Thrombophilia and direct thrombin inhibitor lepirudin clinical and monitoring aspects

Thrombophilia (TF) predisposes both to venous and arterial thrombosis at a young age. TF may also impact the thrombosis or stenosis of hemodialysis (HD) vascular access in patients with end-stage renal disease (ESRD). When involved in severe thrombosis TF may associate with inappropriate response to anticoagulation. Lepirudin, a potent direct thrombin inhibitor (DTI), indicated for heparin-induced thrombocytopenia-related thrombosis, could offer a treatment alternative in TF. Monitoring of narrow-ranged lepirudin demands new insights also in laboratory. The above issues constitute the targets in this thesis. We evaluated the prevalence of TF in patients with ESRD and its impact upon thrombosis- or stenosis-free survival of the vascular access. Altogether 237 ESRD patients were prospectively screened for TF and thrombogenic risk factors prior to HD access surgery in 2002-2004 (mean follow-up of 3.6 years). TF was evident in 43 (18%) of the ESRD patients, more often in males (23 vs. 9%, p=0.009). Known gene mutations of FV Leiden and FII G20210A occurred in 4%. Vascular access sufficiently matured in 226 (95%). The 1-year thrombosis- and stenosis-free access survival was 72%. Female gender (hazards ratio, HR, 2.5; 95% CI 1.6-3.9) and TF (HR 1.9, 95% CI 1.1-3.3) were independent risk factors for the shortened thrombosis- and stenosis-free survival. Additionally, TF or thrombogenic background was found in relatively young patients having severe thrombosis either in hepatic veins (Budd-Chiari syndrome, BCS, one patient) or inoperable critical limb ischemia (CLI, six patients). Lepirudin was evaluated in an off-label setting in the severe thrombosis after inefficacious traditional anticoagulation without other treatment options except severe invasive procedures, such as lower extremity amputation. Lepirudin treatments were repeatedly monitored clinically and with laboratory assessments (e.g. activated partial thromboplastin time, APTT). Our preliminary studies with lepirudin in thrombotic calamities appeared safe, and no bleeds occurred. An effective DTI lepirudin calmed thrombosis as all patients gradually recovered. Only one limb amputation was performed 3 years later during the follow-up (mean 4 years). Furthermore, we aimed to overcome the limitations of APTT and confounding effects of warfarin (INR of 1.5-3.9) and lupus anticoagulant (LA). Lepirudin responses were assessed in vitro by five specific laboratory methods. Ecarin chromogenic assay (ECA) or anti-Factor IIa (anti-FIIa) correlated precisely (r=0.99) with each other and with spiked lepirudin in all plasma pools: normal, warfarin, and LA-containing plasma. In contrast, in the presence of warfarin and LA both APTT and prothrombinase-induced clotting time (PiCT®) were limited by non-linear and imprecise dose responses. As a global coagulation test APTT is useful in parallel to the precise chromogenic methods ECA or Anti-FIIa in challenging clinical situations. Lepirudin treatment requires multidisciplinary approach to ensure appropriate patient selection, interpretation of laboratory monitoring, and treatment safety. TF seemed to be associated with complicated thrombotic events, in venous (BCS), arterial (CLI), and vascular access systems. TF screening should be aimed to patients with repeated access complications or prior unprovoked thromboembolic events. Lepirudin inhibits free and clot-bound thrombin which heparin fails to inhibit. Lepirudin seems to offer a potent and safe option for treatment of severe thrombosis. Multi-centered randomized trials are necessary to assess the possible management of complicated thrombotic events with DTIs like lepirudin and seek prevention options against access complications.

Seismic damage estimation through measurable dynamic characteristics

Ductility based design of reinforced concrete structures implicitly assumes certain damage under the action of a design basis earthquake. The damage undergone by a structure needs to be quantified, so as to assess the post-seismic reparability and functionality of the structure. The paper presents an analytical method of quantification and location of seismic damage, through system identification methods. It may be noted that soft ground storied buildings are the major casualties in any earthquake and hence the example structure is a soft or weak first storied one, whose seismic response and temporal variation of damage are computed using a non-linear dynamic analysis program (IDARC) and compared with a normal structure. Time period based damage identification model is used and suitably calibrated with classic damage models. Regenerated stiffness of the three degrees of freedom model (for the three storied frame) is used to locate the damage, both on-line as well as after the seismic event. Multi resolution analysis using wavelets is also used for localized damage identification for soft storey columns.

Genetic programming metamodel for rotating beams

This paper investigates the use of Genetic Programming (GP) to create an approximate model for the non-linear relationship between flexural stiffness, length, mass per unit length and rotation speed associated with rotating beams and their natural frequencies. GP, a relatively new form of artificial intelligence, is derived from the Darwinian concept of evolution and genetics and it creates computer programs to solve problems by manipulating their tree structures. GP predicts the size and structural complexity of the empirical model by minimizing the mean square error at the specified points of input-output relationship dataset. This dataset is generated using a finite element model. The validity of the GP-generated model is tested by comparing the natural frequencies at training and at additional input data points. It is found that by using a non-dimensional stiffness, it is possible to get simple and accurate function approximation for the natural frequency. This function approximation model is then used to study the relationships between natural frequency and various influencing parameters for uniform and tapered beams. The relations obtained with GP model agree well with FEM results and can be used for preliminary design and structural optimization studies.

High energy oxygen ion induced modifications in lead based perovskite thin films

The lead based ferroelectric PbZr0.53Ti0.47O3 (PZT), (Pb0.90La0.10)TiO3 (PLT10) and (Pb0.80La0.20)TiO3 (PLT20) thin films, prepared by pulsed laser ablation technique, were studied for their response to the 70 MeV oxygen ion irradiation. The dielectric analysis, capacitance-voltage (C- V) and DC leakage current measurements were performed before and after the irradiation to high-energy oxygen ions. The irradiation produced considerable changes in the dielectric, C-V, leakage characteristics and induced some amount of amorphization. The PZT films showed partial recrystallization after a thermal annealing at 400 degrees C for 10 min. The phase transition temperature [T-c] of PLT20 increased from 115 degrees C to 120 degrees C. The DC conductivity measurements showed a shift in the onset of non-linear conduction region. The current density decreased by two orders of magnitude after irradiation. After annealing the irradiated films at a temperature of 400 degrees C for 10 min, the films partially regained the dielectric and electrical properties. The results are discussed in terms of the irradiation-induced amorphization, the pinning of the ferroelectric domains by trapped charges and the thermal annealing of the defects generated during the irradiation. (C) 2007 Elsevier B.V. All rights reserved.

Highly stable Ag nanoparticles in agar-agar matrix as inorganic-organic hybrid

A novel synthesis of inorganic-organic hybrid films containing well dispersed and almost uniform size Ag nanoparticles in agar-agar matrix has been reported. The films are found to be highly stable for more than a year. The colloidal particles of Ag can be obtained in large quantities in the form of a film or in the gel form when dispersed in agar-agar or by dissolving in a suitable solvent as solution. Characterization has been done by UV-visible spectroscopy and TEM. The hybrid may be of interest to study third-order non-linear susceptibility.

GMM based Bayesian approach to speech enhancement in signal transform domain

Considering a general linear model of signal degradation, by modeling the probability density function (PDF) of the clean signal using a Gaussian mixture model (GMM) and additive noise by a Gaussian PDF, we derive the minimum mean square error (MMSE) estimator. The derived MMSE estimator is non-linear and the linear MMSE estimator is shown to be a special case. For speech signal corrupted by independent additive noise, by modeling the joint PDF of time-domain speech samples of a speech frame using a GMM, we propose a speech enhancement method based on the derived MMSE estimator. We also show that the same estimator can be used for transform-domain speech enhancement.

Modeling of magnetostrictive materials and structures

The constitutive model for a magnetostrictive material and its effect on the structural response is presented in this article. The example of magnetostrictive material considered is the TERFENOL-D. As like the piezoelectric material, this material has two constitutive laws, one of which is the sensing law and the other is the actuation law, both of which are highly coupled and non-linear. For the purpose of analysis, the constitutive laws can be characterized as coupled or uncoupled and linear or non linear. Coupled model is studied without assuming any explicit direct relationship with magnetic field. In the linear coupled model, which is assumed to preserve the magnetic flux line continuity, the elastic modulus, the permeability and magneto-elastic constant are assumed as constant. In the nonlinear-coupled model, the nonlinearity is decoupled and solved separately for the magnetic domain and the mechanical domain using two nonlinear curves, namely the stress vs. strain curve and the magnetic flux density vs. magnetic field curve. This is performed by two different methods. In the first, the magnetic flux density is computed iteratively, while in the second, the artificial neural network is used, where in the trained network will give the necessary strain and magnetic flux density for a given magnetic field and stress level. The effect of nonlinearity is demonstrated on a simple magnetostrictive rod.

Cyclosporine population pharmacokinetics in pediatric renal transplant recipients

Cyclosporine is an immunosuppressant drug with a narrow therapeutic index and large variability in pharmacokinetics. To improve cyclosporine dose individualization in children, we used population pharmacokinetic modeling to study the effects of developmental, clinical, and genetic factors on cyclosporine pharmacokinetics in altogether 176 subjects (age range: 0.36–20.2 years) before and up to 16 years after renal transplantation. Pre-transplantation test doses of cyclosporine were given intravenously (3 mg/kg) and orally (10 mg/kg), on separate occasions, followed by blood sampling for 24 hours (n=175). After transplantation, in a total of 137 patients, cyclosporine concentration was quantified at trough, two hours post-dose, or with dose-interval curves. One-hundred-four of the studied patients were genotyped for 17 putatively functionally significant sequence variations in the ABCB1, SLCO1B1, ABCC2, CYP3A4, CYP3A5, and NR1I2 genes. Pharmacokinetic modeling was performed with the nonlinear mixed effects modeling computer program, NONMEM. A 3-compartment population pharmacokinetic model with first order absorption without lag-time was used to describe the data. The most important covariate affecting systemic clearance and distribution volume was allometrically scaled body weight i.e. body weight**3/4 for clearance and absolute body weight for volume of distribution. The clearance adjusted by absolute body weight declined with age and pre-pubertal children (< 8 years) had an approximately 25% higher clearance/body weight (L/h/kg) than did older children. Adjustment of clearance for allometric body weight removed its relationship to age after the first year of life. This finding is consistent with a gradual reduction in relative liver size towards adult values, and a relatively constant CYP3A content in the liver from about 6–12 months of age to adulthood. The other significant covariates affecting cyclosporine clearance and volume of distribution were hematocrit, plasma cholesterol, and serum creatinine, explaining up to 20%–30% of inter-individual differences before transplantation. After transplantation, their predictive role was smaller, as the variations in hematocrit, plasma cholesterol, and serum creatinine were also smaller. Before transplantation, no clinical or demographic covariates were found to affect oral bioavailability, and no systematic age-related changes in oral bioavailability were observed. After transplantation, older children receiving cyclosporine twice daily as the gelatine capsule microemulsion formulation had an about 1.25–1.3 times higher bioavailability than did the younger children receiving the liquid microemulsion formulation thrice daily. Moreover, cyclosporine oral bioavailability increased over 1.5-fold in the first month after transplantation, returning thereafter gradually to its initial value in 1–1.5 years. The largest cyclosporine doses were administered in the first 3–6 months after transplantation, and thereafter the single doses of cyclosporine were often smaller than 3 mg/kg. Thus, the results suggest that cyclosporine displays dose-dependent, saturable pre-systemic metabolism even at low single doses, whereas complete saturation of CYP3A4 and MDR1 (P-glycoprotein) renders cyclosporine pharmacokinetics dose-linear at higher doses. No significant associations were found between genetic polymorphisms and cyclosporine pharmacokinetics before transplantation in the whole population for which genetic data was available (n=104). However, in children older than eight years (n=22), heterozygous and homozygous carriers of the ABCB1 c.2677T or c.1236T alleles had an about 1.3 times or 1.6 times higher oral bioavailability, respectively, than did non-carriers. After transplantation, none of the ABCB1 SNPs or any other SNPs were found to be associated with cyclosporine clearance or oral bioavailability in the whole population, in the patients older than eight years, or in the patients younger than eight years. In the whole population, in those patients carrying the NR1I2 g.-25385C–g.-24381A–g.-205_-200GAGAAG–g.7635G–g.8055C haplotype, however, the bioavailability of cyclosporine was about one tenth lower, per allele, than in non-carriers. This effect was significant also in a subgroup of patients older than eight years. Furthermore, in patients carrying the NR1I2 g.-25385C–g.-24381A–g.-205_-200GAGAAG–g.7635G–g.8055T haplotype, the bioavailability was almost one fifth higher, per allele, than in non-carriers. It may be possible to improve individualization of cyclosporine dosing in children by accounting for the effects of developmental factors (body weight, liver size), time after transplantation, and cyclosporine dosing frequency/formulation. Further studies are required on the predictive value of genotyping for individualization of cyclosporine dosing in children.

The Photoemission from Quantum Wells, Wires and Carbon Nanotubes:Simplified Theory and Relative Comparison

We investigate the photoemission from quantum wells (QWs) in ultrathin films (UFs) and quantum well wires (QWWs) of non-linear optical materials on the basis of a newly formulated electron dispersion law considering the anisotropies of the effective electron masses, the spin-orbit splitting constants and the presence of the crystal field splitting within the framework of k.p formalism. The results of quantum confined Ill-V compounds form the special cases of our generalized analysis. The photoemission has also been studied for quantum confined II-VI, n-GaP, n-Ge, PtSb2, stressed materials and Bismuth on the basis of respective dispersion relations. It has been found taking quantum confined CdGeAS(2), InAs, InSb, CdS, GaP, Ge, PtSb2, stressed n-InSb and B1 that the photoemission exhibits quantized variations with the incident photon energy, changing electron concentration and film thickness, respectively, for all types of quantum confinement. The photoemission from CNs exhibits oscillatory dependence with increasing normalized electron degeneracy and the signature of the entirely different types of quantum systems are evident from the plots. Besides, under certain special conditions, all the results for all the materials gets simplified to the well-known expression of photoemission from non-degenerate semiconductors and parabolic energy bands, leading to the compatibility test.

Real-coded genetic algorithm for machining condition optimization

In this paper, we consider the machining condition optimization models presented in earlier studies. Finding the optimal combination of machining conditions within the constraints is a difficult task. Hence, in earlier studies standard optimization methods are used. The non-linear nature of the objective function, and the constraints that need to be satisfied makes it difficult to use the standard optimization methods for the solution. In this paper, we present a real coded genetic algorithm (RCGA), to find the optimal combination of machining conditions. We present various issues related to real coded genetic algorithm such as solution representation, crossover operators, and repair algorithm in detail. We also present the results obtained for these models using real coded genetic algorithm and discuss the advantages of using real coded genetic algorithm for these problems. From the results obtained, we conclude that real coded genetic algorithm is reliable and accurate for solving the machining condition optimization models.

Self-interrupted regenerative metal cutting in turning

A new approach is used to study the global dynamics of regenerative metal cutting in turning. The cut surface is modeled using a partial differential equation (PDE) coupled, via boundary conditions, to an ordinary differential equation (ODE) modeling the dynamics of the cutting tool. This approach automatically incorporates the multiple-regenerative effects accompanying self-interrupted cutting. Taylor's 3/4 power law model for the cutting force is adopted. Lower dimensional ODE approximations are obtained for the combined tool–workpiece model using Galerkin projections, and a bifurcation diagram computed. The unstable solution branch off the subcritical Hopf bifurcation meets the stable branch involving self-interrupted dynamics in a turning point bifurcation. The tool displacement at that turning point is estimated, which helps identify cutting parameter ranges where loss of stability leads to much larger self-interrupted motions than in some other ranges. Numerical bounds are also obtained on the parameter values which guarantee global stability of steady-state cutting, i.e., parameter values for which there exist neither unstable periodic motions nor self-interrupted motions about the stable equilibrium.

Formal Verification of Full-Wave Rectifier: A Case Study

We present a case study of formal verification of full-wave rectifier for analog and mixed signal designs. We have used the Checkmate tool from CMU [1], which is a public domain formal verification tool for hybrid systems. Due to the restriction imposed by Checkmate it necessitates to make the changes in the Checkmate implementation to implement the complex and non-linear system. Full-wave rectifier has been implemented by using the Checkmate custom blocks and the Simulink blocks from MATLAB from Math works. After establishing the required changes in the Checkmate implementation we are able to efficiently verify, the safety properties of the full-wave rectifier.

Unsteady MHD mixed convection flow over an impulsively stretched permeable vertical surface in a quiescent fluid

The unsteady mixed convection flow of an incompressible laminar electrically conducting fluid over an impulsively stretched permeable vertical surface in an unbounded quiescent fluid in the presence of a transverse magnetic field has been investigated. At the same time, the surface temperature is suddenly increased from the surrounding fluid temperature or a constant heat flux is suddenly imposed on the surface. The problem is formulated in such a way that for small time it is governed by Rayleigh type of equation and for large time by Crane type of equation. The non-linear coupled parabolic partial differential equations governing the unsteady mixed convection flow under boundary layer approximations have been solved analytically by using the homotopy analysis method as well as numerically by an implicit finite difference scheme. The local skin friction coefficient and the local Nusselt number are found to decrease rapidly with time in a small time interval and they tend to steady-state values for t* >= 5. They also increase with the buoyancy force and suction, but decrease with injection rate. The local skin friction coefficient increases with the magnetic field, but the local Nusselt number decreases. There is a smooth transition from the unsteady state to the steady state. (C) 2010 Elsevier Ltd. All rights reserved.

Dynamics of ''internal'' interannual variability of the Indian summer monsoon in a GCM

1] The poor predictability of the Indian summer monsoon ( ISM) appears to be due to the fact that a large fraction of interannual variability (IAV) is governed by unpredictable "internal'' low frequency variations. Mechanisms responsible for the internal IAV of the monsoon have not been clearly identified. Here, an attempt has been made to gain insight regarding the origin of internal IAV of the seasonal ( June - September, JJAS) mean rainfall from "internal'' IAV of the ISM simulated by an atmospheric general circulation model (AGCM) driven by fixed annual cycle of sea surface temperature (SST). The underlying hypothesis that monsoon ISOs are responsible for internal IAV of the ISM is tested. The spatial and temporal characteristics of simulated summer intraseasonal oscillations ( ISOs) are found to be in good agreement with those observed. A long integration with the AGCM forced with observed SST, shows that ISO activity over the Asian monsoon region is not modulated by the observed SST variations. The internal IAV of ISM, therefore, appears to be decoupled from external IAV. Hence, insight gained from this study may be useful in understanding the observed internal IAV of ISM. The spatial structure of the ISOs has a significant projection on the spatial structure of the seasonal mean and a common spatial mode governs both intraseasonal and interannual variability. Statistical average of ISO anomalies over the season ( seasonal ISO bias) strengthens or weakens the seasonal mean. It is shown that interannual anomalies of seasonal mean are closely related to the seasonal mean of intraseasonal anomalies and explain about 50% of the IAV of the seasonal mean. The seasonal mean ISO bias arises partly due to the broad-band nature of the ISO spectrum allowing the time series to be aperiodic over the season and partly due to a non-linear process where the amplitude of ISO activity is proportional to the seasonal bias of ISO anomalies. The later relation is a manifestation of the binomial character of rainfall time series. The remaining 50% of the IAV may arise due to land-surface processes, interaction between high frequency variability and ISOs, etc.

Primordial Perturbations from a Self-interacting Curvaton

Inflation is a period of accelerated expansion in the very early universe, which has the appealing aspect that it can create primordial perturbations via quantum fluctuations. These primordial perturbations have been observed in the cosmic microwave background, and these perturbations also function as the seeds of all large-scale structure in the universe. Curvaton models are simple modifications of the standard inflationary paradigm, where inflation is driven by the energy density of the inflaton, but another field, the curvaton, is responsible for producing the primordial perturbations. The curvaton decays after inflation as ended, where the isocurvature perturbations of the curvaton are converted into adiabatic perturbations. Since the curvaton must decay, it must have some interactions. Additionally realistic curvaton models typically have some self-interactions. In this work we consider self-interacting curvaton models, where the self-interaction is a monomial in the potential, suppressed by the Planck scale, and thus the self-interaction is very weak. Nevertheless, since the self-interaction makes the equations of motion non-linear, it can modify the behaviour of the model very drastically. The most intriguing aspect of this behaviour is that the final properties of the perturbations become highly dependent on the initial values. Departures of Gaussian distribution are important observables of the primordial perturbations. Due to the non-linearity of the self-interacting curvaton model and its sensitivity to initial conditions, it can produce significant non-Gaussianity of the primordial perturbations. In this work we investigate the non-Gaussianity produced by the self-interacting curvaton, and demonstrate that the non-Gaussianity parameters do not obey the analytically derived approximate relations often cited in the literature. Furthermore we also consider a self-interacting curvaton with a mass in the TeV-scale. Motivated by realistic particle physics models such as the Minimally Supersymmetric Standard Model, we demonstrate that a curvaton model within the mass range can be responsible for the observed perturbations if it can decay late enough.