical experience, work situation and work status. Pearson correlation coefficient analyses found significant positive relationships between treatment theories and postures. There were significant high correlations between usage of all pairs of treatment procedures. ^

Optimum wireless power transmission for sensors embedded in concrete

Various nondestructive testing (NDT) technologies for construction and performance monitoring have been studied for decades. Recently, the rapid evolution of wireless sensor network (WSN) technologies has enabled the development of sensors that can be embedded in concrete to monitor the structural health of infrastructure. Such sensors can be buried inside concrete and they can collect and report valuable volumetric data related to the health of a structure during and/or after construction. Wireless embedded sensors monitoring system is also a promising solution for decreasing the high installation and maintenance cost of the conventional wire based monitoring systems. Wireless monitoring sensors need to operate for long time. However, sensor batteries have finite life-time. Therefore, in order to enable long operational life of wireless sensors, novel wireless powering methods, which can charge the sensors’ rechargeable batteries wirelessly, need to be developed. The optimization of RF wireless powering of sensors embedded in concrete is studied here. First, our analytical results focus on calculating the transmission loss and propagation loss of electromagnetic waves penetrating into plain concrete at different humidity conditions for various frequencies. This analysis specifically leads to the identification of an optimum frequency range within 20–80 MHz that is validated through full-wave electromagnetic simulations. Second, the effects of various reinforced bar configurations on the efficiency of wireless powering are investigated. Specifically, effects of the following factors are studied: rebar types, rebar period, rebar radius, depth inside concrete, and offset placement. This analysis leads to the identification of the 902–928 MHz ISM band as the optimum power transmission frequency range for sensors embedded in reinforced concrete, since antennas working in this band are less sensitive to the effects of varying humidity as well as rebar configurations. Finally, optimized rectennas are designed for receiving and/or harvesting power in order to charge the rechargeable batteries of the embedded sensors. Such optimized wireless powering systems exhibit significantly larger efficiencies than the efficiencies of conventional RF wireless powering systems for sensors embedded in plain or reinforced concrete.

Optimization of wireless power transfer via magnetic resonance in different media

A wide range of non-destructive testing (NDT) methods for the monitoring the health of concrete structure has been studied for several years. The recent rapid evolution of wireless sensor network (WSN) technologies has resulted in the development of sensing elements that can be embedded in concrete, to monitor the health of infrastructure, collect and report valuable related data. The monitoring system can potentially decrease the high installation time and reduce maintenance cost associated with wired monitoring systems. The monitoring sensors need to operate for a long period of time, but sensors batteries have a finite life span. Hence, novel wireless powering methods must be devised. The optimization of wireless power transfer via Strongly Coupled Magnetic Resonance (SCMR) to sensors embedded in concrete is studied here. First, we analytically derive the optimal geometric parameters for transmission of power in the air. This specifically leads to the identification of the local and global optimization parameters and conditions, it was validated through electromagnetic simulations. Second, the optimum conditions were employed in the model for propagation of energy through plain and reinforced concrete at different humidity conditions, and frequencies with extended Debye's model. This analysis leads to the conclusion that SCMR can be used to efficiently power sensors in plain and reinforced concrete at different humidity levels and depth, also validated through electromagnetic simulations. The optimization of wireless power transmission via SMCR to Wearable and Implantable Medical Device (WIMD) are also explored. The optimum conditions from the analytics were used in the model for propagation of energy through different human tissues. This analysis shows that SCMR can be used to efficiently transfer power to sensors in human tissue without overheating through electromagnetic simulations, as excessive power might result in overheating of the tissue. Standard SCMR is sensitive to misalignment; both 2-loops and 3-loops SCMR with misalignment-insensitive performances are presented. The power transfer efficiencies above 50% was achieved over the complete misalignment range of 0°-90° and dramatically better than typical SCMR with efficiencies less than 10% in extreme misalignment topologies.

A model for continuous measurement of drilled shaft diameter during construction

Non-Destructive Testing (NDT) of deep foundations has become an integral part of the industry's standard manufacturing processes. It is not unusual for the evaluation of the integrity of the concrete to include the measurement of ultrasonic wave speeds. Numerous methods have been proposed that use the propagation speed of ultrasonic waves to check the integrity of concrete for drilled shaft foundations. All such methods evaluate the integrity of the concrete inside the cage and between the access tubes. The integrity of the concrete outside the cage remains to be considered to determine the location of the border between the concrete and the soil in order to obtain the diameter of the drilled shaft. It is also economic to devise a methodology to obtain the diameter of the drilled shaft using the Cross-Hole Sonic Logging system (CSL). Performing such a methodology using the CSL and following the CSL tests is performed and used to check the integrity of the inside concrete, thus allowing the determination of the drilled shaft diameter without having to set up another NDT device.^ This proposed new method is based on the installation of galvanized tubes outside the shaft across from each inside tube, and performing the CSL test between the inside and outside tubes. From the performed experimental work a model is developed to evaluate the relationship between the thickness of concrete and the ultrasonic wave properties using signal processing. The experimental results show that there is a direct correlation between concrete thicknesses outside the cage and maximum amplitude of the received signal obtained from frequency domain data. This study demonstrates how this new method to measuring the diameter of drilled shafts during construction using a NDT method overcomes the limitations of currently-used methods. ^ In the other part of study, a new method is proposed to visualize and quantify the extent and location of the defects. It is based on a color change in the frequency amplitude of the signal recorded by the receiver probe in the location of defects and it is called Frequency Tomography Analysis (FTA). Time-domain data is transferred to frequency-domain data of the signals propagated between tubes using Fast Fourier Transform (FFT). Then, distribution of the FTA will be evaluated. This method is employed after CSL has determined the high probability of an anomaly in a given area and is applied to improve location accuracy and to further characterize the feature. The technique has a very good resolution and clarifies the exact depth location of any void or defect through the length of the drilled shaft for the voids inside the cage. ^ The last part of study also evaluates the effect of voids inside and outside the reinforcement cage and corrosion in the longitudinal bars on the strength and axial load capacity of drilled shafts. The objective is to quantify the extent of loss in axial strength and stiffness of drilled shafts due to presence of different types of symmetric voids and corrosion throughout their lengths.^

Looking to the future : Predicting renal replacement outcomes in a large community cohort with chronic kidney disease

Peer reviewed

Looking to the future : Predicting renal replacement outcomes in a large community cohort with chronic kidney disease

Peer reviewed