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Sample records for high dialysis performance

  1. Performance measures for a dialysis setting.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji

    2018-03-01

    This study from Japan extracted performance measures for dialysis unit management and investigated their characteristics from professional views. Two surveys were conducted using self-administered questionnaires, in which dialysis managers/staff were asked to rate the usefulness of 44 performance indicators. A total of 255 managers and 2,097 staff responded. Eight performance measures were elicited from dialysis manager and staff responses: these were safety, operational efficiency, quality of working life, financial effectiveness, employee development, mortality, patient/employee satisfaction and patient-centred health care. These performance measures were almost compatible with those extracted in overall healthcare settings in a previous study. Internal reliability, content and construct validity of the performance measures for the dialysis setting were ensured to some extent. As a general trend, both dialysis managers and staff perceived performance measures as highly useful, especially for safety, mortality, operational efficiency and patient/employee satisfaction, but showed relatively low concerns for patient-centred health care and employee development. However, dialysis managers' usefulness perceptions were significantly higher than staff. Important guidelines for designing a holistic hospital/clinic management system were yielded. Performance measures must be balanced for outcomes and performance shaping factors (PSF); a common set of performance measures could be applied to all the healthcare settings, although performance indicators of each measure should be composed based on the application field and setting; in addition, sound causal relationships between PSF and outcome measures/indicators should be explored for further improvement. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  2. High sensitivity pyrogen testing in water and dialysis solutions.

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    Daneshian, Mardas; Wendel, Albrecht; Hartung, Thomas; von Aulock, Sonja

    2008-07-20

    The dialysis patient is confronted with hundreds of litres of dialysis solution per week, which pass the natural protective barriers of the body and are brought into contact with the tissue directly in the case of peritoneal dialysis or indirectly in the case of renal dialysis (hemodialysis). The components can be tested for living specimens or dead pyrogenic (fever-inducing) contaminations. The former is usually detected by cultivation and the latter by the endotoxin-specific Limulus Amoebocyte Lysate Assay (LAL). However, the LAL assay does not reflect the response of the human immune system to the wide variety of possible pyrogenic contaminations in dialysis fluids. Furthermore, the test is limited in its sensitivity to detect extremely low concentrations of pyrogens, which in their sum result in chronic pathologies in dialysis patients. The In vitro Pyrogen Test (IPT) employs human whole blood to detect the spectrum of pyrogens to which humans respond by measuring the release of the endogenous fever mediator interleukin-1beta. Spike recovery checks exclude interference. The test has been validated in an international study for pyrogen detection in injectable solutions. In this study we adapted the IPT to the testing of dialysis solutions. Preincubation of 50 ml spiked samples with albumin-coated microspheres enhanced the sensitivity of the assay to detect contaminations down to 0.1 pg/ml LPS or 0.001 EU/ml in water or saline and allowed pyrogen detection in dialysis concentrates or final working solutions. This method offers high sensitivity detection of human-relevant pyrogens in dialysis solutions and components.

  3. Precise Quantitative Assessment of the Clinical Performances of Two High-Flux Polysulfone Hemodialyzers in Hemodialysis: Validation of a Blood-Based Simple Kinetic Model Versus Direct Dialysis Quantification.

    Science.gov (United States)

    Lim, Paik-Seong; Lin, Yuyu; Chen, Minfeng; Xu, Xiaoqi; Shi, Yun; Bowry, Sudhir; Canaud, Bernard

    2018-05-01

    Highly permeable dialysis membranes with better design filters have contributed to improved solute removal and dialysis efficacy. However, solute membrane permeability needs to be well controlled to avoid increased loss of albumin that is considered to be detrimental for dialysis patients. A novel high-flux dialyzer type (FX CorDiax; Fresenius Medical Care) incorporating an advanced polysulfone membrane modified with nano-controlled spinning technology to enhance the elimination of a broader spectrum of uremic toxins has been released. The aim of this study was to compare in the clinical setting two dialyzer types having the same surface area, the current (FX dialyzer) and the new dialyzer generation (FX CorDiax), with respect to solute removal capacity over a broad spectrum of markers, including assessment of albumin loss based on a direct dialysis quantification method. We performed a crossover study following an A1-B-A2 design involving 10 patients. Phase A1 was 1 week of thrice-weekly bicarbonate hemodialysis with the FX dialyzer, 4 h per treatment; phase B was performed with a similar treatment regimen but with a new FX CorDiax dialyzer and finally the phase A2 was repeated with FX dialyzer as the former phase. Solute removal markers of interest were assessed from blood samples taken before and after treatment and from total spent dialysate collection (direct dialysis quantification) permitting a mass transfer calculation (mg/session into total spent dialysate/ultrafiltrate). On the blood side, there were no significant differences in the solute percent reduction between FX CorDiax 80 and FX 80. On the dialysate side, no difference was observed regarding eliminated mass of different solutes including β 2 -microglobulin (143.1 ± 33.6 vs. 138.3 ± 41.9 mg, P = 0.8), while the solute mass removal of total protein (1.65 ± 0.51 vs. 2.14 ± 0.75 g, P = 0.04), and albumin (0.41 ± 0.21 vs. 1.22 ± 0.51 g, P < 0.001) were

  4. High fall incidence and fracture rate in elderly dialysis patients.

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    Polinder-Bos, H A; Emmelot-Vonk, M H; Gansevoort, R T; Diepenbroek, A; Gaillard, C A J M

    2014-12-01

    Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors for falls in an elderly dialysis population. A one-year observational study of chronic dialysis patients aged ≥ 70 years. At baseline, patient characteristics were noted and during follow-up the vital parameters and laboratory values were recorded. Patients were questioned weekly about falls, fall circumstances and consequences by trained nurses. 49 patients were included with a median age of 79.3 years (70-89 years). During follow-up 40 fall accidents occurred in 27 (55%) patients. Falls resulted in fractures in 15% of cases and in hospital admissions in 15%. In haemodialysis (HD) patients, the mean systolic blood pressure (SBP) before HD was lower in fallers compared with non-fallers (130 vs. 143 mmHg). Several patients in the lower blood pressure category received antihypertensive medication. For every 5 mmHg lower SBP (before HD) the fall risk increased by 30% (hazard ratio (HR) 1.30, 95% CI 1.03-1.65, p = 0.03). Furthermore, fall risk increased by 22% for every 10 pmol/l rise of parathyroid hormone (HR 1.22, 95% CI 1.06-1.39, p = 0.004). Elderly dialysis patients have a high incidence of falls accompanied by a high fracture rate. Given the high complication rate, elderly patients at risk of falling should be identified and managed. Reduction of blood pressure-lowering medication might be a treatment strategy to reduce falls.

  5. Increasing fill volume reduces cardiac performance in peritoneal dialysis

    DEFF Research Database (Denmark)

    Ivarsen, Per; Povlsen, Johan V; Jensen, Jens Dam

    2007-01-01

    BACKGROUND: It is generally accepted that peritoneal dialysis (PD) affects systemic haemodynamics less than haemodialysis, but little is known about changes in haemodynamics during PD. It is unknown if increasing PD volume causes changes in cardiovascular haemodynamics possibly increasing...

  6. Dialyzer Reuse and Outcomes of High Flux Dialysis.

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    Argyropoulos, Christos; Roumelioti, Maria-Eleni; Sattar, Abdus; Kellum, John A; Weissfeld, Lisa; Unruh, Mark L

    2015-01-01

    The bulk of randomized trial evidence for the expanding use of High Flux (HF) hemodialysis worldwide comes from two randomized controlled trials, one of which (HEMODIALYSIS, HEMO) allowed, while the other (Membrane Outcomes Permeability, MPO) excluded, the reuse of membranes. It is not known whether dialyzer reuse has a differential impact on outcomes with HF vs low flyx (LF) dialyzers. Proportional Hazards Models and Joint Models for longitudinal measures and survival outcomes were used in HEMO to analyze the relationship between β2-microglobulin (β2M) concentration, flux, and reuse. Meta-analysis and regression techniques were used to synthesize the evidence for HF dialysis from HEMO and MPO. In HEMO, minimally reused (membranes (p for interaction between reuse and flux benefit with more extensively reused dialyzers. Meta-regression of HEMO and MPO estimated an adjusted HR of 0.63 (95% CI: 0.51-0.78) for non-reused HF dialyzers compared with non-reused LF membranes. This secondary analysis and synthesis of two large hemodialysis trials supports the widespread use of HF dialyzers in clinical hemodialysis over the last decade. A mechanistic understanding of the effects of HF dialysis and the reuse process on dialyzers may suggest novel biomarkers for uremic toxicity and may accelerate membrane technology innovations that will improve patient outcomes.

  7. Conceptual framework for holistic dialysis management based on key performance indicators.

    Science.gov (United States)

    Liu, Hu-Chen; Itoh, Kenji

    2013-10-01

    This paper develops a theoretical framework of holistic hospital management based on performance indicators that can be applied to dialysis hospitals, clinics or departments in Japan. Selection of a key indicator set and its validity tests were performed primarily by a questionnaire survey to dialysis experts as well as their statements obtained through interviews. The expert questionnaire asked respondents to rate the degree of "usefulness" for each of 66 indicators on a three-point scale (19 responses collected). Applying the theoretical framework, we selected a minimum set of key performance indicators for dialysis management that can be used in the Japanese context. The indicator set comprised 27 indicators and items that will be collected through three surveys: patient satisfaction, employee satisfaction, and safety culture. The indicators were confirmed by expert judgment from viewpoints of face, content and construct validity as well as their usefulness. This paper established a theoretical framework of performance measurement for holistic dialysis management from primary healthcare stakeholders' perspectives. In this framework, performance indicators were largely divided into healthcare outcomes and performance shaping factors. Indicators of the former type may be applied for the detection of operational problems or weaknesses in a dialysis hospital, clinic or department, while latent causes of each problem can be more effectively addressed by the latter type of indicators in terms of process, structure and culture/climate within the organization. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  8. The effects of high-load strength training with protein- or nonprotein-containing nutritional supplementation in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Mølsted, Stig; Harrison, Adrian Paul; Eidemak, Inge

    2013-01-01

    or a nonprotein drink after every training session. MAIN OUTCOME MEASURE: Muscle strength and power were tested using the good strength equipment and the leg extensor power rig. Physical performance and function were assessed using a chair stand test and the Short Form 36 questionnaire. Muscle fiber type size......OBJECTIVE: The aim of this study was to investigate the effects of high-load strength training and protein intake in patients undergoing dialysis with a focus on muscle strength, physical performance, and muscle morphology. DESIGN: This was a randomized controlled study conducted in three dialysis...... centers. SUBJECTS: Subjects for the study included 29 patients undergoing dialysis. INTERVENTION: The participants went through a control period of 16 weeks before completing 16 weeks of strength training. Before the training period, the participants were randomly assigned to receive a protein...

  9. Dialyzer Reuse and Outcomes of High Flux Dialysis.

    Directory of Open Access Journals (Sweden)

    Christos Argyropoulos

    Full Text Available The bulk of randomized trial evidence for the expanding use of High Flux (HF hemodialysis worldwide comes from two randomized controlled trials, one of which (HEMODIALYSIS, HEMO allowed, while the other (Membrane Outcomes Permeability, MPO excluded, the reuse of membranes. It is not known whether dialyzer reuse has a differential impact on outcomes with HF vs low flyx (LF dialyzers.Proportional Hazards Models and Joint Models for longitudinal measures and survival outcomes were used in HEMO to analyze the relationship between β2-microglobulin (β2M concentration, flux, and reuse. Meta-analysis and regression techniques were used to synthesize the evidence for HF dialysis from HEMO and MPO.In HEMO, minimally reused (< 6 times HF dialyzers were associated with a hazard ratio (HR of 0.67 (95% confidence interval, 95%CI: 0.48-0.92, p = 0.015, 0.64 (95%CI: 0.44 - 0.95, p = 0.03, 0.61 (95%CI: 0.41 - 0.90, p = 0.012, 0.53 (95%CI: 0.28 - 1.02, p = 0.057 relative to minimally reused LF ones for all cause, cardiovascular, cardiac and infectious mortality respectively. These relationships reversed for extensively reused membranes (p for interaction between reuse and flux < 0.001, p = 0.005 for death from all cause and cardiovascular causes, while similar trends were noted for cardiac and infectious mortality (p of interaction between reuse and flux of 0.10 and 0.08 respectively. Reduction of β2M explained only 1/3 of the effect of minimally reused HF dialyzers on all cause mortality, while non-β2M related factors explained the apparent attenuation of the benefit with more extensively reused dialyzers. Meta-regression of HEMO and MPO estimated an adjusted HR of 0.63 (95% CI: 0.51-0.78 for non-reused HF dialyzers compared with non-reused LF membranes.This secondary analysis and synthesis of two large hemodialysis trials supports the widespread use of HF dialyzers in clinical hemodialysis over the last decade. A mechanistic understanding of the effects of

  10. Impact of pay for performance on access at first dialysis in Queensland.

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    Haarsager, Jennie; Krishnasamy, Rathika; Gray, Nicholas A

    2018-05-01

    Commencement of haemodialysis with an arteriovenous fistula (AVF) or arteriovenous graft (AVG) is associated with improved survival compared with commencement with a central venous catheter. In 2011-2012, Queensland Health made incentive payments to renal units for early referred patients who commenced peritoneal dialysis (PD), or haemodialysis with an AVF/AVG. The aim of this study was to determine if pay for performance improved clinical care. All patients who commenced dialysis in Australia between 2009 and 2014 and were registered with the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were included. A multivariable regression model was used to compare rates of commencing dialysis with a PD catheter or permanent AVF/AVG during the pay-for-performance period (2011-2012) with periods prior (2009-2010) and after (2013-2014). A total of 10 858 early referred patients commenced dialysis during the study period, including 2058 in Queensland. In Queensland, PD as first modality increased with time (P pay-for-performance period as reference, the odds ratio for commencement with PD or haemodialysis with an AVF/AVG in Queensland was 1.02 (95% CI 0.81-1.29) in 2009-2010 and 1.28 (95% CI 1.01-1.61) in 2013-2014. There was no change for the rest of Australia (0.97 95% CI 0.87-1.09 in 2009-2010 and 1.00 95% CI 0.90-1.11 in 2013-14). Pay for performance did not improve rates of commencement of dialysis with PD or an AVF/AVG during the payment period. A lag effect on clinical care may explain the improvement in later years. © 2017 Asian Pacific Society of Nephrology.

  11. High fall incidence and fracture rate in elderly dialysis patients

    NARCIS (Netherlands)

    Polinder-Bos, H. A.; Emmelot-Vonk, M. H.; Gansevoort, R. T.; Diepenbroek, A.; Gaillard, C. A. J. M.

    2014-01-01

    Background: Although it is recognised that the dialysis population is ageing rapidly, geriatric complications such as falls are poorly appreciated, despite the many risk factors for falls in this population. The objective of this study was to determine the incidence, complications and risk factors

  12. Evaluation of Efficacy of Performed Dialysis According to Changes in Bone Metabolism Related Parameters in Hamadan City

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    N. Sheikh

    2005-07-01

    Full Text Available Introduction & Objective : Most of the CRF patients undergo dialysis to correct the CRF complications. Alterations in biochemical parameters of blood depends on the quality of dialysis. Several factors such as membrane , concentration of dialysis solutions , and dilution are involved in this process. Since the efficacy of the dialysis performed in Hamadan have not been studied previously and there was not information about the efficiency of Iranian made membrane (HD , R4 , R3 , S3 , this study was designed and performed.Materials & Methods: In this study some biochemical parameters including Hb , Hct , alkaline phosphatase , Ca , P , total protein , urea , creatinine before and after dialysis were measured in all patients referring to dialysis center of Hamadan. After collecting the blood samples before and after the dialysis, Hb and Htc were measured using the ABX cell counter. The other parameters were measured using Technicon RA1000 autoanalyser. The mean of these parameters before and after dialysis were compared using paired t-test. The results of different membranes were compared using ANOVA.Results: Results showed the serum level of total Ca increased 33% after dialysis (P<0.0001 while the P showed 36% decrease (P<0.0001. Alkaline phosphatase activity did not show any significant differences. Comparing the efficacy of different membrane in correction of urea and creatinine , HD membrane showed the most efficiency and R4 had the least (P<0.03. Other parameters did not show significant differences.Conclusion: The data obtained from this study showed a significant change in Ca , P, and ALP level after dialysis . Also it was concluded that different membrane had different effect on correction of studied parameters.

  13. Preparation and Preliminary Dialysis Performance Research of Polyvinylidene Fluoride Hollow Fiber Membranes

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    Zhang, Qinglei; Lu, Xiaolong; Liu, Juanjuan; Zhao, Lihua

    2015-01-01

    In this study, the separation properties of Polyvinylidene fluoride (PVDF) hollow fiber hemodialysis membranes were improved by optimizing membrane morphology and structure. The results showed that the PVDF membrane had better mechanical and separation properties than Fresenius Polysulfone High-Flux (F60S) membrane. The PVDF membrane tensile stress at break, tensile elongation and bursting pressure were 11.3 MPa, 395% and 0.625 MPa, respectively. Ultrafiltration (UF) flux of pure water reached 108.2 L∙h−1∙m−2 and rejection of Albumin from bovine serum was 82.3%. The PVDF dialyzers were prepared by centrifugal casting. The influences of membrane area and simulate fluid flow rate on dialysis performance were investigated. The results showed that the clearance rate of urea and Lysozyme (LZM) were improved with increasing membrane area and fluid flow rate while the rejection of albumin from bovine serum (BSA) had little influence. The high-flux PVDF dialyzer UF coefficient reached 62.6 mL/h/mmHg. The PVDF dialyzer with membrane area 0.69 m2 has the highest clearance rate to LZM and urea. The clearance rate of LZM was 66.8% and urea was 87.7%. PMID:25807890

  14. Evaluation of Exercise Tolerance in Dialysis Patients Performing Tai Chi Training: Preliminary Study

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    Wioletta Dziubek

    2016-01-01

    Full Text Available Introduction. Patients with end-stage renal disease (ESRD have poor physical performance and exercise capacity due to frequent dialysis treatments. Tai Chi exercises can be very useful in the area of rehabilitation of people with ESRD. Objectives. The aim of the study was to assess exercise capacity in ESRD patients participating in 6-month Tai Chi training. Patients and Methods. Twenty dialysis patients from Wroclaw took part in the training; at the end of the project, 14 patients remained (age 69.2±8.6 years. A 6-minute walk test (6MWT and spiroergometry were performed at the beginning and after 6 months of training. Results. After 6 months of Tai Chi, significant improvements were recorded in mean distance in the 6MWT (387.89 versus 436.36 m, rate of perceived exertion (7.4 versus 4.7, and spiroergometry (8.71 versus 10.08 min. Conclusions. In the ESRD patients taking part in Tai Chi training, a definite improvement in exercise tolerance was recorded after the 6-month training. Tai Chi exercises conducted on days without dialysis can be an effective and interesting form of rehabilitation for patients, offering them a chance for a better quality of life and fewer falls and hospitalisations that are the result of it.

  15. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement.

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    Fang, Wei; Ni, Zhaohui; Qian, Jiaqi

    2014-06-01

    The proportion of end-stage renal disease (ESRD) patients on peritoneal dialysis (PD) has increased very fast in China over the last decade. Renji Hospital, affiliated with Shanghai Jiaotong University School of Medicine, is a recognized high-quality PD unit with a high PD utilization rate, excellent patient and technique survival (1-year and 5-year patient survival rate of 93% and 71%, and 1-year and 5-year technique survival of 96% and 82%, respectively), low peritonitis rate and a well-documented good quality of life of the treated patients. We believe that a dedicated and experienced PD team, a structured patient training program, continuous patient support, establishing and utilizing standardized protocols, starting PD with low dialysis dose, monitoring key performance indicators (KPIs), and continuous quality improvement (CQI) are the key factors underlying this successful PD program. Copyright © 2014 International Society for Peritoneal Dialysis.

  16. Standard on microbiological management of fluids for hemodialysis and related therapies by the Japanese Society for Dialysis Therapy 2008.

    Science.gov (United States)

    Kawanishi, Hideki; Akiba, Takashi; Masakane, Ikuto; Tomo, Tadashi; Mineshima, Michio; Kawasaki, Tadayuki; Hirakata, Hideki; Akizawa, Tadao

    2009-04-01

    The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.

  17. Introduction of Renal Key Performance Indicators Associated with Increased Uptake of Peritoneal Dialysis in a Publicly Funded Health Service.

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    Toussaint, Nigel D; McMahon, Lawrence P; Dowling, Gregory; Holt, Stephen G; Smith, Gillian; Safe, Maria; Knight, Richard; Fair, Kathleen; Linehan, Leanne; Walker, Rowan G; Power, David A

    2017-01-01

    ♦ BACKGROUND: Increased demand for treatment of end-stage kidney disease has largely been accommodated by a costly increase in satellite hemodialysis (SHD) in most jurisdictions. In the Australian State of Victoria, a marked regional variation in the uptake of home-based dialysis suggests that use of home therapies could be increased as an alternative to SHD. An earlier strategy based solely on increased remuneration had failed to increase uptake of home therapies. Therefore, the public dialysis funder adopted the incidence and prevalence of home-based dialysis therapies as a key performance indicator (KPI) for its health services to encourage greater uptake of home therapies. ♦ METHODS: A KPI data collection and bench-marking program was established in 2012 by the Victorian Department of Health and Human Services, with data provided monthly by all renal units in Victoria using a purpose-designed website portal. A KPI Working Group was responsible for analyzing data each quarter and ensuring indicators remained accurate and relevant and each KPI had clear definitions and targets. We present a prospective, observational study of all dialysis patients in Victoria over a 4-year period following the introduction of the renal KPI program, with descriptive analyses to evaluate the proportion of patients using home therapies as well as home dialysis modality survival. ♦ RESULTS: Following the introduction of the KPI program, the net growth of dialysis patient numbers in Victoria remained stable over 4 years, at 75 - 80 per year (approximately 4%). However, unlike the previous decade, about 40% of this growth was through an increase in home dialysis, which was almost exclusively peritoneal dialysis (PD). The increase was identified particularly in the young (20 - 49) and the elderly (> 80). Disappointingly, however, 67% of these incident patients ceased PD within 2 years of commencement, 46% of whom transferred to SHD. ♦ CONCLUSIONS: Introduction of a KPI program

  18. High prevalence of secondary hyperparathyroidism in chronic kidney disease patients on dialysis in Argentina.

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    Douthat, Walter G; Castellano, Mauro; Berenguer, Leandro; Guzmán, M Alejandra; de Arteaga, Javier; Chiurchiu, Carlos R; Massari, Pablo U; Garay, Gabriela; Capra, Raúl; de La Fuente, Jorge L

    2013-01-01

    There are few data in Argentina on the prevalence and management of bone and mineral metabolism (BMM) in patients with chronic kidney disease (CKD). A survey was carried out in dialysis units in 2010 to measure the prevalence of and types of treatments for BMM disorders in Argentina. The data obtained was then compared to the published results from other large population studies. We recorded characteristics of dialysis centres and participating patients, the frequency of measurements and individual results for BMM biochemical markers, as well as the type of management used to control hyperphosphataemia and secondary hyperparathyroidism. 1210 patients from 25 dialysis centres in Argentina participated in the study (representing 4.7% of the country’s prevalent dialysis population in 2010). The mean patient age was 55.3±17.6 years, 60.8% were male, 3.3% were on peritoneal dialysis and 29.1% suffered diabetes. In all centres, phosphataemia and calcaemia were measured on a monthly basis, 60% of centres measured intact parathyroid hormone (iPTH) every 6 months, 36% every 3 to 4 months, and 4% annually. As recommended by K/DOQI, 51.6% of patients had adequate levels of calcium (8.4-9.5 mg/dl), 51.6% had adequate phosphorus (3.5-5.5 mg/dl) and 21.1% displayed acceptable iPTH levels (150-300 pg/ml). 24% had iPTH 300 pg/ml. iPTH ≥600 pg/ml was present in 28.3%, and 13.3% had values ≥1000 pg/ml. These figures differed from those published by the DOPPS II study, in which 51.1% of patients had iPTH hyperparathyroidism, oral or intravenous calcitriol was predominantly used (50.5%) with a small percentage of patients receiving paricalcitol or doxercalciferol. The present study shows a high prevalence of secondary hyperparathyroidism, which differs from that published by other large population studies. There was a high proportion of patients with BMM markers outside the ranges suggested by K/DOQI. Mainly phosphate binders based on calcium and calcitriol continue to be used

  19. In Vitro Dialysis of Cytokine-Rich Plasma With High and Medium Cut-Off Membranes Reduces Its Procalcific Activity.

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    Willy, Kevin; Hulko, Michael; Storr, Markus; Speidel, Rose; Gauss, Julia; Schindler, Ralf; Zickler, Daniel

    2017-09-01

    Recently developed high-flux (HF) dialysis membranes with extended permeability provide better clearance of middle-sized molecules such as interleukins (ILs). Whether this modulation of inflammation influences the procalcific effects of septic plasma on vascular smooth muscle cells (VSMCs) is not known. To assess the effects of high cut-off (HCO) and medium cut-off (MCO) membranes on microinflammation and in vitro vascular calcification we developed a miniature dialysis model. Plasma samples from lipopolysaccharide-spiked blood were dialyzed with HF, HCO, and MCO membranes in an in vitro miniature dialysis model. Afterwards, IL-6 concentrations were determined in dialysate and plasma. Calcifying VSMCs were incubated with dialyzed plasma samples and vascular calcification was assessed. Osteopontin (OPN) and matrix Gla protein (MGP) were measured in VSMC supernatants. IL-6 plasma concentrations were markedly lower with HCO and MCO dialysis. VSMC calcification was significantly lower after incubation with MCO- and HCO-serum compared to HF plasma. MGP and OPN levels in supernatants were significantly lower in the MCO but not in the HCO group compared to HF. In vitro dialysis of cytokine-enriched plasma samples with MCO and HCO membranes reduces IL-6 levels. The induction of vascular calcification by cytokine-enriched plasma is reduced after HCO and MCO dialysis. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  20. Effectiveness of peritonaeal dialysis

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    Jovanović Nataša

    2005-01-01

    Full Text Available Introduction. In the last few years, an increasing number of patients suffering from terminal renal disease of various leading causes was treated with renal replacement therapy. Peritonaeal dialysis involves an exchange of water and solutes between blood in the peritonaeal capillaries and dialysate in the peritonaeal cavum throughout the peritonaeum. Effective dialysis treatment should provide good quality of life, decrease the number of physical complaints, and bring the incidence of morbidity and mortality closer to the incidence of morbidity and mortality in the healthy population. Aim. The aim of this study was the evaluation of peritonaeal transport characteristics and dialysis effectiveness in 58 patients affected by terminal renal disease who underwent peritonaeal dialysis treatment during August 2003 at the Clinic of Nephrology of the Clinical Centre of Serbia. Method. We examined 30 male and 28 female patients, with an average age of 52 years (range 26 to 78 years. The average duration of peritoneal dialysis treatment was 20 months (ranging from 2 to 66 months, and the end-stage renal failure was caused by different leading disease in our patients. We applied different dialysis modalities: continuous ambulatory peritonaeal dialysis (CAPD with three to five 2- or 3-litre exchanges daily, cyclic peritonaeal dialysis (CCPD, intermittent peritonaeal dialysis (IPD, or automatic peritonaeal dialysis (APD, according to the transport characteristics of the peritonaeal membrane, the residual renal function (RRF, and the clinical status of the patients, in order to perform adequate depuration as suggested by the new international criteria. A peritonaeal equilibrium test (PET was performed according to the new international advice; urea and creatinine clearances (Kt/V and Ccr as well as RRF were calculated using the internationally suggested formulas. Results. Most of our patients received effective dialysis treatment, thanks to the modulation of

  1. Peritoneal Dialysis

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    ... include: Infections. An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis. An ... day. You might have a lower risk of peritonitis because you connect and disconnect to the dialysis ...

  2. Impact of High-Cut-Off Dialysis on Renal Recovery in Dialysis-Dependent Multiple Myeloma Patients: Results from a Case-Control Study.

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    Hans U Gerth

    Full Text Available High-cut-off hemodialysis (HCO-HD can effectively reduce high concentrations of circulating serum free light chains (sFLC in patients with dialysis-dependent acute kidney injury (AKI due to multiple myeloma (MM. Therefore, the aim of this study was to analyze renal recovery in a retrospective single-center cohort of dialysis-dependent MM patients treated with either conventional HD (conv. HD or HCO-HD.The final cohort consisted of 59 patients treated with HCO-HD (n = 42 or conv. HD (n = 17. A sustained sFLC response was detected in a significantly higher proportion of HCO-HD patients (83.3% compared with conv. HD patients (29.4%; p = 0.007. The median duration of sFLC required to reach values <1000 mg/l was 14.5 days in the HCO-HD group and 36 days in the conv. HD group. The corresponding rates of renal recovery were 64.3% and 29.4%, respectively (chi-squared test, p = 0.014. Multivariate regression and decision tree analysis (recursive partitioning revealed HCO-HD (adjusted odds ratio [OR] 6.1 [95% confidence interval (CI 1.5-24.5], p = 0.011 and low initial uric acid values (adjusted OR 1.3 [95%CI 1.0-1.7], p = 0.045 as independent and paramount variables associated with a favorable renal outcome.In summary, the results from this retrospective case-control study suggest in addition to novel agent-based chemotherapy a benefit of HCO-HD in sFLC removal and renal outcome in dialysis-dependent AKI secondary to MM. This finding was especially pertinent in patients with low initial uric acid values, resulting in a promising renal recovery rate of 71.9%. Further prospective studies are warranted.

  3. Sister Earth, Our Common Home: Toward a Sustainable, Planet Friendly Approach to Dialysis, a Paradigm of High Technology Medicine.

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    Piccoli, Giorgina Barbara; Mery, David

    2017-11-01

    In our high-technology, highly polluted world, medicine plays an important role balancing saving lives with the expenses of growing amounts of waste products, not only biologically dangerous (the potentially "contaminated" or "hazardous" waste) but also potentially harmful for the planet (nonrecyclable, plastic waste). Dialysis, the prototype of high-technology medicine, is central to these problems, as the present treatment of about 2 million patients produces an enormous quantity of waste (considering hazardous waste only about 2 kg per session, with 160 sessions per year, that is 320 kg per patient, or about 640,000 tons of hazardous waste per year for 2 million patients, roughly corresponding to 6 nuclear aircraft carriers). Furthermore, obsolete dialysis machines, and water treatments are discharged, adding to the "technological waste." Water produced by the reverse osmosis is also discharged; this is the only nonhazardous, nonpolluting waste, but in particular in dry areas, wasting water is a great ecologic concern. The present review is aimed at discussing strategies already in place and to be further implemented for reducing this particular "uremic toxin" for the earth: dialysis waste, including dialysis disposables, water, and dialysis machines. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  4. Superior survival of high transporters treated with automated versus continuous ambulatory peritoneal dialysis.

    Science.gov (United States)

    Johnson, David W; Hawley, Carmel M; McDonald, Stephen P; Brown, Fiona G; Rosman, Johan B; Wiggins, Kathryn J; Bannister, Kym M; Badve, Sunil V

    2010-06-01

    Automated peritoneal dialysis (APD) is widely recommended for the management of high transporters by the International Society of Peritoneal Dialysis (ISPD), although there have been no adequate studies to date comparing the outcomes of APD and continuous ambulatory peritoneal dialysis (CAPD) in this high risk group. The relative impact of APD versus CAPD on patient and technique survival rates was examined by both intention-to-treat (PD modality at Day 90) and 'as-treated' time-varying Cox proportional hazards model analyses in all patients who started PD in Australia or New Zealand between 1 April 1999 and 31 March 2004 and who had baseline peritoneal equilibration tests confirming the presence of high peritoneal transport status. During the study period, 4128 patients commenced PD. Of these, 628 patients were high transporters on PD at Day 90 (486 on APD and 142 on CAPD). Compared to high transporters treated with CAPD, APD-treated high transporters were more likely to be younger and Caucasian, and less likely to be diabetic. On multivariate intention-to-treat analysis, APD treatment was associated with superior survival [adjusted hazard ratio (HR) 0.56, 95% confidence interval (CI) 0.35-0.87] and comparable death-censored technique survival (HR 0.88, 95% CI 0.64-1.21). Superior survival of high transporters treated with APD versus CAPD was also confirmed in supplemental as-treated analysis (HR 0.72, 95% CI 0.54-0.96), matched case-control analysis (HR 0.60, 95% CI 0.36-0.96) and subgroup analysis of high transporters treated entirely with APD versus those treated entirely with CAPD (HR 0.29, 95% CI 0.14-0.60). There were no statistically significant differences in patient survival or death-censored technique survival between APD and CAPD for any other transport group, except for low transporters, who experienced a higher mortality rate on APD compared with CAPD (HR 2.19, 95% CI 1.02-4.70). APD treatment is associated with a significant survival advantage in

  5. Improving Dialysis Adherence for High Risk Patients Using Automated Messaging: Proof of Concept

    OpenAIRE

    Som, A.; Groenendyk, J.; An, T.; Patel, K.; Peters, R.; Polites, G.; Ross, W. R.

    2017-01-01

    Comorbidities and socioeconomic barriers often limit patient adherence and self-management with hemodialysis. Missed sessions, often associated with communication barriers, can result in emergency dialysis and avoidable hospitalizations. This proof of concept study explored using a novel digital-messaging platform, EpxDialysis, to improve patient-to-dialysis center communication via widely available text messaging and telephone technology. A randomized controlled trial was conducted through W...

  6. Fiber type specific response of skeletal muscle satellite cells to high-intensity resistance training in dialysis patients

    DEFF Research Database (Denmark)

    Molsted, Stig; Andersen, Jesper Løvind; Harrison, Adrian Paul

    2015-01-01

    Introduction. The aim was to investigate the effect of high-intensity resistance training on satellite cell (SC) and myonuclear number in the muscle of patients undergoing dialysis. Methods. Patients (n=21) underwent a 16-week control period, followed by 16 weeks of resistance training thrice...

  7. Connective tissue growth factor (CTGF/CCN2) is increased in peritoneal dialysis patients with high peritoneal solute transport rate

    NARCIS (Netherlands)

    Mizutani, Makoto; Ito, Yasuhiko; Mizuno, Masashi; Nishimura, Hayato; Suzuki, Yasuhiro; Hattori, Ryohei; Matsukawa, Yoshihisa; Imai, Masaki; Oliver, Noelynn; Goldschmeding, Roel; Aten, Jan; Krediet, Raymond T.; Yuzawa, Yukio; Matsuo, Seiichi

    2010-01-01

    Mizutani M, Ito Y, Mizuno M, Nishimura H, Suzuki Y, Hattori R, Matsukawa Y, Imai M, Oliver N, Goldschmeding R, Aten J, Krediet RT, Yuzawa Y, Matsuo S. Connective tissue growth factor (CTGF/CCN2) is increased in peritoneal dialysis patients with high peritoneal solute transport rate. Am J Physiol

  8. High peritoneal transport status is not an independent risk factor for high mortality in patients treated with automated peritoneal dialysis.

    Science.gov (United States)

    Chang, Tae Ik; Park, Jung Tak; Lee, Dong Hyung; Lee, Ju Hyun; Yoo, Tae Hyun; Kim, Beom Seok; Kang, Shin-Wook; Lee, Ho Yung; Choi, Kyu Hun

    2010-09-01

    We undertook this study to elucidate whether baseline peritoneal membrane transport characteristics are associated with high mortality in incident automated peritoneal dialysis (APD) patients. This retrospective study includes 117 patients who started APD at Yonsei University Health System from 1996 to 2008 and had a PET within 3 months of APD initiation. High transporters were significantly older and had a higher incidence of cardiovascular disease. Patient survival for years 1, 3, and 5 were 85%, 64%, and 35% for high transporter and 94%, 81%, and 68% for non-high transporter group (Ptransport status was not a significant predictor for mortality in this population when the other covariates were included. Even though high transport was significantly associated with mortality in the univariate analysis, its role seemed to be influenced by other comorbid conditions. These findings suggest that the proper management of these comorbid conditions, as well as appropriate ultrafiltration by use of APD and/or icodextrin, must be considered as protective strategies to improve survival in peritoneal dialysis patients with high transport.

  9. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients

    Science.gov (United States)

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-01-01

    Abstract Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients’ technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients. This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes. During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality. We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality. These results may help to identify and target patients who are at higher risk of HPR at the start

  10. Equilibrium Dialysis

    African Journals Online (AJOL)

    context of antimicrobial therapy in malnutrition. Dialysis has in the past presented technical problems, being complicated and time-consuming. A new dialysis system based on the equilibrium technique has now become available, and it is the principles and practical application of this apparatus (Kontron Diapack; Kontron.

  11. Use of Self-Organizing Maps for Balanced Scorecard analysis to monitor the performance of dialysis clinic chains.

    Science.gov (United States)

    Cattinelli, Isabella; Bolzoni, Elena; Barbieri, Carlo; Mari, Flavio; Martin-Guerrero, José David; Soria-Olivas, Emilio; Martinez-Martinez, José Maria; Gomez-Sanchis, Juan; Amato, Claudia; Stopper, Andrea; Gatti, Emanuele

    2012-03-01

    The Balanced Scorecard (BSC) is a validated tool to monitor enterprise performances against specific objectives. Through the choice and the evaluation of strategic Key Performance Indicators (KPIs), it provides a measure of the past company's outcome and allows planning future managerial strategies. The Fresenius Medical Care (FME) BSC makes use of 30 KPIs for a continuous quality improvement strategy within its dialysis clinics. Each KPI is monthly associated to a score that summarizes the clinic efficiency for that month. Standard statistical methods are currently used to analyze the BSC data and to give a comprehensive view of the corporate improvements to the top management. We herein propose the Self-Organizing Maps (SOMs) as an innovative approach to extrapolate information from the FME BSC data and to present it in an easy-readable informative form. A SOM is a computational technique that allows projecting high-dimensional datasets to a two-dimensional space (map), thus providing a compressed representation. The SOM unsupervised (self-organizing) training procedure results in a map that preserves similarity relations existing in the original dataset; in this way, the information contained in the high-dimensional space can be more easily visualized and understood. The present work demonstrates the effectiveness of the SOM approach in extracting useful information from the 30-dimensional BSC dataset: indeed, SOMs enabled both to highlight expected relationships between the KPIs and to uncover results not predictable with traditional analyses. Hence we suggest SOMs as a reliable complementary approach to the standard methods for BSC interpretation.

  12. Dialysis and contrast media

    International Nuclear Information System (INIS)

    Morcos, Sameh K.; Thomsen, Henrik S.; Webb, Judith A.W.

    2002-01-01

    In a previous survey we revealed uncertainty among responders about (a) whether or not to perform hemodialysis in patients with severely reduced renal function who had received contrast medium; and (b) when to perform hemodialysis in patients on regular treatment with hemodialysis or continuous ambulatory dialysis who received contrast medium. Therefore, the Contrast Media Safety Committee of The European Society of Urogenital Radiology decided to review the literature and to issue guidelines. The committee performed a Medline search. Based on this, a report and guidelines were prepared. The report was discussed at the Ninth European Symposium on Urogenital Radiology in Genoa, Italy. Hemodialysis and peritoneal dialysis safely remove both iodinated and gadolinium-based contrast media. The effectiveness of hemodialysis depends on many factors including blood and dialysate flow rate, permeability of dialysis membrane, duration of hemodialysis and molecular size, protein binding, hydrophilicity, and electrical charge of the contrast medium. Generally, several hemodialysis sessions are needed to removal all contrast medium, whereas it takes 3 weeks for continuous ambulatory dialysis to remove the agent completely. There is no need to schedule the dialysis in relation to the injection of iodinated or MR contrast media or the injection of contrast agent in relation to the dialysis program. Hemodialysis does not protect poorly functioning kidneys against contrast-medium-induced nephrotoxicity. Simple guidelines are given. (orig.)

  13. The Effects Of The Use Of A High-Efficiency, High-Flux Dialysis Membrane On The Nutritional Status Of Patients Receiving Maintenance Hemodialysis

    Directory of Open Access Journals (Sweden)

    Won-Min Hwang

    2012-06-01

    Full Text Available It is possible to observe improvement in the general state of patients receiving maintenance hemodialysis, including decreased joint symptoms, decreased pruritus, and better appetite, by using a high-efficiency, high-flux dialysis membrane. We aimed to determine the effects of the use of a high-flux dialysis membrane on improvement in the nutritional status of dialysis patients. Two months before the replacement with a high-efficiency, high-flux dialysis membrane and one, three, six, and twelve months after the replacement, the subjective global assessment (SGA, biochemical markers, and a Body Composition Analyzer was used to assess the nutritional status and determine hemodialysis adequacy, along with a biochemical test, in 25 stable patients (M: F=10:15, 54.5±12.7 (37∼80 yrs. Of all the patients, 3 got better results from SGA, 12 the same results, and 10 worse results, in the follow-up period. There was no significant increase or decrease after the replacement with a high-flux dialysis membrane in biochemical parameters and nutritional parameters. While there was also no improvement in body weight, fat mass, muscle mass, lean fat mass, visceral fat, or the degree of edema measured by the body composition analyzer after the replacement, basal metabolism was improved from 1179.2±143.5 kcal before the replacement to 1264.8±145.4, 1241±138.3, and 1201.0±317.0 kcal one, three, twelve months after the replacement, respectively, on the average (p<0.001, p=0.001, p=0.023; thus, the improvement was greatest one month after the replacement and, then, decreased over time. In conclusion, the use of a high-efficiency, high-flux dialysis membrane generally failed to improve the nutritional status of patients receiving maintenance hemodialysis but increased the indirect index of basal metabolism alone at its early stage.

  14. Peritoneal Dialysis Dose and Adequacy

    Science.gov (United States)

    ... infused dialysis solution and how much urea and creatinine have entered into the solution during a 4-hour dwell. The peritoneal transport rate varies from person to person. People who have a high rate of transport absorb dextrose from the dialysis ...

  15. Phosphate control in dialysis

    Directory of Open Access Journals (Sweden)

    Cupisti A

    2013-10-01

    Full Text Available Adamasco Cupisti,1 Maurizio Gallieni,2 Maria Antonietta Rizzo,2 Stefania Caria,3 Mario Meola,4 Piergiorgio Bolasco31Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 2Nephrology and Dialysis Unit, San Carlo Borromeo Hospital, Milan, Italy; 3Territorial Department of Nephrology and Dialysis, ASL Cagliari, Italy; 4Sant'Anna School of Advanced Studies, University of Pisa, Pisa, ItalyAbstract: Prevention and correction of hyperphosphatemia is a major goal of chronic kidney disease–mineral and bone disorder (CKD–MBD management, achievable through avoidance of a positive phosphate balance. To this aim, optimal dialysis removal, careful use of phosphate binders, and dietary phosphate control are needed to optimize the control of phosphate balance in well-nourished patients on a standard three-times-a-week hemodialysis schedule. Using a mixed diffusive–convective hemodialysis tecniques, and increasing the number and/or the duration of dialysis tecniques are all measures able to enhance phosphorus (P mass removal through dialysis. However, dialytic removal does not equal the high P intake linked to the high dietary protein requirement of dialysis patients; hence, the use of intestinal P binders is mandatory to reduce P net intestinal absorption. Unfortunately, even a large dose of P binders is able to bind approximately 200–300 mg of P on a daily basis, so it is evident that their efficacy is limited in the case of an uncontrolled dietary P load. Hence, limitation of dietary P intake is needed to reach the goal of neutral phosphate balance in dialysis, coupled to an adequate protein intake. To this aim, patients should be informed and educated to avoid foods that are naturally rich in phosphate and also processed food with P-containing preservatives. In addition, patients should preferentially choose food with a low P-to-protein ratio. For example, patients could choose egg white or protein from a vegetable source

  16. (HIV) seropositive Nigerian patients undergoing dialysis

    African Journals Online (AJOL)

    Most dialysis centres in Nigeria currently do not accept HIV positive patients for dialysis therapy for many reasons. The prevailing high level of stigmatization of HIV positive patients and the lack of job security for infected staff are two major reasons for the non-acceptance of HIV infected patients for dialysis by these centres.

  17. Osteoarthropathy in dialysis amyloidosis

    International Nuclear Information System (INIS)

    Baldrati, L.; Feletti, C.; Capponcini, C.; Docci, D.; Rocchi, A.; Balbi, B.; Bonsanto, R.; Mughetti, M.; Pasini, A.

    1991-01-01

    Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of β 2 -microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1±13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions

  18. Effective flow performances and dialysis doses delivered with permanent catheters: a 24-month comparative study of permanent catheters versus arterio-venous vascular accesses.

    Science.gov (United States)

    Canaud, Bernard; Leray-Moragues, Hélène; Kerkeni, Nadia; Bosc, Jean-Yves; Martin, Katja

    2002-07-01

    Permanent venous catheters have emerged as a long-term vascular access option for renal replacement therapy in end-stage renal disease patients. The design and venous location of catheter devices bear intrinsic flow limitations that may negatively affect the adequacy of dialysis and the patient outcome. There is limited data comparing the long-term dialysis adequacy delivered with permanent catheters vs arterio-venous vascular accesses (AVA). To explore this problem, we conducted a prospective 24-month trial comparing the flow performances and dialysis dose (Kt/Vdp) deliveries of both access options in a group of 42 haemodialysis patients during two study phases. During the first 12 months the patients completed a treatment period by means of permanent dual silicone catheters (DualKT). Then they were transferred to an AVA (40 native arterio-venous fistulas and two PTFE grafts) and monitored for an additional 12-month period. Assessments of flow adequacy and dialysis quantification were performed monthly. Dialysis adequacy was achieved in all cases. No patient had to be transferred prematurely to the AVA because of catheter failure. Three catheters had to be replaced due to bacteraemia in three patients. The mean effective blood flow rates achieved were 316+/-3.5 ml/min and 340+/-3.3 ml/min with DualKT and AVA, respectively, for a pre-set machine blood flow of 348+/-2.2 ml/min. Recirculation rates evaluated with the 'slow blood flow' method were 8.6+/-0.6 and 12.1+/-0.8% for DualKT and AVA using mean values of the solute markers urea and creatinine. Due to the possibility of a comparison veno-venous vs arterio-venous blood circulation, a corrected arterio-venous access recirculation could be derived from the difference between the two, which was around 3%. The blood flow resistance of the DualKT was slightly higher than with AVA as indicated by venous pressure differences. Kt/Vdp delivered was 1.37+/-0.02 and 1.45+/-0.02 with DualKT and AVA access respectively. The

  19. Daily dialysis reduces pulse wave velocity in chronic hemodialysis patients.

    Science.gov (United States)

    Di Micco, Lucia; Torraca, Serena; Sirico, Maria Luisa; Tartaglia, Domenico; Di Iorio, Biagio

    2012-05-01

    Pulse wave velocity (PWV) is a predictor of morbidity and mortality in patients with end-stage renal disease (ESRD). Dialysis patients show cyclic changes in PWV related to their hydration status and blood pressure. Our aim is to assess the impact of daily dialysis on PWV. We performed a randomized crossover study of 60 patients who underwent standard hemodialysis (HD) three times per week for at least 6 months. Patients were classified into three groups according to their PWV values before (pre-) and after (post-) HD, with a cutoff value of 12 m s(-1), as follows: the low-low (LL) group had normal pre-HD and post-HD PWV; the high-low (HL) group had high pre-HD PWV and normal post-HD PWV; and the high-high (HH) group had high pre- and post-HD PWV. All patients continued standard HD for 2 weeks. A total of 10 patients from each group were randomly assigned to continue standard HD for 1 week and then underwent daily dialysis for 1 week. The remaining 10 patients underwent daily dialysis for 1 week and then underwent standard HD for 1 week. PWV values were measured before and 1 h after each dialysis session. With daily dialysis treatment, 2 of 20 patients (10%) moved from the PWV-HH group to the PWV-HL group, whereas 18 of 20 patients (90%) moved from the PWV-HL group to the PWV-LL group (P = 0.030). Daily dialysis reduces PWV in the ESRD patients. As PWV is a strong predictor of mortality in ESRD and has cyclic variations in patients who are on standard HD, we believe that daily dialysis may be used in patients with high PWV levels to reduce their mortality risk.

  20. Toward dialysis "a la carte".

    Science.gov (United States)

    Funck-Brentano, J L

    1987-12-01

    From the very beginning, the artificial kidney postponed the death of patients with end-stage renal failure. For years, owing to the performance of the machine, the patient was obliged to follow a severe diet in order to maintain good humoral and circulatory status. Now technological improvements allow "dialysis à la carte," whereby each individual achieves a better clinical status. The next step will be automation of the procedure to improve its security, mainly for dialysis performed at home.

  1. Protein binding studies with radiolabeled compounds containing radiochemical impurities. Equilibrium dialysis versus dialysis rate determination

    DEFF Research Database (Denmark)

    Honoré, B

    1987-01-01

    The influence of radiochemical impurities in dialysis experiments with high-affinity ligands is investigated. Albumin binding of labeled decanoate (97% pure) is studied by two dialysis techniques. It is shown that equilibrium dialysis is very sensitive to the presence of impurities resulting...

  2. Dialysis centers - what to expect

    Science.gov (United States)

    ... kidneys - dialysis centers; Dialysis - what to expect; Renal replacement therapy - dialysis centers; End-stage renal disease - dialysis ... to a tube that connects to the dialysis machine. Your blood will flow through the tube, into ...

  3. Improved glucose tolerance after high-load strength training in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Mølsted, Stig; Harrison, Adrian Paul; Eidemak, Inge

    2013-01-01

    glucose tolerance (n = 9). Conclusion: The conducted strength training was associated with a significant improvement in glucose tolerance in patients with impaired glucose tolerance or type 2 diabetes undergoing dialysis. The effect was apparently not associated with muscle hypertrophy, whereas the muscle...... a week. Muscle fiber size, composition and capillary density were analyzed in biopsies obtained in the vastus lateralis muscle. Glucose tolerance and the insulin response were measured by a 2-hour oral glucose tolerance test. Results: All outcome measures remained unchanged during the control period....... After strength training the relative area of type 2X fibers was decreased. Muscle fiber size and capillary density remained unchanged. After the strength training, insulin concentrations were significantly lower in patients with impaired glucose tolerance or type 2 diabetes (n = 14) (fasting insulin...

  4. Provider Monitoring and Pay-for-Performance When Multiple Providers Affect Outcomes: An Application to Renal Dialysis

    Science.gov (United States)

    Hirth, Richard A; Turenne, Marc N; Wheeler, John RC; Pan, Qing; Ma, Yu; Messana, Joseph M

    2009-01-01

    Objective To characterize the influence of dialysis facilities and nephrologists on resource use and patient outcomes in the dialysis population and to illustrate how such information can be used to inform payment system design. Data Sources Medicare claims for all hemodialysis patients for whom Medicare was the primary payer in 2004, combined with the Medicare Enrollment Database and the CMS Medical Evidence Form (CMS Form 2728), which is completed at onset of renal replacement therapy. Study Design Resource use (mainly drugs and laboratory tests) per dialysis session and two clinical outcomes (achieving targets for anemia management and dose of dialysis) were modeled at the patient level with random effects for nephrologist and dialysis facility, controlling for patient characteristics. Results For each measure, both the physician and the facility had significant effects. However, facilities were more influential than physicians, as measured by the standard deviation of the random effects. Conclusions The success of tools such as P4P and provider profiling relies upon the identification of providers most able to enhance efficiency and quality. This paper demonstrates a method for determining the extent to which variation in health care costs and quality of care can be attributed to physicians and institutional providers. Because variation in quality and cost attributable to facilities is consistently larger than that attributable to physicians, if provider profiling or financial incentives are targeted to only one type of provider, the facility appears to be the appropriate locus. PMID:19555398

  5. High performance homes

    DEFF Research Database (Denmark)

    Beim, Anne; Vibæk, Kasper Sánchez

    2014-01-01

    Can prefabrication contribute to the development of high performance homes? To answer this question, this chapter defines high performance in more broadly inclusive terms, acknowledging the technical, architectural, social and economic conditions under which energy consumption and production occur....... Consideration of all these factors is a precondition for a truly integrated practice and as this chapter demonstrates, innovative project delivery methods founded on the manufacturing of prefabricated buildings contribute to the production of high performance homes that are cost effective to construct, energy...

  6. High Performance Marine Vessels

    CERN Document Server

    Yun, Liang

    2012-01-01

    High Performance Marine Vessels (HPMVs) range from the Fast Ferries to the latest high speed Navy Craft, including competition power boats and hydroplanes, hydrofoils, hovercraft, catamarans and other multi-hull craft. High Performance Marine Vessels covers the main concepts of HPMVs and discusses historical background, design features, services that have been successful and not so successful, and some sample data of the range of HPMVs to date. Included is a comparison of all HPMVs craft and the differences between them and descriptions of performance (hydrodynamics and aerodynamics). Readers will find a comprehensive overview of the design, development and building of HPMVs. In summary, this book: Focuses on technology at the aero-marine interface Covers the full range of high performance marine vessel concepts Explains the historical development of various HPMVs Discusses ferries, racing and pleasure craft, as well as utility and military missions High Performance Marine Vessels is an ideal book for student...

  7. Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

    Science.gov (United States)

    Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

    2015-01-01

    Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

  8. High performance systems

    Energy Technology Data Exchange (ETDEWEB)

    Vigil, M.B. [comp.

    1995-03-01

    This document provides a written compilation of the presentations and viewgraphs from the 1994 Conference on High Speed Computing given at the High Speed Computing Conference, {open_quotes}High Performance Systems,{close_quotes} held at Gleneden Beach, Oregon, on April 18 through 21, 1994.

  9. Employment status of patients receiving maintenance dialysis – peritoneal and hemodialysis: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    B S Lakshmi

    2017-01-01

    Full Text Available The long-term dialysis therapy for end-stage renal disease takes a heavy toll of quality of life of the patient. Several factors such as fatigue and decreased physical capability, impaired social and mental functioning, contribute to this forlorn state. To meld maintenance dialysis treatment with a regular employment can be a serious test. A cross-sectional study of employment of patients on hemodialysis and peritoneal dialysis in a state government tertiary institute in South India was performed between June 2015 and December 2015. Patients who completed 3 months of regular dialysis were only included in the study. The number of patients on hemodialysis was 157 and on peritoneal dialysis was 69. The employment status before the initiation of dialysis was 60% (93 out of 155 and 63.7% (44 out of 69 in hemodialysis and peritoneal dialysis, respectively. After initiation, the loss of employment was observed in 44% (41 out of 93 in hemodialysis and 51.2% (26 out of 44 in peritoneal dialysis (P = 0.2604. Even though there was fall of absolute number of job holders in both the blue and white collar jobs, the proportion of jobholders in the white collar job holders improved. On univariate analysis, the factors which influenced the loss of employment were males, age between 50 and 60 years, number of comorbidities >2, illiteracy and blue collar versus white collar job before the initiation of dialysis. The majority of patients had the scores above 80 on Karnofsky performance scale and the majority belonged upper and middle classes than lower classes on modified Kuppuswamy's socioeconomic status scale; however, the loss of employment was also disproportionately high. There appeared a substantial difference in the attitude of the patients toward the employment. There was no difference between hemodialysis and peritoneal dialysis in the loss of employment of our patients.

  10. Responsive design high performance

    CERN Document Server

    Els, Dewald

    2015-01-01

    This book is ideal for developers who have experience in developing websites or possess minor knowledge of how responsive websites work. No experience of high-level website development or performance tweaking is required.

  11. High Performance Macromolecular Material

    National Research Council Canada - National Science Library

    Forest, M

    2002-01-01

    .... In essence, most commercial high-performance polymers are processed through fiber spinning, following Nature and spider silk, which is still pound-for-pound the toughest liquid crystalline polymer...

  12. Challenges of ECG monitoring and ECG interpretation in dialysis units.

    Science.gov (United States)

    Poulikakos, Dimitrios; Malik, Marek

    Patients on hemodialysis (HD) suffer from high cardiovascular morbidity and mortality due to high rates of coronary artery disease and arrhythmias. Electrocardiography (ECG) is often performed in the dialysis units as part of routine clinical assessment. However, fluid and electrolyte changes have been shown to affect all ECG morphologies and intervals. ECG interpretation thus depends on the time of the recording in relation to the HD session. In addition, arrhythmias during HD are common, and dialysis-related ECG artifacts mimicking arrhythmias have been reported. Studies using advanced ECG analyses have examined the impact of the HD procedure on selected repolarization descriptors and heart rate variability indices. Despite the challenges related to the impact of the fluctuant fluid and electrolyte status on conventional and advanced ECG parameters, further research in ECG monitoring during dialysis has the potential to provide clinically meaningful and practically useful information for diagnostic and risk stratification purposes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  13. Early Mortality Was Highly and Strongly Associated with Functional Status in Incident Japanese Hemodialysis Patients: A Cohort Study of the Large National Dialysis Registry.

    Directory of Open Access Journals (Sweden)

    Masahiko Yazawa

    Full Text Available Although dialysis is typically started in an effort to prolong survival, mortality is reportedly high in the first few months. However, it remains unclear whether this is true in Japanese patients who tend to have a better prognosis than other ethnicities, and if health conditions such as functional status (FS at initiation of dialysis influence prognosis.We investigated the epidemiology of early death and its association with FS using Japanese national registry data in 2007, which included 35,415 patients on incident dialysis and 7,664 with FS data. The main outcome was early death, defined as death within 3 months after initiation of hemodialysis (HD. The main predictor was FS at initiation of HD. Levels of functional disability were categorized as follows: severe (bedridden, moderate (overt difficulties in exerting basic activities of daily living, or mild/none (none or some functional disabilities.Early death remained relatively common, especially among elderly patients (overall: 7.1%; those aged ≥80 years: 15.8%. Severely and even only a moderately impaired FS were significantly associated with early death after starting dialysis (adjusted risk ratios: 3.93 and 2.38, respectively. The incidence of early death in those with impaired FS increased with age (36.5% in those with severely impaired FS and aged ≥80 years.Early death after starting dialysis was relatively common, especially among the elderly, even in Japanese patients. Further, early death was significantly associated with impaired FS at initiation of HD.

  14. The strange case of Mr. H. Starting dialysis at 90 years of age: clinical choices impact on ethical decisions.

    Science.gov (United States)

    Piccoli, Giorgina Barbara; Sofronie, Andreea Corina; Coindre, Jean-Philippe

    2017-11-09

    Starting dialysis at an advanced age is a clinical challenge and an ethical dilemma. The advantages of starting dialysis at "extreme" ages are questionable as high dialysis-related morbidity induces a reflection on the cost- benefit ratio of this demanding and expensive treatment in a person that has a short life expectancy. Where clinical advantages are doubtful, ethical analysis can help us reach decisions and find adapted solutions. Mr. H is a ninety-year-old patient with end-stage kidney disease that is no longer manageable with conservative care, in spite of optimal nutritional management, good blood pressure control and strict clinical and metabolic evaluations; dialysis is the next step, but its morbidity is challenging. The case is analysed according to principlism (beneficence, non-maleficence, justice and respect for autonomy). In the setting of care, dialysis is available without restriction; therefore the principle of justice only partially applied, in the absence of restraints on health-care expenditure. The final decision on whether or not to start dialysis rested with Mr. H (respect for autonomy). However, his choice depended on the balance between beneficence and non-maleficence. The advantages of dialysis in restoring metabolic equilibrium were clear, and the expected negative effects of dialysis were therefore decisive. Mr. H has a contraindication to peritoneal dialysis (severe arthritis impairing self-performance) and felt performing it with nursing help would be intrusive. Post dialysis fatigue, poor tolerance, hypotension and intrusiveness in daily life of haemodialysis patients are closely linked to the classic thrice-weekly, four-hour schedule. A personalized incremental dialysis approach, starting with one session per week, adapting the timing to the patient's daily life, can limit side effects and "dialysis shock". An individualized approach to complex decisions such as dialysis start can alter the delicate benefit/side-effect balance

  15. Hepatitis C virus in Vietnam: high prevalence of infection in dialysis and multi-transfused patients involving diverse and novel virus variants.

    Directory of Open Access Journals (Sweden)

    Linda Dunford

    Full Text Available Hepatitis C virus (HCV is a genetically diverse pathogen infecting approximately 2-3% of the world's population. Herein, we describe results of a large, multicentre serological and molecular epidemiological study cataloguing the prevalence and genetic diversity of HCV in five regions of Vietnam; Ha Noi, Hai Phong, Da Nang, Khanh Hoa and Can Tho. Individuals (n=8654 with varying risk factors for infection were analysed for the presence of HCV Ab/Ag and, in a subset of positive specimens, for HCV RNA levels (n=475 and genotype (n=282. In lower risk individuals, including voluntary blood donors, military recruits and pregnant women, the prevalence of infection was 0.5% (n=26/5250. Prevalence rates were significantly higher (p<0.001 in intravenous drug users (IDUs; 55.6%, n=556/1000, dialysis patients (26.6%, n=153/575 commercial sex workers (CSWs; 8.7%, n=87/1000, and recipients of multiple blood transfusions (6.0%, n=32/529. The prevalence of HCV in dialysis patients varied but remained high in all regions (11-43% and was associated with the receipt of blood transfusions [OR: 2.08 (1.85-2.34, p=0.001], time from first transfusion [OR: 1.07 (1.01-1.13, p=0.023], duration of dialysis [OR: 1.31 (1.19-1.43, p<0.001] and male gender [OR: 1.60 (1.06-2.41, p=0.026]. Phylogenetic analysis revealed high genetic diversity, particularly amongst dialysis and multi-transfused patients, identifying subtypes 1a (33%, 1b (27%, 2a (0.4%, 3a (0.7%, 3b (1.1%, 6a (18.8%, 6e (6.0%, 6h (4.6%, 6l (6.4% and 2 clusters of novel genotype 6 variants (2.1%. HCV genotype 1 predominated in Vietnam (60%, n=169/282 but the proportion of infections attributable to genotype 1 varied between regions and risk groups and, in the Southern part of Vietnam, genotype 6 viruses dominated in dialysis and multi-transfused patients (73.9%. This study confirms a high prevalence of HCV infection in Vietnamese IDUs and, notably, reveals high levels of HCV infection associated with dialysis and

  16. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

  17. Risk factors and outcomes of high peritonitis rate in continuous ambulatory peritoneal dialysis patients: A retrospective study.

    Science.gov (United States)

    Tian, Yuanshi; Xie, Xishao; Xiang, Shilong; Yang, Xin; Zhang, Xiaohui; Shou, Zhangfei; Chen, Jianghua

    2016-12-01

    Peritonitis remains a major complication of peritoneal dialysis (PD). A high peritonitis rate (HPR) affects continuous ambulatory peritoneal dialysis (CAPD) patients' technique survival and mortality. Predictors and outcomes of HPR, rather than the first peritonitis episode, were rarely studied in the Chinese population. In this study, we examined the risk factors associated with HPR and its effects on clinical outcomes in CAPD patients.This is a single center, retrospective, observational cohort study. A total of 294 patients who developing at least 1 episode of peritonitis were followed up from March 1st, 2002, to July 31, 2014, in our PD center. Multivariate logistic regression was used to determine the factors associated with HPR, and the Cox proportional hazard model was conducted to assess the effects of HPR on clinical outcomes.During the study period of 2917.5 patient-years, 489 episodes of peritonitis were recorded, and the total peritonitis rate was 0.168 episodes per patient-year. The multivariate analysis showed that factors associated with HPR include a quick occurrence of peritonitis after CAPD initiation (shorter than 12 months), and a low serum albumin level at the start of CAPD. In the Cox proportional hazard model, HPR was a significant predictor of technique failure. There were no differences between HPR and low peritonitis rate (LPR) group for all-cause mortality. However, when the peritonitis rate was considered as a continuous variable, a positive correlation was observed between the peritonitis rate and mortality.We found the quick peritonitis occurrence after CAPD and the low serum albumin level before CAPD were strongly associated with an HPR. Also, our results verified that HPR was positively correlated with technique failure. More importantly, the increase in the peritonitis rate suggested a higher risk of all-cause mortality.These results may help to identify and target patients who are at higher risk of HPR at the start of CAPD and to

  18. Clojure high performance programming

    CERN Document Server

    Kumar, Shantanu

    2013-01-01

    This is a short, practical guide that will teach you everything you need to know to start writing high performance Clojure code.This book is ideal for intermediate Clojure developers who are looking to get a good grip on how to achieve optimum performance. You should already have some experience with Clojure and it would help if you already know a little bit of Java. Knowledge of performance analysis and engineering is not required. For hands-on practice, you should have access to Clojure REPL with Leiningen.

  19. High Performance Concrete

    Directory of Open Access Journals (Sweden)

    Traian Oneţ

    2009-01-01

    Full Text Available The paper presents the last studies and researches accomplished in Cluj-Napoca related to high performance concrete, high strength concrete and self compacting concrete. The purpose of this paper is to raid upon the advantages and inconveniences when a particular concrete type is used. Two concrete recipes are presented, namely for the concrete used in rigid pavement for roads and another one for self-compacting concrete.

  20. High performance polymeric foams

    International Nuclear Information System (INIS)

    Gargiulo, M.; Sorrentino, L.; Iannace, S.

    2008-01-01

    The aim of this work was to investigate the foamability of high-performance polymers (polyethersulfone, polyphenylsulfone, polyetherimide and polyethylenenaphtalate). Two different methods have been used to prepare the foam samples: high temperature expansion and two-stage batch process. The effects of processing parameters (saturation time and pressure, foaming temperature) on the densities and microcellular structures of these foams were analyzed by using scanning electron microscopy

  1. Critical Care Dialysis System

    Science.gov (United States)

    1992-01-01

    Organon Teknika Corporation's REDY 2000 dialysis machine employs technology originally developed under NASA contract by Marquardt Corporation. The chemical process developed during the project could be applied to removing toxic waste from used dialysis fluid. This discovery led to the development of a kidney dialysis machine using "sorbent" dialysis, a method of removing urea from human blood by treating a dialysate solution. The process saves electricity and, because the need for a continuous water supply is eliminated, the patient has greater freedom.

  2. Satisfaction with care in peritoneal dialysis patients.

    Science.gov (United States)

    Kirchgessner, J; Perera-Chang, M; Klinkner, G; Soley, I; Marcelli, D; Arkossy, O; Stopper, A; Kimmel, P L

    2006-10-01

    Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL.

  3. High performance conductometry

    International Nuclear Information System (INIS)

    Saha, B.

    2000-01-01

    Inexpensive but high performance systems have emerged progressively for basic and applied measurements in physical and analytical chemistry on one hand, and for on-line monitoring and leak detection in plants and facilities on the other. Salient features of the developments will be presented with specific examples

  4. Danish High Performance Concretes

    DEFF Research Database (Denmark)

    Nielsen, M. P.; Christoffersen, J.; Frederiksen, J.

    1994-01-01

    In this paper the main results obtained in the research program High Performance Concretes in the 90's are presented. This program was financed by the Danish government and was carried out in cooperation between The Technical University of Denmark, several private companies, and Aalborg University...... concretes, workability, ductility, and confinement problems....

  5. High performance homes

    DEFF Research Database (Denmark)

    Beim, Anne; Vibæk, Kasper Sánchez

    2014-01-01

    . Consideration of all these factors is a precondition for a truly integrated practice and as this chapter demonstrates, innovative project delivery methods founded on the manufacturing of prefabricated buildings contribute to the production of high performance homes that are cost effective to construct, energy...

  6. Myths in peritoneal dialysis.

    Science.gov (United States)

    Lee, Martin B; Bargman, Joanne M

    2016-11-01

    To clarify misconceptions about the feasibility and risks of peritoneal dialysis that unnecessarily limit peritoneal dialysis uptake or continuation in patients for whom peritoneal dialysis is the preferred dialysis modality. The inappropriate choice of haemodialysis as a result of these misconceptions contributes to low peritoneal dialysis penetrance, increases transfer from peritoneal dialysis to haemodialysis, increases expenditure on haemodialysis and compromises quality of life for these patients. Peritoneal dialysis is an excellent renal replacement modality that is simple, cost-effective and provides comparable clinical outcomes to conventional in-centre haemodialysis. Unfortunately, many patients are deemed unsuitable to start or continue peritoneal dialysis because of false or inaccurate beliefs about peritoneal dialysis. Here, we examine some of these 'myths' and critically review the evidence for and against each of them. We review the feasibility and risk of peritoneal dialysis in patients with prior surgery, ostomies, obesity and mesh hernia repairs. We examine the fear of mediastinitis with peritoneal dialysis after coronary artery bypass graft surgery and the belief that the use of hypertonic glucose dialysate causes peritoneal membrane failure. By clarifying common myths about peritoneal dialysis, we hope to reduce overly cautious practices surrounding this therapy.

  7. High-Performance Networking

    CERN Multimedia

    CERN. Geneva

    2003-01-01

    The series will start with an historical introduction about what people saw as high performance message communication in their time and how that developed to the now to day known "standard computer network communication". It will be followed by a far more technical part that uses the High Performance Computer Network standards of the 90's, with 1 Gbit/sec systems as introduction for an in depth explanation of the three new 10 Gbit/s network and interconnect technology standards that exist already or emerge. If necessary for a good understanding some sidesteps will be included to explain important protocols as well as some necessary details of concerned Wide Area Network (WAN) standards details including some basics of wavelength multiplexing (DWDM). Some remarks will be made concerning the rapid expanding applications of networked storage.

  8. Dialysis search filters for PubMed, Ovid MEDLINE, and Embase databases.

    Science.gov (United States)

    Iansavichus, Arthur V; Haynes, R Brian; Lee, Christopher W C; Wilczynski, Nancy L; McKibbon, Ann; Shariff, Salimah Z; Blake, Peter G; Lindsay, Robert M; Garg, Amit X

    2012-10-01

    Physicians frequently search bibliographic databases, such as MEDLINE via PubMed, for best evidence for patient care. The objective of this study was to develop and test search filters to help physicians efficiently retrieve literature related to dialysis (hemodialysis or peritoneal dialysis) from all other articles indexed in PubMed, Ovid MEDLINE, and Embase. A diagnostic test assessment framework was used to develop and test robust dialysis filters. The reference standard was a manual review of the full texts of 22,992 articles from 39 journals to determine whether each article contained dialysis information. Next, 1,623,728 unique search filters were developed, and their ability to retrieve relevant articles was evaluated. The high-performance dialysis filters consisted of up to 65 search terms in combination. These terms included the words "dialy" (truncated), "uremic," "catheters," and "renal transplant wait list." These filters reached peak sensitivities of 98.6% and specificities of 98.5%. The filters' performance remained robust in an independent validation subset of articles. These empirically derived and validated high-performance search filters should enable physicians to effectively retrieve dialysis information from PubMed, Ovid MEDLINE, and Embase.

  9. High performance data transfer

    Science.gov (United States)

    Cottrell, R.; Fang, C.; Hanushevsky, A.; Kreuger, W.; Yang, W.

    2017-10-01

    The exponentially increasing need for high speed data transfer is driven by big data, and cloud computing together with the needs of data intensive science, High Performance Computing (HPC), defense, the oil and gas industry etc. We report on the Zettar ZX software. This has been developed since 2013 to meet these growing needs by providing high performance data transfer and encryption in a scalable, balanced, easy to deploy and use way while minimizing power and space utilization. In collaboration with several commercial vendors, Proofs of Concept (PoC) consisting of clusters have been put together using off-the- shelf components to test the ZX scalability and ability to balance services using multiple cores, and links. The PoCs are based on SSD flash storage that is managed by a parallel file system. Each cluster occupies 4 rack units. Using the PoCs, between clusters we have achieved almost 200Gbps memory to memory over two 100Gbps links, and 70Gbps parallel file to parallel file with encryption over a 5000 mile 100Gbps link.

  10. An Assessment of Dialysis Provider's Attitudes towards Timing of Dialysis Initiation in Canada

    Directory of Open Access Journals (Sweden)

    Bikaramjit S Mann

    2014-04-01

    Full Text Available Background: Physicians' perceptions and opinions may influence when to initiate dialysis. Objective: To examine providers' perspectives and opinions regarding the timing of dialysis initiation. Design: Online survey. Setting: Community and academic dialysis practices in Canada. Participants: A nationally-representative sample of dialysis providers. Measurements and Methods: Dialysis providers opinions assessing reasons to initiate dialysis at low or high eGFR. Responses were obtained using a 9-point Likert scale. Early dialysis was defined as initiation of dialysis in an individual with an eGFR greater than or equal to 10.5 ml/min/m 2 . A detailed survey was emailed to all members of the Canadian Society of Nephrology (CSN in February 2013. The survey was designed and pre-tested to evaluate duration and ease of administration. Results: One hundred and forty one (25% response rate physicians participated in the survey. The majority were from urban, academic centres and practiced in regionally administered renal programs. Very few respondents had a formal policy regarding the timing of dialysis initiation or formally reviewed new dialysis starts (N = 4, 3.1%. The majority of respondents were either neutral or disagreed that late compared to early dialysis initiation improved outcomes (85–88%, had a negative impact on quality of life (89%, worsened AVF or PD use (84–90%, led to sicker patients (83% or was cost effective (61%. Fifty-seven percent of respondents felt uremic symptoms occurred earlier in patients with advancing age or co-morbid illness. Half (51.8% of the respondents felt there was an absolute eGFR at which they would initiate dialysis in an asymptomatic patient. The majority of respondents would initiate dialysis for classic indications for dialysis, such as volume overload (90.1% and cachexia (83.7% however a significant number chose other factors that may lead them to early dialysis initiation including avoiding an emergency (28

  11. Factors Associated with Unplanned Dialysis Starts in Patients followed by Nephrologists: A Retropective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Pierre Antoine Brown

    Full Text Available The number of patients starting dialysis is increasing world wide. Unplanned dialysis starts (patients urgently starting dialysis in hospital is associated with increased costs and high morbidity and mortality. Risk factors for starting dialysis urgently in hospital have not been well studied. The primary objective of this study was to identify risk factors for unplanned dialysis starts in patients followed in a multidisciplinary chronic kidney disease (CKD clinic. We performed a retrospective cohort study of 649 advanced CKD patients followed in a multidisciplinary CKD clinic at a tertiary care hospital from January 01, 2010 to April 30, 2013. Patients were classified as unplanned start (in hospital or elective start. Multivariable logistic regression was used to identify variables associated with unplanned dialysis initiation. 184 patients (28.4% initiated dialysis, of which 76 patients (41.3% initiated dialysis in an unplanned fashion and 108 (58.7% starting electively. Unplanned start patients were more likely to have diabetes (68.4% versus 51.9%; p = 0.04, CAD (42.1% versus 24.1%; p = 0.02, congestive heart failure (36.8% versus 17.6%; p = 0.01, and were less likely to receive modality education (64.5% vs 89.8%; p < 0.01 or be assessed by a surgeon for access creation (40.8% vesrus 78.7% p < 0.01. On multivariable analysis, higher body mass index (OR 1.07, 95% CI 1.02, 1.13, and a history of congestive heart failure (OR 2.41, 95% CI 1.09, 5.41 were independently associated with an unplanned start. Unplanned dialysis initiation is common among advanced CKD patients, even if they are followed in a multidisciplinary chronic kidney disease clinic. Timely education and access creation in patients at risk may lead to lower costs and less morbidity and mortality.

  12. High performance sapphire windows

    Science.gov (United States)

    Bates, Stephen C.; Liou, Larry

    1993-02-01

    High-quality, wide-aperture optical access is usually required for the advanced laser diagnostics that can now make a wide variety of non-intrusive measurements of combustion processes. Specially processed and mounted sapphire windows are proposed to provide this optical access to extreme environment. Through surface treatments and proper thermal stress design, single crystal sapphire can be a mechanically equivalent replacement for high strength steel. A prototype sapphire window and mounting system have been developed in a successful NASA SBIR Phase 1 project. A large and reliable increase in sapphire design strength (as much as 10x) has been achieved, and the initial specifications necessary for these gains have been defined. Failure testing of small windows has conclusively demonstrated the increased sapphire strength, indicating that a nearly flawless surface polish is the primary cause of strengthening, while an unusual mounting arrangement also significantly contributes to a larger effective strength. Phase 2 work will complete specification and demonstration of these windows, and will fabricate a set for use at NASA. The enhanced capabilities of these high performance sapphire windows will lead to many diagnostic capabilities not previously possible, as well as new applications for sapphire.

  13. The Effects of High Level Magnesium Dialysis/Substitution Fluid on Magnesium Homeostasis under Regional Citrate Anticoagulation in Critically Ill.

    Directory of Open Access Journals (Sweden)

    Mychajlo Zakharchenko

    Full Text Available The requirements for magnesium (Mg supplementation increase under regional citrate anticoagulation (RCA because citrate acts by chelation of bivalent cations within the blood circuit. The level of magnesium in commercially available fluids for continuous renal replacement therapy (CRRT may not be sufficient to prevent hypomagnesemia.Patients (n = 45 on CRRT (2,000 ml/h, blood flow (Qb 100 ml/min with RCA modality (4% trisodium citrate using calcium free fluid with 0.75 mmol/l of Mg with additional magnesium substitution were observed after switch to the calcium-free fluid with magnesium concentration of 1.50 mmol/l (n = 42 and no extra magnesium replenishment. All patients had renal indications for CRRT, were treated with the same devices, filters and the same postfilter ionized calcium endpoint (<0.4 mmol/l of prefilter citrate dosage. Under the high level Mg fluid the Qb, dosages of citrate and CRRT were consequently escalated in 9h steps to test various settings.Median balance of Mg was -0.91 (-1.18 to -0.53 mmol/h with Mg 0.75 mmol/l and 0.2 (0.06-0.35 mmol/h when fluid with Mg 1.50 mmol/l was used. It was close to zero (0.02 (-0.12-0.18 mmol/h with higher blood flow and dosage of citrate, increased again to 0.15 (-0.11-0.25 mmol/h with 3,000 ml/h of high magnesium containing fluid (p<0.001. The arterial levels of Mg were mildly increased after the change for high level magnesium containing fluid (p<0.01.Compared to ordinary dialysis fluid the mildly hypermagnesemic fluid provided even balances and adequate levels within ordinary configurations of CRRT with RCA and without a need for extra magnesium replenishment.ClinicalTrials.gov Identifier: NCT01361581.

  14. [Technological advances and micro-inflammation in dialysis patients].

    Science.gov (United States)

    Ferro, Giuseppe; Ravaglia, Fiammetta; Ferrari, Elisa; Romoli, Elena; Michelassi, Stefano; Caiani, David; Pizzarelli, Francesco

    2015-01-01

    As currently performed, on line hemodiafiltration reduces, but does not normalize, the micro-inflammation of uremic patients. Recent technological advances make it possible to further reduce the inflammation connected to the dialysis treatment. 
Short bacterial DNA fragments are pro-inflammatory and can be detected in the dialysis fluids. However, their determination is not currently within normal controls of the quality of the dialysate. The scenario may change once the analysis of these fragments yields reliable, inexpensive, quick and easy to evaluate the results. At variance with standard bicarbonate dialysate, Citrate dialysate induces far less inflammation both for the well-known anti-inflammatory effect of such buffer and also because it is completely acetate free, e.g. a definitely pro-inflammatory buffer. However, the extensive use of citrate dialysate in chronic dialysis is prevented because of concerns about its potential calcium lowering effect. In our view, high convective exchange on line hemodiafiltration performed with dialysate, whose sterility and a-pirogenicity is guaranteed by increasingly sophisticated controls and with citrate buffer whose safety is certified, can serve as the gold standard of dialysis treatments in future.

  15. Peritoneal Dialysis in Asia.

    Science.gov (United States)

    Kwong, Vickie Wai-Ki; Li, Philip Kam-Tao

    2015-12-01

    There is a growing demand of dialysis in Asia for end-stage renal failure patients. Diabetes mellitus is the leading cause of end-stage renal failure in many countries in Asia. The growth of peritoneal dialysis (PD) in Asia is significant and seeing a good trend. With the enhanced practices of PD, the quality of care in PD in Asia is also improved. Overall, PD and hemodialysis (HD) are comparable in clinical outcome. There is a global trend in the reduction of peritonitis rates and Asian countries also witness such improvement. The socio-economic benefits of PD for end-stage renal failure patients in both urban and rural areas in the developed and developing regions of Asia are an important consideration. This can help to reduce the financial burden of renal failure in addressing the growing demand of patients on dialysis. Initiatives should be considered to further drive down the cost of PD in Asia. Growing demand for dialysis by an increasing number of end-stage renal failure patients requires the use of a cost-effective quality dialysis modality. PD is found to be comparable to HD in outcome and quality. In most countries in Asia, PD should be more cost-effective than HD. A 'PD-first' or a 'PD as first considered therapy' policy can be an overall strategy in many countries in Asia in managing renal failure patients, taking the examples of Hong Kong and Thailand. (1) PD is cheaper than HD and provides a better quality of life worldwide, but its prevalence is significantly lower than that of HD in all countries, with the exception of Hong Kong. Allowing reimbursement of PD but not HD has permitted to increase the use of PD over HD in many Asian countries like Hong Kong, Vietnam, Taiwan, Thailand, as well as in New Zealand and Australia over the last years. In the Western world, however, HD is still promoted, and the proportion of patients treated with PD decreases. Japan remains an exception in Asia where PD penetration is very low. Lack of adequate education of

  16. R high performance programming

    CERN Document Server

    Lim, Aloysius

    2015-01-01

    This book is for programmers and developers who want to improve the performance of their R programs by making them run faster with large data sets or who are trying to solve a pesky performance problem.

  17. EARLY APPLICATION OF HIGH CUT-OFF HAEMODYALISIS FOR DE-NOVO MYELOMA NEPHROPATHY IS ASSOCIATED WITH LONG-TERM DIALYSIS-INDEPENDENCY AND RENAL RECOVERY

    Directory of Open Access Journals (Sweden)

    Alhossain A. Khalafallah

    2013-01-01

    Full Text Available Background Multiple myeloma (MM is a haematological malignancy associated with kidney injury resulting from cast nephropathy, which can be caused by monoclonal free light chains (FLC. It has been demonstrated that reduction of FLC can lead to a higher proportion of patients recovering renal function with a better outcome, especially if extended high cut-off haemodialysis (HCO-HD combined with chemotherapy is used. Patients and Methods In this study, four cases of MM nephropathy were treated with HCO-HD and chemotherapy at a single institution during the period from August 2009 to August 2011. All of the patients presented with acute renal failure and high serum FLC. All patients underwent a bone marrow biopsy to confirm the diagnosis of MM, according to the WHO criteria. Three patients had de-novo MM and one patient had relapsed light chain myeloma disease. All patients underwent HCO-HD concomitantly with specific myeloma therapy once the diagnosis or relapse of MM was established. Results After a median follow up of 26 months, (range, 13-36 our data showed that all patients had a significant decrease in serum FLC through HCO-HD, proving the effectiveness of HCO-HD in managing MM. De-novo MM patients restored their renal function and achieved low-level FLC early on the treatment and become dialysis-independent. One patient with relapsed myeloma remained dialysis dependant. Conclusion Our study suggests that if myeloma nephropathy associated with light-chain disease, HCO-HD should be initiated as early as possible. At the same time a specific MM treatment should be initiated to gain control of the disease and salvage the kidneys in order to achieve dialysis-independency. Further trials to confirm our results are warranted. Key Words: Multiple myeloma, renal failure, High cut-off haemodialysis, chemotherapy, outcome.

  18. Advances in peritoneal dialysis

    NARCIS (Netherlands)

    Krediet, R. T.

    2007-01-01

    New peritoneal dialysis (PD) patients have a better survival than new haemodialysis (HD) patients in the first years on dialysis. During long-term treatment, this changes into a survival advantage for HD. The superior initial survival on PD is related to a better preservation of residual renal

  19. High performance work practices, innovation and performance

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Newton, Cameron; Johnston, Kim

    2013-01-01

    Research spanning nearly 20 years has provided considerable empirical evidence for relationships between High Performance Work Practices (HPWPs) and various measures of performance including increased productivity, improved customer service, and reduced turnover. What stands out from......, and Africa to examine these various questions relating to the HPWP-innovation-performance relationship. Each paper discusses a practice that has been identified in HPWP literature and potential variables that can facilitate or hinder the effects of these practices of innovation- and performance...

  20. Removal of methadone by extended dialysis using a high cut-off dialyzer: implications for the treatment of overdose and for pain management in patients undergoing light chain removal.

    Science.gov (United States)

    Arelin, Viktor; Schmidt, Julius J; Kayser, Nathalie; Kühn-Velten, W Nikolaus; Suhling, Hendrik; Eden, Gabriele; Kielstein, Jan T

    2016-06-01

    The synthetic opioid methadone hydrochloride has a low molecular weight of 346 D, a high volume of distribution (4 - 7 L/kg), and is lipophilic. It is used as an analgesic and for the maintenance treatment of opiate dependence. In drug addicts, methadone is frequently involved in mixed intoxications that can lead to death. Here we present the case of a drug addict in whom a high cut-off dialysis membrane together with extended dialysis was used in the setting of suspected overdose and acute kidney injury. Although the observed dialyzer plasma clearance (31.5 mL/min) and reduction ratio (38%) were higher than previously reported for standard hemodialysis, the total amount of methadone in the spent dialysate after 1 extended dialysis session was quite low. Hence, even extended dialysis with a high cut-off membrane does not seem to offer a clinically relevant benefit in the setting of overdose for enhanced methadone removal. On the other hand, in patients undergoing high cut-off dialysis for the removal of light chains, methadone could still be used as an analgesic without an additional dose after high cut-off hemodialysis.

  1. Postprocedural Aspiration Test to Predict Adequacy of Dialysis Following Tunneled Catheter Placement

    International Nuclear Information System (INIS)

    Smith, Jason C.; Sullivan, Kevin L.; Michael, Beckie

    2006-01-01

    The objective of the study was to determine if a timed aspiration technique with a 20-ml syringe can be used to predict adequacy of blood flow in tunneled dialysis catheters. Sixteen patients referred for de novo placement or manipulation of failing tunneled hemodialysis catheters had the time it takes to fill a 20-ml syringe with the plunger fully withdrawn measured to the nearest tenth of a second. These measurements were correlated with flow rates recorded in dialysis just prior to (if failed catheter) and in the following dialysis session with adequacy determined as at least 300 ml/min. Syringe-filling time (22 catheters in 16 patients) was plotted against adequacy of dialysis. The mean time to fill a 20-ml syringe was 2.2 sec, with a range of 1.0-4.7 sec. The mean time to fill syringes for catheters with adequate dialysis was 1.7 ± 0.5 sec, and for inadequate catheters, it was 2.8 ± 0.8 sec. These differences are statistically significant (p < 0.001). Using a filling time of greater than or equal to 2 sec as a threshold gives the highest sensitivity (100%) for predicting inadequate dialysis while maintaining high specificity (75%). To achieve a specificity of 100%, a 3-sec cutoff would be necessary, but would lead to a sensitivity of only 20%. A simple and objective aspiration technique can be performed at the time of tunneled dialysis catheter placement/manipulation to reasonably predict adequacy of subsequent dialysis

  2. Python high performance programming

    CERN Document Server

    Lanaro, Gabriele

    2013-01-01

    An exciting, easy-to-follow guide illustrating the techniques to boost the performance of Python code, and their applications with plenty of hands-on examples.If you are a programmer who likes the power and simplicity of Python and would like to use this language for performance-critical applications, this book is ideal for you. All that is required is a basic knowledge of the Python programming language. The book will cover basic and advanced topics so will be great for you whether you are a new or a seasoned Python developer.

  3. High performance germanium MOSFETs

    Energy Technology Data Exchange (ETDEWEB)

    Saraswat, Krishna [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States)]. E-mail: saraswat@stanford.edu; Chui, Chi On [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Krishnamohan, Tejas [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Kim, Donghyun [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Nayfeh, Ammar [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States); Pethe, Abhijit [Department of Electrical Engineering, Stanford University, Stanford, CA 94305 (United States)

    2006-12-15

    Ge is a very promising material as future channel materials for nanoscale MOSFETs due to its high mobility and thus a higher source injection velocity, which translates into higher drive current and smaller gate delay. However, for Ge to become main-stream, surface passivation and heterogeneous integration of crystalline Ge layers on Si must be achieved. We have demonstrated growth of fully relaxed smooth single crystal Ge layers on Si using a novel multi-step growth and hydrogen anneal process without any graded buffer SiGe layer. Surface passivation of Ge has been achieved with its native oxynitride (GeO {sub x}N {sub y} ) and high-permittivity (high-k) metal oxides of Al, Zr and Hf. High mobility MOSFETs have been demonstrated in bulk Ge with high-k gate dielectrics and metal gates. However, due to their smaller bandgap and higher dielectric constant, most high mobility materials suffer from large band-to-band tunneling (BTBT) leakage currents and worse short channel effects. We present novel, Si and Ge based heterostructure MOSFETs, which can significantly reduce the BTBT leakage currents while retaining high channel mobility, making them suitable for scaling into the sub-15 nm regime. Through full band Monte-Carlo, Poisson-Schrodinger and detailed BTBT simulations we show a dramatic reduction in BTBT and excellent electrostatic control of the channel, while maintaining very high drive currents in these highly scaled heterostructure DGFETs. Heterostructure MOSFETs with varying strained-Ge or SiGe thickness, Si cap thickness and Ge percentage were fabricated on bulk Si and SOI substrates. The ultra-thin ({approx}2 nm) strained-Ge channel heterostructure MOSFETs exhibited >4x mobility enhancements over bulk Si devices and >10x BTBT reduction over surface channel strained SiGe devices.

  4. High performance germanium MOSFETs

    International Nuclear Information System (INIS)

    Saraswat, Krishna; Chui, Chi On; Krishnamohan, Tejas; Kim, Donghyun; Nayfeh, Ammar; Pethe, Abhijit

    2006-01-01

    Ge is a very promising material as future channel materials for nanoscale MOSFETs due to its high mobility and thus a higher source injection velocity, which translates into higher drive current and smaller gate delay. However, for Ge to become main-stream, surface passivation and heterogeneous integration of crystalline Ge layers on Si must be achieved. We have demonstrated growth of fully relaxed smooth single crystal Ge layers on Si using a novel multi-step growth and hydrogen anneal process without any graded buffer SiGe layer. Surface passivation of Ge has been achieved with its native oxynitride (GeO x N y ) and high-permittivity (high-k) metal oxides of Al, Zr and Hf. High mobility MOSFETs have been demonstrated in bulk Ge with high-k gate dielectrics and metal gates. However, due to their smaller bandgap and higher dielectric constant, most high mobility materials suffer from large band-to-band tunneling (BTBT) leakage currents and worse short channel effects. We present novel, Si and Ge based heterostructure MOSFETs, which can significantly reduce the BTBT leakage currents while retaining high channel mobility, making them suitable for scaling into the sub-15 nm regime. Through full band Monte-Carlo, Poisson-Schrodinger and detailed BTBT simulations we show a dramatic reduction in BTBT and excellent electrostatic control of the channel, while maintaining very high drive currents in these highly scaled heterostructure DGFETs. Heterostructure MOSFETs with varying strained-Ge or SiGe thickness, Si cap thickness and Ge percentage were fabricated on bulk Si and SOI substrates. The ultra-thin (∼2 nm) strained-Ge channel heterostructure MOSFETs exhibited >4x mobility enhancements over bulk Si devices and >10x BTBT reduction over surface channel strained SiGe devices

  5. High Performance Computing Multicast

    Science.gov (United States)

    2012-02-01

    A History of the Virtual Synchrony Replication Model,” in Replication: Theory and Practice, Charron-Bost, B., Pedone, F., and Schiper, A. (Eds...Performance Computing IP / IPv4 Internet Protocol (version 4.0) IPMC Internet Protocol MultiCast LAN Local Area Network MCMD Dr. Multicast MPI

  6. NGINX high performance

    CERN Document Server

    Sharma, Rahul

    2015-01-01

    System administrators, developers, and engineers looking for ways to achieve maximum performance from NGINX will find this book beneficial. If you are looking for solutions such as how to handle more users from the same system or load your website pages faster, then this is the book for you.

  7. The influence of renal dialysis and hip fracture sites on the 10-year mortality of elderly hip fracture patients

    Science.gov (United States)

    Hung, Li-Wei; Hwang, Yi-Ting; Huang, Guey-Shiun; Liang, Cheng-Chih; Lin, Jinn

    2017-01-01

    Abstract Hip fractures in older people requiring dialysis are associated with high mortality. Our study primarily aimed to evaluate the specific burden of dialysis on the mortality rate following hip fracture. The secondary aim was to clarify the effect of the fracture site on mortality. A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database to analyze nationwide health data regarding dialysis and non-dialysis patients ≥65 years who sustained a first fragility-related hip fracture during the period from 2001 to 2005. Each dialysis hip fracture patient was age- and sex-matched to 5 non-dialysis hip fracture patients to construct the matched cohort. Survival status of patients was followed-up until death or the end of 2011. Survival analyses using multivariate Cox proportional hazards models and the Kaplan-Meier estimator were performed to compare between-group survival and impact of hip fracture sites on mortality. A total of 61,346 hip fracture patients were included nationwide. Among them, 997 dialysis hip fracture patients were identified and matched to 4985 non-dialysis hip fracture patients. Mortality events were 155, 188, 464, and 103 in the dialysis group, and 314, 382, 1505, and 284 in the non-dialysis group, with adjusted hazard ratios (associated 95% confidence intervals) of 2.58 (2.13–3.13), 2.95 (2.48–3.51), 2.84 (2.55–3.15), and 2.39 (1.94–2.93) at 0 to 3 months, 3 months to 1 year, 1 to 6 years, and 6 to 10 years after the fracture, respectively. In the non-dialysis group, survival was consistently better for patients who sustained femoral neck fractures compared to trochanteric fractures (0–10 years’ log-rank test, P fractures was better than that of patients with trochanteric fractures only within the first 6 years post-fracture (0–6 years’ log-rank, P fracture patients. Survival outcome was better for non-dialysis patients with femoral neck fractures compared to those with

  8. Peritoneal Dialysis Tailored to Pediatric Needs

    Directory of Open Access Journals (Sweden)

    C. P. Schmitt

    2011-01-01

    Full Text Available Consideration of specific pediatric aspects is essential to achieve adequate peritoneal dialysis (PD treatment in children. These are first of all the rapid growth, in particular during infancy and puberty, which must be accompanied by a positive calcium balance, and the age dependent changes in body composition. The high total body water content and the high ultrafiltration rates required in anuric infants for adequate nutrition predispose to overshooting convective sodium losses and severe hypotension. Tissue fragility and rapid increases in intraabdominal fat mass predispose to hernia and dialysate leaks. Peritoneal equilibration tests should repeatedly been performed to optimize individual dwell time. Intraperitoneal pressure measurements give an objective measure of intraperitoneal filling, which allow for an optimized dwell volume, that is, increased dialysis efficiency without increasing the risk of hernias, leaks, and retrofiltration. We present the concept of adapted PD, that is, the combination of short dwells with low fill volume to promote ultrafiltration and long dwells with a high fill volume to improve purification within one PD session. The use of PD solutions with low glucose degradation product content is recommended in children, but unfortunately still not feasible in many countries.

  9. Standardization of heparins by means of high performance liquid chromatography equipped with a low angle laser light scattering detector

    NARCIS (Netherlands)

    Hennink, W.E.; van den Berg, J.W.A.; Feijen, Jan

    1987-01-01

    This study shows that HPLC-LALLS (high performance liquid chromatography with a light-scattering detector) is a convenient and reliable method for the characterization of standard heparin samples, provided that polyelectrolyte artefacts are suppressed by a suitable dialysis procedure. The method has

  10. Amyloidosis associated with dialysis

    International Nuclear Information System (INIS)

    Schadmand, S.; Klose, K.J.; Wandel, E.

    1991-01-01

    Amongst the complications of dialysis, amyloid osteopathy is getting increasingly significant. It is due to deposition of β2-microglobulin. To determine the incidence and time of development of this complication, the skeletal radiographs of 185 patients undergoing dialysis, some for up to ten years, were analysed retrospectively. In about 10% of patients, the presence of β2-microglobulin osteopathy may be expected. The radiological features, sites of predilection and differential diagnosis of amyloid osteopathy and of other skeletal changes due to dialysis are discussed. (orig.) [de

  11. High performance proton accelerators

    International Nuclear Information System (INIS)

    Favale, A.J.

    1989-01-01

    In concert with this theme this paper briefly outlines how Grumman, over the past 4 years, has evolved from a company that designed and fabricated a Radio Frequency Quadrupole (RFQ) accelerator from the Los Alamos National Laboratory (LANL) physics and specifications to a company who, as prime contractor, is designing, fabricating, assembling and commissioning the US Army Strategic Defense Commands (USA SDC) Continuous Wave Deuterium Demonstrator (CWDD) accelerator as a turn-key operation. In the case of the RFQ, LANL scientists performed the physics analysis, established the specifications supported Grumman on the mechanical design, conducted the RFQ tuning and tested the RFQ at their laboratory. For the CWDD Program Grumman has the responsibility for the physics and engineering designs, assembly, testing and commissioning albeit with the support of consultants from LANL, Lawrence Berkeley Laboratory (LBL) and Brookhaven National laboratory. In addition, Culham Laboratory and LANL are team members on CWDD. LANL scientists have reviewed the physics design as well as a USA SDC review board. 9 figs

  12. A call to arms: economic barriers to optimal dialysis care.

    Science.gov (United States)

    McFarlane, P A; Mendelssohn, D C

    2000-01-01

    Epidemic growth rates and the enormous cost of dialysis pressure end-stage renal disease (ESRD) delivery systems around the world. Payers of dialysis services can constrain costs through (1) limiting access to dialysis, (2) reducing the quality of dialysis, and (3) placing constraints on modality distribution. In order to secure the necessary resources for ESRD care, we propose that the nephrology community consider the following suggestions: First, future leaders in dialysis should acquire additional advanced training in innovative pathways such as health care economics, business and health care administration, and health care policy. Second, the international nephrology community must strongly engage in ongoing advocacy for accessible, high quality, cost-effective care.Third, efforts should be made to better define and then implement optimal dialysis modality distributions that maximize patient outcomes but limit unnecessary costs. Fourth, industry should be encouraged to lower the unit cost of dialysis, allowing for improved access to dialysis, especially in developing countries. Fifth, research should be encouraged that seeks to identify measures that will reduce dialysis costs but will not impair quality of care. Finally, early referral of patients with progressive renal disease to nephrology clinics, empowerment of informed patient choice of dialysis modality, and proper and timely access creation should be encouraged and can be expected to help limit overall expenditures. Ongoing efforts in these areas by the nephrology community will be essential if we are to overcome the challenges of ESRD growth in this new decade.

  13. Peritoneal Dialysis in Children*

    African Journals Online (AJOL)

    1971-06-02

    Jun 2, 1971 ... efficiency due to vasodilatation of the peritoneal vessels.' DIALYSIS ... osmotic load in the face of a decreasing blood urea and may thus help ... infection, heart failure, sodium and volume de- depletion; ..... around the catheter.

  14. Dialysis Extraction for Chromatography

    Science.gov (United States)

    Jahnsen, V. J.

    1985-01-01

    Chromatographic-sample pretreatment by dialysis detects traces of organic contaminants in water samples analyzed in field with minimal analysis equipment and minimal quantities of solvent. Technique also of value wherever aqueous sample and solvent must not make direct contact.

  15. Dialysis Facility Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Dialysis Facility Compare Website provided by the Centers for Medicare and Medicaid Services. These data...

  16. Your Dialysis Care Team

    Science.gov (United States)

    ... A to Z Health Guide Your Dialysis Care Team Tweet Share Print Email Good health care is ... dialyzers (artificial kidneys) for reuse. Vascular Access Care Team If you are a hemodialysis patient, another group ...

  17. Non-machinery dialysis that achieves blood purification therapy without using full-scale dialysis machines.

    Science.gov (United States)

    Abe, Takaya; Onoda, Mistutaka; Matsuura, Tomohiko; Sugimura, Jun; Obara, Wataru; Sato, Toshiya; Takahashi, Mihoko; Chiba, Kenta; Abe, Tomiya

    2017-09-01

    An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury. The non-machinery dialysis potassium removal rate was at the same level as continuous blood purification machines with a dialysate flow rate of 5 L/h after 15 min and continuous blood purification machines with a dialysate flow rate of 3 L/h after 30 min. Non-machinery dialysis required an exclusive dialysate circuit, the frequent need to replace bags, and new dialysate exchanged once every 30 min. However, it can be seen as an effective renal replacement therapy for crush-related acute kidney injury patients, even in locations or facilities not having the full-scale dialysis machines.

  18. Dialysis access, infections, and hospitalisations in unplanned dialysis start patients

    DEFF Research Database (Denmark)

    Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

    2017-01-01

    Introduction: Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient ou...

  19. Determination of the total concentration of highly protein-bound drugs in plasma by on-line dialysis and column liquid chromatography: application to non-steroidal anti-inflammatory drugs.

    NARCIS (Netherlands)

    Herraez-Hernandez, R.; van de Merbel, N.C.; Brinkman, U.A.T.

    1995-01-01

    The potential of on-line dialysis as a sample preparation procedure for compounds highly bound to plasma proteins is evaluated, using non-steroidal anti-inflammatory drugs as model compounds and column liquid chromatography as the separation technique. Different strategies to reduce the degree of

  20. Determination of the total concentration of highly protein-bound drugs in plasma by on-line dialysis and column liquid chromatography : application to non-steroidal anti-inflammatory drugs

    NARCIS (Netherlands)

    Herráez-Hernández, R; van de Merbel, N C; Brinkman, U A

    1995-01-01

    The potential of on-line dialysis as a sample preparation procedure for compounds highly bound to plasma proteins is evaluated, using non-steroidal anti-inflammatory drugs as model compounds and column liquid chromatography as the separation technique. Different strategies to reduce the degree of

  1. Spatial Analysis of Case-Mix and Dialysis Modality Associations.

    Science.gov (United States)

    Phirtskhalaishvili, Tamar; Bayer, Florian; Edet, Stephane; Bongiovanni, Isabelle; Hogan, Julien; Couchoud, Cécile

    2016-01-01

    ♦ Health-care systems must attempt to provide appropriate, high-quality, and economically sustainable care that meets the needs and choices of patients with end-stage renal disease (ESRD). France offers 9 different modalities of dialysis, each characterized by dialysis technique, the extent of professional assistance, and the treatment site. The aim of this study was 1) to describe the various dialysis modalities in France and the patient characteristics associated with each of them, and 2) to analyze their regional patterns to identify possible unexpected associations between case-mixes and dialysis modalities. ♦ The clinical characteristics of the 37,421 adult patients treated by dialysis were described according to their treatment modality. Agglomerative hierarchical cluster analysis was used to aggregate the regions into clusters according to their use of these modalities and the characteristics of their patients. ♦ The gradient of patient characteristics was similar from home hemodialyis (HD) to in-center HD and from non-assisted automated peritoneal dialysis (APD) to assisted continuous ambulatory peritoneal dialysis (CAPD). Analyzing their spatial distribution, we found differences in the patient case-mix on dialysis across regions but also differences in the health-care provided for them. The classification of the regions into 6 different clusters allowed us to detect some unexpected associations between case-mixes and treatment modalities. ♦ The 9 modalities of treatment available make it theoretically possible to adapt treatment to patients' clinical characteristics and abilities. However, although we found an overall appropriate association of dialysis modalities to the case-mix, major inter-region heterogeneity and the low rate of peritoneal dialysis (PD) and home HD suggest that factors besides patients' clinical conditions impact the choice of dialysis modality. The French organization should now be evaluated in terms of patients' quality of

  2. High Performance Networks for High Impact Science

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Mary A.; Bair, Raymond A.

    2003-02-13

    This workshop was the first major activity in developing a strategic plan for high-performance networking in the Office of Science. Held August 13 through 15, 2002, it brought together a selection of end users, especially representing the emerging, high-visibility initiatives, and network visionaries to identify opportunities and begin defining the path forward.

  3. Filtering Dialysis Myths from Facts

    Science.gov (United States)

    ... to work. Fact: Many dialysis patients continue to work, go to school, or volunteer . Some take time off when they first start dialysis treatment and back to work or school after they have gotten used to ...

  4. Cardiovascular and noncardiovascular mortality among patients starting dialysis

    DEFF Research Database (Denmark)

    de Jager, Dinanda J; Grootendorst, Diana C; Jager, Kitty J

    2009-01-01

    CONTEXT: Cardiovascular mortality is considered the main cause of death in patients receiving dialysis and is 10 to 20 times higher in such patients than in the general population. OBJECTIVE: To evaluate if high overall mortality in patients starting dialysis is a consequence of increased cardiov...

  5. RavenDB high performance

    CERN Document Server

    Ritchie, Brian

    2013-01-01

    RavenDB High Performance is comprehensive yet concise tutorial that developers can use to.This book is for developers & software architects who are designing systems in order to achieve high performance right from the start. A basic understanding of RavenDB is recommended, but not required. While the book focuses on advanced topics, it does not assume that the reader has a great deal of prior knowledge of working with RavenDB.

  6. High-Performance Operating Systems

    DEFF Research Database (Denmark)

    Sharp, Robin

    1999-01-01

    Notes prepared for the DTU course 49421 "High Performance Operating Systems". The notes deal with quantitative and qualitative techniques for use in the design and evaluation of operating systems in computer systems for which performance is an important parameter, such as real-time applications......, communication systems and multimedia systems....

  7. The Green Dialysis Survey: Establishing a Baseline for Environmental Sustainability across Dialysis Facilities in Victoria, Australia.

    Science.gov (United States)

    Barraclough, Katherine A; Gleeson, Alice; Holt, Stephen G; Agar, John Wm

    2017-11-02

    The Green Dialysis Survey aimed to 1) establish a baseline for environmental sustainability (ES) across Victorian dialysis facilities, and 2) guide future initiatives to reduce the environmental impact of dialysis delivery. Nurse unit managers of all Victorian public dialysis facilities received an online link to the survey, which asked 107 questions relevant to the ES of dialysis services. Responses were received from 71/83 dialysis facilities in Victoria (86%), representing 628/660 dialysis chairs (95%). Low energy lighting was present in 13 facilities (18%), 18 (25%) recycled reverse osmosis water and 7 (10%) reported use of renewable energy. Fifty-six facilities (79%) performed comingled recycling but only 27 (38%) recycled polyvinyl chloride plastic. A minority educated staff in appropriate waste management (n=30;42%) or formally audited waste generation and segregation (n=19;27%). Forty-four (62%) provided secure bicycle parking but only 33 (46%) provided shower and changing facilities. There was limited use of tele- or video-conferencing to replace staff meetings (n=19;27%) or patient clinic visits (n=13;18%). A minority considered ES in procurement decisions (n=28;39%) and there was minimal preparedness to cope with climate change. Only 39 services (49%) confirmed an ES policy and few had ever formed a green group (n=14; 20%) or were currently undertaking a green project (n=8;11%). Only 15 facilities (21%) made formal efforts to raise awareness of ES. This survey provides a baseline for practices that potentially impact the environmental sustainability of dialysis units in Victoria, Australia. It also identifies achievable targets for attention. This article is protected by copyright. All rights reserved.

  8. Performance of the Modified Mini-Mental State Examination (3MS) in Assessing Specific Cognitive Function in Patients Undergoing Peritoneal Dialysis

    Science.gov (United States)

    Li, Yi; Tian, Xue; Xiong, Zu-Ying; Liao, Jin-Lan; Hao, Li; Liu, Gui-Ling; Ren, Ye-Ping; Wang, Qin; Duan, Li-Ping; Zheng, Zhao-Xia; Quan, Wen-Xiang; Dong, Jie

    2016-01-01

    Purpose While Cognitive impairment (CI) has been identified as an independent risk factors for mortality in patients undergoing peritoneal dialysis (PD), it is inadequately assessed. We evaluated the applicability of the Modified Mini-Mental State Examination (3MS) in assessing specific cognitive function and compared it to a detailed neuropsychological test battery as the reference standard. Methods In this multicentric cross-sectional study, we enrolled 445 clinically stable patients from five PD units, who were undergoing PD for at least 3 months. The 3MS was evaluated for general cognitive function. A detailed neuropsychological battery including domains of immediate memory, delayed memory, executive function, language, and visuospatial ability were evaluated as reference standards. Sensitivity and specificity of the 3MS was determined by using receiver operating characteristic (ROC) analysis. Results The CI prevalence evaluated by 3MS was 23.6%. PD patients with CI performed worse in all cognitive domains. The 3MS correlated well with specific cognitive domains. However, 18.5%, 57.4%, 12.6%, 8.8%, and 41.2% of patients whom were idendified as normal by 3MS still showed executive dysfunction, immediate memory impairment, delayed memory impairment, and language-ability and visuospatial-ability impairment, respectively. The 3MS identified patients having specific cognitive dysfunction with varied extent of diagnostic value, with 0.50, 0.42, 0.35, 0.34, and 0.26 of Youden index in executive function, delayed memory, language ability, immediate memory, and visuospatial ability, respectively. Conclusions The 3MS is not a comprehensive instrument for major cognitive domains in PD patients. It could, however, be used for executive dysfunction and delayed memory impairment screening. PMID:27911914

  9. Enhanced H-filter based on Fåhræus-Lindqvist effect for efficient and robust dialysis without membrane.

    Science.gov (United States)

    Zheng, Wei-Chao; Xie, Rui; He, Li-Qun; Xi, Yue-Heng; Liu, Ying-Mei; Meng, Zhi-Jun; Wang, Wei; Ju, Xiao-Jie; Chen, Gang; Chu, Liang-Yin

    2015-07-01

    A novel microfluidic device for highly efficient and robust dialysis without membrane is highly desired for the development of portable or wearable microdialyzer. Here we report an enhanced H-filter with pillar array based on Fåhræus-Lindqvist effect (F-L effect) for highly efficient and robust membraneless dialysis of simplified blood for the first time. The H-filter employs two fluids laminarly flowing in the microchannel for continuously membraneless dialysis. With pillar array in the microchannel, the two laminar flows, with one containing blood cells and small molecules and another containing dialyzate solution, can form a cell-free layer at the interface as selective zones for separation. This provides enhanced mixing yet extremely low shear for extraction of small molecules from the blood-cell-containing flow into the dialyzate flow, resulting in robust separation with reduced cell loss and improved efficiency. We demonstrate this by first using Chlorella pyrenoidosa as model cells to quantitatively study the separation performances, and then using simplified human blood for dialysis. The advanced H-filter, with highly efficient and robust performance for membraneless dialysis, shows great potential as promising candidate for rapid blood analysis/separation, and as fundamental structure for portable dialyzer.

  10. Peritoneal Dialysis in Children*

    African Journals Online (AJOL)

    1971-06-02

    Jun 2, 1971 ... cellular fluid' into the peritoneal cavity allows both the removal of excess fluid ... occur. In adults the maximum peritoneal urea clearance is ob- tained with a dialysis ..... and Records. Pulse and respiration rates, temperature and blood .... diffusion of urea out of the brain cells, with consequent movement of ...

  11. Optimizing home dialysis: role of hemodiafiltration.

    Science.gov (United States)

    Vilar, Enric; Farrington, Ken; Bates, Chris; Mumford, Carol; Greenwood, Roger

    2011-01-01

    Over the last 40 years the technical obstacles which prevented a convective contribution to diffusive dialysis have been overcome. Hemodiafiltration represents a natural evolution of intermittent extracorporeal blood purification and the technology is now available to offer this as standard treatment in-center. The first randomized control trial of dialysis dose (National Cooperative Dialysis Study) showed that for three times weekly dialysis a critical level of urea clearance was necessary to ensure complication-free survival, the effect being noticeable by 3 months. Following this, observational studies suggested that higher doses improved longer term outcome. In a second large randomized controlled study (HEMO), higher small molecule clearance did not further improve outcome, but high-flux membranes, which permitted enhanced clearance of middle molecules, appeared to confer survival benefit in patients who had already been on dialysis > 3.7 years. Recently, outcomes from the Membrane Permeability Outcome study confirmed a survival benefit of high-flux membranes in high-risk patients. These studies indicate that in the medium term survival is critically dependent on achieving a minimum level of small solute removal. However, longer term survival (measured in years or decades) not only requires better small solute clearance but also enhanced clearance of middle molecules, the toxicity of which manifest over longer time scales. The rationale for convective treatment is strongest, therefore in those patients who have the greatest potential for long-term survival. Patients who opt for self-care at home to allow frequent dialysis generally are constituents of this group. Hemodiafiltration is likely to become standard therapy in-center and in the home. Copyright © 2011 S. Karger AG, Basel.

  12. Predictors of chain acquisition among independent dialysis facilities.

    Science.gov (United States)

    Pozniak, Alyssa S; Hirth, Richard A; Banaszak-Holl, Jane; Wheeler, John R C

    2010-04-01

    To determine the predictors of chain acquisition among independent dialysis providers. Retrospective facility-level data combined from CMS Cost Reports, Medical Evidence Forms, Annual Facility Surveys, and claims for 1996-2003. Independent dialysis facilities' probability of acquisition by a dialysis chain (overall and by chain size) was estimated using a discrete time hazard rate model, controlling for financial and clinical performance, practice patterns, market factors, and other facility characteristics. The sample includes all U.S. freestanding dialysis facilities that report not being chain affiliated for at least 1 year between 1997 and 2003. Above-average costs and better quality outcomes are significant determinants of dialysis chain acquisition. Facilities in larger markets were more likely to be acquired by a chain. Furthermore, small dialysis chains have different acquisition strategies than large chains. Dialysis chains appear to employ a mix of turn-around and cream-skimming strategies. Poor financial health is a predictor of chain acquisition as in other health care sectors, but the increased likelihood of chain acquisition among higher quality facilities is unique to the dialysis industry. Significant differences among predictors of acquisition by small and large chains reinforce the importance of using a richer classification for chain status.

  13. Croatian Recommendations for Dialysis of HIV-Positive Patients

    Directory of Open Access Journals (Sweden)

    Gulin Marijana

    2016-06-01

    Full Text Available Human immunodeficiency virus (HIV infection may be associated with renal impairment since about 0.4% of all HIV-positive patients develop end-stage renal disease. The share of patients with HIV infection in hemodialysis centers throughout the world ranges from 0.3% to as high as 38%. In Croatia, renal replacement therapy was needed by 1% of all the HIV-positive patients from 1985 until the end of 2014. Healthcare professionals (HP should be aware of the risks of occupational exposure to blood-borne infections in their daily work. Performing dialysis in HIV-positive patients increases the risk of exposure to HIV during the extracorporeal circulation of the infected blood. However, post-exposure prophylaxis (PEP with effective antiretroviral drugs significantly reduces the risk of infection after occupational exposure. On behalf of the Croatian Society of Nephrology, Dialysis and Transplantation, the authors of this paper have proposed recommendations for the management of HIVpositive patients on dialysis, which aim to prevent the transmission of HIV among patients and HPs. The important recommendations include the following: 1. when the need arises, it is necessary to provide HIV-positive patients with dialysis in the vicinity of their place of residence. 2. HIV-positive patients should be dialyzed with a separate hemodialysis machine in an isolated area. Alternatively, they can be dialyzed in an area for the hemodialysis of HCV-positive and/or HBVpositive patients. 3. Specialized and trained personnel should be provided during the hemodialysis procedure, together with strict compliance with the standard precautions for the prevention of blood-borne infections. 4. There should be a good and prompt cooperation with the National Referral Center for HIV infection.

  14. The Manchester contribution to peritoneal dialysis

    NARCIS (Netherlands)

    Krediet, Raymond T.

    2011-01-01

    Two names emerge when considering the contribution of Manchester in the development of peritoneal dialysis (PD). The first is Ram Gokal; the second is icodextrin. As there will be a separate article on icodextrin, this one will focus more on other aspects of the activities performed by the Renal

  15. Fungal peritonitis in children on peritoneal dialysis.

    NARCIS (Netherlands)

    Raaijmakers, R.; Schroder, C.; Monnens, L.A.H.; Cornelissen, E.A.M.; Warris, A.

    2007-01-01

    Fungal peritonitis is a rare but serious complication in children on peritoneal dialysis (PD). In this study, risk factors were evaluated, and therapeutic measures were reviewed. A retrospective, multi-centre study was performed in 159 Dutch paediatric PD patients, between 1980 and 2005 (3,573

  16. Identifying High Performance ERP Projects

    OpenAIRE

    Stensrud, Erik; Myrtveit, Ingunn

    2002-01-01

    Learning from high performance projects is crucial for software process improvement. Therefore, we need to identify outstanding projects that may serve as role models. It is common to measure productivity as an indicator of performance. It is vital that productivity measurements deal correctly with variable returns to scale and multivariate data. Software projects generally exhibit variable returns to scale, and the output from ERP projects is multivariate. We propose to use Data Envelopment ...

  17. INL High Performance Building Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Jennifer D. Morton

    2010-02-01

    High performance buildings, also known as sustainable buildings and green buildings, are resource efficient structures that minimize the impact on the environment by using less energy and water, reduce solid waste and pollutants, and limit the depletion of natural resources while also providing a thermally and visually comfortable working environment that increases productivity for building occupants. As Idaho National Laboratory (INL) becomes the nation’s premier nuclear energy research laboratory, the physical infrastructure will be established to help accomplish this mission. This infrastructure, particularly the buildings, should incorporate high performance sustainable design features in order to be environmentally responsible and reflect an image of progressiveness and innovation to the public and prospective employees. Additionally, INL is a large consumer of energy that contributes to both carbon emissions and resource inefficiency. In the current climate of rising energy prices and political pressure for carbon reduction, this guide will help new construction project teams to design facilities that are sustainable and reduce energy costs, thereby reducing carbon emissions. With these concerns in mind, the recommendations described in the INL High Performance Building Strategy (previously called the INL Green Building Strategy) are intended to form the INL foundation for high performance building standards. This revised strategy incorporates the latest federal and DOE orders (Executive Order [EO] 13514, “Federal Leadership in Environmental, Energy, and Economic Performance” [2009], EO 13423, “Strengthening Federal Environmental, Energy, and Transportation Management” [2007], and DOE Order 430.2B, “Departmental Energy, Renewable Energy, and Transportation Management” [2008]), the latest guidelines, trends, and observations in high performance building construction, and the latest changes to the Leadership in Energy and Environmental Design

  18. High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Xiangxue Lu

    2018-03-01

    Full Text Available Background/Aims: Chronic inflammation is associated with increased risk of cardiovascular death in patients with end-stage renal disease (ESRD. Although elevated neutrophil-to-lymphocyte ratio (NLR, a novel inflammatory marker, has been shown to predict cardiovascular disease and all-cause mortality in the general population, limited evidence is available for its role in ESRD. Methods: We enrolled 86 patients undergoing peritoneal dialysis (PD for a 36-month follow-up to investigate the association between the NLR and arterial stiffness markers, namely, carotid-femoral pulse wave velocity (cfPWV and carotid augmentation index (AIx, and mortality in PD patients. The primary endpoints were cardiovascular mortality and all-cause mortality. Kaplan–Meier curves were used to show the cumulative incidence of cardiovascular mortality and all-cause mortality. Results: High NLR was found to be a predictor of increased cfPWV (β = 1.150; P < 0.001 and AIx (β = 3.945; P < 0.001 in patients on PD. Patients with higher NLR had lower survival during follow-up. Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with NLR ≥ 4.5 (both P < 0.01. Conclusion: Our results suggest that high NLR is independently associated with arterial stiffness and predicts cardiovascular and all-cause mortality in PD patients.

  19. [Liver albumin dialysis (MARS)--treatment of choice in Amanita phalloides poisoning?].

    Science.gov (United States)

    Hydzik, Piotr; Gawlikowski, Tomasz; Ciszowski, Krzysztof; Kwella, Norbert; Sein Anand, Jacek; Wójcicki, Maciej; Lubikowski, Jerzy; Czupryńska, Małgorzata

    2005-01-01

    Amanita phalloides is a direct life-threatening poisoning because of acute multiorgan failure. Urgent liver transplantation (LTx) is the last chance to save patient's life in severe cases. In many cases of mushroom poisoning the patient dies because of unavailability of a liver graft. Liver albumin dialysis (MARS) is a promising treatment to bridge the patient to LTx or stabilize his or her condition until spontaneous liver regeneration occurs. Four family members (father, mother and two sons) were eating self-collected mushrooms (Russula vesca). Typically for the Amanita phalloides poisoning, the first symptoms appeared in all persons more than 12 hours after mushroom ingestion. Because they did not improve, the whole family was admitted to the Regional Hospital in Ketrzyn (24 hours after mushroom ingestion). Mycological examination of gastric washings was positive only in the mother, in whom the Amanita phalloides spores were found. During the first 48 hours of poisoning the biochemical indexes of liver injury were observed in all persons. The whole family members were sent to centers where liver albumin dialysis could be performed: the mother was admitted to the Department of Nephrology and Dialysis Therapy in Olsztyn, the father and the first son were admitted to the Clinical Toxicology Department in Krak6w, and the second son was admitted to the Department of Internal Medicine and Acute Poisonings in Gdańsk. Three albumin dialysis procedures were performed in the case of mother with complete liver recovery. After the first liver albumin dialysis, the father of the family was disqualified from the following procedures because of severe coagulation disturbances (GI bleeding), and died the fourth day after mushroom ingestion. The first son fulfilled the King's College criteria and was accepted for high urgency liver transplantation. After two albumin dialysis procedures had been able and the patient was urgently sent to the Department of General and

  20. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers

    Directory of Open Access Journals (Sweden)

    Wang Virginia

    2013-01-01

    Full Text Available Abstract Background Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA, requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. Methods We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1 VA, (2 VA-outsourced settings, or (3 both (“dual” settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans’ baseline dialysis date. Results Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48% were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. Conclusions VA expenditures for “buying” outsourced dialysis are high and increasing relative to “making” dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans’ access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  1. Comparison of outcomes for veterans receiving dialysis care from VA and non-VA providers.

    Science.gov (United States)

    Wang, Virginia; Maciejewski, Matthew L; Patel, Uptal D; Stechuchak, Karen M; Hynes, Denise M; Weinberger, Morris

    2013-01-18

    Demand for dialysis treatment exceeds its supply within the Veterans Health Administration (VA), requiring VA to outsource dialysis care by purchasing private sector dialysis for veterans on a fee-for-service basis. It is unclear whether outcomes are similar for veterans receiving dialysis from VA versus non-VA providers. We assessed the extent of chronic dialysis treatment utilization and differences in all-cause hospitalizations and mortality between veterans receiving dialysis from VA versus VA-outsourced providers. We constructed a retrospective cohort of veterans in 2 VA regions who received chronic dialysis treatment financed by VA between January 2007 and December 2008. From VA administrative data, we identified veterans who received outpatient dialysis in (1) VA, (2) VA-outsourced settings, or (3) both ("dual") settings. In adjusted analyses, we used two-part and logistic regression to examine associations between dialysis setting and all-cause hospitalization and mortality one-year from veterans' baseline dialysis date. Of 1,388 veterans, 27% received dialysis exclusively in VA, 47% in VA-outsourced settings, and 25% in dual settings. Overall, half (48%) were hospitalized and 12% died. In adjusted analysis, veterans in VA-outsourced settings incurred fewer hospitalizations and shorter hospital stays than users of VA due to favorable selection. Dual-system dialysis patients had lower one-year mortality than veterans receiving VA dialysis. VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system. Outcomes comparisons inform future make-or-buy decisions and suggest the need for VA to consider veterans' access to care, long-term VA savings, and optimal patient outcomes in its placement decisions for dialysis services.

  2. High performance fuel technology development

    Energy Technology Data Exchange (ETDEWEB)

    Koon, Yang Hyun; Kim, Keon Sik; Park, Jeong Yong; Yang, Yong Sik; In, Wang Kee; Kim, Hyung Kyu [KAERI, Daejeon (Korea, Republic of)

    2012-01-15

    {omicron} Development of High Plasticity and Annular Pellet - Development of strong candidates of ultra high burn-up fuel pellets for a PCI remedy - Development of fabrication technology of annular fuel pellet {omicron} Development of High Performance Cladding Materials - Irradiation test of HANA claddings in Halden research reactor and the evaluation of the in-pile performance - Development of the final candidates for the next generation cladding materials. - Development of the manufacturing technology for the dual-cooled fuel cladding tubes. {omicron} Irradiated Fuel Performance Evaluation Technology Development - Development of performance analysis code system for the dual-cooled fuel - Development of fuel performance-proving technology {omicron} Feasibility Studies on Dual-Cooled Annular Fuel Core - Analysis on the property of a reactor core with dual-cooled fuel - Feasibility evaluation on the dual-cooled fuel core {omicron} Development of Design Technology for Dual-Cooled Fuel Structure - Definition of technical issues and invention of concept for dual-cooled fuel structure - Basic design and development of main structure components for dual- cooled fuel - Basic design of a dual-cooled fuel rod.

  3. High Performance Bulk Thermoelectric Materials

    Energy Technology Data Exchange (ETDEWEB)

    Ren, Zhifeng [Boston College, Chestnut Hill, MA (United States)

    2013-03-31

    Over 13 plus years, we have carried out research on electron pairing symmetry of superconductors, growth and their field emission property studies on carbon nanotubes and semiconducting nanowires, high performance thermoelectric materials and other interesting materials. As a result of the research, we have published 104 papers, have educated six undergraduate students, twenty graduate students, nine postdocs, nine visitors, and one technician.

  4. High performance in software development

    CERN Multimedia

    CERN. Geneva; Haapio, Petri; Liukkonen, Juha-Matti

    2015-01-01

    What are the ingredients of high-performing software? Software development, especially for large high-performance systems, is one the most complex tasks mankind has ever tried. Technological change leads to huge opportunities but challenges our old ways of working. Processing large data sets, possibly in real time or with other tight computational constraints, requires an efficient solution architecture. Efficiency requirements span from the distributed storage and large-scale organization of computation and data onto the lowest level of processor and data bus behavior. Integrating performance behavior over these levels is especially important when the computation is resource-bounded, as it is in numerics: physical simulation, machine learning, estimation of statistical models, etc. For example, memory locality and utilization of vector processing are essential for harnessing the computing power of modern processor architectures due to the deep memory hierarchies of modern general-purpose computers. As a r...

  5. Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis-related protein-energy wasting in Malaysia.

    Science.gov (United States)

    Harvinder, Gilcharan Singh; Swee, Winnie Chee Siew; Karupaiah, Tilakavati; Sahathevan, Sharmela; Chinna, Karuthan; Ahmad, Ghazali; Bavanandan, Sunita; Goh, Bak Leong

    2016-01-01

    Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. MIS cut-off score of >=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, pmalnutrition classification were established (score >=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.

  6. Severe Hyperammonemic Encephalopathy Requiring Dialysis Aggravated by Prolonged Fasting and Intermittent High Fat Load in a Ramadan Fasting Month in a Patient with CPTII Homozygous Mutation.

    Science.gov (United States)

    Phowthongkum, P; Ittiwut, C; Shotelersuk, V

    2017-11-21

    Carnitine palmitoyltransferase II (CPTII) deficiency is a mitochondrial fatty acid oxidation disorder that can present antenatally as congenital brain malformations, or postnatally with lethal neonatal, severe infantile, or the most common adult myopathic forms. No case of severe hyperammonemia without liver dysfunction has been reported. We described a 23-year-old man who presented to the emergency department with seizures and was found to have markedly elevation of serum ammonia. Continuous renal replacement therapy was initiated with successfully decreased ammonia to a safety level. He had a prolonged history of epilepsies and encephalopathic attacks that was associated with high ammonia level. Molecular diagnosis revealed a homozygous mutation in CPTII. The plasma acylcarnitine profile was consistent with the diagnosis. Failure to produce acetyl-CoA, the precursor of urea cycle from fatty acid in prolonged fasting state in Ramadan month, worsening mitochondrial functions from circulating long chain fatty acid and valproate toxicities were believed to contribute to this critical metabolic decompensation. Fatty acid oxidation disorders should be considered in the differential diagnosis of hyperammonemia even without liver dysfunction. To our knowledge, this is the first case of CPTII deficiency presented with severe hyperammonemic encephalopathy required dialysis after prolonged religious related fasting.

  7. Dialysis-related amyloidosis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Scarpioni R

    2016-12-01

    , we will focus our attention on the etiology of dialysis-related amyloidosis, its prevention, therapy, and future solutions. Keywords: chronic inflammation, long-term dialysis, β2 microglobulin, high-flux dialysis membrane, mineral bone disease

  8. Neo4j high performance

    CERN Document Server

    Raj, Sonal

    2015-01-01

    If you are a professional or enthusiast who has a basic understanding of graphs or has basic knowledge of Neo4j operations, this is the book for you. Although it is targeted at an advanced user base, this book can be used by beginners as it touches upon the basics. So, if you are passionate about taming complex data with the help of graphs and building high performance applications, you will be able to get valuable insights from this book.

  9. Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients.

    Science.gov (United States)

    Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn

    2014-06-01

    Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P periodontal disease index; r = 0.56, P periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C-reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  10. High performance MEAs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-07-15

    The aim of the present project is through modeling, material and process development to obtain significantly better MEA performance and to attain the technology necessary to fabricate stable catalyst materials thereby providing a viable alternative to current industry standard. This project primarily focused on the development and characterization of novel catalyst materials for the use in high temperature (HT) and low temperature (LT) proton-exchange membrane fuel cells (PEMFC). New catalysts are needed in order to improve fuel cell performance and reduce the cost of fuel cell systems. Additional tasks were the development of new, durable sealing materials to be used in PEMFC as well as the computational modeling of heat and mass transfer processes, predominantly in LT PEMFC, in order to improve fundamental understanding of the multi-phase flow issues and liquid water management in fuel cells. An improved fundamental understanding of these processes will lead to improved fuel cell performance and hence will also result in a reduced catalyst loading to achieve the same performance. The consortium have obtained significant research results and progress for new catalyst materials and substrates with promising enhanced performance and fabrication of the materials using novel methods. However, the new materials and synthesis methods explored are still in the early research and development phase. The project has contributed to improved MEA performance using less precious metal and has been demonstrated for both LT-PEM, DMFC and HT-PEM applications. New novel approach and progress of the modelling activities has been extremely satisfactory with numerous conference and journal publications along with two potential inventions concerning the catalyst layer. (LN)

  11. High Performance Proactive Digital Forensics

    International Nuclear Information System (INIS)

    Alharbi, Soltan; Traore, Issa; Moa, Belaid; Weber-Jahnke, Jens

    2012-01-01

    With the increase in the number of digital crimes and in their sophistication, High Performance Computing (HPC) is becoming a must in Digital Forensics (DF). According to the FBI annual report, the size of data processed during the 2010 fiscal year reached 3,086 TB (compared to 2,334 TB in 2009) and the number of agencies that requested Regional Computer Forensics Laboratory assistance increasing from 689 in 2009 to 722 in 2010. Since most investigation tools are both I/O and CPU bound, the next-generation DF tools are required to be distributed and offer HPC capabilities. The need for HPC is even more evident in investigating crimes on clouds or when proactive DF analysis and on-site investigation, requiring semi-real time processing, are performed. Although overcoming the performance challenge is a major goal in DF, as far as we know, there is almost no research on HPC-DF except for few papers. As such, in this work, we extend our work on the need of a proactive system and present a high performance automated proactive digital forensic system. The most expensive phase of the system, namely proactive analysis and detection, uses a parallel extension of the iterative z algorithm. It also implements new parallel information-based outlier detection algorithms to proactively and forensically handle suspicious activities. To analyse a large number of targets and events and continuously do so (to capture the dynamics of the system), we rely on a multi-resolution approach to explore the digital forensic space. Data set from the Honeynet Forensic Challenge in 2001 is used to evaluate the system from DF and HPC perspectives.

  12. Comparison of survival between dialysis patients with incident high-flux hemodialysis versus on-line hemodiafiltration: A single center experience in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mohamed Said Abdelsalam

    2018-01-01

    Full Text Available Conventional hemodialysis (HD is the most common treatment modality used for renal replacement therapy. The concept of HD is based on the diffusion of solutes across a semipermeable membrane. Hemofiltration (HF is based on convective transport of solutes; hemodiafiltration (HDF is based on combined convective and diffusive therapies. Data about survival benefit of on-line HDF (OL-HDF over high-flux HD (HF-HD is conflicting. We conducted this study to investigate if there is a survival difference between the two treatment modalities. This study is a retrospective, single-center study in which 78 patients were screened; 18 were excluded and 60 patients were analyzed. The study patients were aged 47.5 ± 20.7 years, 33 patients (55% were on HF-HD, and 27 patients (45% were on OL-HDF. A total of 24 patients (40% of both groups were diabetic and, the mean duration on dialysis was 43.5 ±21.3 months in the HF-HD group and 41.2 ± 22.0 months in the OL-HDF group. The mean substitution volume for OL-HDF was 22.3 ± 2.5 L. Survival was 73% [95%, confidence interval (CI 60–84] in the HF-HD group and 65% (95%, CI 54–75 in the OL-HDF group by the end of the study period. The unadjusted hazard ratio (HR with 95% CI comparing HF-HD to high-volume postdilution OL-HDF was 0.78 (0.10–5.6; P = 0.810. Kaplan–Meier analysis for patient survival over five years showed no significant difference between the two modalities. Prospective controlled trials with a larger number of patients will be needed to assess the long-term clinical outcome of postdilution OL-HDF over HF-HD.

  13. Conformational Analysis of Proteins in Highly Concentrated Solutions by Dialysis-Coupled Hydrogen/Deuterium Exchange Mass Spectrometry

    DEFF Research Database (Denmark)

    Houde, Damian; Esmail Nazari, Zeinab; Bou-Assaf, George M

    2016-01-01

    When highly concentrated, an antibody solution can exhibit unusual behaviors, which can lead to unwanted properties, such as increased levels of protein aggregation and unusually high viscosity. Molecular modeling, along with many indirect biophysical measurements, has suggested that the cause fo...... in industry. Graphical Abstract ᅟ....

  14. High thiamine diphosphate concentrations in erythrocytes can be achieved in dialysis patients by oral administration of benfontiamine.

    Science.gov (United States)

    Frank, T; Bitsch, R; Maiwald, J; Stein, G

    2000-06-01

    The influence of either orally administered S-benzoylthiamine-O-monophosphate (benfotiamine) or thiamine nitrate on the thiamine status was tested in a randomised, two-group comparison study in 20 end-stage renal disease (ESRD) patients. Main outcome measures were the pharmacokinetics of thiamine diphosphate (TDP) in blood, the in vitro erythrocyte transketolase activity, its activation coefficient (alpha-ETK) and the TDP concentration in erythrocytes. After ingestion of a single dose of either 100 mg thiamine nitrate (corresponding to 305 micromol thiamine) or 100 mg benfotiamine (corresponding to 214 micromol thiamine), the blood levels of thiamine phosphate esters were analysed by means of high-performance liquid chromatography for a 24-h period. The TDP concentration in erythrocytes was calculated using the haematocrit and TDP concentration in blood. Erythrocyte transketolase activity and alpha-ETK were measured before and 10 h after administration. The pharmacokinetics of TDP in blood were compared with healthy subjects of other studies retrieved from database query. Regarding the blood concentrations of TDP, the patients with ESRD had a 4.3 times higher area under the concentration time curve after benfotiamine administration than after thiamine nitrate. After benfotiamine administration, the peak plasma concentration of TDP exceeded that in healthy subjects by 51%. In the ESRD patients, after 24 h, the mean TDP concentration in erythrocytes increased from 158.7+/-30.9 ng/ml initially to 325.8+/-50.9 ng/ml after administration of benfotiamine and from 166.2+/-51.9 ng/ml to 200.5+/-50.0 ng/ml after thiamine nitrate administration. The ratio between the maximum erythrocyte TDP concentration and basal concentration was 2.66+/-0.6 in the benfotiamine group and 1.44+/-0.2 in the group receiving thiamine nitrate (P benfotiamine intake (P = 0.02) and from 3.71+/-0.8 microkat/l to 4.02+/-0.7 microkat/l after thiamine nitrate intake (P = 0.08). Likewise, alpha

  15. The diagnosis of tuberculosis in dialysis patients

    Directory of Open Access Journals (Sweden)

    Hela Jebali

    2017-01-01

    Full Text Available The incidence of tuberculosis (TB is high in patients undergoing chronic dialysis than it is in the general population. The diagnosis of TB is often difficult and extrapulmonary involvement is predominant. This study investigates the spectrum of clinical presentations and outcome in dialysis patients during a nine-year period. TB was diagnosed in 41 patients. Anti-TB drugs, adverse effects of therapy, and outcome were noted. Thirty-eight patients (92.6% were on hemodialysis and three were on peritoneal dialysis (7.3%. The mean age at diagnosis was 50.8 years and the male/female ratio was 1.16. Four patients had a history of pulmonary TB. Extrapulmonary involvement was observed in 32 (78 % patients. The bacteriological confirmation was made in 41.46% and histological confirmation was made in 26.83%, and in the rest, the diagnosis was retained on the criterion presumption. Nineteen patients (46.34% developed adverse effects of antitubercular drugs. Eight patients (19.51% died during the study from TB or adverse effects of treatment. Low urea reduction ratio and female sex were associated with poor prognosis in our study. The clinical manifestations of TB in patients on dialysis are quite nonspecific, making timely diagnosis difficult, and delaying the initiation of curative treatment, which is a major determinant of the outcome.

  16. Effect of prescribing a high protein diet and increasing the dose of dialysis on nutrition in stable chronic haemodialysis patients : a randomized, controlled trial

    NARCIS (Netherlands)

    Kloppenburg, Wybe; Stegeman, CA; Kremer Hovinga, T; Vastenburg, G; Vos, P; de Jong, PE; Huisman, RM

    Background. Protein requirements in stable, adequately dialysed haemodialysis patients are not known and recommendations vary. It is not known whether increasing the dialysis dose above the accepted adequate level has a favourable effect on nutrition. The aim of this study was to determine whether

  17. Peritoneal Dialysis in Western Countries

    NARCIS (Netherlands)

    Struijk, Dirk G.

    2015-01-01

    Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and

  18. Metabolic alterations in dialysis patients

    NARCIS (Netherlands)

    Drechsler, Christiane

    2010-01-01

    Assessing metabolic risk in dialysis patients, three main aspects are important: a) the pathophysiologic effects of metabolic disturbances as known from the general population are unlikely to completely reverse once patients reach dialysis. b) Specific additional problems related to chronic kidney

  19. High performance light water reactor

    International Nuclear Information System (INIS)

    Squarer, D.; Schulenberg, T.; Struwe, D.; Oka, Y.; Bittermann, D.; Aksan, N.; Maraczy, C.; Kyrki-Rajamaeki, R.; Souyri, A.; Dumaz, P.

    2003-01-01

    The objective of the high performance light water reactor (HPLWR) project is to assess the merit and economic feasibility of a high efficiency LWR operating at thermodynamically supercritical regime. An efficiency of approximately 44% is expected. To accomplish this objective, a highly qualified team of European research institutes and industrial partners together with the University of Tokyo is assessing the major issues pertaining to a new reactor concept, under the co-sponsorship of the European Commission. The assessment has emphasized the recent advancement achieved in this area by Japan. Additionally, it accounts for advanced European reactor design requirements, recent improvements, practical design aspects, availability of plant components and the availability of high temperature materials. The final objective of this project is to reach a conclusion on the potential of the HPLWR to help sustain the nuclear option, by supplying competitively priced electricity, as well as to continue the nuclear competence in LWR technology. The following is a brief summary of the main project achievements:-A state-of-the-art review of supercritical water-cooled reactors has been performed for the HPLWR project.-Extensive studies have been performed in the last 10 years by the University of Tokyo. Therefore, a 'reference design', developed by the University of Tokyo, was selected in order to assess the available technological tools (i.e. computer codes, analyses, advanced materials, water chemistry, etc.). Design data and results of the analysis were supplied by the University of Tokyo. A benchmark problem, based on the 'reference design' was defined for neutronics calculations and several partners of the HPLWR project carried out independent analyses. The results of these analyses, which in addition help to 'calibrate' the codes, have guided the assessment of the core and the design of an improved HPLWR fuel assembly. Preliminary selection was made for the HPLWR scale

  20. Oxalate quantification in hemodialysate to assess dialysis adequacy for primary hyperoxaluria.

    Science.gov (United States)

    Tang, Xiaojing; Voskoboev, Nikolay V; Wannarka, Stacie L; Olson, Julie B; Milliner, Dawn S; Lieske, John C

    2014-01-01

    Patients with primary hyperoxaluria (PH) overproduce oxalate which is eliminated via the kidneys. If end-stage kidney disease develops they are at high risk for systemic oxalosis, unless adequate oxalate is removed during hemodialysis (HD) to equal or exceed ongoing oxalate production. The purpose of this study was to validate a method to measure oxalate removal in this unique group of dialysis patients. Fourteen stable patients with a confirmed diagnosis of PH on HD were included in the study. Oxalate was measured serially in hemodialysate and plasma samples in order to calculate rates of oxalate removal. HD regimens were adjusted according to a given patient's historical oxalate production, amount of oxalate removal at dialysis, residual renal clearance of oxalate, and plasma oxalate levels. After a typical session of HD, plasma oxalate was reduced by 78.4 ± 7.7%. Eight patients performed HD 6 times/week, 2 patients 5 times/week, and 3 patients 3 times/week. Combined oxalate removal by HD and the kidneys was sufficient to match or exceed endogenous oxalate production. After a median period of 9 months, pre-dialysis plasma oxalate was significantly lower than initially (75.1 ± 33.4 vs. 54.8 ± 46.6 mmol/l, p = 0.02). This methodology can be used to individualize the dialysis prescription of PH patients to prevent oxalosis during the time they are maintained on HD and to reduce risk of oxalate injury to a transplanted kidney.

  1. Development of high performance cladding

    International Nuclear Information System (INIS)

    Kiuchi, Kiyoshi

    2003-01-01

    The developments of superior next-generation light water reactor are requested on the basis of general view points, such as improvement of safety, economics, reduction of radiation waste and effective utilization of plutonium, until 2030 year in which conventional reactor plants should be renovate. Improvements of stainless steel cladding for conventional high burn-up reactor to more than 100 GWd/t, developments of manufacturing technology for reduced moderation-light water reactor (RMWR) of breeding ratio beyond 1.0 and researches of water-materials interaction on super critical pressure-water cooled reactor are carried out in Japan Atomic Energy Research Institute. Stable austenite stainless steel has been selected for fuel element cladding of advanced boiling water reactor (ABWR). The austenite stain less has the superiority for anti-irradiation properties, corrosion resistance and mechanical strength. A hard spectrum of neutron energy up above 0.1 MeV takes place in core of the reduced moderation-light water reactor, as liquid metal-fast breeding reactor (LMFBR). High performance cladding for the RMWR fuel elements is required to get anti-irradiation properties, corrosion resistance and mechanical strength also. Slow strain rate test (SSRT) of SUS 304 and SUS 316 are carried out for studying stress corrosion cracking (SCC). Irradiation tests in LMFBR are intended to obtain irradiation data for damaged quantity of the cladding materials. (M. Suetake)

  2. Peritoneal dialysis in Asia.

    Science.gov (United States)

    Cheng, I K

    1996-01-01

    The socioeconomic status of Asian countries is diverse, and government reimbursement policies for treatment of patients suffering from end-stage renal disease (ESRD) vary greatly from one country to another. Both of these factors have a major impact not only on the choice of treatment for ESRD but also on the utilization of peritoneal dialysis (PD) in this region. Based on the data collected from 11 representative Asian countries, several observations can be made. First, the treatment rates for ESRD in these countries correlated closely with their gross domestic product (GDP) per capita income. Second, the PD utilization rate appeared to have a biphasic relationship with the GDP per capita income and treatment rate, in that countries with the highest and the lowest treatment rates tended to have lower PD utilization rates, whereas countries with modest treatment rates tended to have higher PD utilization rates. The reason for low PD utilization in countries with the highest treatment rates differs from that in countries with low treatment rates. In the former, because of full government reimbursement, there is little physician incentive to introduce PD as an alternative form of ESRD treatment to in-center hemodialysis (HD), whereas in the latter, the complete lack of government reimbursement prevents the introduction of PD as a form of treatment. This pattern is likely to change in the future because, of the 11 countries surveyed, all except Thailand have recorded a growth rate which is higher for PD than HD over the last three years. The rate of utilization of different PD systems varies greatly among different Asian countries. Automated PD has yet to gain popularity in Asia. Conventional straight-line systems remain the dominant PD systems in use in Hong Kong, Korea, Thailand, and the Philippines, while in Malaysia and Singapore UV germicidal connection devices are most popular. However, in all these countries there has been a progressive shift over the last

  3. [Customization of hemodialysis therapy: dialysis is not a washing machine].

    Science.gov (United States)

    Santoro, Antonio

    2018-02-01

    In recent years, the population of chronic dialysis has grown in number but also in age and frequency of co-morbidies such as cardiac diseases, vascular pathologies, diabetes, etc. The majority of patients on chronic hemodialysis are over 70 years and, given the high number of comorbidities, they often exhibit poor tolerance to dialysis treatments. A non-tolerated dialytic treatment can have side-effects that would require an intensification of the dialysis sessions and many hospitalizations. Consequently, the problematic dialysis treatments, as well as harmful for the patient, become economically more detrimental than other treatments apparently more expensive but more tolerated ones In the current days we have, thanks to the huge developments in dialysis technology, powerful weapons to ensure effective and scarcely symptomatic dialysis treatments to the majority of the HD patients. New, highly biocompatible membranes with defined and modular cut-off and / or absorption capacity may allow us to provide adequate purification. Moreover the monitoring and biofeedback systems such as blood volume tracking, body temperature monitoring (BTM) and blood pressure (BPM) can be very useful in reducing the risk of intra-dialytic hypotension and symptoms. Therefore, the dialytic therapy, as well as all the pharmacological therapies for the chronic patient, must consider the specificity of the patient, basing on his metabolic problems, cardiovascular tolerance, residual renal function and on his dietary and general compliance. The central aim of the nephrologist is to formulate the better prescription for the individual patient, considering the dialysis modalities, the membrane type, the dry weight (ideal post-dialysis body weight), the frequency and the duration of the weekly sessions and the technological tools that can optimize the treatment. Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.

  4. Superior Predictive Value for NTproBNP Compared with High Sensitivity cTnT in Dialysis Patients: A Pilot Prospective Observational Study

    Directory of Open Access Journals (Sweden)

    Luminita Voroneanu

    2014-12-01

    Full Text Available Background/Aims: The clinical utility of the new biomarker, high sensitivity cardiac T troponin (hs-cTnT is still unclear in dialysis patients. Furthermore, the prognostic value of combining N-terminal pro-B-type natriuretic peptide (NT-pro-BNP and hs-cTnT has not been explored so far. The objective of this pilot study was to determine the utility of hs-cTnT alone versus hs-cTnT in combination with NT-proBNP for predicting death in a stable hemodialysis cohort. Methods: A prospective observational pilot study including 98 chronic asymptomatic hemodialysis patients with a follow up period of 24 months was designed. The cut-off values for NT-proBNP and hs-cTnT were calculated using receiver operating characteristic (ROC analysis, using mortality as an end-point. Based on the cut-off values, the cohort was divided into four groups. Group 1 - NT-proBNP 69.48 ng/l; group 3 - NT-proBNP > 14275 pg/ml and hs-cTnT 14275 pg/ml and hs-cTnT > 69.48 ng/l. Survival for each group was determined using the Kaplan-Meier method and Cox regression analysis. Results: During the follow-up period 16 patients died. According to the ROC curves analysis, the cut-off point for hs-cTnT and for NT-proBNP were 69.43 ng/l (AUC = 0.618; p = 0.04 and 14275 pg/ml (AUC = 0.722; p = 0.003, respectively. In univariate Cox analysis, both hs-cTnT (HR = 3.34; p = 0.016 and NT-proBNP (HR = 5.94; p = 0.01 were predictors of death. In the multivariable Cox proportional hazards model, only NT-pro-BNP levels above the cut-off value remained an independent predictor of all-cause mortality. The combined elevation of both biomarkers did not improve significantly the prognostic value compared with NT-proBNP alone (HR = 6.15 versus HR =4 .78; p = 0.338. Conclusion: NT-pro-BNP is a strong predictor of overall mortality in asymptomatic hemodialysis patients. The addition of hs-cTnT did not improve the prognostic accuracy compared with NT proBNP alone.

  5. Peritoneal membrane characteristics in patients on peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Jamal Al-wakeel

    2011-01-01

    Full Text Available Peritoneal dialysis (PD is a well-established modality for treatment of patients with end-stage renal disease, giving excellent patient and technique survival rates. In Saudi Arabia, data collected by the Saudi Center for Organ Transplantation showed that in 2008, patients on PD accounted for a mere 4.8% of total patients on renal replacement therapy, including hemodialysis and renal transplantation. This study was conducted to identify the characteristics of membrane per-meability in the Saudi population and to assess the role of various factors affecting solute transport across the peritoneal membrane. We followed up a total of 52 patients on Continuous Ambulatory Peritoneal Dialysis (CAPD as well as Automated Peritoneal Dialysis (APD, being treated in the PD unit of the King Khalid University Hospital, Riyadh. There were 30 female and 22 male patients; 14 patients were using CAPD while 38 patients were on APD. The mean age of the patients was 50.5 years, with a range of 14-86 years. The average body mass index (BMI was 27.1 kg/m 2 and the mean body surface area (BSA of the study patients was 1.71 m 2 . A standardized PET test was performed on all patients, 4-6 weeks after initiation of regular PD. The Kt/V and creatinine clearance measured 6-8 weeks after initiation of dialysis were 1.96 and 56.59 L/week, respectively. Residual renal function was assessed on the basis of daily urine output, using 24-hour urine collection. The mean serum urea con-centration was 16.91 mmol/L and mean serum creatinine was 702 μmol/L. According to the Peritoneal Equiliberation Test (PET, 8% of the subjects belonged to the high trans-porter category, 44% patients belonged to the high-average transport group, 46% to the low-average category and 2% came in the low transporter category. Our study suggests that the patient characteristics and demographic para-meters seen in the Saudi population are comparable to those seen in other studies from the Middle East and

  6. Pregnancy in chronic dialysis, late diagnosis, and other problems

    Science.gov (United States)

    Ramadani, S.; Nasution, A. T.; Nasution, S.; Lubis, H. R.

    2018-03-01

    The incidence of pregnancy in patients with chronic kidney disease (CKD) undergoing hemodialysis is rare. Forpregnant patients with CKD undergoing regular hemodialysis, the effects of renal disease on the fetus should be noted and require specific strategies. A 30-year-old woman had no menstruation for 4 months. Abdominal ultrasound showed single fetus within 16 weeks of pregnancy. She had previously been in regular hemodialysis twice a week since 2015, then the frequency of hemodialysis was increased to thrice a week for 4 hours/dialysis. During pregnancy, she was given erythropoiesis stimulating agent, controlled protein nutrition (0.6-1.5g/kg/day) and routine pregnancy controls to an obstetrician. After 31-32 weeks gestation, thebaby was born alive with low birth weight (1800g). Maintaining pregnancy in women with regular hemodialysis is still challenging and difficult. Prolonged/intensive dialysis during pregnancy results in longer gestational periods, higher fetal weights, and a higher likelihood of survival. Based on a dialysis guideline for pregnancy in CKD, hemodialysis is performed at least 20 hours/week to maintain pre-dialysis of BUN≤50mg/dl hemoglobin should be at least 10-11g/dL. We reported a case of pregnancy in dialysis CKD patient undergoing hemodialysis thricea week (4 hours/dialysis). The baby was born alive with low birth weight (1800 g).

  7. What's the Deal with Dialysis?

    Science.gov (United States)

    ... Dialysis Work? Other Options Print Don't you love swimming in a cool, blue pool? Splashing around ... dialysate cleanses the blood and rebalances the blood's chemistry. After about an hour, the machine drains the ...

  8. Impact of facility size and profit status on intermediate outcomes in chronic dialysis patients.

    Science.gov (United States)

    Frankenfield, D L; Sugarman, J R; Presley, R J; Helgerson, S D; Rocco, M V

    2000-08-01

    Little information is available regarding the influence of dialysis facility size or profit status on intermediate outcomes in chronic dialysis patients. We have combined data from the Health Care Financing Administration (HCFA) Core Indicators Project; the end-stage renal disease (ESRD) facility survey; and the HCFA On-Line Survey, Certification, and Reporting System to analyze trends in this area. For hemodialysis patients, larger facilities were more likely than smaller facilities to perform dialysis on patients who were younger than 65 years of age, black, or undergoing dialysis 2 years or more (P profit units (P reduction ratio, but not with hematocrit or serum albumin values. Facility profit status was not associated with these intermediate outcomes. For peritoneal dialysis patients, there were no significant differences in patient demographics based on facility size. More patients in nonprofit units had been undergoing dialysis 2 or more years than patients in for-profit units (P profit status.

  9. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Jacek Waniewski

    2016-01-01

    Full Text Available During peritoneal dialysis (PD, the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87 years; median time on PD 19 (3–100 months underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS, fraction of ultrasmall pores (αu, osmotic conductance for glucose (OCG, and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters. Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane.

  10. Peritoneal Fluid Transport rather than Peritoneal Solute Transport Associates with Dialysis Vintage and Age of Peritoneal Dialysis Patients

    Science.gov (United States)

    Waniewski, Jacek; Antosiewicz, Stefan; Baczynski, Daniel; Poleszczuk, Jan; Pietribiasi, Mauro; Lindholm, Bengt; Wankowicz, Zofia

    2016-01-01

    During peritoneal dialysis (PD), the peritoneal membrane undergoes ageing processes that affect its function. Here we analyzed associations of patient age and dialysis vintage with parameters of peritoneal transport of fluid and solutes, directly measured and estimated based on the pore model, for individual patients. Thirty-three patients (15 females; age 60 (21–87) years; median time on PD 19 (3–100) months) underwent sequential peritoneal equilibration test. Dialysis vintage and patient age did not correlate. Estimation of parameters of the two-pore model of peritoneal transport was performed. The estimated fluid transport parameters, including hydraulic permeability (LpS), fraction of ultrasmall pores (α u), osmotic conductance for glucose (OCG), and peritoneal absorption, were generally independent of solute transport parameters (diffusive mass transport parameters). Fluid transport parameters correlated whereas transport parameters for small solutes and proteins did not correlate with dialysis vintage and patient age. Although LpS and OCG were lower for older patients and those with long dialysis vintage, αu was higher. Thus, fluid transport parameters—rather than solute transport parameters—are linked to dialysis vintage and patient age and should therefore be included when monitoring processes linked to ageing of the peritoneal membrane. PMID:26989432

  11. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have 45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  12. A study on the information-motivation-behavioural skills model among Chinese adults with peritoneal dialysis.

    Science.gov (United States)

    Chang, Tian-Ying; Zhang, Yi-Lin; Shan, Yan; Liu, Sai-Sai; Song, Xiao-Yue; Li, Zheng-Yan; Du, Li-Ping; Li, Yan-Yan; Gao, Douqing

    2018-05-01

    To examine whether the information-motivation-behavioural skills model could predict self-care behaviour among Chinese peritoneal dialysis patients. Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The information-motivation-behavioural model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation and evaluation of self-care programmes. A cross-sectional, observational study. A total of 201 adults with peritoneal dialysis were recruited at a 3A grade hospital in China. Participant data were collected on demographics, self-care information (knowledge), social support (social motivation), self-care attitude (personal motivation), self-efficacy (behaviour skills) and self-care behaviour. We also collected data on whether the recruited patients had peritoneal dialysis-associated peritonitis from electronic medical records. Measured variable path analysis was performed using mplus 7.4 to identify the information-motivation-behavioural model. Self-efficacy, information and social motivation predict peritoneal dialysis self-care behaviour directly. Information and personal support affect self-care behaviour through self-efficacy, whereas peritoneal dialysis self-care behaviour has a direct effect on the prevention of peritoneal dialysis-associated peritonitis. The information-motivation-behavioural model is an appropriate and applicable model to explain and predict the self-care behaviour of Chinese peritoneal dialysis patients. Poor self-care behaviour among peritoneal dialysis patients results in peritoneal dialysis-associated peritonitis. The findings suggest that self-care education programmes for peritoneal dialysis patients should include strategies based on the information-motivation-behavioural model to enhance knowledge, motivation and behaviour

  13. Learning Apache Solr high performance

    CERN Document Server

    Mohan, Surendra

    2014-01-01

    This book is an easy-to-follow guide, full of hands-on, real-world examples. Each topic is explained and demonstrated in a specific and user-friendly flow, from search optimization using Solr to Deployment of Zookeeper applications. This book is ideal for Apache Solr developers and want to learn different techniques to optimize Solr performance with utmost efficiency, along with effectively troubleshooting the problems that usually occur while trying to boost performance. Familiarity with search servers and database querying is expected.

  14. High-performance composite chocolate

    Science.gov (United States)

    Dean, Julian; Thomson, Katrin; Hollands, Lisa; Bates, Joanna; Carter, Melvyn; Freeman, Colin; Kapranos, Plato; Goodall, Russell

    2013-07-01

    The performance of any engineering component depends on and is limited by the properties of the material from which it is fabricated. It is crucial for engineering students to understand these material properties, interpret them and select the right material for the right application. In this paper we present a new method to engage students with the material selection process. In a competition-based practical, first-year undergraduate students design, cost and cast composite chocolate samples to maximize a particular performance criterion. The same activity could be adapted for any level of education to introduce the subject of materials properties and their effects on the material chosen for specific applications.

  15. High-Performance Composite Chocolate

    Science.gov (United States)

    Dean, Julian; Thomson, Katrin; Hollands, Lisa; Bates, Joanna; Carter, Melvyn; Freeman, Colin; Kapranos, Plato; Goodall, Russell

    2013-01-01

    The performance of any engineering component depends on and is limited by the properties of the material from which it is fabricated. It is crucial for engineering students to understand these material properties, interpret them and select the right material for the right application. In this paper we present a new method to engage students with…

  16. Toward High-Performance Organizations.

    Science.gov (United States)

    Lawler, Edward E., III

    2002-01-01

    Reviews management changes that companies have made over time in adopting or adapting four approaches to organizational performance: employee involvement, total quality management, re-engineering, and knowledge management. Considers future possibilities and defines a new view of what constitutes effective organizational design in management.…

  17. Intraperitoneal pressure in peritoneal dialysis

    Directory of Open Access Journals (Sweden)

    Vicente Pérez Díaz

    2017-11-01

    Full Text Available The measure of intraperitoneal pressure in peritoneal dialysis is easy and provides clear therapeutic benefits. However it is measured only rarely in adult peritoneal dialysis units. This review aims to disseminate the usefulness of measuring intraperitoneal pressure. This measurement is performed in supine before initiating the drain of a manual exchange with “Y” system, by raising the drain bag and measuring from the mid-axillary line the height of the liquid column that rises from the patient. With typical values of 10–16 cm H2O, intraperitoneal pressure should never exceed 18 cm H2O. With basal values that depend on body mass index, it increases 1–3 cm H2O/L of intraperitoneal volume, and varies with posture and physical activity. Its increase causes discomfort, sleep and breathing disturbances, and has been linked to the occurrence of leaks, hernias, hydrothorax, gastro-esophageal reflux and enteric peritonitis. Less known and valued is its ability to decrease the effectiveness of dialysis significantly counteracting ultrafiltration and decreasing solute clearance to a smaller degree. Because of its easy measurement and potential utility, should be monitored in case of ultrafiltration failure to rule out its eventual contribution in some patients. Although not yet mentioned in the clinical practice guidelines for PD, its clear benefits justify its inclusion among the periodic measurements to consider for prescribing and monitoring peritoneal dialysis. Resumen: La medida de la presión intraperitoneal en diálisis peritoneal es muy sencilla y aporta claros beneficios terapéuticos. Sin embargo, su monitorización todavía no se ha generalizado en las unidades de diálisis peritoneal de adultos. Esta revisión pretende divulgar su conocimiento y la utilidad de su medida. Se realiza en decúbito antes de iniciar el drenaje de un intercambio manual con bolsa en Y, elevando la bolsa de

  18. Association of betaine with blood pressure in dialysis patients.

    Science.gov (United States)

    Wang, Lulu; Zhao, Mingming; Liu, Wenjin; Li, Xiurong; Chu, Hong; Bai, Youwei; Sun, Zhuxing; Gao, Chaoqing; Zheng, Lemin; Yang, Junwei

    2018-02-01

    Mechanisms underlying elevated blood pressure in dialysis patients are complex as a variety of non-traditional factors are involved. We sought to explore the association of circulating betaine, a compound widely distributed in food, with blood pressure in dialysis patients. We used baseline data of an ongoing cohort study involving patients on hemodialysis. Plasma betaine was measured by high performance liquid chromatography in 327 subjects. Blood pressure level was determined by intradialytic ambulatory blood pressure monitoring. The mean age of the patients was 52.6 ± 11.9 years, and 58.4% were male. Average interdialytic ambulatory systolic and diastolic blood pressure were 138.4 ± 22.7 mm Hg and 84.4 ± 12.5 mm Hg, respectively. Mean plasma betaine level was 37.6 μmol/L. Multiple linear regression analysis revealed significant associations of betaine with both systolic blood pressure (β = -3.66, P = .003) and diastolic blood pressure (β = -2.00, P = .004). The associations persisted even after extensive adjustment for cardiovascular covariates. Subgroup analysis revealed that the association between betaine and blood pressure was mainly limited to female patients. Our data suggest that alteration of circulating betaine possibly contributes to blood pressure regulation in these patients. ©2018 Wiley Periodicals, Inc.

  19. Functional High Performance Financial IT

    DEFF Research Database (Denmark)

    Berthold, Jost; Filinski, Andrzej; Henglein, Fritz

    2011-01-01

    at the University of Copenhagen that attacks this triple challenge of increased performance, transparency and productivity in the financial sector by a novel integration of financial mathematics, domain-specific language technology, parallel functional programming, and emerging massively parallel hardware. HIPERFIT......The world of finance faces the computational performance challenge of massively expanding data volumes, extreme response time requirements, and compute-intensive complex (risk) analyses. Simultaneously, new international regulatory rules require considerably more transparency and external...... auditability of financial institutions, including their software systems. To top it off, increased product variety and customisation necessitates shorter software development cycles and higher development productivity. In this paper, we report about HIPERFIT, a recently etablished strategic research center...

  20. High performance Mo adsorbent PZC

    Energy Technology Data Exchange (ETDEWEB)

    Anon,

    1998-10-01

    We have developed Mo adsorbents for natural Mo(n, {gamma}){sup 99}Mo-{sup 99m}Tc generator. Among them, we called the highest performance adsorbent PZC that could adsorb about 250 mg-Mo/g. In this report, we will show the structure, adsorption mechanism of Mo, and the other useful properties of PZC when you carry out the examination of Mo adsorption and elution of {sup 99m}Tc. (author)

  1. Indoor Air Quality in High Performance Schools

    Science.gov (United States)

    High performance schools are facilities that improve the learning environment while saving energy, resources, and money. The key is understanding the lifetime value of high performance schools and effectively managing priorities, time, and budget.

  2. High performance inertial fusion targets

    International Nuclear Information System (INIS)

    Nuckolls, J.H.; Bangerter, R.O.; Lindl, J.D.; Mead, W.C.; Pan, Y.L.

    1977-01-01

    Inertial confinement fusion (ICF) designs are considered which may have very high gains (approximately 1000) and low power requirements (<100 TW) for input energies of approximately one megajoule. These include targets having very low density shells, ultra thin shells, central ignitors, magnetic insulation, and non-ablative acceleration

  3. High performance inertial fusion targets

    International Nuclear Information System (INIS)

    Nuckolls, J.H.; Bangerter, R.O.; Lindl, J.D.; Mead, W.C.; Pan, Y.L.

    1978-01-01

    Inertial confinement fusion (ICF) target designs are considered which may have very high gains (approximately 1000) and low power requirements (< 100 TW) for input energies of approximately one megajoule. These include targets having very low density shells, ultra thin shells, central ignitors, magnetic insulation, and non-ablative acceleration

  4. High performance nuclear fuel element

    International Nuclear Information System (INIS)

    Mordarski, W.J.; Zegler, S.T.

    1980-01-01

    A fuel-pellet composition is disclosed for use in fast breeder reactors. Uranium carbide particles are mixed with a powder of uraniumplutonium carbides having a stable microstructure. The resulting mixture is formed into fuel pellets. The pellets thus produced exhibit a relatively low propensity to swell while maintaining a high density

  5. High Performance JavaScript

    CERN Document Server

    Zakas, Nicholas

    2010-01-01

    If you're like most developers, you rely heavily on JavaScript to build interactive and quick-responding web applications. The problem is that all of those lines of JavaScript code can slow down your apps. This book reveals techniques and strategies to help you eliminate performance bottlenecks during development. You'll learn how to improve execution time, downloading, interaction with the DOM, page life cycle, and more. Yahoo! frontend engineer Nicholas C. Zakas and five other JavaScript experts -- Ross Harmes, Julien Lecomte, Steven Levithan, Stoyan Stefanov, and Matt Sweeney -- demonstra

  6. Peritoneal Dialysis in Western Countries.

    Science.gov (United States)

    Struijk, Dirk G

    2015-12-01

    Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. First the major events in the history of the development of PD are described. Then important insights into the physiology of peritoneal transport are discussed and linked to the changes in time observed in biopsies of the peritoneal membrane. Furthermore, the developments in peritoneal access, more biocompatible dialysate solutions, automated PD at home, the establishment of parameters for dialysis adequacy and strategies to prevent infectious complications are mentioned. Finally non-medical issues responsible for the declining penetration in the Western world are analyzed. Only after introduction of the concept of continuous ambulatory PD by Moncrief and Popovich has this treatment evolved in time to a renal replacement therapy. Of all structures present in the peritoneal membrane, the capillary endothelium offers the rate-limiting hindrance for solute and water transport for the diffusive and convective transport of solutes and osmosis. The functional and anatomical changes in the peritoneal membrane in time can be monitored by the peritoneal equilibrium test. Peritonitis incidence decreased by introduction of the Y-set and prophylaxis using mupirocin on the exit site. The decrease in the proportion of patients treated with PD in the Western world can be explained by non-medical issues such as inadequate predialysis patient education, physician experience and training, ease of HD initiation, overcapacity of in-center HD, lack of adequate infrastructure for PD treatment, costs and reimbursement issues of the treatment. (1) PD is cheaper than HD and provides a

  7. Carpet Aids Learning in High Performance Schools

    Science.gov (United States)

    Hurd, Frank

    2009-01-01

    The Healthy and High Performance Schools Act of 2002 has set specific federal guidelines for school design, and developed a federal/state partnership program to assist local districts in their school planning. According to the Collaborative for High Performance Schools (CHPS), high-performance schools are, among other things, healthy, comfortable,…

  8. Hepatitis C virus and the immunological response to hepatitis B virus vaccine in dialysis patients: meta-analysis of clinical studies.

    Science.gov (United States)

    Fabrizi, F; Dixit, V; Martin, P; Messa, P

    2011-12-01

    It is well known that the seroconversion rate of patients following hepatitis B virus (HBV) vaccination is lower in uraemic than healthy subjects. A variety of inherited or acquired factors have been implicated in this diminished response, and the high prevalence of hepatitis C virus (HCV) infection among patients on maintenance dialysis has been suggested to play a role. However, the impact of HCV on the immune response to HB vaccine in patients receiving long-term dialysis is not entirely understood. Here, we evaluate the influence of HCV infection on the immunological response to HBV vaccine in dialysis population by performing a systematic review of the literature with a meta-analysis of clinical studies.We used the random-effects model of DerSimonian and Laird with heterogeneity and sensitivity analyses. The end-point of interest was the rate of patients showing seroprotective anti-hepatitis B titres at completion of HBV vaccine schedule among HCV-positive versus HCV-negative patients on chronic dialysis. We identified eight studies involving 520 unique patients on long-term dialysis. Aggregation of study results did not show a significant decrease in response rates among HCV-infected versus noninfected patients [pooled odds ratio = 0.621 (95% CI, 0.285; 1.353)]. The P-value was 0.007 for our test of study heterogeneity. Stratified analysis in various subgroups of interest did not meaningfully change our results. Our meta-analysis showed no association between immunological response to hepatitis B vaccine and HCV infection in individuals on long-term dialysis. These results support the use of recombinant vaccine against hepatitis B in patients on regular dialysis with HCV infection. © 2011 Blackwell Publishing Ltd.

  9. Severe hyperparathyroidism in a pre-dialysis chronic kidney disease patient treated with a very low protein diet.

    Science.gov (United States)

    Ohta, Eriko; Akazawa, Masanobu; Noda, Yumi; Mandai, Shintaro; Naito, Shotaro; Ohta, Akihito; Sohara, Eisei; Okado, Tomokazu; Rai, Tatemitsu; Uchida, Shinichi; Sasaki, Sei

    2012-03-01

    The present report describes a case of a 64-year-old pre-dialysis woman with chronic kidney disease (CKD) stage 5, who developed severe hyperparathyroidism. This patient had been on a very low protein diet (VLPD) to delay the progression of CKD and the need for renal replacement therapy (RRT). Her serum calcium levels were high-normal to slightly high during this time. However, her serum intact parathyroid hormone (PTH) levels increased from 400 to 1160 pg/ml rapidly over a period of 3 months. Serum 1,25-(OH)2D levels were low, and ultrasound of the neck showed three markedly enlarged parathyroid glands exceeding 2 cm. Parathyroidectomy was performed, and all glands showed nodular hyperplasia, which indicated severe secondary hyperparathyroidism leading to tertiary. Severe secondary hyperparathyroidism requiring surgical intervention is usually observed in patients with long-term RRT and is relatively rare in the pre-dialysis patient. In this case, extension of the pre-dialysis period by VLPD may have predisposed this patient to develop severe secondary hyperparathyroidism. Thus, careful monitoring of calcium, phosphorus, and PTH may be necessary in patients treated with VLPD even before renal replacement therapy. Furthermore, initiation of dialysis should not be excessively delayed by strict protein restriction dietary therapy.

  10. The dialysis catheter and infectious peritonitis in intermittent peritoneal dialysis

    DEFF Research Database (Denmark)

    Kolmos, Hans Jørn; Hemmeløff Andersen, Karl Erik; Hansen, Lise

    1984-01-01

    118 episodes of infectious peritonitis registered among 156 patients treated with intermittent peritoneal dialysis over a 5-yr period were analysed with special reference to potential routes of infection associated with the dialysis catheter. Peritonitis was randomly distributed among the patients......, and the change of keeping free of peritonitis declined exponentially with time. The main factor determining the individual number of episodes was the total space of time, in which a patient had been wearing a dialysis catheter, whereas the number of catheter disconnections played no significant role. A relative...... preponderance of cases due to Enterobacteriaceae was noted within the first week after catheter implantation. In contrast with this, peritonitis with skin microorganisms was not associated with the implantation of catheters....

  11. High performance electromagnetic simulation tools

    Science.gov (United States)

    Gedney, Stephen D.; Whites, Keith W.

    1994-10-01

    Army Research Office Grant #DAAH04-93-G-0453 has supported the purchase of 24 additional compute nodes that were installed in the Intel iPsC/860 hypercube at the Univesity Of Kentucky (UK), rendering a 32-node multiprocessor. This facility has allowed the investigators to explore and extend the boundaries of electromagnetic simulation for important areas of defense concerns including microwave monolithic integrated circuit (MMIC) design/analysis and electromagnetic materials research and development. The iPSC/860 has also provided an ideal platform for MMIC circuit simulations. A number of parallel methods based on direct time-domain solutions of Maxwell's equations have been developed on the iPSC/860, including a parallel finite-difference time-domain (FDTD) algorithm, and a parallel planar generalized Yee-algorithm (PGY). The iPSC/860 has also provided an ideal platform on which to develop a 'virtual laboratory' to numerically analyze, scientifically study and develop new types of materials with beneficial electromagnetic properties. These materials simulations are capable of assembling hundreds of microscopic inclusions from which an electromagnetic full-wave solution will be obtained in toto. This powerful simulation tool has enabled research of the full-wave analysis of complex multicomponent MMIC devices and the electromagnetic properties of many types of materials to be performed numerically rather than strictly in the laboratory.

  12. High-Performance Data Converters

    DEFF Research Database (Denmark)

    Steensgaard-Madsen, Jesper

    -resolution internal D/A converters are required. Unit-element mismatch-shaping D/A converters are analyzed, and the concept of mismatch-shaping is generalized to include scaled-element D/A converters. Several types of scaled-element mismatch-shaping D/A converters are proposed. Simulations show that, when implemented...... in a standard CMOS technology, they can be designed to yield 100 dB performance at 10 times oversampling. The proposed scaled-element mismatch-shaping D/A converters are well suited for use as the feedback stage in oversampled delta-sigma quantizers. It is, however, not easy to make full use of their potential......-order difference of the output signal from the loop filter's first integrator stage. This technique avoids the need for accurate matching of analog and digital filters that characterizes the MASH topology, and it preserves the signal-band suppression of quantization errors. Simulations show that quantizers...

  13. High performance soft magnetic materials

    CERN Document Server

    2017-01-01

    This book provides comprehensive coverage of the current state-of-the-art in soft magnetic materials and related applications, with particular focus on amorphous and nanocrystalline magnetic wires and ribbons and sensor applications. Expert chapters cover preparation, processing, tuning of magnetic properties, modeling, and applications. Cost-effective soft magnetic materials are required in a range of industrial sectors, such as magnetic sensors and actuators, microelectronics, cell phones, security, automobiles, medicine, health monitoring, aerospace, informatics, and electrical engineering. This book presents both fundamentals and applications to enable academic and industry researchers to pursue further developments of these key materials. This highly interdisciplinary volume represents essential reading for researchers in materials science, magnetism, electrodynamics, and modeling who are interested in working with soft magnets. Covers magnetic microwires, sensor applications, amorphous and nanocrystalli...

  14. High performance polyethylene nanocomposite fibers

    Directory of Open Access Journals (Sweden)

    A. Dorigato

    2012-12-01

    Full Text Available A high density polyethylene (HDPE matrix was melt compounded with 2 vol% of dimethyldichlorosilane treated fumed silica nanoparticles. Nanocomposite fibers were prepared by melt spinning through a co-rotating twin screw extruder and drawing at 125°C in air. Thermo-mechanical and morphological properties of the resulting fibers were then investigated. The introduction of nanosilica improved the drawability of the fibers, allowing the achievement of higher draw ratios with respect to the neat matrix. The elastic modulus and creep stability of the fibers were remarkably improved upon nanofiller addition, with a retention of the pristine tensile properties at break. Transmission electronic microscope (TEM images evidenced that the original morphology of the silica aggregates was disrupted by the applied drawing.

  15. Laparoscopic versus open peritoneal dialysis catheter insertion, the LOCI-trial: A study protocol

    NARCIS (Netherlands)

    S.M. Hagen (Sander); A.M. van Alphen (Adriaan); J.N.M. IJzermans (Jan); F.J.M.F. Dor (Frank)

    2011-01-01

    textabstractBackground: Peritoneal dialysis (PD) is an effective treatment for end-stage renal disease. It allows patients more freedom to perform daily activities compared to haemodialysis. Key to successful PD is the presence of a well-functioning dialysis catheter. Several complications, such as

  16. Comparative Analysis of Serum Levels of Aluminum and Lead in Dialysis Patients, Pre and post Dialysis

    OpenAIRE

    Atieh Makhlough; Mohammad Shokrzadeh; Maryam Shaliji; Siyavash Abedi

    2014-01-01

    Background: Accumulation or deficiency of trace elements can occur in hemodialysis patients and it increases risk of cardiovascular or other organs disorders. Special ions levels such as sodium and bicarbonate in dialysis fluid are accurately regulated but the remaining elements are not regularly measured. Aluminum and lead belong to the biologic performance free heavy metals .They also has a tendency to accumulate in hemodialysis patients. This study aims to compare serum aluminum and lead l...

  17. HIGH-PERFORMANCE COATING MATERIALS

    Energy Technology Data Exchange (ETDEWEB)

    SUGAMA,T.

    2007-01-01

    Corrosion, erosion, oxidation, and fouling by scale deposits impose critical issues in selecting the metal components used at geothermal power plants operating at brine temperatures up to 300 C. Replacing these components is very costly and time consuming. Currently, components made of titanium alloy and stainless steel commonly are employed for dealing with these problems. However, another major consideration in using these metals is not only that they are considerably more expensive than carbon steel, but also the susceptibility of corrosion-preventing passive oxide layers that develop on their outermost surface sites to reactions with brine-induced scales, such as silicate, silica, and calcite. Such reactions lead to the formation of strong interfacial bonds between the scales and oxide layers, causing the accumulation of multiple layers of scales, and the impairment of the plant component's function and efficacy; furthermore, a substantial amount of time is entailed in removing them. This cleaning operation essential for reusing the components is one of the factors causing the increase in the plant's maintenance costs. If inexpensive carbon steel components could be coated and lined with cost-effective high-hydrothermal temperature stable, anti-corrosion, -oxidation, and -fouling materials, this would improve the power plant's economic factors by engendering a considerable reduction in capital investment, and a decrease in the costs of operations and maintenance through optimized maintenance schedules.

  18. Dialysis: Reducing Infections and Changing Culture

    Centers for Disease Control (CDC) Podcasts

    This podcast is an account from an infection preventionist about the challenges and successes with engaging dialysis care teams to focus on "Zero Preventable Infections" in outpatient dialysis facilities.

  19. Treatment Methods for Kidney Failure: Peritoneal Dialysis

    Science.gov (United States)

    ... connect the bags of dialysis solution place the drain tube If you choose automated peritoneal dialysis, you also ... from the new bag of solution into the drain bag. Clamp the tube that goes to the drain bag. Open or ...

  20. Delivering high performance BWR fuel reliably

    International Nuclear Information System (INIS)

    Schardt, J.F.

    1998-01-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  1. Aliskiren prevents the toxic effects of peritoneal dialysis fluids during chronic dialysis in rats.

    Directory of Open Access Journals (Sweden)

    Juan Pérez-Martínez

    Full Text Available The benefits of long-term peritoneal dialysis (PD in patients with end-stage renal failure are short-lived due to structural and functional changes in the peritoneal membrane. In this report, we provide evidence for the in vitro and in vivo participation of the renin-angiotensin-aldosterone system (RAAS in the signaling pathway leading to peritoneal fibrosis during PD. Exposure to high-glucose PD fluids (PDFs increases damage and fibrosis markers in both isolated rat peritoneal mesothelial cells and in the peritoneum of rats after chronic dialysis. In both cases, the addition of the RAAS inhibitor aliskiren markedly improved damage and fibrosis markers, and prevented functional modifications in the peritoneal transport, as measured by the peritoneal equilibrium test. These data suggest that inhibition of the RAAS may be a novel way to improve the efficacy of PD by preventing inflammation and fibrosis following peritoneal exposure to high-glucose PDFs.

  2. Geriatric syndromes are potential determinants of the medication adherence status in prevalent dialysis patients

    Directory of Open Access Journals (Sweden)

    Chia-Ter Chao

    2016-06-01

    Full Text Available Background. Geriatric syndromes (GS exhibit high prevalence in patients with end-stage renal disease (ESRD under chronic dialysis irrespective of age. We sought to determine whether GS influences medication adherence in ESRD patients. Methods. A prospective cohort of chronic dialysis patients was assembled. The presence of GS components, including frailty/prefrailty, polypharmacy, and malnutrition, were ascertained through a validated questionnaire, electronic records and chart abstraction, and laboratory tests. The severity of medication non-adherence was defined using the eight-item Morisky Medication Adherence Scale (MMAS. Multiple logistic regression analysis was performed targeting MMAS results and incorporating relevant clinical features and GS. Results. The prevalence of frailty/pre-frailty, polypharmacy, and hypoalbuminemia/ malnutrition among the enrolled participants was 66.7%, 94%, and 14%, respectively. The average MMAS scores in these dialysis patients were 2 ± 1.7 (range, 0–6, with only 15.7% exhibiting high medication adherence. Multiple regression analyses showed that the absence of frailty/pre-frailty (P = 0.01 were significantly associated with poorer medication adherence, while the presence of polypharmacy (P = 0.02 and lower serum albumin, a potential sign of malnutrition (P = 0.03, were associated with poor adherence in another model. Conclusion. This study is among the very few reports addressing GS and medication adherence, especially in ESRD patients. Interventions targeting frailty, polypharmacy, and malnutrition might potentially improve the medication non-adherence and symptom control in these pill-burdened patients.

  3. The energy cost of kidney proton dialysis in sickle cell anaemia

    African Journals Online (AJOL)

    AJB SERVER

    2007-01-18

    Jan 18, 2007 ... kidney as most of the energy for proton dialysis is wasted as a result of high entropy. Key words: Sickle cell, anaemia, energy, kidney, dialysis, proton, and enthalpy. INTRODUCTION. Evidence exists that for those with sickle cell syndromes. “kidney damage starts very early and progresses throu- ghout life” ...

  4. High performance carbon nanocomposites for ultracapacitors

    Science.gov (United States)

    Lu, Wen

    2012-10-02

    The present invention relates to composite electrodes for electrochemical devices, particularly to carbon nanotube composite electrodes for high performance electrochemical devices, such as ultracapacitors.

  5. Strategies and Experiences Using High Performance Fortran

    National Research Council Canada - National Science Library

    Shires, Dale

    2001-01-01

    .... High performance Fortran (HPF) is a relative new addition to the Fortran dialect It is an attempt to provide an efficient high-level Fortran parallel programming language for the latest generation of been debatable...

  6. Insomnia in chronic renal patients on dialysis in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Hejaili Fayez F

    2010-06-01

    Full Text Available Abstract Background Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD. This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis. Methods This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data. Results Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 ± 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (P-values: 0.05, 0.01, Conclusion Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.

  7. High Performance Grinding and Advanced Cutting Tools

    CERN Document Server

    Jackson, Mark J

    2013-01-01

    High Performance Grinding and Advanced Cutting Tools discusses the fundamentals and advances in high performance grinding processes, and provides a complete overview of newly-developing areas in the field. Topics covered are grinding tool formulation and structure, grinding wheel design and conditioning and applications using high performance grinding wheels. Also included are heat treatment strategies for grinding tools, using grinding tools for high speed applications, laser-based and diamond dressing techniques, high-efficiency deep grinding, VIPER grinding, and new grinding wheels.

  8. Strategy Guideline: High Performance Residential Lighting

    Energy Technology Data Exchange (ETDEWEB)

    Holton, J.

    2012-02-01

    The Strategy Guideline: High Performance Residential Lighting has been developed to provide a tool for the understanding and application of high performance lighting in the home. The high performance lighting strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner's expectations for high quality lighting.

  9. Carbon nanomaterials for high-performance supercapacitors

    OpenAIRE

    Tao Chen; Liming Dai

    2013-01-01

    Owing to their high energy density and power density, supercapacitors exhibit great potential as high-performance energy sources for advanced technologies. Recently, carbon nanomaterials (especially, carbon nanotubes and graphene) have been widely investigated as effective electrodes in supercapacitors due to their high specific surface area, excellent electrical and mechanical properties. This article summarizes the recent progresses on the development of high-performance supercapacitors bas...

  10. Targeted separation of antibacterial peptide from protein hydrolysate of anchovy cooking wastewater by equilibrium dialysis.

    Science.gov (United States)

    Tang, Wenting; Zhang, Hui; Wang, Li; Qian, Haifeng; Qi, Xiguang

    2015-02-01

    Anchovy (Engraulis japonicus) cooking wastewater (ACWW) is a by-product resulted from the production of boiled-dried anchovies in the seafood processing industry. In this study, the protein hydrolysate of ACWW (ACWWPH) was found to have antimicrobial activity after enzymatic hydrolysis with Protamex. For the targeted screening of antibacterial peptides, liposomes constructed from Staphylococcus aureus membrane lipids were used in an equilibrium dialysis system. The hydrolysate was further purified by liposome equilibrium dialysis combined with high performance liquid chromatography. The purified antimicrobial peptide (ACWWP1) was determined to be GLSRLFTALK, with a molecular weight of 1104.6622Da. The peptide exhibited no haemolytic activity up to a concentration of 512μg/ml. It displayed a dose-dependent bactericidal effect in reconstituted milk. The change in cell surface hydrophobicity and membrane-permeable action of the purified ACWWP1 may have contributed to the antibacterial effect. This study suggests that liposome equilibrium dialysis can be used for the targeted screening of antimicrobial peptides. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Prevalence of Sarcopenia and Dynapenia and Their Determinants in Iranian Peritoneal Dialysis Patients.

    Science.gov (United States)

    As'habi, Atefeh; Najafi, Iraj; Tabibi, Hadi; Hedayati, Mehdi

    2018-01-01

    Uremic sarcopenia and dynapenia are prevalent in chronic kidney disease patients, including dialysis patients. The present study was designed to determine the prevalence of sarcopenia and dynapenia and their determinants in peritoneal dialysis (PD) patients in Tehran, Iran. All eligible PD patients at the peritoneal dialysis centers of Tehran were included in this cross-sectional study. Skeletal muscle mass and muscle strength were assessed using bioelectrical impedance analysis and hand grip strength, respectively. Physical performance was determined by a 4-m walk gait speed test. The prevalence rates of dynapenia and sarcopenia were 43.0% and 11.5% in the PD patients, respectively. There were significant associations between the prevalence of dynapenia and the age of patients (P = .03), physical activity level (P = .04), and the presence of diabetes mellitus (P = .005). In addition, a significant association was found between the prevalence of sarcopenia and sex (P = .009). This study indicates that uremic sarcopenia and dynapenia are prevalent in PD patients in Tehran, Iran. These conditions may contribute to physical disability, decreased the quality of life, increased morbidity, and a high mortality rate. Therefore, prevention and treatment of uremic sarcopenia and dynapenia are necessary for Iranian PD patients.

  12. Team Development for High Performance Management.

    Science.gov (United States)

    Schermerhorn, John R., Jr.

    1986-01-01

    The author examines a team development approach to management that creates shared commitments to performance improvement by focusing the attention of managers on individual workers and their task accomplishments. It uses the "high-performance equation" to help managers confront shared beliefs and concerns about performance and develop realistic…

  13. Frailty in Chinese Peritoneal Dialysis Patients: Prevalence and Prognostic Significance

    Directory of Open Access Journals (Sweden)

    Jack Kit-Chung Ng

    2016-10-01

    Full Text Available Background/Aims: Previous studies showed that frailty is prevalent in both pre-dialysis and dialysis patients. However, the prevalence and prognostic implication of frailty in Chinese peritoneal dialysis (PD patients remain unknown. Methods: We used a validated questionnaire to determine the Frailty Score of 193 unselected prevalent PD patients. All patients were then followed for 2 years for their need of hospitalization and mortality. Results: Amongst the 193 patients, 134 (69.4% met the criteria of being frail. Frailty Score significantly correlated with Charlson's comorbidity score (r = 0.40, p Conclusions: Frailty is prevalent among Chinese PD patients. Frail PD patients have a high risk of requiring hospitalization and their hospital stay tends to be prolonged. Early identification may allow timely intervention to prevent adverse health outcomes in this group of patients.

  14. Delivering high performance BWR fuel reliably

    Energy Technology Data Exchange (ETDEWEB)

    Schardt, J.F. [GE Nuclear Energy, Wilmington, NC (United States)

    1998-07-01

    Utilities are under intense pressure to reduce their production costs in order to compete in the increasingly deregulated marketplace. They need fuel, which can deliver high performance to meet demanding operating strategies. GE's latest BWR fuel design, GE14, provides that high performance capability. GE's product introduction process assures that this performance will be delivered reliably, with little risk to the utility. (author)

  15. HPTA: High-Performance Text Analytics

    OpenAIRE

    Vandierendonck, Hans; Murphy, Karen; Arif, Mahwish; Nikolopoulos, Dimitrios S.

    2017-01-01

    One of the main targets of data analytics is unstructured data, which primarily involves textual data. High-performance processing of textual data is non-trivial. We present the HPTA library for high-performance text analytics. The library helps programmers to map textual data to a dense numeric representation, which can be handled more efficiently. HPTA encapsulates three performance optimizations: (i) efficient memory management for textual data, (ii) parallel computation on associative dat...

  16. Effect on hemo-dialysis on concentration of lactate dehyrogenase, creatine kinase and a-amylase in renal failure

    International Nuclear Information System (INIS)

    Modawe, G. O. H.; Idris, O. F.

    2009-01-01

    This study was conducted to compare the concentration of plasma enzymes in chronic renal failure pre dialysis (group A) and post dialysis (group B), and evaluate the concentration of these enzymes between pre and post dialysis. The study was performed in 25 samples of Sudanese patients (chronic renal failure) and compared with 15 samples as the control groups. plasma samples were analyzed using spectrophotometric methods, plasma concentration of these enzymes showed increase in chronic renal failure pre and post dialysis. The mean values of lactate dehydrogenase pre dialysis was 259IU/L, post dialysis was 276IU/L, the mean of creatine kinase pre dialysis was 252IU/L, and post dialysis was 241 IU/L but the mean of amylase pre and post dialysis was the same 144 IU/L. This study showed that there was no difference of concentration of amylase enzyme, but the different in concentration of CK and LDH between pre and post dialysis during chronic renal failure depend on normal range of this enzyme in control groups.(Author)

  17. Conflict when making decisions about dialysis modality.

    Science.gov (United States)

    Chen, Nien-Hsin; Lin, Yu-Ping; Liang, Shu-Yuan; Tung, Heng-Hsin; Tsay, Shiow-Luan; Wang, Tsae-Jyy

    2018-01-01

    To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. A predictive correlational cross-sectional study design was used. Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis

  18. Total knee arthroplasty in patients with dialysis: Early complications and mortality

    Directory of Open Access Journals (Sweden)

    Jen-Hung Chen

    2014-04-01

    Full Text Available Background: Total hip arthroplasty (THA in patients on long-term hemodialysis may result in a high prevalence of complications which related to nature of the disease, and associated cardiovascular conditions. However, the result of total knee artrhopalsty (TKA in those patients is not clear. The purpose of this study was to retrospectively evaluate the early mortality and complications of TKA performed in patients with dialysis. Methods: We retrospectively evaluated 15 dialysis patients (18 knees who underwent TKA using antibiotic-loaded cement fixation. Fourteen patients had maintained hemodialysis and one patient had continuous ambulatory peritoneal dialysis. The function of the knee was evaluated before operation and postoperatively using Knee Society evaluating system. Postoperative complications and mortality were recorded for all patients. The average follow up period was 25 months (6 to 59 months. Results: There were no mortalities including short-term (≤90 days or long-term (>90 days follow up. The mean knee and function scores improved from preoperative 36 points (27~46 and 19.4 points (10~35 to 79 points (68~87 and 81 points (70~95 respectively at the latest follow up. One (6.7% patient had early postoperative pneumonia (≤90 days. The late (>90 days complica-tion rate was 20% including 1 sepsis with toe gangrene, 1 recurrent stroke and 1 acute myocardiac infarction. There was no deep prosthetic joint infection or loosening of the components. Conclusion: TKA with antibiotic-loaded cement resulted in a substantial low short-term mortality and deep infections in 15 patients with dialysis. However, a longer term follow up is necessary.

  19. Non-adherence in patients on peritoneal dialysis: a systematic review.

    Directory of Open Access Journals (Sweden)

    Konstadina Griva

    Full Text Available BACKGROUND: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions. METHODS: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. RESULTS: The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. CONCLUSION: Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

  20. Non-adherence in patients on peritoneal dialysis: a systematic review.

    Science.gov (United States)

    Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P

    2014-01-01

    It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6-53% for dialysis exchanges, 3.9-85% for medication, and 14.4-67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population.

  1. Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

    Science.gov (United States)

    Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P.

    2014-01-01

    Background It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of non-adherence varied across studies: 2.6–53% for dialysis exchanges, 3.9–85% for medication, and 14.4–67% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient population. PMID:24586478

  2. Phosphate binding therapy in dialysis patients: focus on lanthanum carbonate

    Directory of Open Access Journals (Sweden)

    Ismail A Mohammed

    2008-11-01

    Full Text Available Ismail A Mohammed, Alastair J HutchisonManchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Oxford Road, Manchester, UKAbstract: Hyperphosphatemia is an inevitable consequence of end stage chronic kidney disease and is present in the majority of dialysis patients. Recent observational data has associated hyperphosphatemia with increased cardiovascular mortality among dialysis patients. Dietary restriction of phosphate and current dialysis prescription practices are not enough to maintain serum phosphate levels within the recommended range so that the majority of dialysis patients require oral phosphate binders. Unfortunately, conventional phosphate binders are not reliably effective and are associated with a range of limitations and side effects. Aluminium-containing agents are highly efficient but no longer widely used because of well established and proven toxicity. Calcium based salts are inexpensive, effective and most widely used but there is now concern about their association with hypercalcemia and vascular calcification. Sevelamer hydrochloride is associated with fewer adverse effects, but a large pill burden and high cost are limiting factors to its wider use. In addition, the efficacy of sevelamer as a monotherapy in lowering phosphate to target levels in severe hyperphosphatemia remains debatable. Lanthanum carbonate is a promising new non-aluminium, calcium-free phosphate binder. Preclinical and clinical studies have demonstrated a good safety profile, and it appears well tolerated and effective in reducing phosphate levels in dialysis patients. Its identified adverse events are apparently mild to moderate in severity and mostly GI related. It appears to be effective as a monotherapy, with a reduced pill burden, but like sevelamer, it is significantly more expensive than calcium-based binders. Data on its safety profile over 6 years of treatment are now available.Keywords: hyperphosphatemia, lanthanum

  3. Strategy Guideline. Partnering for High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, Duncan [IBACOS, Inc., Pittsburgh, PA (United States)

    2013-01-01

    High performance houses require a high degree of coordination and have significant interdependencies between various systems in order to perform properly, meet customer expectations, and minimize risks for the builder. Responsibility for the key performance attributes is shared across the project team and can be well coordinated through advanced partnering strategies. For high performance homes, traditional partnerships need to be matured to the next level and be expanded to all members of the project team including trades, suppliers, manufacturers, HERS raters, designers, architects, and building officials as appropriate. This guide is intended for use by all parties associated in the design and construction of high performance homes. It serves as a starting point and features initial tools and resources for teams to collaborate to continually improve the energy efficiency and durability of new houses.

  4. Albumin Dialysis for Liver Failure: A Systematic Review.

    Science.gov (United States)

    Tsipotis, Evangelos; Shuja, Asim; Jaber, Bertrand L

    2015-09-01

    Albumin dialysis is the best-studied extracorporeal nonbiologic liver support system as a bridge or destination therapy for patients with liver failure awaiting liver transplantation or recovery of liver function. We performed a systematic review to examine the efficacy and safety of 3 albumin dialysis systems (molecular adsorbent recirculating system [MARS], fractionated plasma separation, adsorption and hemodialysis [Prometheus system], and single-pass albumin dialysis) in randomized trials for supportive treatment of liver failure. PubMed, Ovid, EMBASE, Cochrane's Library, and ClinicalTrials.gov were searched. Two authors independently screened citations and extracted data on patient characteristics, quality of reports, efficacy, and safety end points. Ten trials (7 of MARS and 3 of Prometheus) were identified (620 patients). By meta-analysis, albumin dialysis achieved a net decrease in serum total bilirubin level relative to standard medical therapy of 8.0 mg/dL (95% confidence interval [CI], -10.6 to -5.4) but not in serum ammonia or bile acids. Albumin dialysis achieved an improvement in hepatic encephalopathy relative to standard medical therapy with a risk ratio of 1.55 (95% CI, 1.16-2.08) but had no effect survival with a risk ratio of 0.95 (95% CI, 0.84-1.07). Because of inconsistency in the reporting of adverse events, the safety analysis was limited but did not demonstrate major safety concerns. Use of albumin dialysis as supportive treatment for liver failure is successful at removing albumin-bound molecules, such as bilirubin and at improving hepatic encephalopathy. Additional experience is required to guide its optimal use and address safety concerns. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  5. High-performance ceramics. Fabrication, structure, properties

    International Nuclear Information System (INIS)

    Petzow, G.; Tobolski, J.; Telle, R.

    1996-01-01

    The program ''Ceramic High-performance Materials'' pursued the objective to understand the chaining of cause and effect in the development of high-performance ceramics. This chain of problems begins with the chemical reactions for the production of powders, comprises the characterization, processing, shaping and compacting of powders, structural optimization, heat treatment, production and finishing, and leads to issues of materials testing and of a design appropriate to the material. The program ''Ceramic High-performance Materials'' has resulted in contributions to the understanding of fundamental interrelationships in terms of materials science, which are summarized in the present volume - broken down into eight special aspects. (orig./RHM)

  6. High Burnup Fuel Performance and Safety Research

    Energy Technology Data Exchange (ETDEWEB)

    Bang, Je Keun; Lee, Chan Bok; Kim, Dae Ho (and others)

    2007-03-15

    The worldwide trend of nuclear fuel development is to develop a high burnup and high performance nuclear fuel with high economies and safety. Because the fuel performance evaluation code, INFRA, has a patent, and the superiority for prediction of fuel performance was proven through the IAEA CRP FUMEX-II program, the INFRA code can be utilized with commercial purpose in the industry. The INFRA code was provided and utilized usefully in the universities and relevant institutes domesticallly and it has been used as a reference code in the industry for the development of the intrinsic fuel rod design code.

  7. ADVANCED HIGH PERFORMANCE SOLID WALL BLANKET CONCEPTS

    International Nuclear Information System (INIS)

    WONG, CPC; MALANG, S; NISHIO, S; RAFFRAY, R; SAGARA, S

    2002-01-01

    OAK A271 ADVANCED HIGH PERFORMANCE SOLID WALL BLANKET CONCEPTS. First wall and blanket (FW/blanket) design is a crucial element in the performance and acceptance of a fusion power plant. High temperature structural and breeding materials are needed for high thermal performance. A suitable combination of structural design with the selected materials is necessary for D-T fuel sufficiency. Whenever possible, low afterheat, low chemical reactivity and low activation materials are desired to achieve passive safety and minimize the amount of high-level waste. Of course the selected fusion FW/blanket design will have to match the operational scenarios of high performance plasma. The key characteristics of eight advanced high performance FW/blanket concepts are presented in this paper. Design configurations, performance characteristics, unique advantages and issues are summarized. All reviewed designs can satisfy most of the necessary design goals. For further development, in concert with the advancement in plasma control and scrape off layer physics, additional emphasis will be needed in the areas of first wall coating material selection, design of plasma stabilization coils, consideration of reactor startup and transient events. To validate the projected performance of the advanced FW/blanket concepts the critical element is the need for 14 MeV neutron irradiation facilities for the generation of necessary engineering design data and the prediction of FW/blanket components lifetime and availability

  8. High performance liquid chromatographic determination of ...

    African Journals Online (AJOL)

    STORAGESEVER

    2010-02-08

    ) high performance liquid chromatography (HPLC) grade .... applications. These are important requirements if the reagent is to be applicable to on-line pre or post column derivatisation in a possible automation of the analytical.

  9. Analog circuit design designing high performance amplifiers

    CERN Document Server

    Feucht, Dennis

    2010-01-01

    The third volume Designing High Performance Amplifiers applies the concepts from the first two volumes. It is an advanced treatment of amplifier design/analysis emphasizing both wideband and precision amplification.

  10. High-performance computing using FPGAs

    CERN Document Server

    Benkrid, Khaled

    2013-01-01

    This book is concerned with the emerging field of High Performance Reconfigurable Computing (HPRC), which aims to harness the high performance and relative low power of reconfigurable hardware–in the form Field Programmable Gate Arrays (FPGAs)–in High Performance Computing (HPC) applications. It presents the latest developments in this field from applications, architecture, and tools and methodologies points of view. We hope that this work will form a reference for existing researchers in the field, and entice new researchers and developers to join the HPRC community.  The book includes:  Thirteen application chapters which present the most important application areas tackled by high performance reconfigurable computers, namely: financial computing, bioinformatics and computational biology, data search and processing, stencil computation e.g. computational fluid dynamics and seismic modeling, cryptanalysis, astronomical N-body simulation, and circuit simulation.     Seven architecture chapters which...

  11. Embedded High Performance Scalable Computing Systems

    National Research Council Canada - National Science Library

    Ngo, David

    2003-01-01

    The Embedded High Performance Scalable Computing Systems (EHPSCS) program is a cooperative agreement between Sanders, A Lockheed Martin Company and DARPA that ran for three years, from Apr 1995 - Apr 1998...

  12. Gradient High Performance Liquid Chromatography Method ...

    African Journals Online (AJOL)

    Purpose: To develop a gradient high performance liquid chromatography (HPLC) method for the simultaneous determination of phenylephrine (PHE) and ibuprofen (IBU) in solid ..... nimesulide, phenylephrine. Hydrochloride, chlorpheniramine maleate and caffeine anhydrous in pharmaceutical dosage form. Acta Pol.

  13. Highlighting High Performance: Whitman Hanson Regional High School; Whitman, Massachusetts

    Energy Technology Data Exchange (ETDEWEB)

    2006-06-01

    This brochure describes the key high-performance building features of the Whitman-Hanson Regional High School. The brochure was paid for by the Massachusetts Technology Collaborative as part of their Green Schools Initiative. High-performance features described are daylighting and energy-efficient lighting, indoor air quality, solar and wind energy, building envelope, heating and cooling systems, water conservation, and acoustics. Energy cost savings are also discussed.

  14. Fate of patients during the first year of dialysis

    Directory of Open Access Journals (Sweden)

    Selma Siham El Khayat

    2013-01-01

    Full Text Available Care in dialysis is often associated with significant morbidity and mortality during the first year. Knowledge of its magnitude and causes could improve the prognosis of these patients. The aim of this study was to evaluate the survival and morbidity during the first year of dialysis for patients who initiated their dialysis between January 1, 2009 and December 31, 2009 and to study their possible correlation with baseline status at the beginning of treatment. A multi-center retrospective study was conducted in 11 dialysis centers. Clinical data at the beginning of dialysis and during the following year were collected. Mortality and morbidity risk factors were assessed by comparing different groups. Statistical analysis was performed with SPSS version 11. This study involved 134 patients, 79 men and 55 women, of whom 132 were on hemodialysis and two patients were on peritoneal dialysis. The mean age at initiation of treatment was 54.37 ± 18.09 years. Initial causes of nephropathy were dominated by diabetes (44.02% and hypertension (11.19%. Among these patients, 39.55% had never received prior nephrological follow-up and 64.92% had started renal replacement therapy on an emergency basis. The initial clinical state was dominated by the presence of hypertension (50.74%, diabetes (44.02%, coronary insufficiency (13.43% and heart failure (7.46%. Only 26.86% of the incident patients showed no comorbidity. During the first year of follow-up, 37.31% of the patients experienced at least one episode of comorbidity. Hospitalization was necessary in about half of these cases (17.91% of all patients. The overall mortality rate was 14.17%. One patient received a kidney transplant. The mortality rate in the first year of dialysis was lower in our study than in other series. Regular nephrological follow-up of these patients before they reach end-stage could have a significant influence on survival in dialysis.

  15. High performance computing in Windows Azure cloud

    OpenAIRE

    Ambruš, Dejan

    2013-01-01

    High performance, security, availability, scalability, flexibility and lower costs of maintenance have essentially contributed to the growing popularity of cloud computing in all spheres of life, especially in business. In fact cloud computing offers even more than this. With usage of virtual computing clusters a runtime environment for high performance computing can be efficiently implemented also in a cloud. There are many advantages but also some disadvantages of cloud computing, some ...

  16. High-performance computing — an overview

    Science.gov (United States)

    Marksteiner, Peter

    1996-08-01

    An overview of high-performance computing (HPC) is given. Different types of computer architectures used in HPC are discussed: vector supercomputers, high-performance RISC processors, various parallel computers like symmetric multiprocessors, workstation clusters, massively parallel processors. Software tools and programming techniques used in HPC are reviewed: vectorizing compilers, optimization and vector tuning, optimization for RISC processors; parallel programming techniques like shared-memory parallelism, message passing and data parallelism; and numerical libraries.

  17. Governance among Malaysian high performing companies

    Directory of Open Access Journals (Sweden)

    Asri Marsidi

    2016-07-01

    Full Text Available Well performed companies have always been linked with effective governance which is generally reflected through effective board of directors. However many issues concerning the attributes for effective board of directors remained unresolved. Nowadays diversity has been perceived as able to influence the corporate performance due to the likelihood of meeting variety of needs and demands from diverse customers and clients. The study therefore aims to provide a fundamental understanding on governance among high performing companies in Malaysia.

  18. High-performance OPCPA laser system

    International Nuclear Information System (INIS)

    Zuegel, J.D.; Bagnoud, V.; Bromage, J.; Begishev, I.A.; Puth, J.

    2006-01-01

    Optical parametric chirped-pulse amplification (OPCPA) is ideally suited for amplifying ultra-fast laser pulses since it provides broadband gain across a wide range of wavelengths without many of the disadvantages of regenerative amplification. A high-performance OPCPA system has been demonstrated as a prototype for the front end of the OMEGA Extended Performance (EP) Laser System. (authors)

  19. High-performance OPCPA laser system

    Energy Technology Data Exchange (ETDEWEB)

    Zuegel, J.D.; Bagnoud, V.; Bromage, J.; Begishev, I.A.; Puth, J. [Rochester Univ., Lab. for Laser Energetics, NY (United States)

    2006-06-15

    Optical parametric chirped-pulse amplification (OPCPA) is ideally suited for amplifying ultra-fast laser pulses since it provides broadband gain across a wide range of wavelengths without many of the disadvantages of regenerative amplification. A high-performance OPCPA system has been demonstrated as a prototype for the front end of the OMEGA Extended Performance (EP) Laser System. (authors)

  20. Comparing Dutch and British high performing managers

    NARCIS (Netherlands)

    Waal, A.A. de; Heijden, B.I.J.M. van der; Selvarajah, C.; Meyer, D.

    2016-01-01

    National cultures have a strong influence on the performance of organizations and should be taken into account when studying the traits of high performing managers. At the same time, many studies that focus upon the attributes of successful managers show that there are attributes that are similar

  1. Children of home dialysis patients.

    Science.gov (United States)

    Tsaltas, M O

    1976-12-13

    Fifteen children of six families in which one parent was undergoing home dialysis were examined by the Minnesota Multiphasic Personality Inventory, human figure drawings, and family interviews. All the children were found to be clinically depressed, and two thirds had a history of being referred by teachers to school counselors and psychiatrists for behavioral problems in school. Of these referred children, all showed disorders of psychomotor activity and reduced academic achievement. There was no clear-cut evidence that these children were depressed because of exposure to home dialysis per se. The most disturbed children seemed to be responding to depressed parents or to partial object loss. A controlled, prospective study is planned to clarify this question.

  2. Nutrition and the dialysis prescription.

    Science.gov (United States)

    Chertow, G M; Bullard, A; Lazarus, J M

    1996-01-01

    Malnutrition is common among patients with acute and chronic renal failure. The efficiency of modern dialytic techniques has allowed for more liberal administration of nutrients to patients with renal failure, particularly with regard to protein and amino acids. Protein restriction is not indicated for patients on dialysis, and should be employed cautiously, if at all, in patients with renal insufficiency. The 'nutrition prescription' should be considered a vital part of the comprehensive medical, surgical, and dialytic care provided to patients with renal disease.

  3. Anxiety disorders in dialysis patients

    OpenAIRE

    Novaković Milan

    2007-01-01

    Introduction. Anxiety, as a primary symptom, includes all conditions of indefinite fear and psychic disorders dominated by fear. All dialysis patients suffer from anxiety as an independent phenomenon, or as part of another disease. Material and Methods. This study included 753 patients on chronic hemodialysis in Bosnia and Herzegovina (B&H) in the period 1999-2004. The patients were divided into two groups: the first group included 348 patients with Balkan Endemic Nephropathy (BEN), and t...

  4. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

    Science.gov (United States)

    Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

    2017-01-06

    Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

  5. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

    Science.gov (United States)

    Aki, T. Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A.

    2017-01-01

    Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Design, setting, participants, & measurements Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1

  6. Prophylactic dialysis in non-dialysis-dependent patients with renal failure after CABG

    Directory of Open Access Journals (Sweden)

    Roghayyeh Borji

    2014-03-01

    Conclusion: According the results of this study, prophylactic dialysis, before conduct-ing CABG, does not have any significant effect on mortality and other complications. The only exception is lung complications in non-dialysis-dependent patients with renal failure.

  7. Compatibility of Meropenem with Different Commercial Peritoneal Dialysis Solutions.

    Science.gov (United States)

    Wiesholzer, Martin; Winter, Alexandra; Kussmann, Manuel; Zeitlinger, Markus; Pichler, Petra; Burgmann, Heinz; Reznicek, Gottfried; Poeppl, Wolfgang

    ♦ BACKGROUND: Intraperitoneal administration of antimicrobial agents is recommended for the treatment of peritoneal dialysis (PD)-related peritonitis. For home-based antimicrobial therapy it is common to supply patients with PD fluid bags with admixed antibiotic. Thus, the compatibility of meropenem with different PD fluids (PDFs), namely Extraneal, Physioneal 1.36% and Physioneal 2.27% (all Baxter Healthcare Corp., Deerfield, IL, USA), was investigated under varying storage conditions. ♦ METHODS: Meropenem (Venus Pharma, Werne, Germany) was stored at 6°C and 25°C over 14 days and at 37°C over 24 hours. Drug concentration over time was determined using high performance liquid chromatography, drug activity by a diffusion disk method, diluent stability by visual inspection and drug adsorption was calculated. Blank PD fluids and deionized water were used as comparator solutions. ♦ RESULTS: Compared to water, the stability of meropenem was minimally lower in Extraneal but markedly reduced in both Physioneal solutions. No significant drug adsorption was detected for any PDF investigated. ♦ CONCLUSIONS: Meropenem is stable and compatible with Extraneal and might be stored for up to a week at refrigeration temperature (6°C). A loss of ~20% of meropenem after 2 days at room temperature should be considered. Mixed Physioneal appears not suitable for storage at any temperature after meropenem has been admixed. A considerable drug degradation due to the warming up to body temperature through heating plates should further be taken into account in clinical practice. Copyright © 2017 International Society for Peritoneal Dialysis.

  8. Association of education level with dialysis outcome.

    Science.gov (United States)

    Khattak, Muhammad; Sandhu, Gurprataap S; Desilva, Ranil; Goldfarb-Rumyantzev, Alexander S

    2012-01-01

    The impact of education on health care outcome has been studied in the past, but its role in the dialysis population is unclear. In this report, we evaluated this association. We used the United States Renal Data System data of end-stage renal disease patients aged 18 years. Education level at the time of end-stage renal disease onset was the primary variable of interest. The outcome of the study was patient mortality. We used four categories of education level: 0 = less than 12 years of education; 1 = high school graduate; 2 = some college; 3 = college graduate. Subgroups based on age, race, sex, donor type, and diabetic status were also analyzed. After adjustments for covariates in the Cox model, using individuals with less than 12 years of education as a reference, patients with college education showed decreased mortality with hazard ratio of 0.81 (95% confidence interval 0.69–0.95), P = 0.010. In conclusion, we showed that higher education level is associated with improved survival of patients on dialysis.

  9. Modeling and control of dialysis systems

    CERN Document Server

    2013-01-01

    This book is the first text of its kind that presents both the traditional and the modern aspects of dialysis modeling and control in a clear, insightful and highly comprehensive writing style. It provides an in-depth analysis of the mathematical models and algorithms, and demonstrates their applications in real world problems of significant complexity. It explains concepts in a clear, matter-of-fact style. The material of this book will be useful to advanced undergraduate and graduate biomedical engineering students. Also, researchers and practitioners in the field of dialysis, control systems, soft computing will benefit from it. In order to make the reader aware of the applied side of the subject, the book includes:       Chapter openers with a chapter outline, chapter objectives, key terms list, and abstract.       Solved numerical examples to illustrate the application of a particular concept, and also to encourage good problem-solving skills.       More than 1000 questions to give the rea...

  10. High Performance Work Systems for Online Education

    Science.gov (United States)

    Contacos-Sawyer, Jonna; Revels, Mark; Ciampa, Mark

    2010-01-01

    The purpose of this paper is to identify the key elements of a High Performance Work System (HPWS) and explore the possibility of implementation in an online institution of higher learning. With the projected rapid growth of the demand for online education and its importance in post-secondary education, providing high quality curriculum, excellent…

  11. Teacher Accountability at High Performing Charter Schools

    Science.gov (United States)

    Aguirre, Moises G.

    2016-01-01

    This study will examine the teacher accountability and evaluation policies and practices at three high performing charter schools located in San Diego County, California. Charter schools are exempted from many laws, rules, and regulations that apply to traditional school systems. By examining the teacher accountability systems at high performing…

  12. Advanced high performance solid wall blanket concepts

    International Nuclear Information System (INIS)

    Wong, C.P.C.; Malang, S.; Nishio, S.; Raffray, R.; Sagara, A.

    2002-01-01

    First wall and blanket (FW/blanket) design is a crucial element in the performance and acceptance of a fusion power plant. High temperature structural and breeding materials are needed for high thermal performance. A suitable combination of structural design with the selected materials is necessary for D-T fuel sufficiency. Whenever possible, low afterheat, low chemical reactivity and low activation materials are desired to achieve passive safety and minimize the amount of high-level waste. Of course the selected fusion FW/blanket design will have to match the operational scenarios of high performance plasma. The key characteristics of eight advanced high performance FW/blanket concepts are presented in this paper. Design configurations, performance characteristics, unique advantages and issues are summarized. All reviewed designs can satisfy most of the necessary design goals. For further development, in concert with the advancement in plasma control and scrape off layer physics, additional emphasis will be needed in the areas of first wall coating material selection, design of plasma stabilization coils, consideration of reactor startup and transient events. To validate the projected performance of the advanced FW/blanket concepts the critical element is the need for 14 MeV neutron irradiation facilities for the generation of necessary engineering design data and the prediction of FW/blanket components lifetime and availability

  13. [Fungal peritonitis due to Rhodotorula mucilaginosa in a patient with automated peritoneal dialysis: Literature review].

    Science.gov (United States)

    Verdugo, Fernando J; Briones, Eduardo; Porte, Lorena; Amaro, José; Fica, Alberto

    2016-04-01

    Fungal peritonitis is a major complication of peritoneal dialysis associated with high mortality. Most survivors have a high rate of abandonment of peritoneal dialysis. We report a case of fungal peritonitis due to an unusual agent. An 83 year-old woman, with a history of type 2 diabetes mellitus and multiple episodes of bacterial peritonitis associated to technical flaws in the implementation of automated peritoneal dialysis, was admitted due to abdominal pain and cloudy peritoneal fluid. Rhodotorula mucilaginosa was identified in the peritoneal fluid by MALDI-TOF. She was treated with catheter removal and oral posaconazole for 14 days showing clinical resolution and non-recurrence.

  14. Testosterone deficiency in dialysis patients: Differences according to the dialysis techniques

    Directory of Open Access Journals (Sweden)

    Secundino Cigarrán

    2017-09-01

    Conclusions: Circulating testosterone levels in men on dialysis were independently associated with HD technique. It can be concluded that a new factor—namely the dialysis technique—may be associated with falling testosterone levels and the associated loss of muscle mass and inflammation. Further studies are needed to establish whether the dialysis technique itself triggers testosterone elimination.

  15. Improvement of Renal Functions After Embolization of Renal AVF in a Patient Who had been on Dialysis for 5 Years

    International Nuclear Information System (INIS)

    Ulusoy, Şükrü; Özkan, Gülsüm; Dinç, Hasan; Kaynar, Kübra; Öztürk, Mehmet Halil; Gül, Semih; Kaplan, Safiye Tuba

    2011-01-01

    Recently, ultrasound-guided percutaneous renal biopsy has been used in the diagnosis of renal diseases. Development of an arteriovenous fistula (AVF), which is one of the post-biopsy complications, is not frequently encountered. AVFs are usually asymptomatic; however, they may lead to serious outcomes. We report a 21-year-old patient, who had been on dialysis for 5 years. Due to high blood pressure (230/160 mmHg) and a thrill in the lumbar area detected on physical examination, Doppler examination was performed and a renal AVF was detected. Because the patient had a history of renal biopsy 5 years previously, the fistula was thought to be secondary to the biopsy. After embolization of the AVF, renal functions improved enough to terminate dialysis treatment.

  16. High performance bio-integrated devices

    Science.gov (United States)

    Kim, Dae-Hyeong; Lee, Jongha; Park, Minjoon

    2014-06-01

    In recent years, personalized electronics for medical applications, particularly, have attracted much attention with the rise of smartphones because the coupling of such devices and smartphones enables the continuous health-monitoring in patients' daily life. Especially, it is expected that the high performance biomedical electronics integrated with the human body can open new opportunities in the ubiquitous healthcare. However, the mechanical and geometrical constraints inherent in all standard forms of high performance rigid wafer-based electronics raise unique integration challenges with biotic entities. Here, we describe materials and design constructs for high performance skin-mountable bio-integrated electronic devices, which incorporate arrays of single crystalline inorganic nanomembranes. The resulting electronic devices include flexible and stretchable electrophysiology electrodes and sensors coupled with active electronic components. These advances in bio-integrated systems create new directions in the personalized health monitoring and/or human-machine interfaces.

  17. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

    Science.gov (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

    2013-06-01

    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  18. Designing a High Performance Parallel Personal Cluster

    OpenAIRE

    Kapanova, K. G.; Sellier, J. M.

    2016-01-01

    Today, many scientific and engineering areas require high performance computing to perform computationally intensive experiments. For example, many advances in transport phenomena, thermodynamics, material properties, computational chemistry and physics are possible only because of the availability of such large scale computing infrastructures. Yet many challenges are still open. The cost of energy consumption, cooling, competition for resources have been some of the reasons why the scientifi...

  19. vSphere high performance cookbook

    CERN Document Server

    Sarkar, Prasenjit

    2013-01-01

    vSphere High Performance Cookbook is written in a practical, helpful style with numerous recipes focusing on answering and providing solutions to common, and not-so common, performance issues and problems.The book is primarily written for technical professionals with system administration skills and some VMware experience who wish to learn about advanced optimization and the configuration features and functions for vSphere 5.1.

  20. Views of Japanese patients on the advantages and disadvantages of hemodialysis and peritoneal dialysis.

    Science.gov (United States)

    Nakamura-Taira, Nanako; Muranaka, Yoshimi; Miwa, Masako; Kin, Seikon; Hirai, Kei

    2013-08-01

    The preference for dialysis modalities is not well understood in Japan. This study explored the subjective views of Japanese patients undergoing dialysis regarding their treatments. The participants were receiving in-center hemodialysis (CHD) or continuous ambulatory peritoneal dialysis (CAPD). In Study 1, 34 participants (17 CHD and 17 CAPD) were interviewed about the advantages and disadvantages of dialysis modalities. In Study 2, 454 dialysis patients (437 CHD and 17 CAPD) rated the advantages and disadvantages of CHD and CAPD in a cross-sectional survey. Interviews showed that professional care and dialysis-free days were considered as advantages of CHD, while independence, less hospital visits, and flexibility were considered as advantages of CAPD. Disadvantages of CHD included restriction of food and fluids and unpleasant symptoms after each dialysis session. Catheter care was an additional disadvantage of CAPD. Survey showed that the highly ranked advantages were professional care in CHD and less frequent hospital visits in CAPD, while the highly ranked disadvantages were concerns about emergency and time restrictions in CHD, and catheter care and difficulty in soaking in a bath in CAPD. The total scores of advantages and disadvantages showed that CHD patients subjectively rated their own modality better CHD over CAPD, while CAPD patients had the opposite opinion. The results of this study indicate that the factors affecting the decision-making process of Japanese patients are unique to Japanese culture, namely considering the trouble caused to the people around patients (e.g., families, spouses, and/or caregivers).

  1. Development of a standardized transfusion ratio as a metric for evaluating dialysis facility anemia management practices.

    Science.gov (United States)

    Liu, Jiannong; Li, Suying; Gilbertson, David T; Monda, Keri L; Bradbury, Brian D; Collins, Allan J

    2014-10-01

    Because transfusion avoidance has been the cornerstone of anemia treatment for patients with kidney disease, direct measurement of red blood cell transfusion use to assess dialysis facility anemia management performance is reasonable. We aimed to explore methods for estimating facility-level standardized transfusion ratios (STfRs) to assess provider anemia treatment practices. Retrospective cohort study. Point prevalent US hemodialysis patients on January 1, 2009, with Medicare as primary payer and dialysis duration of 90 days or longer were included (n = 223,901). All dialysis facilities with eligible patients were included (n = 5,345). Dialysis facility assignment. Receiving a red blood cell transfusion in the inpatient or outpatient setting. We evaluated 3 approaches for estimating STfR: ratio of observed to expected numbers of transfusions (STfR(obs)), a Bayesian approach (STfR(Bayes)), and a modified version of the Bayesian approach (STfR(modBayes)). The overall national transfusion rate in 2009 was 23.2 per 100 patient-years. Our model for predicting the expected number of transfusions performed well. For large facilities, all 3 STfRs worked well. However, for small facilities, while the STfR(modBayes) worked well, STfR(obs) values demonstrated instability and the STfR(Bayes) may produce more bias. Administration of transfusions to dialysis patients reflects medical practice both within and outside the dialysis unit. Some transfusions may be deemed unavoidable and transfusion practices are subject to considerable regional variation. Development of an STfR metric is feasible and reasonable for assessing anemia treatment at dialysis facilities. The STfR(obs) is simple to calculate and works well for larger dialysis facilities. The STfR(modBayes) is more analytically complex, but facilitates comparisons across all dialysis facilities, including small facilities. Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  2. [Effects of low-protein diet plus alpha-keto acid on micro-inflammation and the relationship between micro-inflammation and nutritional status in patients performing continuous ambulatory peritoneal dialysis: a randomized controlled trial].

    Science.gov (United States)

    Chen, Wei; Guo, Zhi-Yong; Wu, Hao; Sun, Li-Jing; Cai, Li-Li; Xu, Hai-Yan

    2008-05-01

    To investigate the effects of the combination of alpha-keto acid and low-protein diet on the levels of serum cytokines in patients performing continuous ambulatory peritoneal dialysis (CAPD) and to explore the relationship between inflammation and malnutrition in CAPD patients. Eighty-nine CAPD patients were randomized into three groups, and 78 cases completed a one-year follow-up and with complete data. There were 31 cases in low-protein diet plus alpha-keto acid group, 26 cases in low-protein diet group and 21 cases in routine-protein diet group. The levels of serum albumin (Alb), prealbumin (PA), retinol-binding protein (RBP), transferrin (TRF), cholesterol (TC), triglycerides (TG), leptin, and triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), body mass index (BMI) were measured. The changes of serum interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP) were also detected. Compared with low-protein diet group, serum levels of PA, RBP and TRF were significantly increased both in low-protein diet plus alpha-keto acid and routine-protein diet groups ( Pdiet plus alpha-keto acid group and routine-protein diet group. There was an increased tendency in the content of Alb, TC, TG, BMI, TSF and MAMC, but there were no significant differences. The plasma levels of IL-1alpha, IL-6 and TNF-alpha in low-protein diet plus alpha-keto acid group were decreased as compared with the routine-protein diet group, but there were no significant differences. The plasma level of CRP in low-protein diet plus alpha-keto acid group was lower than that in the routine-protein diet group ( Pketo acid and low-protein diet can ameliorate malnutrition and micro-inflammation in CAPD patients.

  3. High performance parallel I/O

    CERN Document Server

    Prabhat

    2014-01-01

    Gain Critical Insight into the Parallel I/O EcosystemParallel I/O is an integral component of modern high performance computing (HPC), especially in storing and processing very large datasets to facilitate scientific discovery. Revealing the state of the art in this field, High Performance Parallel I/O draws on insights from leading practitioners, researchers, software architects, developers, and scientists who shed light on the parallel I/O ecosystem.The first part of the book explains how large-scale HPC facilities scope, configure, and operate systems, with an emphasis on choices of I/O har

  4. Prevalence of CKD-MBD in pre-dialysis patients using biochemical ...

    African Journals Online (AJOL)

    dialysis patients were sim- ilarly studied, it was found that blacks had significantly lower levels of 25(OH) D but higher levels of calcium, phosphorus and PTH. This high secondary hyperpar- athyroidism (SHPT) and 25(OH) D deficiency occurs.

  5. Hemodialysis versus peritoneal dialysis: a case control study of survival in patients with chronic kidney disease stage 5

    DEFF Research Database (Denmark)

    Maier, Alexandra; Stocks, Franziska; Pommer, Wolfgang

    2009-01-01

    It is still controversial whether the mode of dialysis or preexisting comorbidities may influence the prognosis of patients with chronic kidney disease stage 5. Therefore, we performed a prospective case control study to evaluate whether the mode of dialysis may influence outcome. We found 25 cas...

  6. Strategy Guideline: Partnering for High Performance Homes

    Energy Technology Data Exchange (ETDEWEB)

    Prahl, D.

    2013-01-01

    High performance houses require a high degree of coordination and have significant interdependencies between various systems in order to perform properly, meet customer expectations, and minimize risks for the builder. Responsibility for the key performance attributes is shared across the project team and can be well coordinated through advanced partnering strategies. For high performance homes, traditional partnerships need to be matured to the next level and be expanded to all members of the project team including trades, suppliers, manufacturers, HERS raters, designers, architects, and building officials as appropriate. In an environment where the builder is the only source of communication between trades and consultants and where relationships are, in general, adversarial as opposed to cooperative, the chances of any one building system to fail are greater. Furthermore, it is much harder for the builder to identify and capitalize on synergistic opportunities. Partnering can help bridge the cross-functional aspects of the systems approach and achieve performance-based criteria. Critical success factors for partnering include support from top management, mutual trust, effective and open communication, effective coordination around common goals, team building, appropriate use of an outside facilitator, a partnering charter progress toward common goals, an effective problem-solving process, long-term commitment, continuous improvement, and a positive experience for all involved.

  7. Long-term bridge performance high priority bridge performance issues.

    Science.gov (United States)

    2014-10-01

    Bridge performance is a multifaceted issue involving performance of materials and protective systems, : performance of individual components of the bridge, and performance of the structural system as a whole. The : Long-Term Bridge Performance (LTBP)...

  8. Validated High Performance Liquid Chromatography Method for ...

    African Journals Online (AJOL)

    Purpose: To develop a simple, rapid and sensitive high performance liquid chromatography (HPLC) method for the determination of cefadroxil monohydrate in human plasma. Methods: Schimadzu HPLC with LC solution software was used with Waters Spherisorb, C18 (5 μm, 150mm × 4.5mm) column. The mobile phase ...

  9. An Introduction to High Performance Fortran

    Directory of Open Access Journals (Sweden)

    John Merlin

    1995-01-01

    Full Text Available High Performance Fortran (HPF is an informal standard for extensions to Fortran 90 to assist its implementation on parallel architectures, particularly for data-parallel computation. Among other things, it includes directives for specifying data distribution across multiple memories, and concurrent execution features. This article provides a tutorial introduction to the main features of HPF.

  10. High performance computing on vector systems

    CERN Document Server

    Roller, Sabine

    2008-01-01

    Presents the developments in high-performance computing and simulation on modern supercomputer architectures. This book covers trends in hardware and software development in general and specifically the vector-based systems and heterogeneous architectures. It presents innovative fields like coupled multi-physics or multi-scale simulations.

  11. High Performance Electronics on Flexible Silicon

    KAUST Repository

    Sevilla, Galo T.

    2016-09-01

    Over the last few years, flexible electronic systems have gained increased attention from researchers around the world because of their potential to create new applications such as flexible displays, flexible energy harvesters, artificial skin, and health monitoring systems that cannot be integrated with conventional wafer based complementary metal oxide semiconductor processes. Most of the current efforts to create flexible high performance devices are based on the use of organic semiconductors. However, inherent material\\'s limitations make them unsuitable for big data processing and high speed communications. The objective of my doctoral dissertation is to develop integration processes that allow the transformation of rigid high performance electronics into flexible ones while maintaining their performance and cost. In this work, two different techniques to transform inorganic complementary metal-oxide-semiconductor electronics into flexible ones have been developed using industry compatible processes. Furthermore, these techniques were used to realize flexible discrete devices and circuits which include metal-oxide-semiconductor field-effect-transistors, the first demonstration of flexible Fin-field-effect-transistors, and metal-oxide-semiconductors-based circuits. Finally, this thesis presents a new technique to package, integrate, and interconnect flexible high performance electronics using low cost additive manufacturing techniques such as 3D printing and inkjet printing. This thesis contains in depth studies on electrical, mechanical, and thermal properties of the fabricated devices.

  12. Debugging a high performance computing program

    Science.gov (United States)

    Gooding, Thomas M.

    2013-08-20

    Methods, apparatus, and computer program products are disclosed for debugging a high performance computing program by gathering lists of addresses of calling instructions for a plurality of threads of execution of the program, assigning the threads to groups in dependence upon the addresses, and displaying the groups to identify defective threads.

  13. Technology Leadership in Malaysia's High Performance School

    Science.gov (United States)

    Yieng, Wong Ai; Daud, Khadijah Binti

    2017-01-01

    Headmaster as leader of the school also plays a role as a technology leader. This applies to the high performance schools (HPS) headmaster as well. The HPS excel in all aspects of education. In this study, researcher is interested in examining the role of the headmaster as a technology leader through interviews with three headmasters of high…

  14. Toward High Performance in Industrial Refrigeration Systems

    DEFF Research Database (Denmark)

    Thybo, C.; Izadi-Zamanabadi, Roozbeh; Niemann, H.

    2002-01-01

    Achieving high performance in complex industrial systems requires information manipulation at different system levels. The paper shows how different models of same subsystems, but using different quality of information/data, are used for fault diagnosis as well as robust control design...

  15. Towards high performance in industrial refrigeration systems

    DEFF Research Database (Denmark)

    Thybo, C.; Izadi-Zamanabadi, R.; Niemann, Hans Henrik

    2002-01-01

    Achieving high performance in complex industrial systems requires information manipulation at different system levels. The paper shows how different models of same subsystems, but using different quality of information/data, are used for fault diagnosis as well as robust control design...

  16. Validated high performance liquid chromatographic (HPLC) method ...

    African Journals Online (AJOL)

    STORAGESEVER

    2010-02-22

    Feb 22, 2010 ... specific and accurate high performance liquid chromatographic method for determination of ZER in micro-volumes ... tional medicine as a cure for swelling, sores, loss of appetite and ... Receptor Activator for Nuclear Factor κ B Ligand .... The effect of ... be suitable for preclinical pharmacokinetic studies. The.

  17. Validated High Performance Liquid Chromatography Method for ...

    African Journals Online (AJOL)

    Purpose: To develop a simple, rapid and sensitive high performance liquid ... response, tailing factor and resolution of six replicate injections was < 3 %. ... Cefadroxil monohydrate, Human plasma, Pharmacokinetics Bioequivalence ... Drug-free plasma was obtained from the local .... Influence of probenicid on the renal.

  18. Integrated plasma control for high performance tokamaks

    International Nuclear Information System (INIS)

    Humphreys, D.A.; Deranian, R.D.; Ferron, J.R.; Johnson, R.D.; LaHaye, R.J.; Leuer, J.A.; Penaflor, B.G.; Walker, M.L.; Welander, A.S.; Jayakumar, R.J.; Makowski, M.A.; Khayrutdinov, R.R.

    2005-01-01

    Sustaining high performance in a tokamak requires controlling many equilibrium shape and profile characteristics simultaneously with high accuracy and reliability, while suppressing a variety of MHD instabilities. Integrated plasma control, the process of designing high-performance tokamak controllers based on validated system response models and confirming their performance in detailed simulations, provides a systematic method for achieving and ensuring good control performance. For present-day devices, this approach can greatly reduce the need for machine time traditionally dedicated to control optimization, and can allow determination of high-reliability controllers prior to ever producing the target equilibrium experimentally. A full set of tools needed for this approach has recently been completed and applied to present-day devices including DIII-D, NSTX and MAST. This approach has proven essential in the design of several next-generation devices including KSTAR, EAST, JT-60SC, and ITER. We describe the method, results of design and simulation tool development, and recent research producing novel approaches to equilibrium and MHD control in DIII-D. (author)

  19. Project materials [Commercial High Performance Buildings Project

    Energy Technology Data Exchange (ETDEWEB)

    None

    2001-01-01

    The Consortium for High Performance Buildings (ChiPB) is an outgrowth of DOE'S Commercial Whole Buildings Roadmapping initiatives. It is a team-driven public/private partnership that seeks to enable and demonstrate the benefit of buildings that are designed, built and operated to be energy efficient, environmentally sustainable, superior quality, and cost effective.

  20. High performance structural ceramics for nuclear industry

    International Nuclear Information System (INIS)

    Pujari, Vimal K.; Faker, Paul

    2006-01-01

    A family of Saint-Gobain structural ceramic materials and products produced by its High performance Refractory Division is described. Over the last fifty years or so, Saint-Gobain has been a leader in developing non oxide ceramic based novel materials, processes and products for application in Nuclear, Chemical, Automotive, Defense and Mining industries

  1. A new high performance current transducer

    International Nuclear Information System (INIS)

    Tang Lijun; Lu Songlin; Li Deming

    2003-01-01

    A DC-100 kHz current transducer is developed using a new technique on zero-flux detecting principle. It was shown that the new current transducer is of high performance, its magnetic core need not be selected very stringently, and it is easy to manufacture

  2. [10 years of external quality assurance in dialysis in Germany: Results and future prospects].

    Science.gov (United States)

    Büchtemann, Dorothea; Meinhold, Stefan; Follert, Peter

    2017-10-01

    In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme on the basis of the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres. Data on quality parameters are collected and analysed quarterly. Regional associations of statutory health insurance physicians take responsibility for quality improvement measures and sanctions. This article aims to provide an overview of the development of quality parameters from 2008 to 2015. We analysed the summarised annual quality reports published on the website of the Federal Joint Committee between 2009 and 2016. We present results on the so-called core quality parameters duration and frequency of dialysis sessions (both for haemodialysis patients), wKt/V for peritoneal dialysis patients, and percentage of haemodialysis patients with central venous catheters which has only been measured since 2014. In 2015, 92,000 patients received outpatient dialysis. Between 2008 and 2015, the results for the core quality parameters duration and frequency of haemodialysis improved while the results for wKt/V seemingly show an unfavourable trend. The percentage of patients with central venous catheters appears to be quite high, and thus indicates that there is potential for quality improvement. For the future, the Federal Joint Committee has resolved to merge the quality assurance programmes in dialysis and in kidney transplantation into a newly designed programme that has the potential to follow patients through all stages and kinds of renal replacement therapy and to focus on further aspects

  3. Strategy Guideline. High Performance Residential Lighting

    Energy Technology Data Exchange (ETDEWEB)

    Holton, J. [IBACOS, Inc., Pittsburgh, PA (United States)

    2012-02-01

    This report has been developed to provide a tool for the understanding and application of high performance lighting in the home. The strategies featured in this guide are drawn from recent advances in commercial lighting for application to typical spaces found in residential buildings. This guide offers strategies to greatly reduce lighting energy use through the application of high quality fluorescent and light emitting diode (LED) technologies. It is important to note that these strategies not only save energy in the home but also serve to satisfy the homeowner’s expectations for high quality lighting.

  4. Reimbursement and economic factors influencing dialysis modality choice around the world

    Science.gov (United States)

    Just, Paul M.; de Charro, Frank Th.; Tschosik, Elizabeth A.; Noe, Les L.; Bhattacharyya, Samir K.; Riella, Miguel C.

    2008-01-01

    The worldwide incidence of kidney failure is on the rise and treatment is costly; thus, the global burden of illness is growing. Kidney failure patients require either a kidney transplant or dialysis to maintain life. This review focuses on the economics of dialysis. Alternative dialysis modalities are haemodialysis (HD) and peritoneal dialysis (PD). Important economic factors influencing dialysis modality selection include financing, reimbursement and resource availability. In general, where there is little or no facility or physician reimbursement or payment for PD, the share of PD is very low. Regarding resource availability, when centre HD capacity is high, there is an incentive to use that capacity rather than place patients on home dialysis. In certain countries, there is interest in revising the reimbursement structure to favour home-based therapies, including PD and home HD. Modality selection is influenced by employment status, with an association between being employed and PD as the modality choice. Cost drivers differ for PD and HD. PD is driven mainly by variable costs such as solutions and tubing, while HD is driven mainly by fixed costs of facility space and staff. Many cost comparisons of dialysis modalities have been conducted. A key factor to consider in reviewing cost comparisons is the perspective of the analysis because different costs are relevant for different perspectives. In developed countries, HD is generally more expensive than PD to the payer. Additional research is needed in the developing world before conclusive statements may be made regarding the relative costs of HD and PD. PMID:18234844

  5. Body size and longitudinal body weight changes do not increase mortality in incident peritoneal dialysis patients of the Brazilian peritoneal dialysis multicenter study

    Science.gov (United States)

    da Silva Fernandes, Natália Maria; Bastos, Marcus Gomes; Franco, Márcia Regina Gianotti; Chaoubah, Alfredo; da Glória Lima, Maria; Divino-Filho, José Carolino; Qureshi, Abdul Rashid

    2013-01-01

    OBJECTIVES: To determine the roles of body size and longitudinal body weight changes in the survival of incident peritoneal dialysis patients. PATIENTS AND METHODS: Patients (n = 1911) older than 18 years of age recruited from 114 dialysis centers (Dec/2004-Oct/2007) and participating in the Brazilian Peritoneal Dialysis Multicenter Cohort Study were included. Clinical and laboratory data were collected monthly (except if the patient received a transplant, recovered renal function, was transferred to hemodialysis, or died). RESULTS: Survival analyses were performed using Kaplan-Meier survival curves and Cox proportional hazards. Total follow-up was 34 months. The mean age was 59 years (54% female). The weight category percentages were as follows: underweight: 8%; normal: 51%; overweight: 29%; and obese 12%. The multivariate model showed a higher risk of death for a body mass index 30 kg/m2. Patients were divided into five categories according to quintiles of body weight changes during the first year of dialysis: +7.1%. Patients in the lowest quintile had significantly higher mortality, whereas no negative impact was observed in the other quintiles. CONCLUSION: These findings suggest that overweight/obesity and a positive body weight variation during the first year of peritoneal dialysis therapy do not increase mortality in incident dialysis patients in Brazil. PMID:23420157

  6. Architecting Web Sites for High Performance

    Directory of Open Access Journals (Sweden)

    Arun Iyengar

    2002-01-01

    Full Text Available Web site applications are some of the most challenging high-performance applications currently being developed and deployed. The challenges emerge from the specific combination of high variability in workload characteristics and of high performance demands regarding the service level, scalability, availability, and costs. In recent years, a large body of research has addressed the Web site application domain, and a host of innovative software and hardware solutions have been proposed and deployed. This paper is an overview of recent solutions concerning the architectures and the software infrastructures used in building Web site applications. The presentation emphasizes three of the main functions in a complex Web site: the processing of client requests, the control of service levels, and the interaction with remote network caches.

  7. Rationale for a home dialysis virtual ward: design and implementation.

    Science.gov (United States)

    Schachter, Michael E; Bargman, Joanne M; Copland, Michael; Hladunewich, Michelle; Tennankore, Karthik K; Levin, Adeera; Oliver, Matthew; Pauly, Robert P; Perl, Jeffrey; Zimmerman, Deborah; Chan, Christopher T

    2014-02-14

    Home-based renal replacement therapy (RRT) [peritoneal dialysis (PD) and home hemodialysis (HHD)] offers independent quality of life and clinical advantages compared to conventional in-center hemodialysis. However, follow-up may be less complete for home dialysis patients following a change in care settings such as post hospitalization. We aim to implement a Home Dialysis Virtual Ward (HDVW) strategy, which is targeted to minimize gaps of care. The HDVW Pilot Study will enroll consecutive PD and HHD patients who fulfilled any one of our inclusion criteria: 1. following discharge from hospital, 2. after interventional procedure(s), 3. prescription of anti-microbial agents, or 4. following completion of home dialysis training. Clinician-led telephone interviews are performed weekly for 2 weeks until VW discharge. Case-mix (modified Charlson Comorbidity Index), symptoms (the modified Edmonton Symptom Assessment Scale) and patient satisfaction are assessed serially. The number of VW interventions relating to eight pre-specified domains will be measured. Adverse events such as re-hospitalization and health-services utilization will be ascertained through telephone follow-up after discharge from the VW at 2, 4, 12 weeks. The VW re-hospitalization rate will be compared with a contemporary cohort (matched for age, gender, renal replacement therapy and co-morbidities). Our protocol has been approved by research ethics board (UHN: 12-5397-AE). Written informed consent for participation in the study will be obtained from participants. This report serves as a blueprint for the design and implementation of a novel health service delivery model for home dialysis patients. The major goal of the HDVW initiative is to provide appropriate and effective supports to medically complex patients in a targeted window of vulnerability. (NCT01912001).

  8. Should ribavirin be used to treat hepatitis C in dialysis patients?

    Science.gov (United States)

    Carrion, Andres F; Fabrizi, Fabrizio; Martin, Paul

    2011-01-01

    Hepatitis C virus infection adversely affects outcomes in patients with chronic kidney disease undergoing maintenance dialysis. Pegylated interferon and ribavirin, the standard-of-care treatment in patients with intact renal function, is associated with severe side effects, toxicity, and high dropout rates in this population. Ribavirin has an important role in maintaining antiviral response following completion of therapy and increases sustained viral response (SVR) rates. However, the use of ribavirin in dialysis patients has been limited by the high frequency of severe hemolytic anemia and is currently reserved for study protocols and highly selected candidates treated at experienced centers. Encouraging data from small trials have shown a significant increase in SVR rates with the use of different dosing regimens of ribavirin in addition to interferon-based therapy and aggressive erythroid-stimulating agent support in dialysis patients. Use of ribavirin in selected dialysis patients, particularly renal transplant candidates, by experienced clinicians is appropriate. © 2011 Wiley Periodicals, Inc.

  9. Prevalence of Cognitive Impairment Among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis.

    Science.gov (United States)

    Shea, Yat Fung; Lam, Man Fai; Lee, Mi Suen Connie; Mok, Ming Yee Maggie; Lui, Sing-Leung; Yip, Terence P S; Lo, Wai Kei; Chu, Leung Wing; Chan, Tak-Mao

    2016-01-01

    ♦ Chronic renal failure and aging are suggested as risk factors for cognitive impairment (CI). We studied the prevalence of CI among peritoneal dialysis (PD) patients using Montreal Cognitive Assessment (MoCA), its impact on PD-related peritonitis in the first year, and the potential role of assisted PD. ♦ One hundred fourteen patients were newly started on PD between February 2011 and July 2013. Montreal Cognitive Assessment was performed in the absence of acute illness. Data on patient characteristics including demographics, comorbidities, blood parameters, dialysis adequacy, presence of helpers, medications, and the number PD-related infections were collected. ♦ The age of studied patients was 59±15.0 years, and 47% were female. The prevalence of CI was 28.9%. Patients older than 65 years old (odds ratio [OR] 4.88, confidence interval [CI] 1.79 - 13.28 p = 0.002) and with an education of primary level or below (OR 4.08, CI 1.30 - 12.81, p = 0.016) were independent risk factors for CI in multivariate analysis. Patients with PD-related peritonitis were significantly older (p peritonitis among self-care PD patients (OR 2.20, CI 0.65 - 7.44, p = 0.20). When we compared patients with MoCA-defined CI receiving self-care and assisted PD, there were no statistically significant differences between the 2 groups in terms of age, MoCA scores, or comorbidities. There were also no statistically significant differences in 1-year outcome of PD-related peritonitis rates or exit-site infections. ♦ Cognitive impairment is common among local PD patients. Even with CI, peritonitis rate in self-care PD with adequate training is similar to CI patients on assisted PD. Copyright © 2016 International Society for Peritoneal Dialysis.

  10. Dialysis: Reducing Infections and Changing Culture

    Centers for Disease Control (CDC) Podcasts

    2018-03-19

    This podcast is an account from an infection preventionist about the challenges and successes with engaging dialysis care teams to focus on “Zero Preventable Infections” in outpatient dialysis facilities.  Created: 3/19/2018 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/19/2018.

  11. High performance anode for advanced Li batteries

    Energy Technology Data Exchange (ETDEWEB)

    Lake, Carla [Applied Sciences, Inc., Cedarville, OH (United States)

    2015-11-02

    The overall objective of this Phase I SBIR effort was to advance the manufacturing technology for ASI’s Si-CNF high-performance anode by creating a framework for large volume production and utilization of low-cost Si-coated carbon nanofibers (Si-CNF) for the battery industry. This project explores the use of nano-structured silicon which is deposited on a nano-scale carbon filament to achieve the benefits of high cycle life and high charge capacity without the consequent fading of, or failure in the capacity resulting from stress-induced fracturing of the Si particles and de-coupling from the electrode. ASI’s patented coating process distinguishes itself from others, in that it is highly reproducible, readily scalable and results in a Si-CNF composite structure containing 25-30% silicon, with a compositionally graded interface at the Si-CNF interface that significantly improve cycling stability and enhances adhesion of silicon to the carbon fiber support. In Phase I, the team demonstrated the production of the Si-CNF anode material can successfully be transitioned from a static bench-scale reactor into a fluidized bed reactor. In addition, ASI made significant progress in the development of low cost, quick testing methods which can be performed on silicon coated CNFs as a means of quality control. To date, weight change, density, and cycling performance were the key metrics used to validate the high performance anode material. Under this effort, ASI made strides to establish a quality control protocol for the large volume production of Si-CNFs and has identified several key technical thrusts for future work. Using the results of this Phase I effort as a foundation, ASI has defined a path forward to commercialize and deliver high volume and low-cost production of SI-CNF material for anodes in Li-ion batteries.

  12. NINJA: Java for High Performance Numerical Computing

    Directory of Open Access Journals (Sweden)

    José E. Moreira

    2002-01-01

    Full Text Available When Java was first introduced, there was a perception that its many benefits came at a significant performance cost. In the particularly performance-sensitive field of numerical computing, initial measurements indicated a hundred-fold performance disadvantage between Java and more established languages such as Fortran and C. Although much progress has been made, and Java now can be competitive with C/C++ in many important situations, significant performance challenges remain. Existing Java virtual machines are not yet capable of performing the advanced loop transformations and automatic parallelization that are now common in state-of-the-art Fortran compilers. Java also has difficulties in implementing complex arithmetic efficiently. These performance deficiencies can be attacked with a combination of class libraries (packages, in Java that implement truly multidimensional arrays and complex numbers, and new compiler techniques that exploit the properties of these class libraries to enable other, more conventional, optimizations. Two compiler techniques, versioning and semantic expansion, can be leveraged to allow fully automatic optimization and parallelization of Java code. Our measurements with the NINJA prototype Java environment show that Java can be competitive in performance with highly optimized and tuned Fortran code.

  13. Development of high performance cladding materials

    International Nuclear Information System (INIS)

    Park, Jeong Yong; Jeong, Y. H.; Park, S. Y.

    2010-04-01

    The irradiation test for HANA claddings conducted and a series of evaluation for next-HANA claddings as well as their in-pile and out-of pile performances tests were also carried out at Halden research reactor. The 6th irradiation test have been completed successfully in Halden research reactor. As a result, HANA claddings showed high performance, such as corrosion resistance increased by 40% compared to Zircaloy-4. The high performance of HANA claddings in Halden test has enabled lead test rod program as the first step of the commercialization of HANA claddings. DB has been established for thermal and LOCA-related properties. It was confirmed from the thermal shock test that the integrity of HANA claddings was maintained in more expanded region than the criteria regulated by NRC. The manufacturing process of strips was established in order to apply HANA alloys, which were originally developed for the claddings, to the spacer grids. 250 kinds of model alloys for the next-generation claddings were designed and manufactured over 4 times and used to select the preliminary candidate alloys for the next-generation claddings. The selected candidate alloys showed 50% better corrosion resistance and 20% improved high temperature oxidation resistance compared to the foreign advanced claddings. We established the manufacturing condition controlling the performance of the dual-cooled claddings by changing the reduction rate in the cold working steps

  14. A Linux Workstation for High Performance Graphics

    Science.gov (United States)

    Geist, Robert; Westall, James

    2000-01-01

    The primary goal of this effort was to provide a low-cost method of obtaining high-performance 3-D graphics using an industry standard library (OpenGL) on PC class computers. Previously, users interested in doing substantial visualization or graphical manipulation were constrained to using specialized, custom hardware most often found in computers from Silicon Graphics (SGI). We provided an alternative to expensive SGI hardware by taking advantage of third-party, 3-D graphics accelerators that have now become available at very affordable prices. To make use of this hardware our goal was to provide a free, redistributable, and fully-compatible OpenGL work-alike library so that existing bodies of code could simply be recompiled. for PC class machines running a free version of Unix. This should allow substantial cost savings while greatly expanding the population of people with access to a serious graphics development and viewing environment. This should offer a means for NASA to provide a spectrum of graphics performance to its scientists, supplying high-end specialized SGI hardware for high-performance visualization while fulfilling the requirements of medium and lower performance applications with generic, off-the-shelf components and still maintaining compatibility between the two.

  15. The path toward HEP High Performance Computing

    CERN Document Server

    Apostolakis, John; Carminati, Federico; Gheata, Andrei; Wenzel, Sandro

    2014-01-01

    High Energy Physics code has been known for making poor use of high performance computing architectures. Efforts in optimising HEP code on vector and RISC architectures have yield limited results and recent studies have shown that, on modern architectures, it achieves a performance between 10% and 50% of the peak one. Although several successful attempts have been made to port selected codes on GPUs, no major HEP code suite has a 'High Performance' implementation. With LHC undergoing a major upgrade and a number of challenging experiments on the drawing board, HEP cannot any longer neglect the less-than-optimal performance of its code and it has to try making the best usage of the hardware. This activity is one of the foci of the SFT group at CERN, which hosts, among others, the Root and Geant4 project. The activity of the experiments is shared and coordinated via a Concurrency Forum, where the experience in optimising HEP code is presented and discussed. Another activity is the Geant-V project, centred on th...

  16. Update on dialysis economics in the UK.

    Science.gov (United States)

    Sharif, Adnan; Baboolal, Keshwar

    2011-03-01

    The burgeoning population of patients requiring renal replacement therapy contributes a disproportionate strain on National Health Service resources. Although renal transplantation is the preferred treatment modality for patients with established renal failure, achieving both clinical and financial advantages, limitations to organ donation and clinical comorbidities will leave a significant proportion of patients with established renal failure requiring expensive dialysis therapy in the form of either hemodialysis or peritoneal dialysis. An understanding of dialysis economics is essential for both healthcare providers and clinical leaders to establish clinically efficient and cost-effective treatment modalities that maximize service provision. In light of changes to the provision of healthcare funds in the form of "Payment by Results," it is imperative for UK renal units to adopt clinically effective and financially accountable dialysis programs. This article explores the role of dialysis economics and implications for UK renal replacement therapy programs.

  17. Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

    OpenAIRE

    Griva, Konstadina; Lai, Alden Yuanhong; Lim, Haikel Asyraf; Yu, Zhenli; Foo, Marjorie Wai Yin; Newman, Stanton P.

    2014-01-01

    Background: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non...

  18. High Performance Commercial Fenestration Framing Systems

    Energy Technology Data Exchange (ETDEWEB)

    Mike Manteghi; Sneh Kumar; Joshua Early; Bhaskar Adusumalli

    2010-01-31

    A major objective of the U.S. Department of Energy is to have a zero energy commercial building by the year 2025. Windows have a major influence on the energy performance of the building envelope as they control over 55% of building energy load, and represent one important area where technologies can be developed to save energy. Aluminum framing systems are used in over 80% of commercial fenestration products (i.e. windows, curtain walls, store fronts, etc.). Aluminum framing systems are often required in commercial buildings because of their inherent good structural properties and long service life, which is required from commercial and architectural frames. At the same time, they are lightweight and durable, requiring very little maintenance, and offer design flexibility. An additional benefit of aluminum framing systems is their relatively low cost and easy manufacturability. Aluminum, being an easily recyclable material, also offers sustainable features. However, from energy efficiency point of view, aluminum frames have lower thermal performance due to the very high thermal conductivity of aluminum. Fenestration systems constructed of aluminum alloys therefore have lower performance in terms of being effective barrier to energy transfer (heat loss or gain). Despite the lower energy performance, aluminum is the choice material for commercial framing systems and dominates the commercial/architectural fenestration market because of the reasons mentioned above. In addition, there is no other cost effective and energy efficient replacement material available to take place of aluminum in the commercial/architectural market. Hence it is imperative to improve the performance of aluminum framing system to improve the energy performance of commercial fenestration system and in turn reduce the energy consumption of commercial building and achieve zero energy building by 2025. The objective of this project was to develop high performance, energy efficient commercial

  19. Fracture toughness of ultra high performance concrete by flexural performance

    Directory of Open Access Journals (Sweden)

    Manolova Emanuela

    2016-01-01

    Full Text Available This paper describes the fracture toughness of the innovative structural material - Ultra High Performance Concrete (UHPC, evaluated by flexural performance. For determination the material behaviour by static loading are used adapted standard test methods for flexural performance of fiber-reinforced concrete (ASTM C 1609 and ASTM C 1018. Fracture toughness is estimated by various deformation parameters derived from the load-deflection curve, obtained by testing simple supported beam under third-point loading, using servo-controlled testing system. This method is used to be estimated the contribution of the embedded fiber-reinforcement into improvement of the fractural behaviour of UHPC by changing the crack-resistant capacity, fracture toughness and energy absorption capacity with various mechanisms. The position of the first crack has been formulated based on P-δ (load- deflection response and P-ε (load - longitudinal deformation in the tensile zone response, which are used for calculation of the two toughness indices I5 and I10. The combination of steel fibres with different dimensions leads to a composite, having at the same time increased crack resistance, first crack formation, ductility and post-peak residual strength.

  20. Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients.

    Science.gov (United States)

    Machowska, Anna; Alscher, Mark Dominik; Reddy Vanga, Satyanarayana; Koch, Michael; Aarup, Michael; Qureshi, Abdul Rashid; Lindholm, Bengt; Rutherford, Peter A

    2016-01-01

    Unplanned dialysis start (UPS) leads to worse clinical outcomes than planned start, and only a minority of patients ever receive education on this topic and are able to make a modality choice, particularly for home dialysis. This study aimed to determine the predictive factors for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis demonstrated that the initial dialysis modality was a predictive factor for referral and receipt of UPS-EP and modality decision making. In contrast, age was a predictor for referral and receipt of UPS-EP only, and comorbidity was not a predictor for any step, except for myocardial infarction, which was a weak predictor for lower likelihood of receiving preferred modality. Country practices predicted UPS-EP receipt and decision making. Economic analysis demonstrated the potential benefit of UPS-EP implementation because dialysis modality costs were associated with modality distribution driven by patient preference. Education and decision support can allow UPS patients to understand their options and choose dialysis modality, and attention needs to be focused on ensuring equity of access to educational

  1. Vasoactive Peptide Levels after Change of Dialysis Mode

    Directory of Open Access Journals (Sweden)

    Fredrik Uhlin

    2015-10-01

    Full Text Available Background/Aims: Plasma concentrations of the N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP are increased in end-stage renal disease. Improvement in hemodynamic stability has been reported when switching from hemodialysis (HD to on-line hemodiafiltration (ol-HDF. The aim of this study was to investigate plasma concentrations of NT-proBNP, BNP and neuropeptide Y (NPY during a 1-year follow-up, after a change from high-flux HD to postdilution ol-HDF. Additional variables were also studied, e.g. pulse wave velocity and ordinary clinical parameters. Method: We conducted a prospective, single-center study including 35 patients who were switched from HD to HDF. Plasma concentrations of NT-proBNP, BNP and NPY before and after dialysis were measured at baseline (i.e. HD and at 1, 2, 4, 6 and 12 months on HDF. Results: All three peptide levels decreased significantly during HD and HDF when comparing concentrations before and after dialysis. Mean absolute value (before/after and relative decrease (% before versus after dialysis was 13.697/9.497 ng/l (31% for NT-proBNP, 62/40 ng/ml (35% for BNP and 664/364 pg/l (45% for NPY. No significant differences were observed when comparing predialysis values over time. However, postdialysis NT-proBNP concentration showed a significant decrease of 48% over time after the switch to HDF. Conclusion: The postdialysis plasma levels of NT-proBNP, BNP and NPY decreased significantly during both dialysis modes when compared to before dialysis. The postdialysis lowering of NT-proBNP increased further over time after the switch to ol-HDF; the predialysis levels were unchanged, suggesting no effect on its production in the ventricles of the heart.

  2. Tanatophobia in the patients on dialysis

    Directory of Open Access Journals (Sweden)

    Novaković Milan

    2006-01-01

    Full Text Available Background/Aim. Thanatophobia is an exaggerated, specific, structured fear of death. It appears in childhood and continues to grow over the years, and in the old age it is accompanied with nosophobia and other mental disorders. The aim of this study was to analyze thanatophobia in dialysed patients which was in the direct connection with a basic disorder, and the influence of this disorder on functioning and the quality of life of the patients on dialysis. Methods. In the study we examined 753 patients from the chronic program of haemodialysis in a period from 1999 to 2004. The patients were classified in two groups: 348 randomized patients with Balkan Endemic Nephropathy (BEN, and the control group (N18 of patients with terminal renal insufficiency, and other diagnoses (n = 405. Since the study was a comparative, cross-sectional one, the patients were tested by the appropriate questionnaires for anxiety, depression and general mental functioning. Statistical analysis was done by the standard descriptive and analytic statistic methods. Results. Based on socio-demographics data we revealed a highly significant difference regarding the place of living between the groups BEN and N18 (χ2 = 23.970; p < 0.01, the frequency of occurrence of renal comorbidity (χ2 = 23.970; p < 0.01, the frequency of family renal comorbidity in siblings (χ2 = 23.970; p < 0.01, and the frequency of migrationes (χ2 = 4.874; p < 0.01. According to psychiatry scales, the patients from the BEN group were significantly more anxious and depressive than those from the control group. Conclusion. The signs of thanatophobia were revealed in both examined groups, but significantly more in the patients with BEN than in those with other nephrologic diseases. Thanatophobia starts before dialysis, and dialysis structures it into fear of death which is in a direct connection with the basic disorder. This intensive fear may be connected with dementia and depression, but also with

  3. Hypothyroidism and Mortality among Dialysis Patients

    Science.gov (United States)

    Rhee, Connie M.; Alexander, Erik K.; Bhan, Ishir

    2013-01-01

    Summary Background and objectives Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear. Design, setting, participants, & measurements This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time. Results Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4–2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death. Conclusions These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement

  4. Risky business for dialysis services.

    Science.gov (United States)

    Schohl, Joseph

    2010-05-01

    When self-insured health plans and their third-party administrators pay an artificially low out-of-network rate for dialysis services, they could be liable for the difference between that rate and the reimbursement level provided for by their health plan. Paying a rate that the repricers advised them to pay does not relieve self-insured health plans and third-party administrators of that obligation; only where the repricer has legitimately secured a negotiated contract rate is a lower payment justified. [Editor's note: The term "repricer" has no universally-accepted or formal definition, but it will be used here to describe those companies formed to act as middlemen between health care payers-like self-insured employer plans and TPAs working on behalf of such plans-and health care providers.] Failing to adhere to this will result in lawsuits against self-insured health plans and third-party administrators where they will be forced to defend the repricers' recommended payment amounts, while the repricers try to get themselves dismissed. A better option for plan holders and third-party administrators would be to negotiate directly with the dialysis providers and agree upon a mutually acceptable rate.

  5. The Role of NGAL in Peritoneal Dialysis Effluent in Early Diagnosis of Peritonitis: Case-Control Study in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Martino, Francesca; Scalzotto, Elisa; Giavarina, Davide; Rodighiero, Maria Pia; Crepaldi, Carlo; Day, Sonya; Ronco, Claudio

    2015-01-01

    Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis. This study investigates predictive value of PDE NGAL concentration as a prognostic indicator for PD-related peritonitis. A case-control study with 182 PD patients was conducted. Plasma and PDE were analyzed for the following biomarkers: C-reactive protein (CRP), blood procalcitonin (PCT), leucocytes and NGAL in PDE. The cases consisted of patients with suspected peritonitis, while controls were the patients who came to our ambulatory clinic for routine visits without any sign of peritonitis. The episodes of peritonitis were defined in agreement with International Society for Peritoneal Dialysis guidelines. Continuous variables were presented as the median values and interquartile range (IQR). Mann-Whitney U test was used to compare continuous variables. Univariate and multivariate logistic regression were used to evaluate the association of biomarkers with peritonitis. Receiver operating characteristic (ROC) curve analysis was used to calculate area under curve (AUC) for biomarkers. Finally we evaluated sensitivity, and specificity for each biomarker. All statistical analyses were performed with SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). During the 19-month study, of the 182 patients, 80 had a clinical diagnosis of peritonitis. C-reactive protein levels (p peritonitis. In univariate analysis, CRP (odds ratio [OR] 1,339; p = 0.001), PCT (OR 2,473; p peritonitis. In multivariate regression analysis

  6. HIGH PERFORMANCE CERIA BASED OXYGEN MEMBRANE

    DEFF Research Database (Denmark)

    2014-01-01

    The invention describes a new class of highly stable mixed conducting materials based on acceptor doped cerium oxide (CeO2-8 ) in which the limiting electronic conductivity is significantly enhanced by co-doping with a second element or co- dopant, such as Nb, W and Zn, so that cerium and the co......-dopant have an ionic size ratio between 0.5 and 1. These materials can thereby improve the performance and extend the range of operating conditions of oxygen permeation membranes (OPM) for different high temperature membrane reactor applications. The invention also relates to the manufacturing of supported...

  7. Playa: High-Performance Programmable Linear Algebra

    Directory of Open Access Journals (Sweden)

    Victoria E. Howle

    2012-01-01

    Full Text Available This paper introduces Playa, a high-level user interface layer for composing algorithms for complex multiphysics problems out of objects from other Trilinos packages. Among other features, Playa provides very high-performance overloaded operators implemented through an expression template mechanism. In this paper, we give an overview of the central Playa objects from a user's perspective, show application to a sequence of increasingly complex solver algorithms, provide timing results for Playa's overloaded operators and other functions, and briefly survey some of the implementation issues involved.

  8. Optimizing the design of very high power, high performance converters

    International Nuclear Information System (INIS)

    Edwards, R.J.; Tiagha, E.A.; Ganetis, G.; Nawrocky, R.J.

    1980-01-01

    This paper describes how various technologies are used to achieve the desired performance in a high current magnet power converter system. It is hoped that the discussions of the design approaches taken will be applicable to other power supply systems where stringent requirements in stability, accuracy and reliability must be met

  9. Robust High Performance Aquaporin based Biomimetic Membranes

    DEFF Research Database (Denmark)

    Helix Nielsen, Claus; Zhao, Yichun; Qiu, C.

    2013-01-01

    on top of a support membrane. Control membranes, either without aquaporins or with the inactive AqpZ R189A mutant aquaporin served as controls. The separation performance of the membranes was evaluated by cross-flow forward osmosis (FO) and reverse osmosis (RO) tests. In RO the ABM achieved a water......Aquaporins are water channel proteins with high water permeability and solute rejection, which makes them promising for preparing high-performance biomimetic membranes. Despite the growing interest in aquaporin-based biomimetic membranes (ABMs), it is challenging to produce robust and defect...... permeability of ~ 4 L/(m2 h bar) with a NaCl rejection > 97% at an applied hydraulic pressure of 5 bar. The water permeability was ~40% higher compared to a commercial brackish water RO membrane (BW30) and an order of magnitude higher compared to a seawater RO membrane (SW30HR). In FO, the ABMs had > 90...

  10. Evaluation of high-performance computing software

    Energy Technology Data Exchange (ETDEWEB)

    Browne, S.; Dongarra, J. [Univ. of Tennessee, Knoxville, TN (United States); Rowan, T. [Oak Ridge National Lab., TN (United States)

    1996-12-31

    The absence of unbiased and up to date comparative evaluations of high-performance computing software complicates a user`s search for the appropriate software package. The National HPCC Software Exchange (NHSE) is attacking this problem using an approach that includes independent evaluations of software, incorporation of author and user feedback into the evaluations, and Web access to the evaluations. We are applying this approach to the Parallel Tools Library (PTLIB), a new software repository for parallel systems software and tools, and HPC-Netlib, a high performance branch of the Netlib mathematical software repository. Updating the evaluations with feed-back and making it available via the Web helps ensure accuracy and timeliness, and using independent reviewers produces unbiased comparative evaluations difficult to find elsewhere.

  11. High performance cloud auditing and applications

    CERN Document Server

    Choi, Baek-Young; Song, Sejun

    2014-01-01

    This book mainly focuses on cloud security and high performance computing for cloud auditing. The book discusses emerging challenges and techniques developed for high performance semantic cloud auditing, and presents the state of the art in cloud auditing, computing and security techniques with focus on technical aspects and feasibility of auditing issues in federated cloud computing environments.   In summer 2011, the United States Air Force Research Laboratory (AFRL) CyberBAT Cloud Security and Auditing Team initiated the exploration of the cloud security challenges and future cloud auditing research directions that are covered in this book. This work was supported by the United States government funds from the Air Force Office of Scientific Research (AFOSR), the AFOSR Summer Faculty Fellowship Program (SFFP), the Air Force Research Laboratory (AFRL) Visiting Faculty Research Program (VFRP), the National Science Foundation (NSF) and the National Institute of Health (NIH). All chapters were partially suppor...

  12. Monitoring SLAC High Performance UNIX Computing Systems

    International Nuclear Information System (INIS)

    Lettsome, Annette K.

    2005-01-01

    Knowledge of the effectiveness and efficiency of computers is important when working with high performance systems. The monitoring of such systems is advantageous in order to foresee possible misfortunes or system failures. Ganglia is a software system designed for high performance computing systems to retrieve specific monitoring information. An alternative storage facility for Ganglia's collected data is needed since its default storage system, the round-robin database (RRD), struggles with data integrity. The creation of a script-driven MySQL database solves this dilemma. This paper describes the process took in the creation and implementation of the MySQL database for use by Ganglia. Comparisons between data storage by both databases are made using gnuplot and Ganglia's real-time graphical user interface

  13. High performance parallel computers for science

    International Nuclear Information System (INIS)

    Nash, T.; Areti, H.; Atac, R.; Biel, J.; Cook, A.; Deppe, J.; Edel, M.; Fischler, M.; Gaines, I.; Hance, R.

    1989-01-01

    This paper reports that Fermilab's Advanced Computer Program (ACP) has been developing cost effective, yet practical, parallel computers for high energy physics since 1984. The ACP's latest developments are proceeding in two directions. A Second Generation ACP Multiprocessor System for experiments will include $3500 RISC processors each with performance over 15 VAX MIPS. To support such high performance, the new system allows parallel I/O, parallel interprocess communication, and parallel host processes. The ACP Multi-Array Processor, has been developed for theoretical physics. Each $4000 node is a FORTRAN or C programmable pipelined 20 Mflops (peak), 10 MByte single board computer. These are plugged into a 16 port crossbar switch crate which handles both inter and intra crate communication. The crates are connected in a hypercube. Site oriented applications like lattice gauge theory are supported by system software called CANOPY, which makes the hardware virtually transparent to users. A 256 node, 5 GFlop, system is under construction

  14. Acquired cystic kidney disease in dialysis and renal transplant patients: ultrasonography and CT analysis

    International Nuclear Information System (INIS)

    Jeon, Young Tae; Lee, Hae Kyung; Jung, Mi Sun; Yoon, Jong Pil; Hong, Hyun Sook; Kwon, Kui Hyang; Choi, Deuk Lin; Hwang, Seung Duk; Lee, Hi Bahl

    1997-01-01

    To evaluate by US and CT the incidence and complications of acquired cystic kidney disease (ACKD) in dialysis and renal transplant patients and to compare the effectiveness of US and CT in the diagnosis of this entity. This study was prospectively performed in 70 dialysis patients and 13 renal transplant patients, and excluded any with multiple renal cysts or polycystic kidney disease, on as seen on initial films. US were obtained in all patients, and CT scans were randomly obtained in 27 who had been on dialysis for 3 years or more; all these US and CT scans were analyzed, with particular emphasis on whether or not cysts were present. In order to correlate the numbers of cysts with duration of dialysis, all patients were assigned to one of three groups, according to the number of cysts found (group 1, 0; group 2, 1-4; group 3, >4). Only group 3 was diagnosed as suffering from ACKD. In order to compare the cyst-detection capability of US with that of CT, 27 dialysis patients who had undergone US and CT were divided into four groups according to the number of cysts found (grade 1, 0; grade 2, 1-4; grade 3, 5-10; grade 4, >10). Seventy dialysis patients were divided according to the results of US, as follows : group 1, 20%; group 2, 47.1%; group 3, 32.9%. The mean duration of dialysis in group 1 (31.9 months) was statistically different from that in group 2 (50.6 months) and in group 3 (95.8 months) (p < 0.000). Thirteen renal transplant patients were divided as follows : group 1, 61.5%; group 2, 38.5%; group 3, 0%. In dialysis patients with ACKD, complications noted were renal cell carcinoma (n=1), hemorrhagic cysts (n=2), and hematomas (n=2). Among the 27 dialysis patients who underwent CT, this and US showed an equal grade of cystic change in 53.7%, while CT showed a higher grade in 46.3%. The detection rate of ACKD in these 27 patients was 46% on US and 63% on CT. A prolongation of dialysis corresponded to an increased incidence of ACKD; renal neoplasm and

  15. Toward a theory of high performance.

    Science.gov (United States)

    Kirby, Julia

    2005-01-01

    What does it mean to be a high-performance company? The process of measuring relative performance across industries and eras, declaring top performers, and finding the common drivers of their success is such a difficult one that it might seem a fool's errand to attempt. In fact, no one did for the first thousand or so years of business history. The question didn't even occur to many scholars until Tom Peters and Bob Waterman released In Search of Excellence in 1982. Twenty-three years later, we've witnessed several more attempts--and, just maybe, we're getting closer to answers. In this reported piece, HBR senior editor Julia Kirby explores why it's so difficult to study high performance and how various research efforts--including those from John Kotter and Jim Heskett; Jim Collins and Jerry Porras; Bill Joyce, Nitin Nohria, and Bruce Roberson; and several others outlined in a summary chart-have attacked the problem. The challenge starts with deciding which companies to study closely. Are the stars the ones with the highest market caps, the ones with the greatest sales growth, or simply the ones that remain standing at the end of the game? (And when's the end of the game?) Each major study differs in how it defines success, which companies it therefore declares to be worthy of emulation, and the patterns of activity and attitude it finds in common among them. Yet, Kirby concludes, as each study's method incrementally solves problems others have faced, we are progressing toward a consensus theory of high performance.

  16. High-performance phase-field modeling

    KAUST Repository

    Vignal, Philippe; Sarmiento, Adel; Cortes, Adriano Mauricio; Dalcin, L.; Collier, N.; Calo, Victor M.

    2015-01-01

    and phase-field crystal equation will be presented, which corroborate the theoretical findings, and illustrate the robustness of the method. Results related to more challenging examples, namely the Navier-Stokes Cahn-Hilliard and a diusion-reaction Cahn-Hilliard system, will also be presented. The implementation was done in PetIGA and PetIGA-MF, high-performance Isogeometric Analysis frameworks [1, 3], designed to handle non-linear, time-dependent problems.

  17. AHPCRC - Army High Performance Computing Research Center

    Science.gov (United States)

    2010-01-01

    computing. Of particular interest is the ability of a distrib- uted jamming network (DJN) to jam signals in all or part of a sensor or communications net...and reasoning, assistive technologies. FRIEDRICH (FRITZ) PRINZ Finmeccanica Professor of Engineering, Robert Bosch Chair, Department of Engineering...High Performance Computing Research Center www.ahpcrc.org BARBARA BRYAN AHPCRC Research and Outreach Manager, HPTi (650) 604-3732 bbryan@hpti.com Ms

  18. Performance concerns for high duty fuel cycle

    International Nuclear Information System (INIS)

    Esposito, V.J.; Gutierrez, J.E.

    1999-01-01

    One of the goals of the nuclear industry is to achieve economic performance such that nuclear power plants are competitive in a de-regulated market. The manner in which nuclear fuel is designed and operated lies at the heart of economic viability. In this sense reliability, operating flexibility and low costs are the three major requirements of the NPP today. The translation of these three requirements to the design is part of our work. The challenge today is to produce a fuel design which will operate with long operating cycles, high discharge burnup, power up-rating and while still maintaining all design and safety margins. European Fuel Group (EFG) understands that to achieve the required performance high duty/energy fuel designs are needed. The concerns for high duty design includes, among other items, core design methods, advanced Safety Analysis methodologies, performance models, advanced material and operational strategies. The operational aspects require the trade-off and evaluation of various parameters including coolant chemistry control, material corrosion, boiling duty, boron level impacts, etc. In this environment MAEF is the design that EFG is now offering based on ZIRLO alloy and a robust skeleton. This new design is able to achieve 70 GWd/tU and Lead Test Programs are being executed to demonstrate this capability. A number of performance issues which have been a concern with current designs have been resolved such as cladding corrosion and incomplete RCCA insertion (IRI). As the core duty becomes more aggressive other new issues need to be addressed such as Axial Offset Anomaly. These new issues are being addressed by combination of the new design in concert with advanced methodologies to meet the demanding needs of NPP. The ability and strategy to meet high duty core requirements, flexibility of operation and maintain acceptable balance of all technical issues is the discussion in this paper. (authors)

  19. DURIP: High Performance Computing in Biomathematics Applications

    Science.gov (United States)

    2017-05-10

    Mathematics and Statistics (AMS) at the University of California, Santa Cruz (UCSC) to conduct research and research-related education in areas of...Computing in Biomathematics Applications Report Title The goal of this award was to enhance the capabilities of the Department of Applied Mathematics and...DURIP: High Performance Computing in Biomathematics Applications The goal of this award was to enhance the capabilities of the Department of Applied

  20. High Performance Computing Operations Review Report

    Energy Technology Data Exchange (ETDEWEB)

    Cupps, Kimberly C. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2013-12-19

    The High Performance Computing Operations Review (HPCOR) meeting—requested by the ASC and ASCR program headquarters at DOE—was held November 5 and 6, 2013, at the Marriott Hotel in San Francisco, CA. The purpose of the review was to discuss the processes and practices for HPC integration and its related software and facilities. Experiences and lessons learned from the most recent systems deployed were covered in order to benefit the deployment of new systems.

  1. Planning for high performance project teams

    International Nuclear Information System (INIS)

    Reed, W.; Keeney, J.; Westney, R.

    1997-01-01

    Both industry-wide research and corporate benchmarking studies confirm the significant savings in cost and time that result from early planning of a project. Amoco's Team Planning Workshop combines long-term strategic project planning and short-term tactical planning with team building to provide the basis for high performing project teams, better project planning, and effective implementation of the Amoco Common Process for managing projects

  2. Adequacy in dialysis: intermittent versus continuous therapies.

    Science.gov (United States)

    Misra, M; Nolph, K D

    2000-01-01

    A vital conceptual difference between intermittent and continuous dialysis therapies is the difference in the relationship between Kt/V urea and dietary protein intake. For a given level of protein intake the intermittent therapies require a higher Kt/V urea due to the reasons mentioned above. The recently released adequacy guidelines by DOQI for intermittent and continuous therapies are based on these assumptions. The link between adequacy targets and patient survival is well documented for an intermittent therapy like HD. For a continuous therapy like CAPD however, the evidence linking improved peritoneal clearance to better survival is not as direct. However, present consensus allows one to extrapolate results based on HD. The concept of earlier and healthier initiation of dialysis is gaining hold and incremental dialysis forms an integral aspect of the whole concept. Tools like urea kinetic modeling give us valuable insight in making mathematical projections about the timing as well as dosing of dialysis. Daily home hemodialysis is still an underutilized modality despite offering best survival figures. Hopefully, with increasing availability of better and simpler machines its use will increase. Still several questions remain unanswered. Despite availability of data in hemodialysis patients suggesting that an increased dialysis prescription leads to a better survival, optimal dialysis dose is yet to be defined. Concerns regarding methodology of such studies and conclusions thereof has been raised. Other issues relating to design of the studies, variation in dialysis delivery, use of uncontrolled historical standards and lack of patient randomization etc also need to be considered when designing such trials. Hopefully an ongoing prospective randomized trial, namely the HEMO study, looking at two precisely defined and carefully maintained dialysis prescriptions will provide some insight into adequacy of dialysis dose and survival. In diabetic patients, the

  3. Computational Biology and High Performance Computing 2000

    Energy Technology Data Exchange (ETDEWEB)

    Simon, Horst D.; Zorn, Manfred D.; Spengler, Sylvia J.; Shoichet, Brian K.; Stewart, Craig; Dubchak, Inna L.; Arkin, Adam P.

    2000-10-19

    The pace of extraordinary advances in molecular biology has accelerated in the past decade due in large part to discoveries coming from genome projects on human and model organisms. The advances in the genome project so far, happening well ahead of schedule and under budget, have exceeded any dreams by its protagonists, let alone formal expectations. Biologists expect the next phase of the genome project to be even more startling in terms of dramatic breakthroughs in our understanding of human biology, the biology of health and of disease. Only today can biologists begin to envision the necessary experimental, computational and theoretical steps necessary to exploit genome sequence information for its medical impact, its contribution to biotechnology and economic competitiveness, and its ultimate contribution to environmental quality. High performance computing has become one of the critical enabling technologies, which will help to translate this vision of future advances in biology into reality. Biologists are increasingly becoming aware of the potential of high performance computing. The goal of this tutorial is to introduce the exciting new developments in computational biology and genomics to the high performance computing community.

  4. A New Application for Albumin Dialysis in Extracorporeal Organ Support: Characterization of a Putative Interaction Between Human Albumin and Proinflammatory Cytokines IL-6 and TNFα.

    Science.gov (United States)

    Pfensig, Claudia; Dominik, Adrian; Borufka, Luise; Hinz, Michael; Stange, Jan; Eggert, Martin

    2016-04-01

    Albumin dialysis in extracorporeal organ support is often performed in the treatment of liver failure as it facilitates the removal of toxic components from the blood. Here, we describe a possible effect of albumin dialysis on proinflammatory cytokine levels in vitro. Initially, albumin samples were incubated with different amounts of cytokines and analyzed by enzyme-linked immunosorbent assay (ELISA). Analysis of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNFα) levels indicated that increased concentrations of albumin reduce the measureable amount of the respective cytokines. This led to the hypothesis that the used proinflammatory cytokines may interact with albumin. Size exclusion chromatography of albumin spiked with cytokines was carried out using high-performance liquid chromatography analysis. The corresponding fractions were evaluated by immunoblotting. We detected albumin and cytokines in the same fractions indicating an interaction of the small-sized cytokines IL-6 and TNFα with the larger-sized albumin. Finally, a two-compartment albumin dialysis in vitro model was used to analyze the effect of albumin on proinflammatory cytokines in the recirculation circuit during 6-h treatment. These in vitro albumin dialysis experiments indicated a significant decrease of IL-6, but not of TNFα, when albumin was added to the dialysate solution. Taken together, we were able to show a putative in vitro interaction of human albumin with the proinflammatory cytokine IL-6, but with less evidence for TNFα, and demonstrated an additional application for albumin dialysis in liver support therapy where IL-6 removal might be indicated. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  5. Alterations of Intercellular Junctions in Peritoneal Mesothelial Cells from Patients Undergoing Dialysis: Effect of Retinoic Acid

    Science.gov (United States)

    Retana, Carmen; Sanchez, Elsa; Perez-Lopez, Alejandro; Cruz, Armando; Lagunas, Jesus; Cruz, Carmen; Vital, Socorro; Reyes, Jose L.

    2015-01-01

    ♦ Background: Dialysis patients are classified according to their peritoneal permeability as low transporter (LT, low solute permeability) or high transporter (HT, high solute permeability). Tight junction (TJ) proteins are critical to maintain ions, molecules and water paracellular transport through peritoneum. Exposure to peritoneal dialysis solutions causes damage to TJ in human peritoneal mesothelial cells (HPMCs). We analyzed the quantity, distribution and function of TJ proteins: claudin-1, -2 and -8, ZO-1 and occludin, in HPMC cultures from LT and HT patients. Since all-trans retinoic acid (ATRA) might modify the expression of TJ proteins, we studied its effect on HPMCs. ♦ Methods: Control HPMCs were isolated from human omentum, while HT or LT cells were obtained from dialysis effluents. Cells were cultured in presence of ATRA 0, 50 or 100 nM. Transepithelial electrical resistance (TER) measurement, immunostaining and Western blot analyses were performed. ♦ Results: HT exhibited lower TER than control and LT monolayers. Immunofluorescence for TJ was weak and discontinuous along the cell contour, in LT and HT. Furthermore, claudin-1, occludin and ZO-1 expressions were decreased. In all groups, claudin-2 was localized at nuclei. We observed that ATRA improved TJ distribution and increased TJ expression in HT. This retinoid did not modify claudin-2 and -8 expressions. All-trans retinoic acid decreased TER in HT, but had no effect in LT. ♦ Conclusions: Tight junctions were altered in HPMCs from dialyzed patients. The HT monolayer has lower TER than LT, which might be associated with the peritoneal permeability in these patients. ATRA might be a therapeutic alternative to maintain mesothelial integrity, since it improved TJ localization and expression. PMID:24584604

  6. High performance separation of lanthanides and actinides

    International Nuclear Information System (INIS)

    Sivaraman, N.; Vasudeva Rao, P.R.

    2011-01-01

    The major advantage of High Performance Liquid Chromatography (HPLC) is its ability to provide rapid and high performance separations. It is evident from Van Deemter curve for particle size versus resolution that packing materials with particle sizes less than 2 μm provide better resolution for high speed separations and resolving complex mixtures compared to 5 μm based supports. In the recent past, chromatographic support material using monolith has been studied extensively at our laboratory. Monolith column consists of single piece of porous, rigid material containing mesopores and micropores, which provide fast analyte mass transfer. Monolith support provides significantly higher separation efficiency than particle-packed columns. A clear advantage of monolith is that it could be operated at higher flow rates but with lower back pressure. Higher operating flow rate results in higher column permeability, which drastically reduces analysis time and provides high separation efficiency. The above developed fast separation methods were applied to assay the lanthanides and actinides from the dissolver solutions of nuclear reactor fuels

  7. Metabolic Profiling of Impaired Cognitive Function in Patients Receiving Dialysis

    OpenAIRE

    Kurella Tamura, Manjula; Chertow, Glenn M.; Depner, Thomas A.; Nissenson, Allen R.; Schiller, Brigitte; Mehta, Ravindra L.; Liu, Sai; Sirich, Tammy L.

    2016-01-01

    Retention of uremic metabolites is a proposed cause of cognitive impairment in patients with ESRD. We used metabolic profiling to identify and validate uremic metabolites associated with impairment in executive function in two cohorts of patients receiving maintenance dialysis. We performed metabolic profiling using liquid chromatography/mass spectrometry applied to predialysis plasma samples from a discovery cohort of 141 patients and an independent replication cohort of 180 patients partici...

  8. High Performance OLED Panel and Luminaire

    Energy Technology Data Exchange (ETDEWEB)

    Spindler, Jeffrey [OLEDWorks LLC, Rochester, NY (United States)

    2017-02-20

    In this project, OLEDWorks developed and demonstrated the technology required to produce OLED lighting panels with high energy efficiency and excellent light quality. OLED panels developed in this program produce high quality warm white light with CRI greater than 85 and efficacy up to 80 lumens per watt (LPW). An OLED luminaire employing 24 of the high performance panels produces practical levels of illumination for general lighting, with a flux of over 2200 lumens at 60 LPW. This is a significant advance in the state of the art for OLED solid-state lighting (SSL), which is expected to be a complementary light source to the more advanced LED SSL technology that is rapidly replacing all other traditional forms of lighting.

  9. The path toward HEP High Performance Computing

    International Nuclear Information System (INIS)

    Apostolakis, John; Brun, René; Gheata, Andrei; Wenzel, Sandro; Carminati, Federico

    2014-01-01

    High Energy Physics code has been known for making poor use of high performance computing architectures. Efforts in optimising HEP code on vector and RISC architectures have yield limited results and recent studies have shown that, on modern architectures, it achieves a performance between 10% and 50% of the peak one. Although several successful attempts have been made to port selected codes on GPUs, no major HEP code suite has a 'High Performance' implementation. With LHC undergoing a major upgrade and a number of challenging experiments on the drawing board, HEP cannot any longer neglect the less-than-optimal performance of its code and it has to try making the best usage of the hardware. This activity is one of the foci of the SFT group at CERN, which hosts, among others, the Root and Geant4 project. The activity of the experiments is shared and coordinated via a Concurrency Forum, where the experience in optimising HEP code is presented and discussed. Another activity is the Geant-V project, centred on the development of a highperformance prototype for particle transport. Achieving a good concurrency level on the emerging parallel architectures without a complete redesign of the framework can only be done by parallelizing at event level, or with a much larger effort at track level. Apart the shareable data structures, this typically implies a multiplication factor in terms of memory consumption compared to the single threaded version, together with sub-optimal handling of event processing tails. Besides this, the low level instruction pipelining of modern processors cannot be used efficiently to speedup the program. We have implemented a framework that allows scheduling vectors of particles to an arbitrary number of computing resources in a fine grain parallel approach. The talk will review the current optimisation activities within the SFT group with a particular emphasis on the development perspectives towards a simulation framework able to profit

  10. A High Performance COTS Based Computer Architecture

    Science.gov (United States)

    Patte, Mathieu; Grimoldi, Raoul; Trautner, Roland

    2014-08-01

    Using Commercial Off The Shelf (COTS) electronic components for space applications is a long standing idea. Indeed the difference in processing performance and energy efficiency between radiation hardened components and COTS components is so important that COTS components are very attractive for use in mass and power constrained systems. However using COTS components in space is not straightforward as one must account with the effects of the space environment on the COTS components behavior. In the frame of the ESA funded activity called High Performance COTS Based Computer, Airbus Defense and Space and its subcontractor OHB CGS have developed and prototyped a versatile COTS based architecture for high performance processing. The rest of the paper is organized as follows: in a first section we will start by recapitulating the interests and constraints of using COTS components for space applications; then we will briefly describe existing fault mitigation architectures and present our solution for fault mitigation based on a component called the SmartIO; in the last part of the paper we will describe the prototyping activities executed during the HiP CBC project.

  11. Management issues for high performance storage systems

    Energy Technology Data Exchange (ETDEWEB)

    Louis, S. [Lawrence Livermore National Lab., CA (United States); Burris, R. [Oak Ridge National Lab., TN (United States)

    1995-03-01

    Managing distributed high-performance storage systems is complex and, although sharing common ground with traditional network and systems management, presents unique storage-related issues. Integration technologies and frameworks exist to help manage distributed network and system environments. Industry-driven consortia provide open forums where vendors and users cooperate to leverage solutions. But these new approaches to open management fall short addressing the needs of scalable, distributed storage. We discuss the motivation and requirements for storage system management (SSM) capabilities and describe how SSM manages distributed servers and storage resource objects in the High Performance Storage System (HPSS), a new storage facility for data-intensive applications and large-scale computing. Modem storage systems, such as HPSS, require many SSM capabilities, including server and resource configuration control, performance monitoring, quality of service, flexible policies, file migration, file repacking, accounting, and quotas. We present results of initial HPSS SSM development including design decisions and implementation trade-offs. We conclude with plans for follow-on work and provide storage-related recommendations for vendors and standards groups seeking enterprise-wide management solutions.

  12. Automatic Energy Schemes for High Performance Applications

    Energy Technology Data Exchange (ETDEWEB)

    Sundriyal, Vaibhav [Iowa State Univ., Ames, IA (United States)

    2013-01-01

    Although high-performance computing traditionally focuses on the efficient execution of large-scale applications, both energy and power have become critical concerns when approaching exascale. Drastic increases in the power consumption of supercomputers affect significantly their operating costs and failure rates. In modern microprocessor architectures, equipped with dynamic voltage and frequency scaling (DVFS) and CPU clock modulation (throttling), the power consumption may be controlled in software. Additionally, network interconnect, such as Infiniband, may be exploited to maximize energy savings while the application performance loss and frequency switching overheads must be carefully balanced. This work first studies two important collective communication operations, all-to-all and allgather and proposes energy saving strategies on the per-call basis. Next, it targets point-to-point communications to group them into phases and apply frequency scaling to them to save energy by exploiting the architectural and communication stalls. Finally, it proposes an automatic runtime system which combines both collective and point-to-point communications into phases, and applies throttling to them apart from DVFS to maximize energy savings. The experimental results are presented for NAS parallel benchmark problems as well as for the realistic parallel electronic structure calculations performed by the widely used quantum chemistry package GAMESS. Close to the maximum energy savings were obtained with a substantially low performance loss on the given platform.

  13. High-performance computing in seismology

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-09-01

    The scientific, technical, and economic importance of the issues discussed here presents a clear agenda for future research in computational seismology. In this way these problems will drive advances in high-performance computing in the field of seismology. There is a broad community that will benefit from this work, including the petroleum industry, research geophysicists, engineers concerned with seismic hazard mitigation, and governments charged with enforcing a comprehensive test ban treaty. These advances may also lead to new applications for seismological research. The recent application of high-resolution seismic imaging of the shallow subsurface for the environmental remediation industry is an example of this activity. This report makes the following recommendations: (1) focused efforts to develop validated documented software for seismological computations should be supported, with special emphasis on scalable algorithms for parallel processors; (2) the education of seismologists in high-performance computing technologies and methodologies should be improved; (3) collaborations between seismologists and computational scientists and engineers should be increased; (4) the infrastructure for archiving, disseminating, and processing large volumes of seismological data should be improved.

  14. A high performance architecture for accelerator controls

    International Nuclear Information System (INIS)

    Allen, M.; Hunt, S.M; Lue, H.; Saltmarsh, C.G.; Parker, C.R.C.B.

    1991-01-01

    The demands placed on the Superconducting Super Collider (SSC) control system due to large distances, high bandwidth and fast response time required for operation will require a fresh approach to the data communications architecture of the accelerator. The prototype design effort aims at providing deterministic communication across the accelerator complex with a response time of < 100 ms and total bandwidth of 2 Gbits/sec. It will offer a consistent interface for a large number of equipment types, from vacuum pumps to beam position monitors, providing appropriate communications performance for each equipment type. It will consist of highly parallel links to all equipment: those with computing resources, non-intelligent direct control interfaces, and data concentrators. This system will give each piece of equipment a dedicated link of fixed bandwidth to the control system. Application programs will have access to all accelerator devices which will be memory mapped into a global virtual addressing scheme. Links to devices in the same geographical area will be multiplexed using commercial Time Division Multiplexing equipment. Low-level access will use reflective memory techniques, eliminating processing overhead and complexity of traditional data communication protocols. The use of commercial standards and equipment will enable a high performance system to be built at low cost

  15. A high performance architecture for accelerator controls

    International Nuclear Information System (INIS)

    Allen, M.; Hunt, S.M.; Lue, H.; Saltmarsh, C.G.; Parker, C.R.C.B.

    1991-03-01

    The demands placed on the Superconducting Super Collider (SSC) control system due to large distances, high bandwidth and fast response time required for operation will require a fresh approach to the data communications architecture of the accelerator. The prototype design effort aims at providing deterministic communication across the accelerator complex with a response time of <100 ms and total bandwidth of 2 Gbits/sec. It will offer a consistent interface for a large number of equipment types, from vacuum pumps to beam position monitors, providing appropriate communications performance for each equipment type. It will consist of highly parallel links to all equipments: those with computing resources, non-intelligent direct control interfaces, and data concentrators. This system will give each piece of equipment a dedicated link of fixed bandwidth to the control system. Application programs will have access to all accelerator devices which will be memory mapped into a global virtual addressing scheme. Links to devices in the same geographical area will be multiplexed using commercial Time Division Multiplexing equipment. Low-level access will use reflective memory techniques, eliminating processing overhead and complexity of traditional data communication protocols. The use of commercial standards and equipment will enable a high performance system to be built at low cost. 1 fig

  16. High performance computing in linear control

    International Nuclear Information System (INIS)

    Datta, B.N.

    1993-01-01

    Remarkable progress has been made in both theory and applications of all important areas of control. The theory is rich and very sophisticated. Some beautiful applications of control theory are presently being made in aerospace, biomedical engineering, industrial engineering, robotics, economics, power systems, etc. Unfortunately, the same assessment of progress does not hold in general for computations in control theory. Control Theory is lagging behind other areas of science and engineering in this respect. Nowadays there is a revolution going on in the world of high performance scientific computing. Many powerful computers with vector and parallel processing have been built and have been available in recent years. These supercomputers offer very high speed in computations. Highly efficient software, based on powerful algorithms, has been developed to use on these advanced computers, and has also contributed to increased performance. While workers in many areas of science and engineering have taken great advantage of these hardware and software developments, control scientists and engineers, unfortunately, have not been able to take much advantage of these developments

  17. Building Trust in High-Performing Teams

    Directory of Open Access Journals (Sweden)

    Aki Soudunsaari

    2012-06-01

    Full Text Available Facilitation of growth is more about good, trustworthy contacts than capital. Trust is a driving force for business creation, and to create a global business you need to build a team that is capable of meeting the challenge. Trust is a key factor in team building and a needed enabler for cooperation. In general, trust building is a slow process, but it can be accelerated with open interaction and good communication skills. The fast-growing and ever-changing nature of global business sets demands for cooperation and team building, especially for startup companies. Trust building needs personal knowledge and regular face-to-face interaction, but it also requires empathy, respect, and genuine listening. Trust increases communication, and rich and open communication is essential for the building of high-performing teams. Other building materials are a shared vision, clear roles and responsibilities, willingness for cooperation, and supporting and encouraging leadership. This study focuses on trust in high-performing teams. It asks whether it is possible to manage trust and which tools and operation models should be used to speed up the building of trust. In this article, preliminary results from the authors’ research are presented to highlight the importance of sharing critical information and having a high level of communication through constant interaction.

  18. Improving UV Resistance of High Performance Fibers

    Science.gov (United States)

    Hassanin, Ahmed

    High performance fibers are characterized by their superior properties compared to the traditional textile fibers. High strength fibers have high modules, high strength to weight ratio, high chemical resistance, and usually high temperature resistance. It is used in application where superior properties are needed such as bulletproof vests, ropes and cables, cut resistant products, load tendons for giant scientific balloons, fishing rods, tennis racket strings, parachute cords, adhesives and sealants, protective apparel and tire cords. Unfortunately, Ultraviolet (UV) radiation causes serious degradation to the most of high performance fibers. UV lights, either natural or artificial, cause organic compounds to decompose and degrade, because the energy of the photons of UV light is high enough to break chemical bonds causing chain scission. This work is aiming at achieving maximum protection of high performance fibers using sheathing approaches. The sheaths proposed are of lightweight to maintain the advantage of the high performance fiber that is the high strength to weight ratio. This study involves developing three different types of sheathing. The product of interest that need be protected from UV is braid from PBO. First approach is extruding a sheath from Low Density Polyethylene (LDPE) loaded with different rutile TiO2 % nanoparticles around the braid from the PBO. The results of this approach showed that LDPE sheath loaded with 10% TiO2 by weight achieved the highest protection compare to 0% and 5% TiO2. The protection here is judged by strength loss of PBO. This trend noticed in different weathering environments, where the sheathed samples were exposed to UV-VIS radiations in different weatheromter equipments as well as exposure to high altitude environment using NASA BRDL balloon. The second approach is focusing in developing a protective porous membrane from polyurethane loaded with rutile TiO2 nanoparticles. Membrane from polyurethane loaded with 4

  19. Intel Xeon Phi coprocessor high performance programming

    CERN Document Server

    Jeffers, James

    2013-01-01

    Authors Jim Jeffers and James Reinders spent two years helping educate customers about the prototype and pre-production hardware before Intel introduced the first Intel Xeon Phi coprocessor. They have distilled their own experiences coupled with insights from many expert customers, Intel Field Engineers, Application Engineers and Technical Consulting Engineers, to create this authoritative first book on the essentials of programming for this new architecture and these new products. This book is useful even before you ever touch a system with an Intel Xeon Phi coprocessor. To ensure that your applications run at maximum efficiency, the authors emphasize key techniques for programming any modern parallel computing system whether based on Intel Xeon processors, Intel Xeon Phi coprocessors, or other high performance microprocessors. Applying these techniques will generally increase your program performance on any system, and better prepare you for Intel Xeon Phi coprocessors and the Intel MIC architecture. It off...

  20. Development of high-performance blended cements

    Science.gov (United States)

    Wu, Zichao

    2000-10-01

    This thesis presents the development of high-performance blended cements from industrial by-products. To overcome the low-early strength of blended cements, several chemicals were studied as the activators for cement hydration. Sodium sulfate was discovered as the best activator. The blending proportions were optimized by Taguchi experimental design. The optimized blended cements containing up to 80% fly ash performed better than Type I cement in strength development and durability. Maintaining a constant cement content, concrete produced from the optimized blended cements had equal or higher strength and higher durability than that produced from Type I cement alone. The key for the activation mechanism was the reaction between added SO4 2- and Ca2+ dissolved from cement hydration products.

  1. Comparative clinical outcomes between pediatric and young adult dialysis patients.

    Science.gov (United States)

    Atkinson, Meredith A; Lestz, Rachel M; Fivush, Barbara A; Silverstein, Douglas M

    2011-12-01

    Published data on the comparative achievement of The Kidney Disease Dialysis Outcome Quality Initiative (KDOQI) recommended clinical performance targets between children and young adults on dialysis are scarce. To characterize the achievement of KDOQI targets among children (young adults (18-24 years) with prevalent end stage renal disease (ESRD), we performed a cross-sectional analysis of data collected by the Mid-Atlantic Renal Coalition, in conjunction with the 2007 and 2008 ESRD Clinical Performance Measures Projects. Data on all enrolled pediatric dialysis patients, categorized into three age groups (0-8, 9-12, 13-17 years), and on a random sample of 5% of patients ≥ 18 years in ESRD Network 5 were examined for two study periods: hemodialysis (HD) data were collected from October to December 2006 and from October to December 2007 and peritoneal dialysis (PD) data were collected from October 2006 to March 2007 and from October 2007 to March 2008. In total, 114 unique patients were enrolled the study, of whom 41.2% (47/114) were on HD and 58.8% (67/114) on PD. Compared to the pediatric patients, young adults were less likely to achieve the KDOQI recommended serum phosphorus levels and serum calcium × phosphorus product values, with less than one-quarter demonstrating values at or below each goal. Multivariate analysis revealed that both young adults and 13- to 17-year-olds were less likely to achieve target values for phosphorus [young adults: odds ratio (OR) 0.04, 95% confidence interval (95% CI) 0.01-0.19, p young adults: OR 0.01, 95% CI 0.002-0.09, p young adult ESRD patients.

  2. Being-in-dialysis: The experience of the machine-body for home dialysis users.

    Science.gov (United States)

    Shaw, Rhonda

    2015-05-01

    New Zealand leads the world in rates of home dialysis use, yet little is known about the experience of home dialysis from the patient's perspective. This article contributes to the literature on the self-care of dialysis patients by examining the relevance of the concept of the machine-body and cyborg embodiment for the lived experience of people with end-stage renal failure. The article, which presents a discussion of 24 in-depth interviews undertaken between 2009 and 2012, shows that although dialysis therapy is disruptive of being and time, study participants experience home dialysis in terms of flexibility, control and independence. While they do not use the term machine-body as a descriptor, the concept resonates with felt experience. Data also indicate that positive experience of home dialysis is relative to socio-economic positioning and the lived relation of patients to others, necessitating further research to examine these factors. © The Author(s) 2014.

  3. Utilities for high performance dispersion model PHYSIC

    International Nuclear Information System (INIS)

    Yamazawa, Hiromi

    1992-09-01

    The description and usage of the utilities for the dispersion calculation model PHYSIC were summarized. The model was developed in the study of developing high performance SPEEDI with the purpose of introducing meteorological forecast function into the environmental emergency response system. The procedure of PHYSIC calculation consists of three steps; preparation of relevant files, creation and submission of JCL, and graphic output of results. A user can carry out the above procedure with the help of the Geographical Data Processing Utility, the Model Control Utility, and the Graphic Output Utility. (author)

  4. An integrated high performance fastbus slave interface

    International Nuclear Information System (INIS)

    Christiansen, J.; Ljuslin, C.

    1992-01-01

    A high performance Fastbus slave interface ASIC is presented. The Fastbus slave integrated circuit (FASIC) is a programmable device, enabling its direct use in many different applications. The FASIC acts as an interface between Fastbus and a 'standard' processor/memory bus. It can work stand-alone or together with a microprocessor. A set of address mapping windows can map Fastbus addresses to convenient memory addresses and at the same time act as address decoding logic. Data rates of 100 MBytes/s to Fastbus can be obtained using an internal FIFO buffer in the FASIC. (orig.)

  5. High performance visual display for HENP detectors

    CERN Document Server

    McGuigan, M; Spiletic, J; Fine, V; Nevski, P

    2001-01-01

    A high end visual display for High Energy Nuclear Physics (HENP) detectors is necessary because of the sheer size and complexity of the detector. For BNL this display will be of special interest because of STAR and ATLAS. To load, rotate, query, and debug simulation code with a modern detector simply takes too long even on a powerful work station. To visualize the HENP detectors with maximal performance we have developed software with the following characteristics. We develop a visual display of HENP detectors on BNL multiprocessor visualization server at multiple level of detail. We work with general and generic detector framework consistent with ROOT, GAUDI etc, to avoid conflicting with the many graphic development groups associated with specific detectors like STAR and ATLAS. We develop advanced OpenGL features such as transparency and polarized stereoscopy. We enable collaborative viewing of detector and events by directly running the analysis in BNL stereoscopic theatre. We construct enhanced interactiv...

  6. High-Performance Vertical Organic Electrochemical Transistors.

    Science.gov (United States)

    Donahue, Mary J; Williamson, Adam; Strakosas, Xenofon; Friedlein, Jacob T; McLeod, Robert R; Gleskova, Helena; Malliaras, George G

    2018-02-01

    Organic electrochemical transistors (OECTs) are promising transducers for biointerfacing due to their high transconductance, biocompatibility, and availability in a variety of form factors. Most OECTs reported to date, however, utilize rather large channels, limiting the transistor performance and resulting in a low transistor density. This is typically a consequence of limitations associated with traditional fabrication methods and with 2D substrates. Here, the fabrication and characterization of OECTs with vertically stacked contacts, which overcome these limitations, is reported. The resulting vertical transistors exhibit a reduced footprint, increased intrinsic transconductance of up to 57 mS, and a geometry-normalized transconductance of 814 S m -1 . The fabrication process is straightforward and compatible with sensitive organic materials, and allows exceptional control over the transistor channel length. This novel 3D fabrication method is particularly suited for applications where high density is needed, such as in implantable devices. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. High Performance Data Distribution for Scientific Community

    Science.gov (United States)

    Tirado, Juan M.; Higuero, Daniel; Carretero, Jesus

    2010-05-01

    Institutions such as NASA, ESA or JAXA find solutions to distribute data from their missions to the scientific community, and their long term archives. This is a complex problem, as it includes a vast amount of data, several geographically distributed archives, heterogeneous architectures with heterogeneous networks, and users spread around the world. We propose a novel architecture (HIDDRA) that solves this problem aiming to reduce user intervention in data acquisition and processing. HIDDRA is a modular system that provides a highly efficient parallel multiprotocol download engine, using a publish/subscribe policy which helps the final user to obtain data of interest transparently. Our system can deal simultaneously with multiple protocols (HTTP,HTTPS, FTP, GridFTP among others) to obtain the maximum bandwidth, reducing the workload in data server and increasing flexibility. It can also provide high reliability and fault tolerance, as several sources of data can be used to perform one file download. HIDDRA architecture can be arranged into a data distribution network deployed on several sites that can cooperate to provide former features. HIDDRA has been addressed by the 2009 e-IRG Report on Data Management as a promising initiative for data interoperability. Our first prototype has been evaluated in collaboration with the ESAC centre in Villafranca del Castillo (Spain) that shows a high scalability and performance, opening a wide spectrum of opportunities. Some preliminary results have been published in the Journal of Astrophysics and Space Science [1]. [1] D. Higuero, J.M. Tirado, J. Carretero, F. Félix, and A. de La Fuente. HIDDRA: a highly independent data distribution and retrieval architecture for space observation missions. Astrophysics and Space Science, 321(3):169-175, 2009

  8. Intra-dialytic blood oxygen saturation (SO2): association with dialysis hypotension (the SOGLIA Study).

    Science.gov (United States)

    Mancini, E; Perazzini, C; Gesualdo, L; Aucella, F; Limido, A; Scolari, F; Savoldi, S; Tramonti, M; Corazza, L; Atti, M; Severi, S; Bolasco, P; Santoro, A

    2017-12-01

    Intradialytic hypotension (IDH) has a dramatic impact on the main outcomes of dialysis patients. Early warning of hemodynamic worsening during dialysis would enable preventive measures to be taken. Blood oxygen saturation (SO 2 ) is used for hemodynamic monitoring in the critical care setting and may provide useful information about IDH onset. To evaluate whether short- and medium-term variations in the SO 2 signal (ST-SO 2var , MT-SO 2var ,) during dialysis are a predictor of IDH. In this 3-month observational cohort study, 51 hypotension-prone chronic hemodialysis (HD) patients, with vascular access by arteriovenous fistula (AVF) or central venous catheter (CVC), were enrolled. Continuous non-invasive blood SO 2 was monitored (fc = 0.2 Hz) by an optical sensor on the arterial line of the extracorporeal circulation; blood pressure (every 30 min), symptoms and their time of appearance were noted. Predictive power of IDH was expressed by the area under curve (AUC) sensitivity and specificity based on intradialytic variations in SO 2 . A total of 1290 HD sessions were analyzed. Overall, off-line ST-SO 2var analysis proved able to correctly predict IDH in 67 % of the sessions where IDH occurred. The best predictive performance was found in the presence of highly arterialized AVF (SO 2  > 95 %) (75 % sensitivity; AUC 0.825; p < 0.05). On the contrary, in sessions with CVC, IDH prediction proved more efficient by MT-SO 2var (AUC 0.575; p = 0.01). Intradialytic SO 2 variability could be a valid parameter to detect in advance the hemodynamic worsening that precedes IDH. Appropriate timely intervention could help prevent IDH onset.

  9. Asymptomatic Effluent Protozoa Colonization in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Simões-Silva, Liliana; Correia, Inês; Barbosa, Joana; Santos-Araujo, Carla; Sousa, Maria João; Pestana, Manuel; Soares-Silva, Isabel; Sampaio-Maia, Benedita

    Currently, chronic kidney disease (CKD) is a global health problem. Considering the impaired immunity of CKD patients, the relevance of infection in peritoneal dialysis (PD), and the increased prevalence of parasites in CKD patients, protozoa colonization was evaluated in PD effluent from CKD patients undergoing PD. Overnight PD effluent was obtained from 49 asymptomatic stable PD patients. Protozoa analysis was performed microscopically by searching cysts and trophozoites in direct wet mount of PD effluent and after staining smears. Protozoa were found in PD effluent of 10.2% of evaluated PD patients, namely Blastocystis hominis, in 2 patients, and Entamoeba sp., Giardia sp., and Endolimax nana in the other 3 patients, respectively. None of these patients presented clinical signs or symptoms of peritonitis at the time of protozoa screening. Our results demonstrate that PD effluent may be susceptible to asymptomatic protozoa colonization. The clinical impact of this finding should be further investigated. Copyright © 2016 International Society for Peritoneal Dialysis.

  10. Circulating thyroid hormone levels and adequacy of dialysis.

    Science.gov (United States)

    Savdie, E; Stewart, J H; Mahony, J F; Hayes, J M; Lazarus, L; Simons, L A

    1978-02-01

    In vitro thyroid function tests were performed in three groups of patients with chronic renal failure who were receiving, on average, 15, 18 and 27 hours of maintenance hemodialysis per week. Total thyroxine levels were low and total triiodothyronine levels low to normal in those receiving the least dialysis (15 hours), and were significantly higher in those receiving longer dialysis. Free thyroxine levels, as measured by the effective thyroxine ratio, were normal and similar in all three groups, as were serum thyrotrophin levels. All patients were clinically euthyroid. As total hormone levels showed a significant inverse relationship to both urea and creatinine, this study suggests that there is a dialyzable metabolite retained in uremia which competes with thyroid hormones for protein-binding sites.

  11. Two Cases of Massive Hydrothorax Complicating Peritoneal Dialysis

    International Nuclear Information System (INIS)

    Bae, Sang Kyun; Yum, Ha Yong; Rim, Hark

    1994-01-01

    Massive hydrothorax complicating continuous ambulatory peritoneal dialysis (CAPD) is relatively rare. A 67-year-old male and a 23-year-old female patients during CAPD presented massive pleural effusion, They have been performing peritoneal dialysis due to end-stage renal disease for 8 months and 2 weeks respectively. We injected '9 9m Tc-labelled radiopharmaceutical (phytate and MAA, respectively) into peritoneal cavity with the dialysate. The anterior, posterior and right lateral images were obtained. The studies reveal visible radioactivity in the right chest indicating the communication between the peritoneal and the pleural space. After sclerotherapy with tetracycline, the same studies reveal no radioactivity in the right chest suggesting successful therapy. We think nuclear imaging is a simple and noninvasive method for the differential diagnosis of pleural effusion in patients during CAPD and the evaluation of therapy.

  12. Sonographic evaluation of complications in patients with peritoneal dialysis

    International Nuclear Information System (INIS)

    Yoo, Won Don; Jho, O. K.; Kim, J. S.; Ko, B. H.; Park, H. C.

    1990-01-01

    Ultrasonography was performed prospectively in 20 patients who were undergoing continuous ambullatory peritoneal dialysis for evaluation of complications. We examined the abdominal wall along the course of catheter and the peritoneal cavity with special attention to the dialysate distribution, dialysate echogenecity, thickness of the peritoneum small bowel distribution and the position of the catheter tip. Peritonitis was the most common complication (n=7); sonographic findings were small bowel adhesion (n=5) multiseptated ascites(n=1), peritoneal thickening(n=4), and tunnel infection(n=1) and exith site infection(n=1). Our initial experience suggests that ultrasonography is useful for diagnosis of complications and monitoring of patient during long term peritoneal dialysis

  13. High-performance laboratories and cleanrooms; TOPICAL

    International Nuclear Information System (INIS)

    Tschudi, William; Sartor, Dale; Mills, Evan; Xu, Tengfang

    2002-01-01

    The California Energy Commission sponsored this roadmap to guide energy efficiency research and deployment for high performance cleanrooms and laboratories. Industries and institutions utilizing these building types (termed high-tech buildings) have played an important part in the vitality of the California economy. This roadmap's key objective to present a multi-year agenda to prioritize and coordinate research efforts. It also addresses delivery mechanisms to get the research products into the market. Because of the importance to the California economy, it is appropriate and important for California to take the lead in assessing the energy efficiency research needs, opportunities, and priorities for this market. In addition to the importance to California's economy, energy demand for this market segment is large and growing (estimated at 9400 GWH for 1996, Mills et al. 1996). With their 24hr. continuous operation, high tech facilities are a major contributor to the peak electrical demand. Laboratories and cleanrooms constitute the high tech building market, and although each building type has its unique features, they are similar in that they are extremely energy intensive, involve special environmental considerations, have very high ventilation requirements, and are subject to regulations-primarily safety driven-that tend to have adverse energy implications. High-tech buildings have largely been overlooked in past energy efficiency research. Many industries and institutions utilize laboratories and cleanrooms. As illustrated, there are many industries operating cleanrooms in California. These include semiconductor manufacturing, semiconductor suppliers, pharmaceutical, biotechnology, disk drive manufacturing, flat panel displays, automotive, aerospace, food, hospitals, medical devices, universities, and federal research facilities

  14. Dialysis services for tourists to the Veneto Region: a qualitative study.

    Science.gov (United States)

    Footman, Katharine; Mitrio, Silva; Zanon, Dario; Glonti, Ketevan; Risso-Gill, Isabelle; McKee, Martin; Knai, Cécile

    2015-03-01

    The European Union has an established mechanism which enables patients with end-stage kidney disease (ESKD) to receive dialysis abroad, allowing them to benefit from the legal right to freedom of movement. The number of patients seeking dialysis abroad has increased in recent years and the Veneto Region of Italy, a major tourist destination, has made significant investment in providing tourist haemodialysis services. To understand the issues involved in providing dialysis services for tourists moving within the European Union, such as the experience of patients using the service, the challenges faced by professionals and patients and continuity of care. Semi-structured interviews. Interviews were conducted with patients, health professionals and key stakeholders in two dialysis centres set up for tourists in the Veneto Region's Local Health Authority 10. The study uncovered high levels of patient satisfaction and a positive impact on patients' quality of life. However, the service faces a number of challenges relating to accessibility, language barriers and continuity of care for the patient when leaving Veneto. The study also demonstrates the importance of coordinating care prior to the tourists' stay. Tourist dialysis centres are necessary to make the right to freedom of movement for patients with ESKD a reality. The findings suggest that communicating and coordinating high-quality care across borders in the EU may be facilitated by increased standardisation of norms and documents for continuity of care, such as care plans and discharge summaries. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  15. Transport in JET high performance plasmas

    International Nuclear Information System (INIS)

    2001-01-01

    Two type of high performance scenarios have been produced in JET during DTE1 campaign. One of them is the well known and extensively used in the past ELM-free hot ion H-mode scenario which has two distinct regions- plasma core and the edge transport barrier. The results obtained during DTE-1 campaign with D, DT and pure T plasmas confirms our previous conclusion that the core transport scales as a gyroBohm in the inner half of plasma volume, recovers its Bohm nature closer to the separatrix and behaves as ion neoclassical in the transport barrier. Measurements on the top of the barrier suggest that the width of the barrier is dependent upon isotope and moreover suggest that fast ions play a key role. The other high performance scenario is a relatively recently developed Optimised Shear Scenario with small or slightly negative magnetic shear in plasma core. Different mechanisms of Internal Transport Barrier (ITB) formation have been tested by predictive modelling and the results are compared with experimentally observed phenomena. The experimentally observed non-penetration of the heavy impurities through the strong ITB which contradicts to a prediction of the conventional neo-classical theory is discussed. (author)

  16. High-performance computing for airborne applications

    International Nuclear Information System (INIS)

    Quinn, Heather M.; Manuzatto, Andrea; Fairbanks, Tom; Dallmann, Nicholas; Desgeorges, Rose

    2010-01-01

    Recently, there has been attempts to move common satellite tasks to unmanned aerial vehicles (UAVs). UAVs are significantly cheaper to buy than satellites and easier to deploy on an as-needed basis. The more benign radiation environment also allows for an aggressive adoption of state-of-the-art commercial computational devices, which increases the amount of data that can be collected. There are a number of commercial computing devices currently available that are well-suited to high-performance computing. These devices range from specialized computational devices, such as field-programmable gate arrays (FPGAs) and digital signal processors (DSPs), to traditional computing platforms, such as microprocessors. Even though the radiation environment is relatively benign, these devices could be susceptible to single-event effects. In this paper, we will present radiation data for high-performance computing devices in a accelerated neutron environment. These devices include a multi-core digital signal processor, two field-programmable gate arrays, and a microprocessor. From these results, we found that all of these devices are suitable for many airplane environments without reliability problems.

  17. Transport in JET high performance plasmas

    International Nuclear Information System (INIS)

    1999-01-01

    Two type of high performance scenarios have been produced in JET during DTE1 campaign. One of them is the well known and extensively used in the past ELM-free hot ion H-mode scenario which has two distinct regions- plasma core and the edge transport barrier. The results obtained during DTE-1 campaign with D, DT and pure T plasmas confirms our previous conclusion that the core transport scales as a gyroBohm in the inner half of plasma volume, recovers its Bohm nature closer to the separatrix and behaves as ion neoclassical in the transport barrier. Measurements on the top of the barrier suggest that the width of the barrier is dependent upon isotope and moreover suggest that fast ions play a key role. The other high performance scenario is a relatively recently developed Optimised Shear Scenario with small or slightly negative magnetic shear in plasma core. Different mechanisms of Internal Transport Barrier (ITB) formation have been tested by predictive modelling and the results are compared with experimentally observed phenomena. The experimentally observed non-penetration of the heavy impurities through the strong ITB which contradicts to a prediction of the conventional neo-classical theory is discussed. (author)

  18. High-performance vertical organic transistors.

    Science.gov (United States)

    Kleemann, Hans; Günther, Alrun A; Leo, Karl; Lüssem, Björn

    2013-11-11

    Vertical organic thin-film transistors (VOTFTs) are promising devices to overcome the transconductance and cut-off frequency restrictions of horizontal organic thin-film transistors. The basic physical mechanisms of VOTFT operation, however, are not well understood and VOTFTs often require complex patterning techniques using self-assembly processes which impedes a future large-area production. In this contribution, high-performance vertical organic transistors comprising pentacene for p-type operation and C60 for n-type operation are presented. The static current-voltage behavior as well as the fundamental scaling laws of such transistors are studied, disclosing a remarkable transistor operation with a behavior limited by injection of charge carriers. The transistors are manufactured by photolithography, in contrast to other VOTFT concepts using self-assembled source electrodes. Fluorinated photoresist and solvent compounds allow for photolithographical patterning directly and strongly onto the organic materials, simplifying the fabrication protocol and making VOTFTs a prospective candidate for future high-performance applications of organic transistors. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Performance of the CMS High Level Trigger

    CERN Document Server

    Perrotta, Andrea

    2015-01-01

    The CMS experiment has been designed with a 2-level trigger system. The first level is implemented using custom-designed electronics. The second level is the so-called High Level Trigger (HLT), a streamlined version of the CMS offline reconstruction software running on a computer farm. For Run II of the Large Hadron Collider, the increases in center-of-mass energy and luminosity will raise the event rate to a level challenging for the HLT algorithms. The increase in the number of interactions per bunch crossing, on average 25 in 2012, and expected to be around 40 in Run II, will be an additional complication. We present here the expected performance of the main triggers that will be used during the 2015 data taking campaign, paying particular attention to the new approaches that have been developed to cope with the challenges of the new run. This includes improvements in HLT electron and photon reconstruction as well as better performing muon triggers. We will also present the performance of the improved trac...

  20. Development of a High Performance Spacer Grid

    Energy Technology Data Exchange (ETDEWEB)

    Song, Kee Nam; Song, K. N.; Yoon, K. H. (and others)

    2007-03-15

    A spacer grid in a LWR fuel assembly is a key structural component to support fuel rods and to enhance the heat transfer from the fuel rod to the coolant. In this research, the main research items are the development of inherent and high performance spacer grid shapes, the establishment of mechanical/structural analysis and test technology, and the set-up of basic test facilities for the spacer grid. The main research areas and results are as follows. 1. 18 different spacer grid candidates have been invented and applied for domestic and US patents. Among the candidates 16 are chosen from the patent. 2. Two kinds of spacer grids are finally selected for the advanced LWR fuel after detailed performance tests on the candidates and commercial spacer grids from a mechanical/structural point of view. According to the test results the features of the selected spacer grids are better than those of the commercial spacer grids. 3. Four kinds of basic test facilities are set up and the relevant test technologies are established. 4. Mechanical/structural analysis models and technology for spacer grid performance are developed and the analysis results are compared with the test results to enhance the reliability of the models.

  1. Low cost high performance uncertainty quantification

    KAUST Repository

    Bekas, C.

    2009-01-01

    Uncertainty quantification in risk analysis has become a key application. In this context, computing the diagonal of inverse covariance matrices is of paramount importance. Standard techniques, that employ matrix factorizations, incur a cubic cost which quickly becomes intractable with the current explosion of data sizes. In this work we reduce this complexity to quadratic with the synergy of two algorithms that gracefully complement each other and lead to a radically different approach. First, we turned to stochastic estimation of the diagonal. This allowed us to cast the problem as a linear system with a relatively small number of multiple right hand sides. Second, for this linear system we developed a novel, mixed precision, iterative refinement scheme, which uses iterative solvers instead of matrix factorizations. We demonstrate that the new framework not only achieves the much needed quadratic cost but in addition offers excellent opportunities for scaling at massively parallel environments. We based our implementation on BLAS 3 kernels that ensure very high processor performance. We achieved a peak performance of 730 TFlops on 72 BG/P racks, with a sustained performance 73% of theoretical peak. We stress that the techniques presented in this work are quite general and applicable to several other important applications. Copyright © 2009 ACM.

  2. Energy Efficient Graphene Based High Performance Capacitors.

    Science.gov (United States)

    Bae, Joonwon; Kwon, Oh Seok; Lee, Chang-Soo

    2017-07-10

    Graphene (GRP) is an interesting class of nano-structured electronic materials for various cutting-edge applications. To date, extensive research activities have been performed on the investigation of diverse properties of GRP. The incorporation of this elegant material can be very lucrative in terms of practical applications in energy storage/conversion systems. Among various those systems, high performance electrochemical capacitors (ECs) have become popular due to the recent need for energy efficient and portable devices. Therefore, in this article, the application of GRP for capacitors is described succinctly. In particular, a concise summary on the previous research activities regarding GRP based capacitors is also covered extensively. It was revealed that a lot of secondary materials such as polymers and metal oxides have been introduced to improve the performance. Also, diverse devices have been combined with capacitors for better use. More importantly, recent patents related to the preparation and application of GRP based capacitors are also introduced briefly. This article can provide essential information for future study. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  3. SISYPHUS: A high performance seismic inversion factory

    Science.gov (United States)

    Gokhberg, Alexey; Simutė, Saulė; Boehm, Christian; Fichtner, Andreas

    2016-04-01

    In the recent years the massively parallel high performance computers became the standard instruments for solving the forward and inverse problems in seismology. The respective software packages dedicated to forward and inverse waveform modelling specially designed for such computers (SPECFEM3D, SES3D) became mature and widely available. These packages achieve significant computational performance and provide researchers with an opportunity to solve problems of bigger size at higher resolution within a shorter time. However, a typical seismic inversion process contains various activities that are beyond the common solver functionality. They include management of information on seismic events and stations, 3D models, observed and synthetic seismograms, pre-processing of the observed signals, computation of misfits and adjoint sources, minimization of misfits, and process workflow management. These activities are time consuming, seldom sufficiently automated, and therefore represent a bottleneck that can substantially offset performance benefits provided by even the most powerful modern supercomputers. Furthermore, a typical system architecture of modern supercomputing platforms is oriented towards the maximum computational performance and provides limited standard facilities for automation of the supporting activities. We present a prototype solution that automates all aspects of the seismic inversion process and is tuned for the modern massively parallel high performance computing systems. We address several major aspects of the solution architecture, which include (1) design of an inversion state database for tracing all relevant aspects of the entire solution process, (2) design of an extensible workflow management framework, (3) integration with wave propagation solvers, (4) integration with optimization packages, (5) computation of misfits and adjoint sources, and (6) process monitoring. The inversion state database represents a hierarchical structure with

  4. Ultra high performance concrete dematerialization study

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-03-01

    Concrete is the most widely used building material in the world and its use is expected to grow. It is well recognized that the production of portland cement results in the release of large amounts of carbon dioxide, a greenhouse gas (GHG). The main challenge facing the industry is to produce concrete in an environmentally sustainable manner. Reclaimed industrial by-proudcts such as fly ash, silica fume and slag can reduce the amount of portland cement needed to make concrete, thereby reducing the amount of GHGs released to the atmosphere. The use of these supplementary cementing materials (SCM) can also enhance the long-term strength and durability of concrete. The intention of the EcoSmart{sup TM} Concrete Project is to develop sustainable concrete through innovation in supply, design and construction. In particular, the project focuses on finding a way to minimize the GHG signature of concrete by maximizing the replacement of portland cement in the concrete mix with SCM while improving the cost, performance and constructability. This paper describes the use of Ductal{sup R} Ultra High Performance Concrete (UHPC) for ramps in a condominium. It examined the relationship between the selection of UHPC and the overall environmental performance, cost, constructability maintenance and operational efficiency as it relates to the EcoSmart Program. The advantages and challenges of using UHPC were outlined. In addition to its very high strength, UHPC has been shown to have very good potential for GHG emission reduction due to the reduced material requirements, reduced transport costs and increased SCM content. refs., tabs., figs.

  5. JT-60U high performance regimes

    International Nuclear Information System (INIS)

    Ishida, S.

    1999-01-01

    High performance regimes of JT-60U plasmas are presented with an emphasis upon the results from the use of a semi-closed pumped divertor with W-shaped geometry. Plasma performance in transient and quasi steady states has been significantly improved in reversed shear and high- βp regimes. The reversed shear regime elevated an equivalent Q DT eq transiently up to 1.25 (n D (0)τ E T i (0)=8.6x10 20 m-3·s·keV) in a reactor-relevant thermonuclear dominant regime. Long sustainment of enhanced confinement with internal transport barriers (ITBs) with a fully non-inductive current drive in a reversed shear discharge was successfully demonstrated with LH wave injection. Performance sustainment has been extended in the high- bp regime with a high triangularity achieving a long sustainment of plasma conditions equivalent to Q DT eq ∼0.16 (n D (0)τ E T i (0)∼1.4x10 20 m -3 ·s·keV) for ∼4.5 s with a large non-inductive current drive fraction of 60-70% of the plasma current. Thermal and particle transport analyses show significant reduction of thermal and particle diffusivities around ITB resulting in a strong Er shear in the ITB region. The W-shaped divertor is effective for He ash exhaust demonstrating steady exhaust capability of τ He */τ E ∼3-10 in support of ITER. Suppression of neutral back flow and chemical sputtering effect have been observed while MARFE onset density is rather decreased. Negative-ion based neutral beam injection (N-NBI) experiments have created a clear H-mode transition. Enhanced ionization cross- section due to multi-step ionization processes was confirmed as theoretically predicted. A current density profile driven by N-NBI is measured in a good agreement with theoretical prediction. N-NBI induced TAE modes characterized as persistent and bursting oscillations have been observed from a low hot beta of h >∼0.1-0.2% without a significant loss of fast ions. (author)

  6. A comparison of the quality of life of the patients undergoing hemodialysis versus peritoneal dialysis and its correlation to the quality of dialysis

    Directory of Open Access Journals (Sweden)

    Abdolamir Atapour

    2016-01-01

    Full Text Available Over the years, there has been a steady increase in the number of patients requiring dialysis. However, no consensus exists between choosing either hemodialysis (HD or peritoneal dialysis (PD as the preferred method of dialysis for patients. In this study, we have compared the quality of life of the patients undergoing either HD or PD. This cross-sectional study was performed in the dialysis center of the Noor and Saint Ali Asghar University Hospital in Isfahan, Iran in 2012. Forty-six patients who underwent PD (28 males and 18 females and 46 similar patients undergoing HD (26 males and 20 females were compared. A standardized Persian version of the short form-36 (SF-36 tool was used to assess the quality of life and to assess the quality of dialysis weekly Kt/V in patients undergoing PD and single random Kt/V sampling in HD patients were assessed. Patients undergoing PD reported higher scores in physical functioning. The lowest scores in both groups were reported in mental health section. In physical functioning section, physical role functioning section and overall score of the SF-36 tool, PD patients reported significantly higher scores compared to the HD patients (P <0.05. There was no significant difference between the qualities of the dialysis in the two patient groups. Aspects of quality of life such as physical functioning, physical role functioning, bodily pain, general health perceptions, and overall score were significantly different between the two groups. If these results are substantiated by subsequent longitudinal studies, then the choice of dialysis could be better guided in patients by the quality of life issues.

  7. High-performance phase-field modeling

    KAUST Repository

    Vignal, Philippe

    2015-04-27

    Many processes in engineering and sciences involve the evolution of interfaces. Among the mathematical frameworks developed to model these types of problems, the phase-field method has emerged as a possible solution. Phase-fields nonetheless lead to complex nonlinear, high-order partial differential equations, whose solution poses mathematical and computational challenges. Guaranteeing some of the physical properties of the equations has lead to the development of efficient algorithms and discretizations capable of recovering said properties by construction [2, 5]. This work builds-up on these ideas, and proposes novel discretization strategies that guarantee numerical energy dissipation for both conserved and non-conserved phase-field models. The temporal discretization is based on a novel method which relies on Taylor series and ensures strong energy stability. It is second-order accurate, and can also be rendered linear to speed-up the solution process [4]. The spatial discretization relies on Isogeometric Analysis, a finite element method that possesses the k-refinement technology and enables the generation of high-order, high-continuity basis functions. These basis functions are well suited to handle the high-order operators present in phase-field models. Two-dimensional and three dimensional results of the Allen-Cahn, Cahn-Hilliard, Swift-Hohenberg and phase-field crystal equation will be presented, which corroborate the theoretical findings, and illustrate the robustness of the method. Results related to more challenging examples, namely the Navier-Stokes Cahn-Hilliard and a diusion-reaction Cahn-Hilliard system, will also be presented. The implementation was done in PetIGA and PetIGA-MF, high-performance Isogeometric Analysis frameworks [1, 3], designed to handle non-linear, time-dependent problems.

  8. Frequency and Genotype of Human Parvovirus B19 among Iranian Hemodialysis and Peritoneal Dialysis Patients.

    Science.gov (United States)

    Sharif, Alireza; Aghakhani, Arezoo; Velayati, Ali Akbar; Banifazl, Mohammad; Sharif, Mohammad Reza; Razeghi, Effat; Kheirkhah, Davood; Kazemimanesh, Monireh; Bavand, Anahita; Ramezani, Amitis

    2016-01-01

    The aim of this study was to evaluate the frequency and genotype of human parvovirus B19 and its relation with anemia among Iranian patients under dialysis. Fifty hemodialysis (HD) and 33 peritoneal dialysis (PD) patients were enrolled. B19 IgG and IgM antibodies were assessed by ELISA, and the presence of B19 DNA was evaluated by nested PCR. PCR products were sequenced directly and phylogenetic analysis was performed. In the HD group, the prevalence of B19 antibodies was 54% for IgG and 4% for IgM. B19 DNA was detected in 10% of the cases, and 10% showed B19 IgG and viremia simultaneously. In the PD group, the prevalence of B19 IgG and IgM was 57.6 and 0% respectively, whereas B19 DNA was found in 12.1% of the group. A total of 9.1% showed B19 IgG and viremia concurrently. There was no significant difference regarding anemia and B19 infection in either group. All B19 isolates were clustered in genotype 1A. Our findings indicate that B19 infection plays no role in leading chronic anemia in dialysis patients. However, persistent B19 viremia and the circulation of the same strains in dialysis patients may indicate a potential risk for the contamination of dialysis equipment and nosocomial spread of B19 infection within dialysis units. © 2017 S. Karger AG, Basel.

  9. [Peritoneal dialysis adequacy in pediatrics. From the peritoneal equilibration test to the aquaporins].

    Science.gov (United States)

    Bolte, Lillian; Cano, Francisco

    2015-01-01

    An evaluation of the characteristics of peritoneal solute and water transport is essential to assess the suitability of prescribing dialysis in patients suffering from chronic renal disease. There are currently a series of models to perform this evaluation. The peritoneal equilibration test (PET) evaluates the peritoneal transport capacity, classifying the patients into four transport categories: high, high-average, low-average, and low. The short PET enables the same evaluation to be made in only 2hours, and has been validated in paediatric patients. On the other hand, the MiniPET provides additional information by evaluating the free water transport capacity by the ultra-small pores, and the Accelerated Peritoneal Examination Time (APEX) evaluates the time when the glucose and urea equilibration curves cross, and has been proposed as the optimum dwell time to achieve adequate ultrafiltration. An analysis is presented on the current information on these diagnostic methods as regards free water transport via aquaporins, which could be an important tool in optimising solute and water transport in patients on chronic peritoneal dialysis, particularly as regards the cardiovascular prognosis. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. High performance visual display for HENP detectors

    International Nuclear Information System (INIS)

    McGuigan, Michael; Smith, Gordon; Spiletic, John; Fine, Valeri; Nevski, Pavel

    2001-01-01

    A high end visual display for High Energy Nuclear Physics (HENP) detectors is necessary because of the sheer size and complexity of the detector. For BNL this display will be of special interest because of STAR and ATLAS. To load, rotate, query, and debug simulation code with a modern detector simply takes too long even on a powerful work station. To visualize the HENP detectors with maximal performance we have developed software with the following characteristics. We develop a visual display of HENP detectors on BNL multiprocessor visualization server at multiple level of detail. We work with general and generic detector framework consistent with ROOT, GAUDI etc, to avoid conflicting with the many graphic development groups associated with specific detectors like STAR and ATLAS. We develop advanced OpenGL features such as transparency and polarized stereoscopy. We enable collaborative viewing of detector and events by directly running the analysis in BNL stereoscopic theatre. We construct enhanced interactive control, including the ability to slice, search and mark areas of the detector. We incorporate the ability to make a high quality still image of a view of the detector and the ability to generate animations and a fly through of the detector and output these to MPEG or VRML models. We develop data compression hardware and software so that remote interactive visualization will be possible among dispersed collaborators. We obtain real time visual display for events accumulated during simulations

  11. Development of high performance ODS alloys

    Energy Technology Data Exchange (ETDEWEB)

    Shao, Lin [Texas A & M Univ., College Station, TX (United States); Gao, Fei [Univ. of Michigan, Ann Arbor, MI (United States); Garner, Frank [Texas A & M Univ., College Station, TX (United States)

    2018-01-29

    This project aims to capitalize on insights developed from recent high-dose self-ion irradiation experiments in order to develop and test the next generation of optimized ODS alloys needed to meet the nuclear community's need for high strength, radiation-tolerant cladding and core components, especially with enhanced resistance to void swelling. Two of these insights are that ferrite grains swell earlier than tempered martensite grains, and oxide dispersions currently produced only in ferrite grains require a high level of uniformity and stability to be successful. An additional insight is that ODS particle stability is dependent on as-yet unidentified compositional combinations of dispersoid and alloy matrix, such as dispersoids are stable in MA957 to doses greater than 200 dpa but dissolve in MA956 at doses less than 200 dpa. These findings focus attention on candidate next-generation alloys which address these concerns. Collaboration with two Japanese groups provides this project with two sets of first-round candidate alloys that have already undergone extensive development and testing for unirradiated properties, but have not yet been evaluated for their irradiation performance. The first set of candidate alloys are dual phase (ferrite + martensite) ODS alloys with oxide particles uniformly distributed in both ferrite and martensite phases. The second set of candidate alloys are ODS alloys containing non-standard dispersoid compositions with controllable oxide particle sizes, phases and interfaces.

  12. Low-Cost High-Performance MRI

    Science.gov (United States)

    Sarracanie, Mathieu; Lapierre, Cristen D.; Salameh, Najat; Waddington, David E. J.; Witzel, Thomas; Rosen, Matthew S.

    2015-10-01

    Magnetic Resonance Imaging (MRI) is unparalleled in its ability to visualize anatomical structure and function non-invasively with high spatial and temporal resolution. Yet to overcome the low sensitivity inherent in inductive detection of weakly polarized nuclear spins, the vast majority of clinical MRI scanners employ superconducting magnets producing very high magnetic fields. Commonly found at 1.5-3 tesla (T), these powerful magnets are massive and have very strict infrastructure demands that preclude operation in many environments. MRI scanners are costly to purchase, site, and maintain, with the purchase price approaching $1 M per tesla (T) of magnetic field. We present here a remarkably simple, non-cryogenic approach to high-performance human MRI at ultra-low magnetic field, whereby modern under-sampling strategies are combined with fully-refocused dynamic spin control using steady-state free precession techniques. At 6.5 mT (more than 450 times lower than clinical MRI scanners) we demonstrate (2.5 × 3.5 × 8.5) mm3 imaging resolution in the living human brain using a simple, open-geometry electromagnet, with 3D image acquisition over the entire brain in 6 minutes. We contend that these practical ultra-low magnetic field implementations of MRI (standards for affordable (<$50,000) and robust portable devices.

  13. Factors influencing access to education, decision making, and receipt of preferred dialysis modality in unplanned dialysis start patients

    DEFF Research Database (Denmark)

    Machowska, Anna; Alscher, Mark Dominik; Vanga, Satyanarayana Reddy

    2016-01-01

    for patients receiving education, making a decision, and receiving their preferred modality choice in UPS patients following a UPS educational program (UPS-EP). Methods: The Offering Patients Therapy Options in Unplanned Start (OPTiONS) study examined the impact of the implementation of a specific UPS......-EP, including decision support tools and pathway improvement on dialysis modality choice. Linear regression models were used to examine the factors predicting three key steps: referral and receipt of UPS-EP, modality decision making, and actual delivery of preferred modality choice. A simple economic assessment...... was performed to examine the potential benefit of implementing UPS-EP in terms of dialysis costs. Results: The majority of UPS patients could receive UPS-EP (214/270 patients) and were able to make a decision (177/214), although not all patients received their preferred choice (159/177). Regression analysis...

  14. Are Diuretics Underutilized in Dialysis Patients?

    Science.gov (United States)

    Trinh, Emilie; Bargman, Joanne M

    2016-09-01

    While oral diuretics are commonly used in patients with chronic kidney disease for the management of volume and blood pressure, they are often discontinued upon initiation of dialysis. We suggest that diuretics are considerably underutilized in peritoneal dialysis and haemodialysis patients despite numerous potential benefits and few side effects. Moreover, when diuretics are used, optimal doses are not always prescribed. In peritoneal dialysis, the use of diuretics can improve volume status and minimize the need for higher glucose-containing solutions. In patients on haemodialysis, diuretics can help lessen interdialytic weight gain, resulting in decreased ultrafiltration rates and fewer episodes of intradialytic hypotension. This paper will review the mechanism of action of diuretics in patients with renal insufficiency, quantify the risk of side effects and elaborate on the potential advantages of diuretic use in peritoneal dialysis and hemodialysis patients with residual kidney function. © 2016 Wiley Periodicals, Inc.

  15. Collagen markers in peritoneal dialysis patients

    DEFF Research Database (Denmark)

    Graff, J; Joffe, P; Fugleberg, S

    1995-01-01

    Possible relationships between the dialysate-to-plasma creatinine equilibration ratio (D/Pcreatinine 4 hour), duration of peritoneal dialysis treatment, number of peritonitis episodes, and mass appearance rates of three connective tissue markers [carboxyterminal propeptide of type I procollagen...... (PICP), aminoterminal propeptide of type III procollagen (PIIINP), and carboxyterminal telopeptide of type I collagen (ICTP)] were studied in 19 nondiabetic peritoneal dialysis patients. The absence of correlation between the mass appearance rates of the markers and the duration of dialysis treatment...... as well as the number of peritonitis episodes supports the concept that peritoneal dialysis does not cause persistent changes in the deposition and degradation rates of collagen. A correlation between the D/Pcreatinine 4 hr and the PICP mass appearance rates was found. Since it is unlikely...

  16. Dialysis: MedlinePlus Health Topic

    Science.gov (United States)

    ... access for hemodialysis (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Dialysis updates by ... for hemodialysis Show More Show Less Related Health Topics Creatinine Kidney Cysts Kidney Failure Peritoneal Disorders National ...

  17. Abdominal aortic calcifications predict survival in peritoneal dialysis patients

    DEFF Research Database (Denmark)

    Mäkelä, Satu M; Asola, Markku; Hadimeri, Henrik

    2018-01-01

    BACKGROUND: Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal...... dialysis (PD) patients using methods easily available in everyday clinical practice. METHODS: We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013. The abdominal aortic calcification score (AACS) was assessed using lateral lumbar.......9) in 17%, and high (> 1.3) in 34% of patients. Altogether 91 patients (37%) died during the median follow-up of 46 months. Only 2 patients (5%) with AACS 0 died compared with 50% of the patients with AACS ≥ 7 (p

  18. High Performance Computing in Science and Engineering '15 : Transactions of the High Performance Computing Center

    CERN Document Server

    Kröner, Dietmar; Resch, Michael

    2016-01-01

    This book presents the state-of-the-art in supercomputer simulation. It includes the latest findings from leading researchers using systems from the High Performance Computing Center Stuttgart (HLRS) in 2015. The reports cover all fields of computational science and engineering ranging from CFD to computational physics and from chemistry to computer science with a special emphasis on industrially relevant applications. Presenting findings of one of Europe’s leading systems, this volume covers a wide variety of applications that deliver a high level of sustained performance. The book covers the main methods in high-performance computing. Its outstanding results in achieving the best performance for production codes are of particular interest for both scientists and engineers. The book comes with a wealth of color illustrations and tables of results.

  19. High Performance Computing in Science and Engineering '17 : Transactions of the High Performance Computing Center

    CERN Document Server

    Kröner, Dietmar; Resch, Michael; HLRS 2017

    2018-01-01

    This book presents the state-of-the-art in supercomputer simulation. It includes the latest findings from leading researchers using systems from the High Performance Computing Center Stuttgart (HLRS) in 2017. The reports cover all fields of computational science and engineering ranging from CFD to computational physics and from chemistry to computer science with a special emphasis on industrially relevant applications. Presenting findings of one of Europe’s leading systems, this volume covers a wide variety of applications that deliver a high level of sustained performance.The book covers the main methods in high-performance computing. Its outstanding results in achieving the best performance for production codes are of particular interest for both scientists and engineers. The book comes with a wealth of color illustrations and tables of results.

  20. Thermal interface pastes nanostructured for high performance

    Science.gov (United States)

    Lin, Chuangang

    Thermal interface materials in the form of pastes are needed to improve thermal contacts, such as that between a microprocessor and a heat sink of a computer. High-performance and low-cost thermal pastes have been developed in this dissertation by using polyol esters as the vehicle and various nanoscale solid components. The proportion of a solid component needs to be optimized, as an excessive amount degrades the performance, due to the increase in the bond line thickness. The optimum solid volume fraction tends to be lower when the mating surfaces are smoother, and higher when the thermal conductivity is higher. Both a low bond line thickness and a high thermal conductivity help the performance. When the surfaces are smooth, a low bond line thickness can be even more important than a high thermal conductivity, as shown by the outstanding performance of the nanoclay paste of low thermal conductivity in the smooth case (0.009 mum), with the bond line thickness less than 1 mum, as enabled by low storage modulus G', low loss modulus G" and high tan delta. However, for rough surfaces, the thermal conductivity is important. The rheology affects the bond line thickness, but it does not correlate well with the performance. This study found that the structure of carbon black is an important parameter that governs the effectiveness of a carbon black for use in a thermal paste. By using a carbon black with a lower structure (i.e., a lower DBP value), a thermal paste that is more effective than the previously reported carbon black paste was obtained. Graphite nanoplatelet (GNP) was found to be comparable in effectiveness to carbon black (CB) pastes for rough surfaces, but it is less effective for smooth surfaces. At the same filler volume fraction, GNP gives higher thermal conductivity than carbon black paste. At the same pressure, GNP gives higher bond line thickness than CB (Tokai or Cabot). The effectiveness of GNP is limited, due to the high bond line thickness. A

  1. High performance liquid chromatography in pharmaceutical analyses

    Directory of Open Access Journals (Sweden)

    Branko Nikolin

    2004-05-01

    Full Text Available In testing the pre-sale procedure the marketing of drugs and their control in the last ten years, high performance liquid chromatographyreplaced numerous spectroscopic methods and gas chromatography in the quantitative and qualitative analysis. In the first period of HPLC application it was thought that it would become a complementary method of gas chromatography, however, today it has nearly completely replaced gas chromatography in pharmaceutical analysis. The application of the liquid mobile phase with the possibility of transformation of mobilized polarity during chromatography and all other modifications of mobile phase depending upon the characteristics of substance which are being tested, is a great advantage in the process of separation in comparison to other methods. The greater choice of stationary phase is the next factor which enables realization of good separation. The separation line is connected to specific and sensitive detector systems, spectrafluorimeter, diode detector, electrochemical detector as other hyphernated systems HPLC-MS and HPLC-NMR, are the basic elements on which is based such wide and effective application of the HPLC method. The purpose high performance liquid chromatography(HPLC analysis of any drugs is to confirm the identity of a drug and provide quantitative results and also to monitor the progress of the therapy of a disease.1 Measuring presented on the Fig. 1. is chromatogram obtained for the plasma of depressed patients 12 h before oral administration of dexamethasone. It may also be used to further our understanding of the normal and disease process in the human body trough biomedical and therapeutically research during investigation before of the drugs registration. The analyses of drugs and metabolites in biological fluids, particularly plasma, serum or urine is one of the most demanding but one of the most common uses of high performance of liquid chromatography. Blood, plasma or

  2. Combining high productivity with high performance on commodity hardware

    DEFF Research Database (Denmark)

    Skovhede, Kenneth

    -like compiler for translating CIL bytecode on the CELL-BE. I then introduce a bytecode converter that transforms simple loops in Java bytecode to GPGPU capable code. I then introduce the numeric library for the Common Intermediate Language, NumCIL. I can then utilizing the vector programming model from Num......CIL and map this to the Bohrium framework. The result is a complete system that gives the user a choice of high-level languages with no explicit parallelism, yet seamlessly performs efficient execution on a number of hardware setups....

  3. Integrating advanced facades into high performance buildings

    International Nuclear Information System (INIS)

    Selkowitz, Stephen E.

    2001-01-01

    Glass is a remarkable material but its functionality is significantly enhanced when it is processed or altered to provide added intrinsic capabilities. The overall performance of glass elements in a building can be further enhanced when they are designed to be part of a complete facade system. Finally the facade system delivers the greatest performance to the building owner and occupants when it becomes an essential element of a fully integrated building design. This presentation examines the growing interest in incorporating advanced glazing elements into more comprehensive facade and building systems in a manner that increases comfort, productivity and amenity for occupants, reduces operating costs for building owners, and contributes to improving the health of the planet by reducing overall energy use and negative environmental impacts. We explore the role of glazing systems in dynamic and responsive facades that provide the following functionality: Enhanced sun protection and cooling load control while improving thermal comfort and providing most of the light needed with daylighting; Enhanced air quality and reduced cooling loads using natural ventilation schemes employing the facade as an active air control element; Reduced operating costs by minimizing lighting, cooling and heating energy use by optimizing the daylighting-thermal tradeoffs; Net positive contributions to the energy balance of the building using integrated photovoltaic systems; Improved indoor environments leading to enhanced occupant health, comfort and performance. In addressing these issues facade system solutions must, of course, respect the constraints of latitude, location, solar orientation, acoustics, earthquake and fire safety, etc. Since climate and occupant needs are dynamic variables, in a high performance building the facade solution have the capacity to respond and adapt to these variable exterior conditions and to changing occupant needs. This responsive performance capability

  4. The need for high performance breeder reactors

    International Nuclear Information System (INIS)

    Vaughan, R.D.; Chermanne, J.

    1977-01-01

    It can be easily demonstrated, on the basis of realistic estimates of continued high oil costs, that an increasing portion of the growth in energy demand must be supplied by nuclear power and that this one might account for 20% of all the energy production by the end of the century. Such assumptions lead very quickly to the conclusion that the discovery, extraction and processing of the uranium will not be able to follow the demand; the bottleneck will essentially be related to the rate at which the ore can be discovered and extracted, and not to the existing quantities nor their grade. Figures as high as 150.000 T/annum and more would be quickly reached, and it is necessary to wonder already now if enough capital can be attracted to meet these requirements. There is only one solution to this problem: improve the conversion ratio of the nuclear system and quickly reach the breeding; this would lead to the reduction of the natural uranium consumption by a factor of about 50. However, this condition is not sufficient; the commercial breeder must have a breeding gain as high as possible because the Pu out-of-pile time and the Pu losses in the cycle could lead to an unacceptable doubling time for the system, if the breeding gain is too low. That is the reason why it is vital to develop high performance breeder reactors. The present paper indicates how the Gas-cooled Breeder Reactor [GBR] can meet the problems mentioned above, on the basis of recent and realistic studies. It briefly describes the present status of GBR development, from the predecessors in the gas cooled reactor line, particularly the AGR. It shows how the GBR fuel takes mostly profit from the LMFBR fuel irradiation experience. It compares the GBR performance on a consistent basis with that of the LMFBR. The GBR capital and fuel cycle costs are compared with those of thermal and fast reactors respectively. The conclusion is, based on a cost-benefit study, that the GBR must be quickly developed in order

  5. High performance nano-composite technology development

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Whung Whoe; Rhee, C. K.; Kim, S. J.; Park, S. D. [KAERI, Taejon (Korea, Republic of); Kim, E. K.; Jung, S. Y.; Ryu, H. J. [KRICT, Taejon (Korea, Republic of); Hwang, S. S.; Kim, J. K.; Hong, S. M. [KIST, Taejon (Korea, Republic of); Chea, Y. B. [KIGAM, Taejon (Korea, Republic of); Choi, C. H.; Kim, S. D. [ATS, Taejon (Korea, Republic of); Cho, B. G.; Lee, S. H. [HGREC, Taejon (Korea, Republic of)

    1999-06-15

    The trend of new material development are being to carried out not only high performance but also environmental attraction. Especially nano composite material which enhances the functional properties of components, extending the component life resulting to reduced the wastes and environmental contamination, has a great effect on various industrial area. The application of nano composite, depends on the polymer matrix and filler materials, has various application from semiconductor to medical field. In spite of nano composite merits, nano composite study are confined to a few special materials as a lab, scale because a few technical difficulties are still on hold. Therefore, the purpose of this study establishes the systematical planning to carried out the next generation projects on order to compete with other countries and overcome the protective policy of advanced countries with grasping over sea's development trends and our present status. (author).

  6. How to create high-performing teams.

    Science.gov (United States)

    Lam, Samuel M

    2010-02-01

    This article is intended to discuss inspirational aspects on how to lead a high-performance team. Cogent topics discussed include how to hire staff through methods of "topgrading" with reference to Geoff Smart and "getting the right people on the bus" referencing Jim Collins' work. In addition, once the staff is hired, this article covers how to separate the "eagles from the ducks" and how to inspire one's staff by creating the right culture with suggestions for further reading by Don Miguel Ruiz (The four agreements) and John Maxwell (21 Irrefutable laws of leadership). In addition, Simon Sinek's concept of "Start with Why" is elaborated to help a leader know what the core element should be with any superior culture. Thieme Medical Publishers.

  7. High performance nano-composite technology development

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Whung Whoe; Rhee, C. K.; Kim, S. J.; Park, S. D. [KAERI, Taejon (Korea, Republic of); Kim, E. K.; Jung, S. Y.; Ryu, H. J. [KRICT, Taejon (Korea, Republic of); Hwang, S. S.; Kim, J. K.; Hong, S. M. [KIST, Taejon (Korea, Republic of); Chea, Y. B. [KIGAM, Taejon (Korea, Republic of); Choi, C. H.; Kim, S. D. [ATS, Taejon (Korea, Republic of); Cho, B. G.; Lee, S. H. [HGREC, Taejon (Korea, Republic of)

    1999-06-15

    The trend of new material development are being to carried out not only high performance but also environmental attraction. Especially nano composite material which enhances the functional properties of components, extending the component life resulting to reduced the wastes and environmental contamination, has a great effect on various industrial area. The application of nano composite, depends on the polymer matrix and filler materials, has various application from semiconductor to medical field. In spite of nano composite merits, nano composite study are confined to a few special materials as a lab, scale because a few technical difficulties are still on hold. Therefore, the purpose of this study establishes the systematical planning to carried out the next generation projects on order to compete with other countries and overcome the protective policy of advanced countries with grasping over sea's development trends and our present status. (author).

  8. High performance nano-composite technology development

    International Nuclear Information System (INIS)

    Kim, Whung Whoe; Rhee, C. K.; Kim, S. J.; Park, S. D.; Kim, E. K.; Jung, S. Y.; Ryu, H. J.; Hwang, S. S.; Kim, J. K.; Hong, S. M.; Chea, Y. B.; Choi, C. H.; Kim, S. D.; Cho, B. G.; Lee, S. H.

    1999-06-01

    The trend of new material development are being to carried out not only high performance but also environmental attraction. Especially nano composite material which enhances the functional properties of components, extending the component life resulting to reduced the wastes and environmental contamination, has a great effect on various industrial area. The application of nano composite, depends on the polymer matrix and filler materials, has various application from semiconductor to medical field. In spite of nano composite merits, nano composite study are confined to a few special materials as a lab, scale because a few technical difficulties are still on hold. Therefore, the purpose of this study establishes the systematical planning to carried out the next generation projects on order to compete with other countries and overcome the protective policy of advanced countries with grasping over sea's development trends and our present status. (author).

  9. High Performance with Prescriptive Optimization and Debugging

    DEFF Research Database (Denmark)

    Jensen, Nicklas Bo

    parallelization and automatic vectorization is attractive as it transparently optimizes programs. The thesis contributes an improved dependence analysis for explicitly parallel programs. These improvements lead to more loops being vectorized, on average we achieve a speedup of 1.46 over the existing dependence...... analysis and vectorizer in GCC. Automatic optimizations often fail for theoretical and practical reasons. When they fail we argue that a hybrid approach can be effective. Using compiler feedback, we propose to use the programmer’s intuition and insight to achieve high performance. Compiler feedback...... enlightens the programmer why a given optimization was not applied, and suggest how to change the source code to make it more amenable to optimizations. We show how this can yield significant speedups and achieve 2.4 faster execution on a real industrial use case. To aid in parallel debugging we propose...

  10. Optimizing High Performance Self Compacting Concrete

    Directory of Open Access Journals (Sweden)

    Raymond A Yonathan

    2017-01-01

    Full Text Available This paper’s objectives are to learn the effect of glass powder, silica fume, Polycarboxylate Ether, and gravel to optimizing composition of each factor in making High Performance SCC. Taguchi method is proposed in this paper as best solution to minimize specimen variable which is more than 80 variations. Taguchi data analysis method is applied to provide composition, optimizing, and the effect of contributing materials for nine variable of specimens. Concrete’s workability was analyzed using Slump flow test, V-funnel test, and L-box test. Compressive and porosity test were performed for the hardened state. With a dimension of 100×200 mm the cylindrical specimens were cast for compressive test with the age of 3, 7, 14, 21, 28 days. Porosity test was conducted at 28 days. It is revealed that silica fume contributes greatly to slump flow and porosity. Coarse aggregate shows the greatest contributing factor to L-box and compressive test. However, all factors show unclear result to V-funnel test.

  11. Cardiovascular morbidity and mortality risk factors in peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Jovanović Dijana B.

    2008-01-01

    Full Text Available Cardiovascular (CVS morbidity and mortality in the endstage renal disease (ESRD patients on peritoneal dialysis therapy is 10-30 folds higher than in general population. The prevalence of well known traditional risk factors such as age, sex, race, arterial hypertension, hyperlipidaemia, diabetes, smoking, physical inactivity is higher in the uraemic patients. Besides these, there are specific, nontraditional risk factors for dialysis patients. Mild inflammation present in peritoneal dialysis (PD patients which can be confirmed by specific inflammatory markers is the cause of CVS morbidity and mortality in these patients. Hypoalbuminaemia, hyperhomocysteinaemia and a higher level of leptin are important predictors of vascular complications as well as CVS events in the PD patients. Plasma norepinephrine, an indicator of sympathetic activity, is high in the ESRD patients and higher in the PD patients than in the patients on haemodialysis (HD. Therefore, norepinephrine may be a stronger risk factor in the PD patients. The same applies to asymmetric dimethylargine (ADMA, an endogenous inhibitor of nitric oxide synthase, which is an important risk factor of CVS morbidity and mortality 15 % higher in the PD than the HD patients. Hyperphosphataemia, secondary hyperparathyroidism and high calcium x phosphate product have been associated with the progression of the coronary artery calcification and valvular calcifications and predict all-cause CVS mortality in the PD patients. Residual renal function (RRF declines with time on dialysis but is slower in the PD than the HD patients. RRF decline is associated with the rise of proinflammatory cytokines and the onset of hypervolaemia and hypertension which increase the risk of CVS diseases, mortality in general and CVS mortality. In conclusion, it is very important to establish all CVS risk factors in the PD patients to prevent CVS diseases and CVS mortality in this population.

  12. High Performance Circularly Polarized Microstrip Antenna

    Science.gov (United States)

    Bondyopadhyay, Probir K. (Inventor)

    1997-01-01

    A microstrip antenna for radiating circularly polarized electromagnetic waves comprising a cluster array of at least four microstrip radiator elements, each of which is provided with dual orthogonal coplanar feeds in phase quadrature relation achieved by connection to an asymmetric T-junction power divider impedance notched at resonance. The dual fed circularly polarized reference element is positioned with its axis at a 45 deg angle with respect to the unit cell axis. The other three dual fed elements in the unit cell are positioned and fed with a coplanar feed structure with sequential rotation and phasing to enhance the axial ratio and impedance matching performance over a wide bandwidth. The centers of the radiator elements are disposed at the corners of a square with each side of a length d in the range of 0.7 to 0.9 times the free space wavelength of the antenna radiation and the radiator elements reside in a square unit cell area of sides equal to 2d and thereby permit the array to be used as a phased array antenna for electronic scanning and is realizable in a high temperature superconducting thin film material for high efficiency.

  13. NCI's Transdisciplinary High Performance Scientific Data Platform

    Science.gov (United States)

    Evans, Ben; Antony, Joseph; Bastrakova, Irina; Car, Nicholas; Cox, Simon; Druken, Kelsey; Evans, Bradley; Fraser, Ryan; Ip, Alex; Kemp, Carina; King, Edward; Minchin, Stuart; Larraondo, Pablo; Pugh, Tim; Richards, Clare; Santana, Fabiana; Smillie, Jon; Trenham, Claire; Wang, Jingbo; Wyborn, Lesley

    2016-04-01

    The Australian National Computational Infrastructure (NCI) manages Earth Systems data collections sourced from several domains and organisations onto a single High Performance Data (HPD) Node to further Australia's national priority research and innovation agenda. The NCI HPD Node has rapidly established its value, currently managing over 10 PBytes of datasets from collections that span a wide range of disciplines including climate, weather, environment, geoscience, geophysics, water resources and social sciences. Importantly, in order to facilitate broad user uptake, maximise reuse and enable transdisciplinary access through software and standardised interfaces, the datasets, associated information systems and processes have been incorporated into the design and operation of a unified platform that NCI has called, the National Environmental Research Data Interoperability Platform (NERDIP). The key goal of the NERDIP is to regularise data access so that it is easily discoverable, interoperable for different domains and enabled for high performance methods. It adopts and implements international standards and data conventions, and promotes scientific integrity within a high performance computing and data analysis environment. NCI has established a rich and flexible computing environment to access to this data, through the NCI supercomputer; a private cloud that supports both domain focused virtual laboratories and in-common interactive analysis interfaces; as well as remotely through scalable data services. Data collections of this importance must be managed with careful consideration of both their current use and the needs of the end-communities, as well as its future potential use, such as transitioning to more advanced software and improved methods. It is therefore critical that the data platform is both well-managed and trusted for stable production use (including transparency and reproducibility), agile enough to incorporate new technological advances and

  14. Adherence of pediatric patients to automated peritoneal dialysis.

    Science.gov (United States)

    Chua, Annabelle N; Warady, Bradley A

    2011-05-01

    Little information is available on adherence to a home automated peritoneal dialysis (APD) prescription for children with end-stage renal disease. We have therefore retrospectively reviewed HomeChoice PRO Card data from patients Adherence was characterized as occurring ≥ 95%, 90-94%, or treatment adherence and patient age, gender, race and if the patient had received training, respectively, was assessed. Of the 51 patients (57% male), with a mean age at peritoneal dialysis (PD) onset of 11.8 ± 5.3 years, 28 (55%) were adherent for all variables. No difference in mean age or if patients were trained existed between the two groups. Males were more likely to be non-adherent (p = 0.026) as were African Americans (p = 0.048). The majority of patients were adherent to duration (96%) and number of cycles (92%), whereas non-adherence was more common with number of sessions (82%) and dialysate volume (78%). In conclusion, 45% of the pediatric patients in our study cohort exhibited some non-adherence to their prescribed APD regimen, emphasizing the value of closely monitoring the performance of home dialysis in children.

  15. Design and protocol for the Dialysis Optimal Health Program (DOHP) randomised controlled trial.

    Science.gov (United States)

    Knowles, Simon R; Ski, Chantal F; Langham, Robyn; O'Flaherty, Emmet; Thompson, David R; Rossell, Susan L; Moore, Gaye; Hsueh, Ya-Seng Arthur; Castle, David J

    2016-09-09

    Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are serious and growing health problems with enormous impact on psychological and social functioning. Despite high rates of comorbid depression and anxiety in these patient populations, and the adverse impact these have upon treatment adherence, quality of life, social connectedness and healthcare costs there has been little attention focused on the prevention or management of these problems. Thus, our aim was to evaluate the Dialysis Optimal Health Program (DOHP) that adopts a person-centred approach and engages collaborative therapy to educate and support those diagnosed with ESKD who are commencing dialysis. The study design is a randomised controlled trial. Ninety-six adult patients initiating haemodialysis or peritoneal dialysis will be randomly allocated to either the intervention (DOHP) or usual care group. Participants receiving the intervention will receive nine (8 + 1 booster session) sequential sessions based on a structured information/workbook, psychosocial and educational supports and skills building. The primary outcome measures are depression and anxiety (assessed by the Hospital Anxiety and Depression Scale; HADS). Secondary outcomes include health-related quality of life (assessed by the Kidney Disease Quality of Life instrument; KDQOL), self-efficacy (assessed by General Self-Efficacy Scale) and clinical indices (e.g. albumin and haemoglobin levels). Cost-effectiveness analysis and process evaluation will also be performed to assess the economic value and efficacy of the DOHP. Primary and secondary measures will be collected at baseline and at 3-, 6-, and 12-month follow-up time points. We believe that this innovative trial will enhance knowledge of interventions aimed at supporting patients in the process of starting dialysis, and will broaden the focus from physical symptoms to include psychosocial factors such as depression, anxiety, self-efficacy, wellbeing and community

  16. High Power Flex-Propellant Arcjet Performance

    Science.gov (United States)

    Litchford, Ron J.

    2011-01-01

    implied nearly frozen flow in the nozzle and yielded performance ranges of 800-1100 sec for hydrogen and 400-600 sec for ammonia. Inferred thrust-to-power ratios were in the range of 30-10 lbf/MWe for hydrogen and 60-20 lbf/MWe for ammonia. Successful completion of this test series represents a fundamental milestone in the progression of high power arcjet technology, and it is hoped that the results may serve as a reliable touchstone for the future development of MW-class regeneratively-cooled flex-propellant plasma rockets.

  17. Silicon Photomultiplier Performance in High ELectric Field

    Science.gov (United States)

    Montoya, J.; Morad, J.

    2016-12-01

    Roughly 27% of the universe is thought to be composed of dark matter. The Large Underground Xenon (LUX) relies on the emission of light from xenon atoms after a collision with a dark matter particle. After a particle interaction in the detector, two things can happen: the xenon will emit light and charge. The charge (electrons), in the liquid xenon needs to be pulled into the gas section so that it can interact with gas and emit light. This allows LUX to convert a single electron into many photons. This is done by applying a high voltage across the liquid and gas regions, effectively ripping electrons out of the liquid xenon and into the gas. The current device used to detect photons is the photomultiplier tube (PMT). These devices are large and costly. In recent years, a new technology that is capable of detecting single photons has emerged, the silicon photomultiplier (SiPM). These devices are cheaper and smaller than PMTs. Their performance in a high electric fields, such as those found in LUX, are unknown. It is possible that a large electric field could introduce noise on the SiPM signal, drowning the single photon detection capability. My hypothesis is that SiPMs will not observe a significant increase is noise at an electric field of roughly 10kV/cm (an electric field within the range used in detectors like LUX). I plan to test this hypothesis by first rotating the SiPMs with no applied electric field between two metal plates roughly 2 cm apart, providing a control data set. Then using the same angles test the dark counts with the constant electric field applied. Possibly the most important aspect of LUX, is the photon detector because it's what detects the signals. Dark matter is detected in the experiment by looking at the ratio of photons to electrons emitted for a given interaction in the detector. Interactions with a low electron to photon ratio are more like to be dark matter events than those with a high electron to photon ratio. The ability to

  18. Influence of Diet Balanced with Essential Amino Acids / Keto Acid Analogs and High-Nutrient Blend on the Progression of Renal Failure in Patients in the Pre-Dialysis Stage of Chronic Kidney Disease Caused by Systemic Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    I.I. Aleksandrova

    2013-09-01

    Full Text Available The aim of the study was to evaluate the effect of a low protein diet (LPD balanced with essential amino acids (EAA / keto acid analogs (KAA and protein “SUPRO-XT 219D” in the composition of the high-energy nutrient blend (HENB for slow down of renal failure in patients in the pre-dialysis stage of chronic kidney disease (CKD induced by systemic autoimmune diseases (SAD.Material and Methods: In this study, 46 patients (35 with systemic lupus erythematosus and 15 with various forms of systemic vasculitis with CKD in stages 3-4 were randomized into three groups. Group 1 (18 patients: 10 with CKD stage 3 and 8 with CKD stage 4 was given LPD (0.6 g protein per kg of body weight per day comprising 0.3 g of vegetable protein and 0.3 g of animal protein balanced with EAA/KAA (Diet #1; Group 2 (18 patients: 9 with CKD stage 3 and 9 with CKD stage 4 was given the same LPD, but with an increased vegetable protein content (purified soy protein SUPRO-XT 219D up to 0.4 g/kg/day in the composition of HENB (Diet #2; Group 3, comparison group, (10 patients: 7 with CKD stage 3 and 3 with CKD stage 4 was given a free diet (Diet #3 based on the patient’s personal preferences. Both options of LPD were offered to all the patients of Groups 1 and 2 regardless of their baseline nutritional status (NS. The duration of the observation was 24-48 months. The NS was evaluated based on the bioelectrical impedance analysis. The protein and calorie intake was calculated from the 3-day food diary.Results: Among the 46 patients with CKD stages 3-4, NS impairment was detected in almost half the patients (45.7%. Both forms of LPD were well tolerated. The correction of the nutritive impairment was achieved in patients with baseline impaired NS; the remaining patients of Groups 1 and 2 demonstrated the safety of NS against LPD. At the same time, among Group 3 patients, during the progression of renal disorders, the NS rate was observed to increase by 1.5 times (from 40% to 60

  19. The Role of Performance Management in the High Performance Organisation

    NARCIS (Netherlands)

    de Waal, André A.; van der Heijden, Beatrice I.J.M.

    2014-01-01

    The allegiance of partnering organisations and their employees to an Extended Enterprise performance is its proverbial sword of Damocles. Literature on Extended Enterprises focuses on collaboration, inter-organizational integration and learning to avoid diminishing or missing allegiance becoming an

  20. Evaluating performance of high efficiency mist eliminators

    Energy Technology Data Exchange (ETDEWEB)

    Waggoner, Charles A.; Parsons, Michael S.; Giffin, Paxton K. [Mississippi State University, Institute for Clean Energy Technology, 205 Research Blvd, Starkville, MS (United States)

    2013-07-01

    Processing liquid wastes frequently generates off gas streams with high humidity and liquid aerosols. Droplet laden air streams can be produced from tank mixing or sparging and processes such as reforming or evaporative volume reduction. Unfortunately these wet air streams represent a genuine threat to HEPA filters. High efficiency mist eliminators (HEME) are one option for removal of liquid aerosols with high dissolved or suspended solids content. HEMEs have been used extensively in industrial applications, however they have not seen widespread use in the nuclear industry. Filtering efficiency data along with loading curves are not readily available for these units and data that exist are not easily translated to operational parameters in liquid waste treatment plants. A specialized test stand has been developed to evaluate the performance of HEME elements under use conditions of a US DOE facility. HEME elements were tested at three volumetric flow rates using aerosols produced from an iron-rich waste surrogate. The challenge aerosol included submicron particles produced from Laskin nozzles and super micron particles produced from a hollow cone spray nozzle. Test conditions included ambient temperature and relative humidities greater than 95%. Data collected during testing HEME elements from three different manufacturers included volumetric flow rate, differential temperature across the filter housing, downstream relative humidity, and differential pressure (dP) across the filter element. Filter challenge was discontinued at three intermediate dPs and the filter to allow determining filter efficiency using dioctyl phthalate and then with dry surrogate aerosols. Filtering efficiencies of the clean HEME, the clean HEME loaded with water, and the HEME at maximum dP were also collected using the two test aerosols. Results of the testing included differential pressure vs. time loading curves for the nine elements tested along with the mass of moisture and solid

  1. Restless legs syndrome in patients on dialysis

    International Nuclear Information System (INIS)

    AlJahdali, Hamdan H; AlQadhi, Waleed A; Khogeer, Haithm A; AlHejaili, Fayez F; Al Sayyari, Abdullah A; AlGhamdi, Saeed M

    2009-01-01

    Restless legs syndrome (RLS) is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG). This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD) on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH), Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC), Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG's RLS Questionnaire (RLSQ). Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 + - 17.2 years and mean duration on dialysis 40.4 + - 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM), coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively). Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS) (P= < 0.001 and 0.001, respectively). Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis and

  2. Restless legs syndrome in patients on dialysis

    Directory of Open Access Journals (Sweden)

    Al-Jahdali Hamdan

    2009-01-01

    Full Text Available Restless legs syndrome (RLS is an extremely distressing problem experienced by patients on dialysis; the prevalence appears to be greater than in the general population, with a wide variation from 6.6% to 80%. The diagnosis of RLS is a clinical one, and its definition has been clarified and standardized by internationally recognized diagnostic criteria, published in 1995 by the International Restless Legs Syndrome Study Group (IRLSSG. This study was designed to find out the prevalence of RLS in Saudi patients with end-stage renal disease (ESRD on maintenance dialysis. This is a cross sectional study carried out between May and Sept 2007 at two centers, King Abdulaziz Medical City-King Fahad National Guard Hospital (KAMC-KFNGH, Riyadh and King Faisal Specialist Hospital and Research Centre (KFHRC, Jeddah, Saudi Arabia. Data were gathered on 227 Saudi patients on chronic maintenance hemodialysis or chronic peritoneal dialysis. The prevalence of RLS was measured using IRLSSG′s RLS Questionnaire (RLSQ. Potential risk factors for RLS including other sleep disorders, underlying cause of chronic renal failure, duration on dialysis, dialysis shift, biochemical tests and demographic data were also evaluated. The overall prevalence of RLS was 50.22% including 53.7% males and 46.3% females. Their mean age was 55.7 ± 17.2 years and mean duration on dialysis 40.4 ± 37.8 months. Significant predictors of RLS were history of diabetes mellitus (DM, coffee intake, afternoon dialysis, gender and type of dialysis (P= 0.03, 0.01, < 0.001, 0.05 and 0.009 respectively. Patients with RLS were found to be at increased risk of having insomnia and excessive daytime sleepiness (EDS (P= < 0.001 and 0.001, respectively. Our study suggests that RLS is a very common problem in dialysis population and was significantly associated with other sleep disorders, particularly insomnia, and EDS. Optimal care of dialysis patient should include particular attention to the diagnosis

  3. Efficacy of peritoneal dialysis during infusion and drainage procedures.

    Science.gov (United States)

    Baczyski, Daniel; Antosiewicz, Stefan; Waniewski, Jacek; Nowak, Zbigniew; Wakowicz, Zofia

    2010-01-01

    Inadequate dialysis is still a major cause of technique failure in peritoneal dialysis (PD). Mathematical models provide the possibility of direct and precise assessment of peritoneal transport of urea and creatinine throughout the dwell and allow calculation of optimal schedules, dwell times, and predicted adequacy of a prescribed regimen. Kinetic modeling is particularly important for automated PD. If the effectiveness of uremic toxin removal that takes place during infusion and drainage of dialysis fluid is not taken into account, the predicted adequacy of the whole PD session may be underestimated. ♢ To estimate the efficacy of urea and creatinine removal during the dialysis fluid exchange procedure. ♢ 17 patients treated with PD were included in the study. PD effectiveness during dialysate exchange was defined as the quotient k of removed amount of creatinine/BUN during the infusion and drainage of dialysate and during a dwell of the same duration as the dialysate exchange. ♢ The effectiveness of creatinine and urea removal was reduced during the exchange procedure (k(creat) = 0.68 ± 0.43 and k(BUN) = 0.87 ± 0.44) and differed between these 2 solutes (p = 0.0009). The k coefficients for urea and creatinine were well correlated (R(2) = 0.83). ♢ The effectiveness of peritoneal transport of creatinine and BUN during the inflow/outflow phase was relatively high compared to that during the same dwell time (68% and 87% respectively). This real effectiveness of the dialysate exchange procedure should be taken into account in the process of planning automated PD sessions, otherwise the predicted overall efficacy of creatinine and urea removal throughout the session may be underestimated. This underestimation is proportional to the number of dwells per day.

  4. Blue Planet dialysis: novel water-sparing strategies for reducing dialysate flow.

    Science.gov (United States)

    Molano-Triviño, Alejandra; Wancjer, Benjamin; Neri, Mauro M; Karopadi, Akash N; Rosner, Mitchell; Ronco, Claudio

    2017-11-08

    Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux. We performed a search in Medline, Pubmed, Scielo, OVID and Biblioteca Redentor, using key words: Dialysate flow rate, Dialysate flux, and decrease; excluding: online, peritoneal, continuous, blood access, needle, hemodiafiltration, acute, pharmacokinetics, increase. We limited our search to adult humans or in vitro trials in English, Spanish, Italian and Portuguese, between January 1980 and June 2017. We found 816 trials. 37 articles were retrieved for review, and 11 articles were analyzed. Conservation of water in chronic HD should be considered an important responsibility of healthcare practitioners all over the world. We present a wider usage of dialysate flow rates, considering that it would lead to significant water conservation without much compromise on dialysis efficacy in small patients. We believe that further investigation into the utility of reduced dialysate flux in different populations is needed to broaden our understanding of how we can use these techniques in order to significantly reduce water consumption during chronic HD while still ensuring optimum efficacy and efficiency of the therapy.

  5. Pharmacokinetics of Intraperitoneal Cefalothin and Cefazolin in Patients Being Treated for Peritoneal Dialysis-Associated Peritonitis.

    Science.gov (United States)

    Roberts, Darren M; Ranganathan, Dwarakanathan; Wallis, Steven C; Varghese, Julie M; Kark, Adrian; Lipman, Jeffrey; Roberts, Jason A

    2016-01-01

    ♦ The standard treatment of peritoneal dialysis (PD)-associated peritonitis (PD-peritonitis) is intraperitoneal (IP) administration of antibiotics. Only limited data on the pharmacokinetics and appropriateness of contemporary dose recommendations of IP cefalothin and cefazolin exist. The aim of this study was to describe the pharmacokinetics of IP cefalothin and cefazolin in patients treated for PD-peritonitis. ♦ As per international guidelines, IP cefalothin or cefazolin 15 mg/kg once daily was dosed with gentamicin in a 6-hour dwell to patients with PD-peritonitis during routine care. Serial plasma and PD effluent samples were collected over the first 24 hours of therapy. Antibiotic concentrations were quantified using a validated chromatographic method with pharmacokinetic analysis performed using a non-compartmental approach. ♦ Nineteen patients were included (cefalothin n = 8, cefazolin n = 11). The median bioavailability for both antibiotics exceeded 92%, but other pharmacokinetic parameters varied markedly between antibiotics. Both antibiotics achieved high PD effluent concentrations throughout the antibiotic dwell. Cefazolin had a smaller volume of distribution compared with cefalothin (14 vs 40 L, p = 0.003). The median trough total plasma antibiotic concentration for cefazolin and cefalothin during the dwell differed (plasma 56 vs 13 mg/L, p Peritoneal Dialysis.

  6. An integrated high performance Fastbus slave interface

    International Nuclear Information System (INIS)

    Christiansen, J.; Ljuslin, C.

    1993-01-01

    A high performance CMOS Fastbus slave interface ASIC (Application Specific Integrated Circuit) supporting all addressing and data transfer modes defined in the IEEE 960 - 1986 standard is presented. The FAstbus Slave Integrated Circuit (FASIC) is an interface between the asynchronous Fastbus and a clock synchronous processor/memory bus. It can work stand-alone or together with a 32 bit microprocessor. The FASIC is a programmable device enabling its direct use in many different applications. A set of programmable address mapping windows can map Fastbus addresses to convenient memory addresses and at the same time act as address decoding logic. Data rates of 100 MBytes/sec to Fastbus can be obtained using an internal FIFO in the FASIC to buffer data between the two buses during block transfers. Message passing from Fastbus to a microprocessor on the slave module is supported. A compact (70 mm x 170 mm) Fastbus slave piggy back sub-card interface including level conversion between ECL and TTL signal levels has been implemented using surface mount components and the 208 pin FASIC chip

  7. High Performance Graphene Oxide Based Rubber Composites

    Science.gov (United States)

    Mao, Yingyan; Wen, Shipeng; Chen, Yulong; Zhang, Fazhong; Panine, Pierre; Chan, Tung W.; Zhang, Liqun; Liang, Yongri; Liu, Li

    2013-01-01

    In this paper, graphene oxide/styrene-butadiene rubber (GO/SBR) composites with complete exfoliation of GO sheets were prepared by aqueous-phase mixing of GO colloid with SBR latex and a small loading of butadiene-styrene-vinyl-pyridine rubber (VPR) latex, followed by their co-coagulation. During co-coagulation, VPR not only plays a key role in the prevention of aggregation of GO sheets but also acts as an interface-bridge between GO and SBR. The results demonstrated that the mechanical properties of the GO/SBR composite with 2.0 vol.% GO is comparable with those of the SBR composite reinforced with 13.1 vol.% of carbon black (CB), with a low mass density and a good gas barrier ability to boot. The present work also showed that GO-silica/SBR composite exhibited outstanding wear resistance and low-rolling resistance which make GO-silica/SBR very competitive for the green tire application, opening up enormous opportunities to prepare high performance rubber composites for future engineering applications. PMID:23974435

  8. Initial rheological description of high performance concretes

    Directory of Open Access Journals (Sweden)

    Alessandra Lorenzetti de Castro

    2006-12-01

    Full Text Available Concrete is defined as a composite material and, in rheological terms, it can be understood as a concentrated suspension of solid particles (aggregates in a viscous liquid (cement paste. On a macroscopic scale, concrete flows as a liquid. It is known that the rheological behavior of the concrete is close to that of a Bingham fluid and two rheological parameters regarding its description are needed: yield stress and plastic viscosity. The aim of this paper is to present the initial rheological description of high performance concretes using the modified slump test. According to the results, an increase of yield stress was observed over time, while a slight variation in plastic viscosity was noticed. The incorporation of silica fume showed changes in the rheological properties of fresh concrete. The behavior of these materials also varied with the mixing procedure employed in their production. The addition of superplasticizer meant that there was a large reduction in the mixture's yield stress, while plastic viscosity remained practically constant.

  9. High thermoelectric performance of graphite nanofibers.

    Science.gov (United States)

    Tran, Van-Truong; Saint-Martin, Jérôme; Dollfus, Philippe; Volz, Sebastian

    2018-02-22

    Graphite nanofibers (GNFs) have been demonstrated to be a promising material for hydrogen storage and heat management in electronic devices. Here, by means of first-principles and transport simulations, we show that GNFs can also be an excellent material for thermoelectric applications thanks to the interlayer weak van der Waals interaction that induces low thermal conductance and a step-like shape in the electronic transmission with mini-gaps, which are necessary ingredients to achieve high thermoelectric performance. This study unveils that the platelet form of GNFs in which graphite layers are perpendicular to the fiber axis can exhibit outstanding thermoelectric properties with a figure of merit ZT reaching 3.55 in a 0.5 nm diameter fiber and 1.1 in a 1.1 nm diameter one. Interestingly, by introducing 14 C isotope doping, ZT can even be enhanced up to more than 5, and more than 8 if we include the effect of finite phonon mean free path, which demonstrates the amazing thermoelectric potential of GNFs.

  10. Durability of high performance concrete in seawater

    International Nuclear Information System (INIS)

    Amjad Hussain Memon; Salihuddin Radin Sumadi; Rabitah Handan

    2000-01-01

    This paper presents a report on the effects of blended cements on the durability of high performance concrete (HPC) in seawater. In this research the effect of seawater was investigated. The specimens were initially subjected to water curing for seven days inside the laboratory at room temperature, followed by seawater curing exposed to tidal zone until testing. In this study three levels of cement replacement (0%, 30% and 70%) were used. The combined use of chemical and mineral admixtures has resulted in a new generation of concrete called HPC. The HPC has been identified as one of the most important advanced materials necessary in the effort to build a nation's infrastructure. HPC opens new opportunities in the utilization of the industrial by-products (mineral admixtures) in the construction industry. As a matter of fact permeability is considered as one of the fundamental properties governing the durability of concrete in the marine environment. Results of this investigation indicated that the oxygen permeability values for the blended cement concretes at the age of one year are reduced by a factor of about 2 as compared to OPC control mix concrete. Therefore both blended cement concretes are expected to withstand in the seawater exposed to tidal zone without serious deterioration. (Author)

  11. Intra-procedural continuous dialysis to facilitate interventional catheterization in pediatric patients with severe renal failure.

    Science.gov (United States)

    Opina, Angeline D; Qureshi, Athar M; Brewer, Eileen; Elenberg, Ewa; Swartz, Sarah; Michael, Mini; Justino, Henri

    2017-11-01

    Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016. Eight patients underwent a total of nine interventional catheterization procedures while receiving intra-procedural dialysis. Median age was 4.5 years (range 8 months to 17 years) and weight, 11.6 kg (11.2-62.6 kg). Six patients had end-stage renal disease (ESRD) and two patients had acute kidney injury (AKI), one due to hepatorenal syndrome and one due to multifactorial causes associated with congenital heart disease. The most common reason for catheterization was occlusive venous thrombosis requiring recanalization. CRRT was used during five cases and CCPD during four cases. Median procedure time was 337 min (95-651 min) and median contrast dose 4.2 mL kg -1 (1.2-8.2 mL kg -1 ). Euvolemia was maintained based on pre- and post-catheterizations weights, and no significant electrolyte abnormalities occurred based on lab monitoring during and post-procedure. Intra-procedural dialysis using CRRT or CCPD enables even small pediatric patients with severe renal failure to undergo long and complex interventional catheterizations by reducing the risk of fluid overload and electrolyte abnormalities. Collaboration between nephrology, cardiology, and dialysis teams is necessary for successful management of this challenging patient population. © 2017 Wiley Periodicals, Inc.

  12. Alternative High-Performance Ceramic Waste Forms

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, S. K. [Alfred Univ., NY (United States)

    2017-02-01

    This final report (M5NU-12-NY-AU # 0202-0410) summarizes the results of the project titled “Alternative High-Performance Ceramic Waste Forms,” funded in FY12 by the Nuclear Energy University Program (NEUP Project # 12-3809) being led by Alfred University in collaboration with Savannah River National Laboratory (SRNL). The overall focus of the project is to advance fundamental understanding of crystalline ceramic waste forms and to demonstrate their viability as alternative waste forms to borosilicate glasses. We processed single- and multiphase hollandite waste forms based on simulated waste streams compositions provided by SRNL based on the advanced fuel cycle initiative (AFCI) aqueous separation process developed in the Fuel Cycle Research and Development (FCR&D). For multiphase simulated waste forms, oxide and carbonate precursors were mixed together via ball milling with deionized water using zirconia media in a polyethylene jar for 2 h. The slurry was dried overnight and then separated from the media. The blended powders were then subjected to melting or spark plasma sintering (SPS) processes. Microstructural evolution and phase assemblages of these samples were studied using x-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersion analysis of x-rays (EDAX), wavelength dispersive spectrometry (WDS), transmission electron spectroscopy (TEM), selective area x-ray diffraction (SAXD), and electron backscatter diffraction (EBSD). These results showed that the processing methods have significant effect on the microstructure and thus the performance of these waste forms. The Ce substitution into zirconolite and pyrochlore materials was investigated using a combination of experimental (in situ XRD and x-ray absorption near edge structure (XANES)) and modeling techniques to study these single phases independently. In zirconolite materials, a transition from the 2M to the 4M polymorph was observed with increasing Ce content. The resulting

  13. John Dique: dialysis pioneer and political advocate.

    Science.gov (United States)

    George, Charles R P

    2016-02-01

    John Dique (1915-1995) epitomized the internationalism of medicine, the intellectual and manual dexterity of many pioneers of dialysis, and the social concern evinced by many nephrologists. Born in Burma of French, German, British and Indian ancestry; educated in India; an Anglo-Indian who described himself as British without ever having visited Britain; he moved to Australia in 1948 to escape the murderous inter-ethnic conflict that befell multicultural India as it and Pakistan became independent. Settling in Brisbane, he pioneered several novel medical techniques. After inventing some simple equipment to facilitate intravenous therapy, he established a neonatal exchange blood transfusion programme. Then, between 1954 and 1963, he personally constructed and operated two haemodialysis machines with which to treat patients suffering from acute renal failure, the first such treatment performed in Australasia. His patients survival results were, for the era, remarkable. He subsequently helped found the Royal Australasian College of Pathologists and went on to establish a successful private pathology practice. The latter years of his life, however, saw him become a social and political advocate. He fiercely opposed the emerging ideologies of multiculturalism and social liberalism that, he predicted, would seriously damage the national fabric of Western society. Public vilification ensued, his medical achievements disregarded. It does seem likely, however, that in none of the areas that he touched - whether medical, social, or political - has the last word yet been said.

  14. Hemodynamic Simulations in Dialysis Access Fistulae

    Science.gov (United States)

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Riley, James; Aliseda, Alberto

    2010-11-01

    Arteriovenous fistulae are created surgically to provide adequate access for dialysis in patients with End-Stage Renal Disease. It has long been hypothesized that the hemodynamic and mechanical forces (such as wall shear stress, wall stretch, or flow- induced wall vibrations) constitute the primary external influence on the remodeling process. Given that nearly 50% of fistulae fail after one year, understanding fistulae hemodynamics is an important step toward improving patency in the clinic. We perform numerical simulations of the flow in patient-specific models of AV fistulae reconstructed from 3D ultrasound scans with physiologically-realistic boundary conditions also obtained from Doppler ultrasound. Comparison of the flow features in different geometries and configurations e.g. end-to-side vs. side-to-side, with the in vivo longitudinal outcomes will allow us to hypothesize which flow conditions are conducive to fistulae success or failure. The flow inertia and pulsatility in the simulations (mean Re 700, max Re 2000, Wo 4) give rise to complex secondary flows and coherent vortices, further complicating the spatio- temporal variability of the wall pressure and shear stresses. Even in mature fistulae, the anastomotic regions are subjected to non-physiological shear stresses (>10.12pcPa) which may potentially lead to complications.

  15. Intelligent Facades for High Performance Green Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Dyson, Anna [Rensselaer Polytechnic Inst., Troy, NY (United States)

    2017-03-01

    Progress Towards Net-Zero and Net-Positive-Energy Commercial Buildings and Urban Districts Through Intelligent Building Envelope Strategies Previous research and development of intelligent facades systems has been limited in their contribution towards national goals for achieving on-site net zero buildings, because this R&D has failed to couple the many qualitative requirements of building envelopes such as the provision of daylighting, access to exterior views, satisfying aesthetic and cultural characteristics, with the quantitative metrics of energy harvesting, storage and redistribution. To achieve energy self-sufficiency from on-site solar resources, building envelopes can and must address this gamut of concerns simultaneously. With this project, we have undertaken a high-performance building integrated combined-heat and power concentrating photovoltaic system with high temperature thermal capture, storage and transport towards multiple applications (BICPV/T). The critical contribution we are offering with the Integrated Concentrating Solar Façade (ICSF) is conceived to improve daylighting quality for improved health of occupants and mitigate solar heat gain while maximally capturing and transferring onsite solar energy. The ICSF accomplishes this multi-functionality by intercepting only the direct-normal component of solar energy (which is responsible for elevated cooling loads) thereby transforming a previously problematic source of energy into a high quality resource that can be applied to building demands such as heating, cooling, dehumidification, domestic hot water, and possible further augmentation of electrical generation through organic Rankine cycles. With the ICSF technology, our team is addressing the global challenge in transitioning commercial and residential building stock towards on-site clean energy self-sufficiency, by fully integrating innovative environmental control systems strategies within an intelligent and responsively dynamic building

  16. Factors Associated with the Choice of Peritoneal Dialysis in Patients with End-Stage Renal Disease

    Directory of Open Access Journals (Sweden)

    Pei-Chun Chiang

    2016-01-01

    Full Text Available Background. The purpose of this study was to analyze the factors associated with receiving peritoneal dialysis (PD in patients with incident end-stage renal disease (ESRD in a hospital in Southern Taiwan. Methods. The study included all consecutive patients with incident ESRD who participated in a multidisciplinary predialysis education (MPE program and started their first dialysis therapy between January 1, 2008, and June 30, 2013, in the study hospital. We provided small group teaching sessions to advanced CKD patients and their family to enhance understanding of various dialysis modalities. Multivariate logistic regression models were used to analyze the association of patient characteristics with the chosen dialysis modality. Results. Of the 656 patients, 524 (80% chose hemodialysis and 132 chose PD. Our data showed that young age, high education level, and high scores of activities of daily living (ADLs were positively associated with PD treatment. Patients who received small group teaching sessions had higher percentages of PD treatment (30.5% versus 19.5%; P=0.108 and preparedness for dialysis (61.1% versus 46.6%; P=0.090. Conclusion. Young age, high education level, and high ADL score were positively associated with choosing PD. Early creation of vascular access may be a barrier for PD.

  17. High-performance commercial building systems

    Energy Technology Data Exchange (ETDEWEB)

    Selkowitz, Stephen

    2003-10-01

    This report summarizes key technical accomplishments resulting from the three year PIER-funded R&D program, ''High Performance Commercial Building Systems'' (HPCBS). The program targets the commercial building sector in California, an end-use sector that accounts for about one-third of all California electricity consumption and an even larger fraction of peak demand, at a cost of over $10B/year. Commercial buildings also have a major impact on occupant health, comfort and productivity. Building design and operations practices that influence energy use are deeply engrained in a fragmented, risk-averse industry that is slow to change. Although California's aggressive standards efforts have resulted in new buildings designed to use less energy than those constructed 20 years ago, the actual savings realized are still well below technical and economic potentials. The broad goal of this program is to develop and deploy a set of energy-saving technologies, strategies, and techniques, and improve processes for designing, commissioning, and operating commercial buildings, while improving health, comfort, and performance of occupants, all in a manner consistent with sound economic investment practices. Results are to be broadly applicable to the commercial sector for different building sizes and types, e.g. offices and schools, for different classes of ownership, both public and private, and for owner-occupied as well as speculative buildings. The program aims to facilitate significant electricity use savings in the California commercial sector by 2015, while assuring that these savings are affordable and promote high quality indoor environments. The five linked technical program elements contain 14 projects with 41 distinct R&D tasks. Collectively they form a comprehensive Research, Development, and Demonstration (RD&D) program with the potential to capture large savings in the commercial building sector, providing significant economic benefits to

  18. Remote Patient Management for Home Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Eric L. Wallace

    2017-11-01

    Full Text Available Remote patient management (RPM offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

  19. Improving the high performance concrete (HPC behaviour in high temperatures

    Directory of Open Access Journals (Sweden)

    Cattelan Antocheves De Lima, R.

    2003-12-01

    Full Text Available High performance concrete (HPC is an interesting material that has been long attracting the interest from the scientific and technical community, due to the clear advantages obtained in terms of mechanical strength and durability. Given these better characteristics, HFC, in its various forms, has been gradually replacing normal strength concrete, especially in structures exposed to severe environments. However, the veiy dense microstructure and low permeability typical of HPC can result in explosive spalling under certain thermal and mechanical conditions, such as when concrete is subject to rapid temperature rises, during a f¡re. This behaviour is caused by the build-up of internal water pressure, in the pore structure, during heating, and by stresses originating from thermal deformation gradients. Although there are still a limited number of experimental programs in this area, some researchers have reported that the addition of polypropylene fibers to HPC is a suitable way to avoid explosive spalling under f re conditions. This change in behavior is derived from the fact that polypropylene fibers melt in high temperatures and leave a pathway for heated gas to escape the concrete matrix, therefore allowing the outward migration of water vapor and resulting in the reduction of interned pore pressure. The present research investigates the behavior of high performance concrete on high temperatures, especially when polypropylene fibers are added to the mix.

    El hormigón de alta resistencia (HAR es un material de gran interés para la comunidad científica y técnica, debido a las claras ventajas obtenidas en término de resistencia mecánica y durabilidad. A causa de estas características, el HAR, en sus diversas formas, en algunas aplicaciones está reemplazando gradualmente al hormigón de resistencia normal, especialmente en estructuras expuestas a ambientes severos. Sin embargo, la microestructura muy densa y la baja permeabilidad t

  20. Hemocompatible polyethersulfone/polyurethane composite membrane for high-performance antifouling and antithrombotic dialyzer.

    Science.gov (United States)

    Yin, Zehua; Cheng, Chong; Qin, Hui; Nie, Chuanxiong; He, Chao; Zhao, Changsheng

    2015-01-01

    Researches on blood purification membranes are fuelled by diverse clinical needs, such as hemodialysis, hemodiafiltration, hemofiltration, plasmapheresis, and plasma collection. To approach high-performance dialyzer, the integrated antifouling and antithrombotic properties are highly necessary for the design/modification of advanced artificial membranes. In this study, we propose and demonstrate that the physical blend of triblock polyurethane (PU) and polyethersulfone (PES) may advance the performance of hemodialysis membranes with greatly enhanced blood compatibility. It was found that the triblock PU could be blended with PES at high ratio owing to their excellent miscibility. The surfaces of the PES/PU composite membranes were characterized using attenuated total reflectance-Fourier transform infrared spectroscopy, X-ray photoelectron spectroscopy, water contact angle measurement, and surface ζ-potentials. The results indicated that the membrane surfaces were assembled with hydrophilic segregation layer owing to the migration of amphiphilic PU segments during membrane preparation, which might confer the composite membranes with superior hemocompatibility. The cross-section scanning electron microscopy images of the composite membranes exhibited structure transformation from finger-like structure to sponge-like structure, which indicated that the composite membrane had tunable porosity and permeability. The further ultrafiltration experiments indicated that the composite membranes showed increased permeability and excellent antifouling ability. The blood compatibility observation indicated that PES/PU composite membranes owned decreased protein adsorption, suppressed platelet adhesion, and prolonged plasma recalcification time. These results indicated that the PES/PU composite membranes exhibited enhanced antifouling and antithrombotic properties than the pristine PES membrane. The strategy may forward the fabrication of blood compatible composite membranes for

  1. Echocardiographic impact of hydration status in dialysis patients.

    Science.gov (United States)

    Juan-García, Isabel; Puchades, María J; Sanjuán, Rafael; Torregrosa, Isidro; Solís, Miguel Á; González, Miguel; Blasco, Marisa; Martínez, Antonio; Miguel, Alfonso

    2012-01-01

    Cardiovascular disease is the main cause of death in Chronic Kidney Disease patients. Left ventricular hypertrophy is the most common manifestation and it is linked to arterial hypertension and overhydration. The goal of this paper is to stratify dialyzed patients according to hydration status and to make an evaluation about the possible echocardiography alterations of the different groups. A transversal study was carried out with 117 patients: 65 were on hemodialysis and 52 on peritoneal dialysis. We performed the following tests: multifrequency bioimpedance with the BCM-Body Composition Freesenius’ Monitor system, transthoracic echocardiography, and blood tests. If ECW/TBW (extracellular water vs total body water) normalization ratio for age and gender was > 2.5% SD, the patient was considered overhydrated. HD patients are significantly overhydrated before HD (67.1%) compared to DP patients (46.1%), and almost half of the overhydrated population presents arterial hypertension. However, after an HD session, a better control of the hydration status is reached (26.1%). DP patients frequently present high arterial pressure and/or are under antihypertensive treatment (DP 76.9% vs HD 49.2%). Left ventricular hypertrophy is much more common in HD overhydrated patients, eccentric LVH being more prevalent. Overhydrated patients present significantly high values of LAVI, ILVM, OH/ECW. Bioimpedance technique allows for the detection of a large number of overhydrated patients. Echocardiographic alterations in dialyzed patients show a high correlation between the hydration stage by ECW/TBW normalized ratio for age and gender and the LAVI and ILVM.

  2. Citrobacter Peritoneal Dialysis Peritonitis: Rare Occurrence with Poor Outcomes

    Science.gov (United States)

    Chao, Chia-Ter; Lee, Szu-Ying; Yang, Wei-Shun; Chen, Huei-Wen; Fang, Cheng-Chung; Yen, Chung-Jen; Chiang, Chih-Kang; Hung, Kuan-Yu; Huang, Jenq-Wen

    2013-01-01

    Introduction: Non-Pseudomonas gram-negative bacteria are responsible for an increasing proportion of cases of peritoneal dialysis (PD)-related peritonitis. The role of Citrobacter species in the etiology of PD-related peritonitis is often underestimated. In the present study, we aimed to describe the clinical features, laboratory findings, and short- and long-term outcomes in PD-related peritonitis caused by Citrobacter. Methods: A retrospective review of all episodes of PD-related peritonitis caused by Citrobacter from a single center between 1990 and 2010 was performed. Clinical features, microbiological data, and outcomes of these episodes were analyzed. Results: Citrobacter species was responsible for 11 PD-related episodes (1.8% of all peritonitis episodes) in 8 patients. Citrobacter freundii was the most common etiologic species (73%), and mixed growth was found in the other 3 episodes (27%). Approximately half (46%) of the episodes were associated with constipation and/or diarrhea. Of the Citrobacter isolates from all episodes, 54% were resistant to cefazolin, and only 18% were susceptible to cefmetazole. All isolates were susceptible to ceftazidime, cefepime, carbapenem, and aminoglycosides. More than half of the patients (54%) were hospitalized for index peritonitis, and 27% of the episodes involved a change in antibiotic medication. One patient had relapsing peritonitis caused by C. koseri (9%). The mortality rate of PD-related peritonitis caused by Citrobacter was 18%, and 89% of surviving patients developed technique failure requiring a modality switch after an average of 12 months of follow-up (range 1.2-31.2 months). Conclusion: PD-related peritonitis caused by Citrobacter is associated with poor outcomes, including high rates of antibiotic resistance, a high mortality rate, and a high rate of technique failure among survivors during the follow-up period. PMID:23869184

  3. Total hip arthroplasty in chronic dialysis patients in the United States.

    Science.gov (United States)

    Abbott, Kevin C; Bucci, Jay R; Agodoa, Lawrence Y

    2003-01-01

    The national incidence of and factors associated with total hip arthroplasty (THA) in chronic dialysis patients has never been reported. We therefore performed an historical cohort study of 375,857 chronic dialysis patients listed in the 2000 United States Renal Data System between 1 April 1995 and 31 December 1999 and followed-up until 14 May 2000. Primary outcomes were associations with hospitalizations for a primary discharge code of THA (ICD9 procedure code 81.51x) after initiation of dialysis. Dialysis patients had a cumulative incidence of THA of 35 episodes/10,000 person-years, compared to 5.3/10,000 in the general population. The leading indication for THA was osteoarthritis of the hip and pelvis (58% of cases). However, the strongest risk factor for THA in dialysis patients was end-stage renal disease (ESRD) due to systemic lupus erythematosus (SLE, adjusted rate ratio (ARR), 6.80, 95% CI 4.62-10.03, in whom avascular necrosis of the hip was the most common indication, 68.4%). The database did not include information on use of corticosteroids. Diabetic recipients were significantly less likely to receive THA, as were males, and African Americans. Mortality after THA was 0.25% at thirty days and 30% at three years, not significantly different from the expected mortality of dialysis, adjusted for comorbidity. The most common indication for THA in dialysis patients is osteoarthritis of the hip, similar to the general population. Patients with SLE are more likely to receive THA which is well tolerated and not associated with increased mortality in this population, perhaps reflecting selection bias due to appropriate screening for this elective procedure.

  4. Spectrally high performing quantum cascade lasers

    Science.gov (United States)

    Toor, Fatima

    Quantum cascade (QC) lasers are versatile semiconductor light sources that can be engineered to emit light of almost any wavelength in the mid- to far-infrared (IR) and terahertz region from 3 to 300 mum [1-5]. Furthermore QC laser technology in the mid-IR range has great potential for applications in environmental, medical and industrial trace gas sensing [6-10] since several chemical vapors have strong rovibrational frequencies in this range and are uniquely identifiable by their absorption spectra through optical probing of absorption and transmission. Therefore, having a wide range of mid-IR wavelengths in a single QC laser source would greatly increase the specificity of QC laser-based spectroscopic systems, and also make them more compact and field deployable. This thesis presents work on several different approaches to multi-wavelength QC laser sources that take advantage of band-structure engineering and the uni-polar nature of QC lasers. Also, since for chemical sensing, lasers with narrow linewidth are needed, work is presented on a single mode distributed feedback (DFB) QC laser. First, a compact four-wavelength QC laser source, which is based on a 2-by-2 module design, with two waveguides having QC laser stacks for two different emission wavelengths each, one with 7.0 mum/11.2 mum, and the other with 8.7 mum/12.0 mum is presented. This is the first design of a four-wavelength QC laser source with widely different emission wavelengths that uses minimal optics and electronics. Second, since there are still several unknown factors that affect QC laser performance, results on a first ever study conducted to determine the effects of waveguide side-wall roughness on QC laser performance using the two-wavelength waveguides is presented. The results are consistent with Rayleigh scattering effects in the waveguides, with roughness effecting shorter wavelengths more than longer wavelengths. Third, a versatile time-multiplexed multi-wavelength QC laser system that

  5. Nova performance at ultra high fluence levels

    International Nuclear Information System (INIS)

    Hunt, J.T.

    1986-01-01

    Nova is a ten beam high power Nd:glass laser used for interial confinement fusion research. It was operated in the high power high energy regime following the completion of construction in December 1984. During this period several interesting nonlinear optical phenomena were observed. These phenomena are discussed in the text. 11 refs., 5 figs

  6. Administration of calcimimetics after dialysis: Same effectiveness, better gastrointestinal tolerability

    Directory of Open Access Journals (Sweden)

    Vicent Esteve Simo

    2015-07-01

    Conclusions: Post-dialysis use of calcimimetic was effective in secondary hyperparathyroidism control, improved gastrointestinal tolerability and ameliorated patients’ satisfaction. Based on our findings, post-dialysis use of calcimimetics should be considered in selected patients with low therapeutic compliance.

  7. Clostridium difficile-associated diarrhea in dialysis patients

    Directory of Open Access Journals (Sweden)

    Sook Eui Oh

    2013-03-01

    Conclusion: Our data indicate that dialysis patients might be at a greater risk of developing CDAD, which suggests that particular attention should be provided to CDAD when antibiotic treatment is administered to dialysis patients.

  8. Potential Role of Vegetarianism on Nutritional and Cardiovascular Status in Taiwanese Dialysis Patients: A Case-Control Study.

    Directory of Open Access Journals (Sweden)

    Shih-Hsiang Ou

    Full Text Available Cardiovascular disease remains the most common cause of death for patients on chronic dialysis. End stage renal disease patients undergoing dialysis imposed to reduce phosphorus intake, which likely contributes to development of vegetarian diet behaviors. Vegetarian diets are often lower in protein content, in contradiction to the recommendation that a high protein diet is followed by patients undergoing dialysis. The purpose of the study was to investigate the effects of a vegetarian diet on the nutritional and cardiovascular status of dialysis patients.A study of 21 vegetarian dialysis patients and 42 age- and sex-matched non-vegetarian dialysis patients selected as controls was conducted in the Kaohsiung Veterans General Hospital. Brachial-ankle pulse wave velocity and biochemistry data including total homocysteine levels, serum lipid profiles, high-sensitivity C-reactive protein, vitamin D levels, albumin, and normalized protein catabolic rate were measured.Compared with the non-vegetarian control group, vegetarian subjects had lower body weight, body mass index, serum phosphate, blood urea nitrogen, serum creatinine, vitamin D, uric acid, albumin, and normalized protein catabolic rate (p < 0.05. The vegetarian group showed higher brachial-ankle pulse wave velocity than the non-vegetarian group (1926.95 ± 456.45 and 1684.82 ± 309.55 cm/sec, respectively, p < 0.05. After adjustment for age, albumin, pre-dialysis systolic blood pressure, and duration of dialysis, vegetarian diet remained an independent risk factor for brachial-ankle pulse wave velocity.The present study revealed that patients on dialysis who follow vegetarian diets may experience subclinical protein malnutrition and vitamin D deficiency that could offset the beneficial cardiovascular effects of vegetarianism.

  9. Durability and Performance of High Performance Infiltration Cathodes

    DEFF Research Database (Denmark)

    Samson, Alfred Junio; Søgaard, Martin; Hjalmarsson, Per

    2013-01-01

    The performance and durability of solid oxide fuel cell (SOFC) cathodes consisting of a porous Ce0.9Gd0.1O1.95 (CGO) infiltrated with nitrates corresponding to the nominal compositions La0.6Sr0.4Co1.05O3-δ (LSC), LaCoO3-δ (LC), and Co3O4 are discussed. At 600°C, the polarization resistance, Rp......, varied as: LSC (0.062Ωcm2)cathode was found to depend on the infiltrate firing temperature and is suggested to originate...... of the infiltrate but also from a better surface exchange property. A 450h test of an LSC-infiltrated CGO cathode showed an Rp with final degradation rate of only 11mΩcm2kh-1. An SOFC with an LSC-infiltrated CGO cathode tested for 1,500h at 700°C and 0.5Acm-2 (60% fuel, 20% air utilization) revealed no measurable...

  10. High Performance Computing in Science and Engineering '02 : Transactions of the High Performance Computing Center

    CERN Document Server

    Jäger, Willi

    2003-01-01

    This book presents the state-of-the-art in modeling and simulation on supercomputers. Leading German research groups present their results achieved on high-end systems of the High Performance Computing Center Stuttgart (HLRS) for the year 2002. Reports cover all fields of supercomputing simulation ranging from computational fluid dynamics to computer science. Special emphasis is given to industrially relevant applications. Moreover, by presenting results for both vector sytems and micro-processor based systems the book allows to compare performance levels and usability of a variety of supercomputer architectures. It therefore becomes an indispensable guidebook to assess the impact of the Japanese Earth Simulator project on supercomputing in the years to come.

  11. From adaptive to high-performance structures

    NARCIS (Netherlands)

    Teuffel, P.

    2011-01-01

    Multiple design aspects influence the building performance such as architectural criteria, various environmental impacts and user behaviour. Specific examples are sun, wind, temperatures, function, occupancy, socio-cultural aspects and other contextual aspects and needs. Even though these aspects

  12. Nutritional status of maintenance dialysis patients

    DEFF Research Database (Denmark)

    Koefoed, Mette Juul; Kromann, Charles Boy; Juliussen, Sophie Ryberg

    2016-01-01

    Background and Aims Maintenance dialysis patients are at increased risk of abnormal nutritional status due to numerous causative factors, both nutritional and non-nutritional. The present study assessed the current prevalence of protein-energy wasting, low lean bodymass index and obesity...... protein catabolic rate in order to assess the prevalence of protein-energy wasting, low lean body mass index and obesity in these patients. Results Seventy-nine eligible maintenance dialysis patients participated. The prevalence of proteinenergy wasted patients was 4%(95%CI: 2-12) as assessed......-energy wasting and obesity varied considerably, depending on nutritional assessment methodology. Conclusions Our data indicate that protein-energy wasting is uncommon, whereas low lean body mass index and obesity are frequent conditions among patients in maintenance dialysis. A focus on how to increase...

  13. Cardiovascular and noncardiovascular mortality among men and women starting dialysis

    DEFF Research Database (Denmark)

    Carrero, Juan J; de Jager, Dinanda J; Verduijn, Marion

    2011-01-01

    Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women.......Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women....

  14. High-performance-vehicle technology. [fighter aircraft propulsion

    Science.gov (United States)

    Povinelli, L. A.

    1979-01-01

    Propulsion needs of high performance military aircraft are discussed. Inlet performance, nozzle performance and cooling, and afterburner performance are covered. It is concluded that nonaxisymmetric nozzles provide cleaner external lines and enhanced maneuverability, but the internal flows are more complex. Swirl afterburners show promise for enhanced performance in the high altitude, low Mach number region.

  15. Construct of Dialysis Employee Satisfaction: Acquiring Satisfaction Factors and Their Contributions.

    Science.gov (United States)

    Gu, Xiuzhu; Itoh, Kenji

    2015-10-01

    We developed a construct of dialysis employees' satisfaction as an assessment framework and identified the crucial factors that contribute to overall job satisfaction. We also seek to capture some important characteristics of dialysis professionals' job satisfaction/dissatisfaction in Japan. A questionnaire was developed, including 35 facet-specific job-related satisfaction and 10 general satisfaction items in closed-ended questions. A questionnaire-based survey was conducted between August and October 2013. A total of 799 valid responses (87% of response rate) were collected from 46 physicians, 470 nurses and 251 technologists in the dialysis department of 43 facilities in Japan. Five satisfaction factors were derived by applying principal component analysis with 61% of cumulative variance accounted for. Physicians, nurses and technologists in the dialysis department shared a similar trend of job satisfaction that they were more satisfied with leadership, and communication and teamwork among the five factors, whereas their satisfaction level was relatively low with salary and welfare conditions. Physicians expressed the strongest satisfaction with any factor while nurses were the least satisfied. Nurses' and technologists' overall job satisfaction was mostly determined by satisfaction with self-actualization, and work demands and workload. A five-factor construct of dialysis employee satisfaction was identified. Overall job satisfaction of dialysis nurses and technologists were not overly high in Japan, and this seems to be caused by their relatively low satisfaction with self-actualization and with work demands and workload. Therefore, it is suggested that their work conditions and environment must be improved to support their self-actualization and to reduce their workload. © 2015 The Authors. Therapeutic Apheresis and Dialysis © 2015 International Society for Apheresis.

  16. Acute hydrothorax from peritoneal dialysis successfully treated with new dialysis regime

    International Nuclear Information System (INIS)

    Lim, C.T.S.; Thong, K.M.

    2015-01-01

    Hydrothorax is a rare and often unrecognized complication associated with peritoneal dialysis (PD). This is usually due to the presence of pleuroperitoneal fistula. Most nephrologist will choose to cease the peritoneal dialysis and rest the peritoneum. More than often surgical interventions include pleurodesis or thoracotomy will be required. In this report, we reported a patient who developed pleural effusion after starting continuous ambulatory peritoneal dialysis. She was successfully managed by the use of low volume exchange during daytime with avoidance of conversion to haemodialysis or any surgical intervention. (author)

  17. Australian consumer perspectives on dialysis: first national census.

    Science.gov (United States)

    Ludlow, Marie J; Lauder, Lydia A; Mathew, Timothy H; Hawley, Carmel M; Fortnum, Debbie

    2012-11-01

    The percentage of people in Australia who undertake home dialysis has steadily decreased over the past 40 years and varies within Australia. Consumer factors related to this decline have not previously been determined. A 78-question survey was developed and piloted in 2008 and 2009. Survey forms were distributed to all adult routine dialysis patients in all Australian states and territories (except Northern Territory) between 2009 and 2010. Of 9223 distributed surveys, 3250 were completed and returned. 49% of respondents indicated they had no choice in the type of dialysis and 48% had no choice in dialysis location. Respondents were twice as likely to receive information about haemodialysis (85%) than APD (39%) or CAPD (41%). The provision of education regarding home modalities differed significantly between states, and decreased with increasing patient age. Additional nursing support and reimbursement of expenses increased the proportion of those willing to commence dialysis at home, from 13% to 34%. State differences in the willingness to consider home dialysis, the degree of choice in dialysis location, the desire to change current dialysis type and/or location, and the provision of information about dialysis were identified. The delivery of pre-dialysis education is variable, and does not support all options of dialysis for all individuals. State variances indicate that local policy and health professional teams significantly influence the operation of dialysis programs. © 2012 The Authors. Nephrology © 2012 Asian Pacific Society of Nephrology.

  18. Quality of life in automated and continuous ambulatory peritoneal dialysis

    NARCIS (Netherlands)

    Michels, Wieneke M.; van Dijk, Sandra; Verduijn, Marion; le Cessie, Saskia; Boeschoten, Elisabeth W.; Dekker, Friedo W.; Krediet, Raymond T.; Apperloo, A. J.; Bijlsma, J. A.; Boekhout, M.; Boer, W. H.; van der Boog, P. J. M.; Büller, H. R.; van Buren, M.; de Charro, F. Th; Doorenbos, C. J.; van den Dorpel, M. A.; van Es, A.; Fagel, W. J.; Feith, G. W.; de Fijter, C. W. H.; Frenken, L. A. M.; Grave, W.; van Geelen, J. A. C. A.; Gerlag, P. G. G.; Gorgels, J. P. M. C.; Huisman, R. M.; Jager, K. J.; Jie, K.; Koning-Mulder, W. A. H.; Koolen, M. I.; Kremer Hovinga, T. K.; Lavrijssen, A. T. J.; Luik, A. J.; van der Meulen, J.; Parlevliet, K. J.; Raasveld, M. H. M.; van der Sande, F. M.; Schonck, M. J. M.; Schuurmans, M. M. J.; Siegert, C. E. H.; Stegeman, C. A.; Stevens, P.; Thijssen, J. G. P.; Valentijn, R. M.; Vastenburg, G. H.; Verburgh, C. A.; Vincent, H. H.; Vos, P. F.

    2011-01-01

    Despite a lack of strong evidence, automated peritoneal dialysis (APD) is often prescribed on account of an expected better quality of life (QoL) than that expected with continuous ambulatory peritoneal dialysis (CAPD). Our aim was to analyze differences in QoL in patients starting dialysis on APD

  19. Dialysis-associated steal syndrome (DASS).

    Science.gov (United States)

    Mohamed, Ahmed S; Peden, Eric K

    2017-03-06

    In this article, we will review the clinical symptoms of dialysis access steal syndrome (DASS), evaluation, treatment options, and our approach and treatment algorithm. We reviewed the literature discussing different aspects of DASS including its epidemiology, pathogenesis, clinical presentation, evaluation and management options. DASS is the most dreaded complication of access surgery. Although the incidence is low, all providers caring for dialysis patients should be aware of this problem. Symptoms can range from mild to limb threatening. Although various tests are available, the diagnosis of DASS remains a clinical one and requires thoughtful management to have the best outcomes. Multiple treatment options exist for steal. We present diagnostic evaluation and management algorithm.

  20. Wearable impedance monitoring system for dialysis patients.

    Science.gov (United States)

    Bonnet, S; Bourgerette, A; Gharbi, S; Rubeck, C; Arkouche, W; Massot, B; McAdams, E; Montalibet, A; Jallon, P

    2016-08-01

    This paper describes the development and the validation of a prototype wearable miniaturized impedance monitoring system for remote monitoring in home-based dialysis patients. This device is intended to assess the hydration status of dialysis patients using calf impedance measurements. The system is based on the low-power AD8302 component. The impedance calibration procedure is described together with the Cole parameter estimation and the hydric volume estimation. Results are given on a test cell to validate the design and on preliminary calf measurements showing Cole parameter variations during hemodialysis.

  1. RISC Processors and High Performance Computing

    Science.gov (United States)

    Bailey, David H.; Saini, Subhash; Craw, James M. (Technical Monitor)

    1995-01-01

    This tutorial will discuss the top five RISC microprocessors and the parallel systems in which they are used. It will provide a unique cross-machine comparison not available elsewhere. The effective performance of these processors will be compared by citing standard benchmarks in the context of real applications. The latest NAS Parallel Benchmarks, both absolute performance and performance per dollar, will be listed. The next generation of the NPB will be described. The tutorial will conclude with a discussion of future directions in the field. Technology Transfer Considerations: All of these computer systems are commercially available internationally. Information about these processors is available in the public domain, mostly from the vendors themselves. The NAS Parallel Benchmarks and their results have been previously approved numerous times for public release, beginning back in 1991.

  2. A high performance thermoacoustic Stirling-engine

    Energy Technology Data Exchange (ETDEWEB)

    Tijani, M.E.H.; Spoelstra, S. [Energy research Centre of the Netherlands (ECN), PO Box 1, 1755 ZG Petten (Netherlands)

    2011-11-10

    In thermoacoustic systems heat is converted into acoustic energy and vice versa. These systems use inert gases as working medium and have no moving parts which makes the thermoacoustic technology a serious alternative to produce mechanical or electrical power, cooling power, and heating in a sustainable and environmentally friendly way. A thermoacoustic Stirling heat engine is designed and built which achieves a record performance of 49% of the Carnot efficiency. The design and performance of the engine is presented. The engine has no moving parts and is made up of few simple components.

  3. Psychological factors in developing high performance athletes

    DEFF Research Database (Denmark)

    Elbe, Anne-Marie; Wikman, Johan Michael

    2017-01-01

    calls for great efforts in dealing with competitive pressure and demands mental strength with regard to endurance, self-motivation and willpower. But while it is somewhat straightforward to specify the physical and physiological skills needed for top performance in a specific sport, it becomes less...... clear with regard to the psychological skills that are needed. Therefore, the main questions to be addressed in this chapter are: (1) which psychological skills are needed to reach top performance? And (2) (how) can these skills be developed in young talents?...

  4. High Performance Expectations: Concept and causes

    DEFF Research Database (Denmark)

    Andersen, Lotte Bøgh; Jacobsen, Christian Bøtcher

    2017-01-01

    literature research, HPE is defined as the degree to which leaders succeed in expressing ambitious expectations to their employees’ achievement of given performance criteria, and it is analyzed how leadership behavior affects employee-perceived HPE. This study applies a large-scale leadership field...... experiment with 3,730 employees nested in 471 organizations and finds that transformational leadership training as well as transactional and combined training of the leaders significantly increased employees’ HPE relative to a control group. Furthermore, transformational leadership and the use of pecuniary...... rewards seem to be important mechanisms. This implies that public leaders can actually affect HPE through their leadership and thus potentially organizational performance as well....

  5. Haemodialysis prescription, adherence and nutritional indicators in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

    Science.gov (United States)

    Hecking, Erwin; Bragg-Gresham, Jennifer L; Rayner, Hugh C; Pisoni, Ronald L; Andreucci, Vittorio E; Combe, Christian; Greenwood, Roger; McCullough, Keith; Feldman, Harold I; Young, Eric W; Held, Philip J; Port, Friedrich K

    2004-01-01

    The Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective, observational study designed to evaluate practice patterns in random samples of haemodialysis facilities and patients across three continents. Participating countries include France, Germany, Italy, Spain and the UK (Euro-DOPPS), Japan and the USA. DOPPS data collection has used the same questionnaires and protocols across all participating countries to assess components of dialysis therapy and outcomes. This study focuses on dialysis prescription, adherence and nutrition among the Euro-DOPPS countries. In each Euro-DOPPS country, patients were selected randomly from 20-21 representative facilities. Simple means and frequencies were calculated to compare relevant data elements to gain insights into differences in therapeutic aspects among nationally representative patients. Participants entering the study within 90 days of beginning dialysis therapy were excluded from these analyses. Among the five countries, mean delivered dose as measured by normalized urea clearance (Kt/V) varied from 1.28 to 1.50 and was accompanied by differences in dialysis prescription components, including blood flow rates, treatment times, and dialyser membrane and flux characteristics. By country, a nearly 2-fold difference was observed in indicators of patient adherence and management (skipping and shortening dialysis, hyperkalaemia, hyperphosphataemia and high interdialytic weight gain). Indicators of malnutrition varied substantially. This study demonstrates differences in the management of haemodialysis patients across Euro-DOPPS and offers opportunities for improving dialysis dose, adherence and nutrition. Correlation of differences in practice patterns at the dialysis unit level with patient outcomes will offer new insights into improving dialysis therapy.

  6. High Rate Performing Li-ion Battery

    Science.gov (United States)

    2015-02-09

    journal article will be sufficient in most cases. This document may be as long or as short as needed to give a fair account of the work performed...Klink, J. J. & Moser, J. EPR Study of Vanadium (4+) in the Anatase and Rutile Phases of TiO2. Phys. Rev. B 34, 3060-3068 (1986). 40 Abragam, A

  7. Engendering a high performing organisational culture through ...

    African Journals Online (AJOL)

    Concluding that Africa's poor organisational performances are attributable to some inadequacies in the cultural foundations of countries and organisations, this paper argues for internal branding as the way forward for African organisations. Through internal branding an African organization can use a systematic and ...

  8. Mastering JavaScript high performance

    CERN Document Server

    Adams, Chad R

    2015-01-01

    If you are a JavaScript developer with some experience in development and want to increase the performance of JavaScript projects by building faster web apps, then this book is for you. You should know the basic concepts of JavaScript.

  9. Gamma and Xray spectroscopy at high performance

    International Nuclear Information System (INIS)

    Borchert, G.L.

    1984-01-01

    The author determines that for many interesting problems in gamma and Xray spectroscopy it is necessary to use crystal diffractometers. The basic features of such instruments are discussed and the special performance of crystal spectrometers is demonstrated by means of typical examples of various applications

  10. High Performance Fortran for Aerospace Applications

    National Research Council Canada - National Science Library

    Mehrotra, Piyush

    2000-01-01

    .... HPF is a set of Fortran extensions designed to provide users with a high-level interface for programming data parallel scientific applications while delegating to the compiler/runtime system the task...

  11. High-Performance Computing Paradigm and Infrastructure

    CERN Document Server

    Yang, Laurence T

    2006-01-01

    With hyperthreading in Intel processors, hypertransport links in next generation AMD processors, multi-core silicon in today's high-end microprocessors from IBM and emerging grid computing, parallel and distributed computers have moved into the mainstream

  12. High performance management bij franchise-supermarkten

    NARCIS (Netherlands)

    Sloot, Laurens; van Nierop, Erjen; de Waal, Andre

    In dit artikel wordt een onderzoek gepresenteerd naar de mate waarin franchise-supermarkten voldoen aan de vijf factoren van high performanceorganisaties (HPO): hoge kwaliteit managers, hoge kwaliteit medewerkers, openheid en actiegerichtheid, continue verbetering en vernieuwing, en

  13. Cost-effectiveness of kidney transplantation compared with chronic dialysis in end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Diego Rosselli

    2015-01-01

    Full Text Available To estimate the costs and effectiveness measured in quality-adjusted life years (QALY of kidney transplantation compared with dialysis in adults suffering from end-stage renal disease from the perspective of the Colombian healthcare system, we designed a Markov model with monthly cycles over a five-year time horizon and eight transitional states, including death as an absorbing state. Transition probabilities were obtained from international registries, costs from different local sources [case studies, official tariffs (ISS 2001 + 35% for procedures and SISMED for medications]. Data were validated by an expert panel and we performed univariate, multivariate and probabilistic sensitivity analyses. Effectiveness indicators were months of life gained, months of dialysis averted and deaths prevented. The annual discount rate was 3% and the cost-utility threshold (willingness to pay was three times gross domestic product (GDP = USD 20,000 per QALY. The costs were adopted in US dollars (USD using the 2012 average exchange rate (1 USD = COP$ 1798. The discounted average total cost for five years was USD 76,718 for transplantation and USD 76,891 for dialysis, with utilities 2.98 and 2.10 QALY, respectively. Additionally, renal transplantation represented 6.9 months gained, 35 months in dialysis averted per patient and one death averted for each of the five patients transplanted in five years. We conclude that renal transplantation improves the overall survival rates and quality of life and is a cost-saving alternative compared with dialysis.

  14. Variation in fistula use across dialysis facilities: is it explained by case-mix?

    Science.gov (United States)

    Tangri, Navdeep; Moorthi, Ranjani; Tighiouhart, Hocine; Meyer, Klemens B; Miskulin, Dana C

    2010-02-01

    Arteriovenous fistulas (AVFs) remain the preferred vascular access for hemodialysis patients. Dialysis facilities that fail to meet Centers for Medicare & Medicaid Services goals cite patient case-mix as a reason for low AVF prevalence. This study aimed to determine the magnitude of the variability in AVF usage across dialysis facilities and the extent to which patient case-mix explains it. The vascular access used in 10,112 patients dialyzed at 173 Dialysis Clinic Inc. facilities from October 1 to December 31, 2004, was evaluated. The access in use was considered to be an AVF if it was used for >70% of hemodialysis treatments. Mixed-effects models with a random intercept for dialysis facilities evaluated the effect of facilities on AVF usage. Sequentially adjusted multivariate models measured the extent to which patient factors (case-mix) explain variation across facilities in AVF rates. 3787 patients (38%) were dialyzed using AVFs. There was a significant facility effect: 7.6% of variation in AVF use was attributable to facility. This was reduced to 7.1% after case-mix adjustment. There were no identified specific facility-level factors that explained the interfacility variation. AVF usage varies across dialysis facilities, and patient case-mix did not reduce this variation. In this study, 92% of the total variation in AVF usage was due to patient factors, but most were not measurable. A combination of patient factors and process indicators should be considered in adjudicating facility performance for this quality indicator.

  15. High performance fuel technology development : Development of high performance cladding materials

    International Nuclear Information System (INIS)

    Park, Jeongyong; Jeong, Y. H.; Park, S. Y.

    2012-04-01

    The superior in-pile performance of the HANA claddings have been verified by the successful irradiation test and in the Halden research reactor up to the high burn-up of 67GWD/MTU. The in-pile corrosion and creep resistances of HANA claddings were improved by 40% and 50%, respectively, over Zircaloy-4. HANA claddings have been also irradiated in the commercial reactor up to 2 reactor cycles, showing the corrosion resistance 40% better than that of ZIRLO in the same fuel assembly. Long-term out-of-pile performance tests for the candidates of the next generation cladding materials have produced the highly reliable test results. The final candidate alloys were selected and they showed the corrosion resistance 50% better than the foreign advanced claddings, which is beyond the original target. The LOCA-related properties were also improved by 20% over the foreign advanced claddings. In order to establish the optimal manufacturing process for the inner and outer claddings of the dual-cooled fuel, 18 different kinds of specimens were fabricated with various cold working and annealing conditions. Based on the performance tests and various out-of-pile test results obtained from the specimens, the optimal manufacturing process was established for the inner and outer cladding tubes of the dual-cooled fuel

  16. Histological Spectrum of Idiopathic Noncirrhotic Portal Hypertension in Liver Biopsies From Dialysis Patients.

    Science.gov (United States)

    Lee, Hwajeong; Ainechi, Sanaz; Singh, Mandeep; Ells, Peter F; Sheehan, Christine E; Lin, Jingmei

    2015-09-01

    Liver biopsy is performed for various indications in dialysis patients. Being a less-common subset, the hepatic pathology in renal dialysis is not well documented. Idiopathic noncirrhotic portal hypertension (INCPH) is a clinical entity associated with unexplained portal hypertension and/or a spectrum of histopathological vascular changes in the liver. After encountering INCPH and vascular changes of INCPH in 2 renal dialysis patients, we sought to further investigate this noteworthy association. A random search for patients on hemodialysis or peritoneal dialysis with liver biopsy was performed. Hematoxylin and eosin, reticulin, trichrome, and CK7 stains were performed on formalin-fixed, paraffin-embedded tissue sections. Histopathological features were reviewed, and the results were correlated with clinical findings. In all, 13 liver biopsies were retrieved. The mean cumulative duration of dialysis was 50 months (range = 17 months to 11 years). All patients had multiple comorbidities. Indications for biopsy were a combination of abnormal liver function tests (6), portal hypertension (4), ascites (3), and possible cirrhosis (3). Two patients with portal hypertension underwent multiple liver biopsies for diagnostic purposes. All (100%) biopsies showed some histological features of INCPH, including narrowed portal venous lumen (9), increased portal vascular channels (8), shunt vessels (3), dilated sinusoids (9), regenerative nodule (5), and features of venous outflow obstruction (3). No cirrhosis was identified. Liver biopsies from patients on dialysis demonstrate histopathological vascular changes of INCPH. Some (31%) patients present with portal hypertension without cirrhosis. The histological changes may be reflective of underlying risk factors for INCPH in this group. © The Author(s) 2015.

  17. Menhir: An Environment for High Performance Matlab

    Directory of Open Access Journals (Sweden)

    Stéphane Chauveau

    1999-01-01

    Full Text Available In this paper we present Menhir a compiler for generating sequential or parallel code from the Matlab language. The compiler has been designed in the context of using Matlab as a specification language. One of the major features of Menhir is its retargetability to generate parallel and sequential C or Fortran code. We present the compilation process and the target system description for Menhir. Preliminary performances are given and compared with MCC, the MathWorks Matlab compiler.

  18. Inclusion control in high-performance steels

    International Nuclear Information System (INIS)

    Holappa, L.E.K.; Helle, A.S.

    1995-01-01

    Progress of clean steel production, fundamentals of oxide and sulphide inclusions as well as inclusion morphology in normal and calcium treated steels are described. Effects of cleanliness and inclusion control on steel properties are discussed. In many damaging constructional and engineering applications the nonmetallic inclusions have a quite decisive role in steel performance. An example of combination of good mechanical properties and superior machinability by applying inclusion control is presented. (author)

  19. Emerging technologies for high performance infrared detectors

    OpenAIRE

    Tan Chee Leong; Mohseni Hooman

    2018-01-01

    Infrared photodetectors (IRPDs) have become important devices in various applications such as night vision, military missile tracking, medical imaging, industry defect imaging, environmental sensing, and exoplanet exploration. Mature semiconductor technologies such as mercury cadmium telluride and III–V material-based photodetectors have been dominating the industry. However, in the last few decades, significant funding and research has been focused to improve the performance of IRPDs such as...

  20. Exploring the association between macroeconomic indicators and dialysis mortality.

    Science.gov (United States)

    Kramer, Anneke; Stel, Vianda S; Caskey, Fergus J; Stengel, Benedicte; Elliott, Robert F; Covic, Adrian; Geue, Claudia; Cusumano, Ana; Macleod, Alison M; Jager, Kitty J

    2012-10-01

    Mortality on dialysis varies greatly worldwide, with patient-level factors explaining only a small part of this variation. The aim of this study was to examine the association of national-level macroeconomic indicators with the mortality of incident dialysis populations and explore potential explanations through renal service indicators, incidence of dialysis, and characteristics of the dialysis population. Aggregated unadjusted survival probabilities were obtained from 22 renal registries worldwide for patients starting dialysis in 2003-2005. General population age and health, macroeconomic indices, and renal service organization data were collected from secondary sources and questionnaires. Linear modeling with log-log transformation of the outcome variable was applied to establish factors associated with survival on dialysis. Two-year survival on dialysis ranged from 62.3% in Iceland to 89.8% in Romania. A higher gross domestic product per capita (hazard ratio=1.02 per 1000 US dollar increase), a higher percentage of gross domestic product spent on healthcare (1.10 per percent increase), and a higher intrinsic mortality of the dialysis population (i.e., general population-derived mortality risk of the dialysis population in that country standardized for age and sex; hazard ratio=1.04 per death per 10,000 person years) were associated with a higher mortality of the dialysis population. The incidence of dialysis and renal service indicators were not associated with mortality on dialysis. Macroeconomic factors and the intrinsic mortality of the dialysis population are associated with international differences in the mortality on dialysis. Renal service organizational factors and incidence of dialysis seem less important.

  1. Development of a high performance liquid chromatography method ...

    African Journals Online (AJOL)

    Development of a high performance liquid chromatography method for simultaneous ... Purpose: To develop and validate a new low-cost high performance liquid chromatography (HPLC) method for ..... Several papers have reported the use of ...

  2. High Performance Home Building Guide for Habitat for Humanity Affiliates

    Energy Technology Data Exchange (ETDEWEB)

    Lindsey Marburger

    2010-10-01

    This guide covers basic principles of high performance Habitat construction, steps to achieving high performance Habitat construction, resources to help improve building practices, materials, etc., and affiliate profiles and recommendations.

  3. Association between Duration of Predialysis Care and Mortality after Dialysis Start.

    Science.gov (United States)

    Liu, Ping; Quinn, Robert R; Oliver, Matthew J; Ronksley, Paul E; Hemmelgarn, Brenda R; Quan, Hude; Hiremath, Swapnil; Bello, Aminu K; Blake, Peter G; Garg, Amit X; Johnson, John; Verrelli, Mauro; Zacharias, James M; Abd ElHafeez, Samar; Tonelli, Marcello; Ravani, Pietro

    2018-03-05

    Early nephrology referral is recommended for people with CKD on the basis of observational studies showing that longer nephrology care before dialysis start (predialysis care) is associated with lower mortality after dialysis start. This association may be observed because predialysis care truly reduces mortality or because healthier people with an uncomplicated course of disease will have both longer predialysis care and lower risk for death. We examined whether the survival benefit of longer predialysis care exists after accounting for the potential confounding effect of disease course that may also be affected by predialysis care. We performed a retrospective cohort study and used data from 3152 adults with end stage kidney failure starting dialysis between 2004 and 2014 in five Canadian dialysis programs. We obtained duration of predialysis care from the earliest nephrology outpatient visit to dialysis start; markers of disease course, including inpatient or outpatient dialysis start and residual kidney function around dialysis start; and all-cause mortality after dialysis start. The percentages of participants with 0, 1-119, 120-364, and ≥365 days of predialysis care were 23%, 8%, 10%, and 59%, respectively. When we ignored markers of disease course as in previous studies, longer predialysis care was associated with lower mortality (hazard ratio 120-364 versus 0-119 days , 0.60; 95% confidence interval, 0.46 to 0.78]; hazard ratio ≥365 versus 0-119 days , 0.60; 95% confidence interval, 0.51 to 0.71; standard Cox model adjusted for demographics and laboratory and clinical characteristics). When we additionally accounted for markers of disease course using the inverse probability of treatment weighted Cox model, this association was weaker and no longer significant (hazard ratio 120-364 versus 0-119 days , 0.84; 95% confidence interval, 0.60 to 1.18; hazard ratio ≥365 versus 0-119 days , 0.88; 95% confidence interval, 0.69 to 1.13). The association between

  4. Systemic and intraperitoneal proinflammatory cytokines profiles in patients on chronic peritoneal dialysis.

    Science.gov (United States)

    Maksić, Doko; Colić, Miodrag; Stanković-Popović, Verica; Radojević, Milorad; Bokonjić, Dubravko

    2007-01-01

    Cytokines are essential mediators of immune response and inflammatory reactions. Patients with chronic renal failure and on Continuous Ambulatory Peritoneal Dialysis commonly present abnormalities of immune function related to impaired kidney function, accumulation of uremic toxins and bioincompatibility of peritoneal dialysis solutions. Aim of this study was to examine effects of the CAPD solutions (standard v.s. biocompatible), as well as dialysis duration upon the local and systemic profile of the pro-inflammatory cytokines (IL-1, TNF and IL-6) in patients on CAPD. The cross-sectional study included 44 CAPD patients (27 M and 17 F, average mean age 57.12+/-16.66), of whom 21 patients were on the standard solutions (A.N.D.Y.Disc) for peritoneal dialysis and 23 on the biocompatible solutions (Gambrosol bio trio, Stay Safe balance). The average dialysis treatment period was 3.59+/-2.67 years. In all CAPD patients dialysed longer than 6 months, levels of IL-1. TNF and IL-6 in the serum and dialysis effluent were analysed in the phase without acute infection-related complications (CAPD peritonitis, infection of the catheter exit-site, other acute infections). The control group included 20 patients with the CRF (stage IV and V) whose serum levels of the examined cytokines were also determined. Levels of the inflammatory cytokines were measured by commercial specific ELISA kits (BioSource, Camarillo, California, USA). Statistical analysis of the obtained results was performed by commercial statistics PC software (Stat for Windows, R.4.5. SAD). The serum IL-1 and IL-6 levels were not statistically significantly different in patients on CAPD, irrespective of the type of the used dialysis solutions and in the control group of patients with CRF. The serum TNF levels, unlike IL-1 and IL-6, were statistically significantly higher in patients on CAPD in comparison with the control group of patients (13.203.23 v.s. 5.594.54, prenal funcion and number of CAPD peritonitis did

  5. High Performance Computing in Science and Engineering '99 : Transactions of the High Performance Computing Center

    CERN Document Server

    Jäger, Willi

    2000-01-01

    The book contains reports about the most significant projects from science and engineering of the Federal High Performance Computing Center Stuttgart (HLRS). They were carefully selected in a peer-review process and are showcases of an innovative combination of state-of-the-art modeling, novel algorithms and the use of leading-edge parallel computer technology. The projects of HLRS are using supercomputer systems operated jointly by university and industry and therefore a special emphasis has been put on the industrial relevance of results and methods.

  6. High Performance Computing in Science and Engineering '98 : Transactions of the High Performance Computing Center

    CERN Document Server

    Jäger, Willi

    1999-01-01

    The book contains reports about the most significant projects from science and industry that are using the supercomputers of the Federal High Performance Computing Center Stuttgart (HLRS). These projects are from different scientific disciplines, with a focus on engineering, physics and chemistry. They were carefully selected in a peer-review process and are showcases for an innovative combination of state-of-the-art physical modeling, novel algorithms and the use of leading-edge parallel computer technology. As HLRS is in close cooperation with industrial companies, special emphasis has been put on the industrial relevance of results and methods.

  7. Development of High Performance Piezoelectric Polyimides

    Science.gov (United States)

    Simpson, Joycelyn O.; St.Clair, Terry L.; Welch, Sharon S.

    1996-01-01

    In this work a series of polyimides are investigated which exhibit a strong piezoelectric response and polarization stability at temperatures in excess of 100 C. This work was motivated by the need to develop piezoelectric sensors suitable for use in high temperature aerospace applications.

  8. Powder metallurgical high performance materials. Proceedings. Volume 1: high performance P/M metals

    International Nuclear Information System (INIS)

    Kneringer, G.; Roedhammer, P.; Wildner, H.

    2001-01-01

    The proceedings of this sequence of seminars form an impressive chronicle of the continued progress in the understanding of refractory metals and cemented carbides and in their manufacture and application. There the ingenuity and assiduous work of thousands of scientists and engineers striving for progress in the field of powder metallurgy is documented in more than 2000 contributions covering some 30000 pages. The 15th Plansee Seminar was convened under the general theme 'Powder Metallurgical High Performance Materials'. Under this broadened perspective the seminar will strive to look beyond the refractory metals and cemented carbides, which remain at its focus, to novel classes of materials, such as intermetallic compounds, with potential for high temperature applications. (author)

  9. Powder metallurgical high performance materials. Proceedings. Volume 1: high performance P/M metals

    Energy Technology Data Exchange (ETDEWEB)

    Kneringer, G; Roedhammer, P; Wildner, H [eds.

    2001-07-01

    The proceedings of this sequence of seminars form an impressive chronicle of the continued progress in the understanding of refractory metals and cemented carbides and in their manufacture and application. There the ingenuity and assiduous work of thousands of scientists and engineers striving for progress in the field of powder metallurgy is documented in more than 2000 contributions covering some 30000 pages. The 15th Plansee Seminar was convened under the general theme 'Powder Metallurgical High Performance Materials'. Under this broadened perspective the seminar will strive to look beyond the refractory metals and cemented carbides, which remain at its focus, to novel classes of materials, such as intermetallic compounds, with potential for high temperature applications. (author)

  10. Evaluation of biofouling in stainless microfluidic channels for implantable multilayered dialysis device

    Science.gov (United States)

    Ota, Takashi; To, Naoya; Kanno, Yoshihiko; Miki, Norihisa

    2017-06-01

    An implantable artificial kidney can markedly improve the quality of life of renal disease patients. Our group has developed an implantable multilayered dialysis system consisting of microfluidic channels and dialysis membranes. Long-term evaluation is necessary for implant devices where biofouling is a critical factor, culminating in the deterioration of dialysis performance. Our previous work revealed that surface conditions, which depend on the manufacturing process, determine the amount of biofouling, and that electrolytic etching is the most suitable technique for forming a channel wall free of biofouling. In this study, we investigated the electrolytic etching conditions in detail. We conducted in vitro experiments for 7 d and evaluated the adhesion of biomaterials by scanning electron microscopy. The experiments revealed that a surface mirror-finished by electrolytic etching effectively prevents biofouling.

  11. High performance flexible electronics for biomedical devices.

    Science.gov (United States)

    Salvatore, Giovanni A; Munzenrieder, Niko; Zysset, Christoph; Kinkeldei, Thomas; Petti, Luisa; Troster, Gerhard

    2014-01-01

    Plastic electronics is soft, deformable and lightweight and it is suitable for the realization of devices which can form an intimate interface with the body, be implanted or integrated into textile for wearable and biomedical applications. Here, we present flexible electronics based on amorphous oxide semiconductors (a-IGZO) whose performance can achieve MHz frequency even when bent around hair. We developed an assembly technique to integrate complex electronic functionalities into textile while preserving the softness of the garment. All this and further developments can open up new opportunities in health monitoring, biotechnology and telemedicine.

  12. High performance image processing of SPRINT

    Energy Technology Data Exchange (ETDEWEB)

    DeGroot, T. [Lawrence Livermore National Lab., CA (United States)

    1994-11-15

    This talk will describe computed tomography (CT) reconstruction using filtered back-projection on SPRINT parallel computers. CT is a computationally intensive task, typically requiring several minutes to reconstruct a 512x512 image. SPRINT and other parallel computers can be applied to CT reconstruction to reduce computation time from minutes to seconds. SPRINT is a family of massively parallel computers developed at LLNL. SPRINT-2.5 is a 128-node multiprocessor whose performance can exceed twice that of a Cray-Y/MP. SPRINT-3 will be 10 times faster. Described will be the parallel algorithms for filtered back-projection and their execution on SPRINT parallel computers.

  13. High-performance commercial building facades

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eleanor; Selkowitz, Stephen; Bazjanac, Vladimir; Inkarojrit, Vorapat; Kohler, Christian

    2002-06-01

    This study focuses on advanced building facades that use daylighting, sun control, ventilation systems, and dynamic systems. A quick perusal of the leading architectural magazines, or a discussion in most architectural firms today will eventually lead to mention of some of the innovative new buildings that are being constructed with all-glass facades. Most of these buildings are appearing in Europe, although interestingly U.S. A/E firms often have a leading role in their design. This ''emerging technology'' of heavily glazed fagades is often associated with buildings whose design goals include energy efficiency, sustainability, and a ''green'' image. While there are a number of new books on the subject with impressive photos and drawings, there is little critical examination of the actual performance of such buildings, and a generally poor understanding as to whether they achieve their performance goals, or even what those goals might be. Even if the building ''works'' it is often dangerous to take a design solution from one climate and location and transport it to a new one without a good causal understanding of how the systems work. In addition, there is a wide range of existing and emerging glazing and fenestration technologies in use in these buildings, many of which break new ground with respect to innovative structural use of glass. It is unclear as to how well many of these designs would work as currently formulated in California locations dominated by intense sunlight and seismic events. Finally, the costs of these systems are higher than normal facades, but claims of energy and productivity savings are used to justify some of them. Once again these claims, while plausible, are largely unsupported. There have been major advances in glazing and facade technology over the past 30 years and we expect to see continued innovation and product development. It is critical in this process to be able to

  14. Miniaturized high performance sensors for space plasmas

    International Nuclear Information System (INIS)

    Young, D.T.

    1996-01-01

    Operating under ever more constrained budgets, NASA has turned to a new paradigm for instrumentation and mission development in which smaller, faster, better, cheaper is of primary consideration for future space plasma investigations. The author presents several examples showing the influence of this new paradigm on sensor development and discuss certain implications for the scientific return from resource constrained sensors. The author also discusses one way to improve space plasma sensor performance which is to search out new technologies, measurement techniques and instrument analogs from related fields including among others, laboratory plasma physics

  15. High Performance Building Mockup in FLEXLAB

    Energy Technology Data Exchange (ETDEWEB)

    McNeil, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kohler, Christian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Lee, Eleanor S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Selkowitz, Stephen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-30

    Genentech has ambitious energy and indoor environmental quality performance goals for Building 35 (B35) being constructed by Webcor at the South San Francisco campus. Genentech and Webcor contracted with the Lawrence Berkeley National Laboratory (LBNL) to test building systems including lighting, lighting controls, shade fabric, and automated shading controls in LBNL’s new FLEXLAB facility. The goal of the testing is to ensure that the systems installed in the new office building will function in a way that reduces energy consumption and provides a comfortable work environment for employees.

  16. High performance computations using dynamical nucleation theory

    International Nuclear Information System (INIS)

    Windus, T L; Crosby, L D; Kathmann, S M

    2008-01-01

    Chemists continue to explore the use of very large computations to perform simulations that describe the molecular level physics of critical challenges in science. In this paper, we describe the Dynamical Nucleation Theory Monte Carlo (DNTMC) model - a model for determining molecular scale nucleation rate constants - and its parallel capabilities. The potential for bottlenecks and the challenges to running on future petascale or larger resources are delineated. A 'master-slave' solution is proposed to scale to the petascale and will be developed in the NWChem software. In addition, mathematical and data analysis challenges are described

  17. Metformin-associated lactic acidosis in a peritoneal dialysis patient

    Directory of Open Access Journals (Sweden)

    Najlaa Almaleki

    2015-01-01

    Full Text Available Metformin is one of the commonly used drugs in type-2 diabetes mellitus. It reduces glucose levels by increasing insulin sensitivity, reducing hepatic glucose release and increasing muscle uptake. One of the serious complications associated with metformin use is lactic acidosis, and it is associated with high morbidity and mortality. This is more likely to happen in patients with renal failure due to reduced clearance. International guidelines recommend discontinuing metformin in advanced renal failure. We report a case of metformin-associated lactic acidosis in a patient with end-stage renal disease on peritoneal dialysis. The patient presented with severe lactic acidosis, which was successfully treated with hemodialysis.

  18. Pressurized planar electrochromatography, high-performance thin-layer chromatography and high-performance liquid chromatography--comparison of performance.

    Science.gov (United States)

    Płocharz, Paweł; Klimek-Turek, Anna; Dzido, Tadeusz H

    2010-07-16

    Kinetic performance, measured by plate height, of High-Performance Thin-Layer Chromatography (HPTLC), High-Performance Liquid Chromatography (HPLC) and Pressurized Planar Electrochromatography (PPEC) was compared for the systems with adsorbent of the HPTLC RP18W plate from Merck as the stationary phase and the mobile phase composed of acetonitrile and buffer solution. The HPLC column was packed with the adsorbent, which was scrapped from the chromatographic plate mentioned. An additional HPLC column was also packed with adsorbent of 5 microm particle diameter, C18 type silica based (LiChrosorb RP-18 from Merck). The dependence of plate height of both HPLC and PPEC separating systems on flow velocity of the mobile phase and on migration distance of the mobile phase in TLC system was presented applying test solute (prednisolone succinate). The highest performance, amongst systems investigated, was obtained for the PPEC system. The separation efficiency of the systems investigated in the paper was additionally confirmed by the separation of test component mixture composed of six hormones. 2010 Elsevier B.V. All rights reserved.

  19. Can Knowledge of the Characteristics of "High Performers" Be Generalised?

    Science.gov (United States)

    McKenna, Stephen

    2002-01-01

    Two managers described as high performing constructed complexity maps of their organization/world. The maps suggested that high performance is socially constructed and negotiated in specific contexts and management competencies associated with it are context specific. Development of high performers thus requires personalized coaching more than…

  20. A high performance totally ordered multicast protocol

    Science.gov (United States)

    Montgomery, Todd; Whetten, Brian; Kaplan, Simon

    1995-01-01

    This paper presents the Reliable Multicast Protocol (RMP). RMP provides a totally ordered, reliable, atomic multicast service on top of an unreliable multicast datagram service such as IP Multicasting. RMP is fully and symmetrically distributed so that no site bears un undue portion of the communication load. RMP provides a wide range of guarantees, from unreliable delivery to totally ordered delivery, to K-resilient, majority resilient, and totally resilient atomic delivery. These QoS guarantees are selectable on a per packet basis. RMP provides many communication options, including virtual synchrony, a publisher/subscriber model of message delivery, an implicit naming service, mutually exclusive handlers for messages, and mutually exclusive locks. It has commonly been held that a large performance penalty must be paid in order to implement total ordering -- RMP discounts this. On SparcStation 10's on a 1250 KB/sec Ethernet, RMP provides totally ordered packet delivery to one destination at 842 KB/sec throughput and with 3.1 ms packet latency. The performance stays roughly constant independent of the number of destinations. For two or more destinations on a LAN, RMP provides higher throughput than any protocol that does not use multicast or broadcast.

  1. High Performance, Three-Dimensional Bilateral Filtering

    International Nuclear Information System (INIS)

    Bethel, E. Wes

    2008-01-01

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  2. High-performance sport, marijuana, and cannabimimetics.

    Science.gov (United States)

    Hilderbrand, Richard L

    2011-11-01

    The prohibition on use of cannabinoids in sporting competitions has been widely debated and continues to be a contentious issue. Information continues to accumulate on the adverse health effects of smoked marijuana and the decrement of performance caused by the use of cannabinoids. The objective of this article is to provide an overview of cannabinoids and cannabimimetics that directly or indirectly impact sport, the rules of sport, and performance of the athlete. This article reviews some of the history of marijuana in Olympic and Collegiate sport, summarizes the guidelines by which a substance is added to the World Anti-Doping Agency Prohibited List, and updates information on the pharmacologic effects of cannabinoids and their mechanism of action. The recently marketed cannabimimetics Spice and K2 are included in the discussion as they activate the same receptors as are activated by THC. The article also provides a view as to why the World Anti-Doping Agency prohibits cannabinoid or cannabimimetic use incompetition and should continue to do so.

  3. High Performance, Three-Dimensional Bilateral Filtering

    Energy Technology Data Exchange (ETDEWEB)

    Bethel, E. Wes

    2008-06-05

    Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

  4. HIGH PERFORMANCE PHOTOGRAMMETRIC PROCESSING ON COMPUTER CLUSTERS

    Directory of Open Access Journals (Sweden)

    V. N. Adrov

    2012-07-01

    Full Text Available Most cpu consuming tasks in photogrammetric processing can be done in parallel. The algorithms take independent bits as input and produce independent bits as output. The independence of bits comes from the nature of such algorithms since images, stereopairs or small image blocks parts can be processed independently. Many photogrammetric algorithms are fully automatic and do not require human interference. Photogrammetric workstations can perform tie points measurements, DTM calculations, orthophoto construction, mosaicing and many other service operations in parallel using distributed calculations. Distributed calculations save time reducing several days calculations to several hours calculations. Modern trends in computer technology show the increase of cpu cores in workstations, speed increase in local networks, and as a result dropping the price of the supercomputers or computer clusters that can contain hundreds or even thousands of computing nodes. Common distributed processing in DPW is usually targeted for interactive work with a limited number of cpu cores and is not optimized for centralized administration. The bottleneck of common distributed computing in photogrammetry can be in the limited lan throughput and storage performance, since the processing of huge amounts of large raster images is needed.

  5. Australia's new high performance research reactor

    International Nuclear Information System (INIS)

    Miller, R.; Abbate, P.M.

    2003-01-01

    A contract for the design and construction of the Replacement Research Reactor was signed in July 2000 between ANSTO and INVAP from Argentina. Since then the detailed design has been completed, a construction authorization has been obtained, and construction has commenced. The reactor design embodies modern safety thinking together with innovative solutions to ensure a highly safe and reliable plant. Also significant effort has been placed on providing the facility with diverse and ample facilities to maximize its use for irradiating material for radioisotope production as well as providing high neutron fluxes for neutron beam research. The project management organization and planing is commensurate with the complexity of the project and the number of players involved. (author)

  6. High Performance Single Nanowire Tunnel Diodes

    DEFF Research Database (Denmark)

    Wallentin, Jesper; Persson, Johan Mikael; Wagner, Jakob Birkedal

    NWs were contacted in a NW-FET setup. Electrical measurements at room temperature display typical tunnel diode behavior, with a Peak-to-Valley Current Ratio (PVCR) as high as 8.2 and a peak current density as high as 329 A/cm2. Low temperature measurements show improved PVCR of up to 27.6....... is the tunnel (Esaki) diode, which provides a low-resistance connection between junctions. We demonstrate an InP-GaAs NW axial heterostructure with tunnel diode behavior. InP and GaAs can be readily n- and p-doped, respectively, and the heterointerface is expected to have an advantageous type II band alignment...

  7. Future Vehicle Technologies : high performance transportation innovations

    Energy Technology Data Exchange (ETDEWEB)

    Pratt, T. [Future Vehicle Technologies Inc., Maple Ridge, BC (Canada)

    2010-07-01

    Battery management systems (BMS) were discussed in this presentation, with particular reference to the basic BMS design considerations; safety; undisclosed information about BMS; the essence of BMS; and Future Vehicle Technologies' BMS solution. Basic BMS design considerations that were presented included the balancing methodology; prismatic/cylindrical cells; cell protection; accuracy; PCB design, size and components; communications protocol; cost of manufacture; and expandability. In terms of safety, the presentation addressed lithium fires; high voltage; high voltage ground detection; crash/rollover shutdown; complete pack shutdown capability; and heat shields, casings, and impact protection. BMS bus bar engineering considerations were discussed along with good chip design. It was concluded that FVTs advantage is a unique skillset in automotive technology and the development of speed and cost effectiveness. tabs., figs.

  8. Radiation cured coatings for high performance products

    International Nuclear Information System (INIS)

    Parkins, J.C.; Teesdale, D.H.

    1984-01-01

    Development over the past ten years of radiation curable coating and lacquer systems and the means of curing them has led to new products in the packaging, flooring, furniture and other industries. Solventless lacquer systems formulated with acrylates and other resins enable high levels of durability, scuff resistance and gloss to be achieved. Ultra violet and electron beam radiation curing are used, the choice depending on the nature of the coating, the product and the scale of the operation. (author)

  9. High thermoelectric performance of graphite nanofibers

    OpenAIRE

    Tran, Van-Truong; Saint-Martin, Jérôme; Dollfus, Philippe; Volz, Sebastian

    2017-01-01

    Graphite nanofibers (GNFs) have been demonstrated to be a promising material for hydrogen storage and heat management in electronic devices. Here, by means of first-principles and transport simulations, we show that GNFs can also be an excellent material for thermoelectric applications thanks to the interlayer weak van der Waals interaction that induces low thermal conductance and a step-like shape in the electronic transmission with mini-gaps, which are necessary ingredients to achieve high ...

  10. New monomers for high performance polymers

    Science.gov (United States)

    Gratz, Roy F.

    1993-01-01

    This laboratory has been concerned with the development of new polymeric materials with high thermo-oxidative stability for use in the aerospace and electronics industries. Currently, there is special emphasis on developing matrix resins and composites for the high speed civil transport (HSCT) program. This application requires polymers that have service lifetimes of 60,000 hr at 350 F (177 C) and that are readily processible into void-free composites, preferably by melt-flow or powder techniques that avoid the use of high boiling solvents. Recent work has focused on copolymers which have thermally stable imide groups separated by flexible arylene ether linkages, some with trifluoromethyl groups attached to the aromatic rings. The presence of trifluoromethyl groups in monomers and polymers often improves their solubility and processibility. The goal of this research was to synthesize several new monomers containing pendant trifluoromethyl groups and to incorporate these monomers into new imide/arylene ether copolymers. Initially, work was begun on the synthesis of three target compounds. The first two, 3,5-dihydroxybenzo trifluoride and 3-amino 5-hydroxybenzo trifluoride, are intermediates in the synthesis of more complex monomers. The third, 3,5-bis (3-amino-phenoxy) benzotrifluoride, is an interesting diamine that could be incorporated into a polyimide directly.

  11. High performance repairing of reinforced concrete structures

    International Nuclear Information System (INIS)

    Iskhakov, I.; Ribakov, Y.; Holschemacher, K.; Mueller, T.

    2013-01-01

    Highlights: ► Steel fibered high strength concrete is effective for repairing concrete elements. ► Changing fibers’ content, required ductility of the repaired element is achieved. ► Experiments prove previously developed design concepts for two layer beams. -- Abstract: Steel fibered high strength concrete (SFHSC) is an effective material that can be used for repairing concrete elements. Design of normal strength concrete (NSC) elements that should be repaired using SFHSC can be based on general concepts for design of two-layer beams, consisting of SFHSC in the compressed zone and NSC without fibers in the tensile zone. It was previously reported that such elements are effective when their section carries rather large bending moments. Steel fibers, added to high strength concrete, increase its ultimate deformations due to the additional energy dissipation potential contributed by fibers. When changing the fibers’ content, a required ductility level of the repaired element can be achieved. Providing proper ductility is important for design of structures to dynamic loadings. The current study discusses experimental results that form a basis for finding optimal fiber content, yielding the highest Poisson coefficient and ductility of the repaired elements’ sections. Some technological issues as well as distribution of fibers in the cross section of two-layer bending elements are investigated. The experimental results, obtained in the frame of this study, form a basis for general technological provisions, related to repairing of NSC beams and slabs, using SFHSC.

  12. Analysis of ultrafiltration failure in peritoneal dialysis patients by means of standard peritoneal permeability analysis

    NARCIS (Netherlands)

    Ho-Dac-Pannekeet, M. M.; Atasever, B.; Struijk, D. G.; Krediet, R. T.

    1997-01-01

    BACKGROUND: Ultrafiltration failure (UFF) is a complication of peritoneal dialysis (PD) treatment that occurs especially in long-term patients. Etiological factors include a large effective peritoneal surface area [measured as high mass transfer area coefficient (MTAC) of creatinine], a high

  13. Information processing among high-performance managers

    Directory of Open Access Journals (Sweden)

    S.C. Garcia-Santos

    2010-01-01

    Full Text Available The purpose of this study was to evaluate the information processing of 43 business managers with a professional superior performance. The theoretical framework considers three models: the Theory of Managerial Roles of Henry Mintzberg, the Theory of Information Processing, and Process Model Response to Rorschach by John Exner. The participants have been evaluated by Rorschach method. The results show that these managers are able to collect data, evaluate them and establish rankings properly. At same time, they are capable of being objective and accurate in the problems assessment. This information processing style permits an interpretation of the world around on basis of a very personal and characteristic processing way or cognitive style.

  14. High temperature performance of polymer composites

    CERN Document Server

    Keller, Thomas

    2014-01-01

    The authors explain the changes in the thermophysical and thermomechanical properties of polymer composites under elevated temperatures and fire conditions. Using microscale physical and chemical concepts they allow researchers to find reliable solutions to their engineering needs on the macroscale. In a unique combination of experimental results and quantitative models, a framework is developed to realistically predict the behavior of a variety of polymer composite materials over a wide range of thermal and mechanical loads. In addition, the authors treat extreme fire scenarios up to more than 1000°C for two hours, presenting heat-protection methods to improve the fire resistance of composite materials and full-scale structural members, and discuss their performance after fire exposure. Thanks to the microscopic approach, the developed models are valid for a variety of polymer composites and structural members, making this work applicable to a wide audience, including materials scientists, polymer chemist...

  15. High performance concrete with blended cement

    International Nuclear Information System (INIS)

    Biswas, P.P.; Saraswati, S.; Basu, P.C.

    2012-01-01

    Principal objectives of the proposed project are two folds. Firstly, to develop the HPC mix suitable to NPP structures with blended cement, and secondly to study its durability necessary for desired long-term performance. Three grades of concrete to b considered in the proposed projects are M35, M50 and M60 with two types of blended cements, i.e. Portland slag cement (PSC) and Portland pozzolana cement (PPC). Three types of mineral admixtures - silica fume, fly ash and ground granulated blast furnace slag will be used. Concrete mixes with OPc and without any mineral admixture will be considered as reference case. Durability study of these mixes will be carried out

  16. High performance VLSI telemetry data systems

    Science.gov (United States)

    Chesney, J.; Speciale, N.; Horner, W.; Sabia, S.

    1990-01-01

    NASA's deployment of major space complexes such as Space Station Freedom (SSF) and the Earth Observing System (EOS) will demand increased functionality and performance from ground based telemetry acquisition systems well above current system capabilities. Adaptation of space telemetry data transport and processing standards such as those specified by the Consultative Committee for Space Data Systems (CCSDS) standards and those required for commercial ground distribution of telemetry data, will drive these functional and performance requirements. In addition, budget limitations will force the requirement for higher modularity, flexibility, and interchangeability at lower cost in new ground telemetry data system elements. At NASA's Goddard Space Flight Center (GSFC), the design and development of generic ground telemetry data system elements, over the last five years, has resulted in significant solutions to these problems. This solution, referred to as the functional components approach includes both hardware and software components ready for end user application. The hardware functional components consist of modern data flow architectures utilizing Application Specific Integrated Circuits (ASIC's) developed specifically to support NASA's telemetry data systems needs and designed to meet a range of data rate requirements up to 300 Mbps. Real-time operating system software components support both embedded local software intelligence, and overall system control, status, processing, and interface requirements. These components, hardware and software, form the superstructure upon which project specific elements are added to complete a telemetry ground data system installation. This paper describes the functional components approach, some specific component examples, and a project example of the evolution from VLSI component, to basic board level functional component, to integrated telemetry data system.

  17. High Performance Fuel Technology Development(I)

    International Nuclear Information System (INIS)

    Song, Kun Woo; Kim, Keon Sik; Bang, Jeong Yong; Park, Je Keon; Chen, Tae Hyun; Kim, Hyung Kyu

    2010-04-01

    The dual-cooled annular fuel has been investigated for the purpose of achieving the power uprate of 20% and decreasing pellet temperature by 30%. The 12x12 rod array and basic design was developed, which is mechanically compatible with the OPR-1000. The reactor core analysis has been performed using this design, and the results have shown that the criteria of nuclear, thermohydraulic and safety design are satisfied and pellet temperature can be lowered by 40% even in 120% power. The basic design of fuel component was developed and the cladding thickness was designed through analysis and experiments. The solutions have been proposed and analyzed to the technical issues such as 'inner channel blockage' and 'imbalance between inner and outer coolant'. The annular pellet was fabricated with good control of shape and size, and especially, a new sintering technique has been developed to control the deviation of inner diameter within ±5μm. The irradiation test of annular pellets has been conducted up to 10 MWD/kgU to find out the densification and swelling behaviors. The 11 types of materials candidates have developed for the PCI-endurance pellet, and the material containing the Mn-Al additive showed its creep performance of much better than UO2 material. The HANA cladding has been irradiated up to 61 MWD/kgU, and the results have shown that its oxidation resistance is better by 40% than that of Zircaloy. The 30 types of candidate materials for next generation have been developed through alloy design and property tests

  18. CA.R.PE.DI.E.M. (Cardio-Renal Pediatric Dialysis Emergency Machine): evolution of continuous renal replacement therapies in infants. A personal journey.

    Science.gov (United States)

    Ronco, Claudio; Garzotto, Francesco; Ricci, Zaccaria

    2012-08-01

    Pedriatric acute kidney injury (AKI) is a well-described clinical syndrome that is characterized by a reduction of both the urine output and glomerular filtration rate. AKI in critically ill children is typically associated with multiple organ dysfunction. A dramatic increase in the incidence of AKI in pediatric intensive care units has been observed in the last 10 years. Unfortunately, the absence of sufficiently effective preventive and therapeutic measures at the present time has limited significant improvements in AKI care. Morality in patients with severe AKI remains unacceptably high (>50 %), with renal replacement therapy (RRT) remaining the most effective form of support for these patients. Despite technological advances during the last 10 years which have resulted in the development of the so-called "third-generation dialysis machines" that are characterized by the highest level of safety and accuracy, a truly pedriatric RRT system has never been developed. Consequently, dialysis/hemofiltration in critically ill children is currently performed by adapting adult systems to the much smaller pediatric patients. In particular, research in this field should focus on children weighing less than 10 kg for whom the delivery of RRT is a clinical and technological challenge. We describe here the evolution of pediatric RRT during the last 30 years and report in detail on the CARPEDIEM project, which has recently been established to finally provide neonates and infants with a reliable dialysis machine that is specifically designed for this age group.

  19. [Evaluation of methods to calculate dialysis dose in daily hemodialysis].

    Science.gov (United States)

    Maduell, F; Gutiérrez, E; Navarro, V; Torregrosa, E; Martínez, A; Rius, A

    2003-01-01

    Daily dialysis has shown excellent clinical results because a higher frequency of dialysis is more physiological. Different methods have been described to calculate dialysis dose which take into consideration change in frequency. The aim of this study was to calculate all dialysis dose possibilities and evaluate the better and practical options. Eight patients, 6 males and 2 females, on standard 4 to 5 hours thrice weekly on-line hemodiafiltration (S-OL-HDF) were switched to daily on-line hemodiafiltration (D-OL-HDF) 2 to 2.5 hours six times per week. Dialysis parameters were identical during both periods and only frequency and dialysis time of each session were changed. Time average concentration (TAC), time average deviation (TAD), normalized protein catabolic rate (nPCR), Kt/V, equilibrated Kt/V (eKt/V), equivalent renal urea clearance (EKR), standard Kt/V (stdKt/V), urea reduction ratio (URR), hemodialysis product and time off dialysis were measured. Daily on-line hemodiafiltration was well accepted and tolerated. Patients maintained the same TAC although TAD decreased from 9.7 +/- 2 in baseline to a 6.2 +/- 2 mg/dl after six months, p time off dialysis was reduced to half. Dialysis frequency is an important urea kinetic parameter which there are to take in consideration. It's necessary to use EKR, stdKt/V or weekly URR to calculate dialysis dose for an adequate comparison between different frequency dialysis schedules.

  20. Carbon nanotubes for high-performance logic

    OpenAIRE

    Chen, Zhihong; Wong, H.S. Phillip; Mitra, Subhasish; Bol, Aggeth; Peng, Lianmao; Hills, Gage; Thissen, Nick

    2014-01-01

    Single-wall carbon nanotubes (CNTs) were discovered in 1993 and have been an area of intense research since then. They offer the right dimensions to explore material science and physical chemistry at the nanoscale and are the perfect system to study low-dimensional physics and transport. In the past decade, more attention has been shifted toward making use of this unique nanomaterial in real-world applications. In this article, we focus on potential applications of CNTs in the high-performanc...

  1. A comparative study of the effect of icodextrin based peritoneal dialysis and hemodialysis on lipid metabolism.

    Science.gov (United States)

    Kadiroğlu, A K; Ustündag, S; Kayabaşi, H; Yilmaz, Z; Yildirım, Y; Sen, S; Yilmaz, M E

    2013-09-01

    Dyslipidemia is frequent in patients with end stage renal disease. Excessive peritoneal glucose absorption from high glucose-containing peritoneal dialysis solutions may enhance disturbances on the lipid metabolism of patients on peritoneal dialysis. We compared the effect of icodextrin-based peritoneal dialysis therapy with hemodialysis (HD) therapy on lipid metabolism. A total of 157 non-diabetic patients on dialysis at least for 3 months; 78 patients on Icodextrin-based continuous ambulatory peritoneal dialysis (CAPD) (44 M, 34 F) and 79 patients in HD group (47M, 32F) were included into the study. After 12 h of fasting and before the dialysis session, serum urea, creatinin, glucose, Sodium, potasium, and albumin, total cholesterol (TC), triglycerides (TG), very low density lipoprotein (VLDL), low density lipoprotein (LDL)-C, high-density lipoprotein (HDL)-C, apolipoprotein A (Apo A), apolipoprotein B, and lipoprotein a were measured. TG (P = 0018) and VLDL (P = 0.022) were lower in CAPD group than HD group, HDL-C (P < 0.001) and Apo A (P = 0.001) were higher in CAPD group than in HD group. A total of 24.4% in CAPD group and 11.4% in HD group (P < 0.034) had normal serum levels of TG, LDL-C, and HDL-C. More patients in CAPD group (47.4%) had high serum Apo A levels than in HD group (21.5%) (P = 0.001). We suggest that patients receiving icodextrin-based CAPD may have better TG, HDL-C, and Apo A levels than patients on HD.

  2. Environmentally friendly, high-performance generation

    International Nuclear Information System (INIS)

    Kalmari, A.

    2003-01-01

    The project developer, owner, and operator of the new 45 MWth BFB-based cogeneration plant in Iisalmi is Termia Oy, part of the Atro Group (formerly Savon Voima Oy). Fired on peat and wood waste and handed over to the customer in November 2002, the plant's electrical output is sold to the parent company and heat locally to customers in Iisalmi. When the construction decision was made, one of the main objectives was to utilise as high a level of indigenous fuels (peat and biomass) as possible, at a high level of efficiency. An environmental impact analysis was carried out, taking into account the impact of various fuels and emissions in terms of combustion and logistics. One main benefit of the type of plant ultimately selected was that the bulk of the fuel can be supplied from the surrounding area. This is very important in terms of fuel supply security and local employment. The government provided a EUR 2.7 million grant for the project, equivalent to 13% of the total EUR 21 million investment budget. Before the plant was built, Termia used approximately 95 GWh of indigenous fuels annually. Today, this figure is 220 GWh. The main fuel used is milled peat. Up to 30% green chips from logging residues can be used. Recycled waste fuel can cover up to 3% of the total fuel requirement

  3. Liquid Argon Calorimeter performance at High Rates

    CERN Document Server

    Seifert, F; The ATLAS collaboration

    2013-01-01

    The expected increase of luminosity at HL-LHC by a factor of ten with respect to LHC luminosities has serious consequences for the signal reconstruction, radiation hardness requirements and operations of the ATLAS liquid argon calorimeters in the endcap, respectively forward region. Small modules of each type of calorimeter have been built and exposed to a high intensity proton beam of 50 GeV at IHEP/Protvino. The beam is extracted via the bent crystal technique, offering the unique opportunity to cover intensities ranging from $10^6$ p/s up to $3\\cdot10^{11}$ p/s. This exceeds the deposited energy per time expected at HL-LHC by more than a factor of 100. The correlation between beam intensity and the read-out signal has been studied. The data show clear indications of pulse shape distortion due to the high ionization build-up, in agreement with MC expectations. This is also confirmed from the dependence of the HV currents on beam intensity.

  4. High-performance silicon nanowire bipolar phototransistors

    Science.gov (United States)

    Tan, Siew Li; Zhao, Xingyan; Chen, Kaixiang; Crozier, Kenneth B.; Dan, Yaping

    2016-07-01

    Silicon nanowires (SiNWs) have emerged as sensitive absorbing materials for photodetection at wavelengths ranging from ultraviolet (UV) to the near infrared. Most of the reports on SiNW photodetectors are based on photoconductor, photodiode, or field-effect transistor device structures. These SiNW devices each have their own advantages and trade-offs in optical gain, response time, operating voltage, and dark current noise. Here, we report on the experimental realization of single SiNW bipolar phototransistors on silicon-on-insulator substrates. Our SiNW devices are based on bipolar transistor structures with an optically injected base region and are fabricated using CMOS-compatible processes. The experimentally measured optoelectronic characteristics of the SiNW phototransistors are in good agreement with simulation results. The SiNW phototransistors exhibit significantly enhanced response to UV and visible light, compared with typical Si p-i-n photodiodes. The near infrared responsivities of the SiNW phototransistors are comparable to those of Si avalanche photodiodes but are achieved at much lower operating voltages. Compared with other reported SiNW photodetectors as well as conventional bulk Si photodiodes and phototransistors, the SiNW phototransistors in this work demonstrate the combined advantages of high gain, high photoresponse, low dark current, and low operating voltage.

  5. High Performance Clocks and Gravity Field Determination

    Science.gov (United States)

    Müller, J.; Dirkx, D.; Kopeikin, S. M.; Lion, G.; Panet, I.; Petit, G.; Visser, P. N. A. M.

    2018-02-01

    Time measured by an ideal clock crucially depends on the gravitational potential and velocity of the clock according to general relativity. Technological advances in manufacturing high-precision atomic clocks have rapidly improved their accuracy and stability over the last decade that approached the level of 10^{-18}. This notable achievement along with the direct sensitivity of clocks to the strength of the gravitational field make them practically important for various geodetic applications that are addressed in the present paper. Based on a fully relativistic description of the background gravitational physics, we discuss the impact of those highly-precise clocks on the realization of reference frames and time scales used in geodesy. We discuss the current definitions of basic geodetic concepts and come to the conclusion that the advances in clocks and other metrological technologies will soon require the re-definition of time scales or, at least, clarification to ensure their continuity and consistent use in practice. The relative frequency shift between two clocks is directly related to the difference in the values of the gravity potential at the points of clock's localization. According to general relativity the relative accuracy of clocks in 10^{-18} is equivalent to measuring the gravitational red shift effect between two clocks with the height difference amounting to 1 cm. This makes the clocks an indispensable tool in high-precision geodesy in addition to laser ranging and space geodetic techniques. We show how clock measurements can provide geopotential numbers for the realization of gravity-field-related height systems and can resolve discrepancies in classically-determined height systems as well as between national height systems. Another application of clocks is the direct use of observed potential differences for the improved recovery of regional gravity field solutions. Finally, clock measurements for space-borne gravimetry are analyzed along with

  6. Gynecologic follow up of 129 women on dialysis and after kidney transplantation: a retrospective cohort study.

    Science.gov (United States)

    Chakhtoura, Zeina; Meunier, Marie; Caby, Jacqueline; Mercadal, Lucile; Arzouk, Nadia; Barrou, Benoît; Touraine, Philippe

    2015-04-01

    To describe the gynecologic issues and follow-up in our referral center of women on dialysis and after kidney transplantation. This retrospective cohort study included 129 dialysed women among whom 102 had had transplants. Data on menstrual pattern, pregnancies, contraception, and cervical cytology were retrieved from patients' files. The follow-up started at age 41.6±14.2 years and lasted for 9.5±10.2 years. Of the women, 78.7% had regular menses before dialysis, decreasing to 30.6% on dialysis (pirregular menses and metrorrhagia which was improved by chlormadinone acetate. We noted high rates of obstetrical complications and abnormal smear tests. Consequently, this population must have close follow-up to identify and treat gynecologic issues. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Development of high performance hybrid rocket fuels

    Science.gov (United States)

    Zaseck, Christopher R.

    . In order to examine paraffin/additive combustion in a motor environment, I conducted experiments on well characterized aluminum based additives. In particular, I investigate the influence of aluminum, unpassivated aluminum, milled aluminum/polytetrafluoroethylene (PTFE), and aluminum hydride on the performance of paraffin fuels for hybrid rocket propulsion. I use an optically accessible combustor to examine the performance of the fuel mixtures in terms of characteristic velocity efficiency and regression rate. Each combustor test consumes a 12.7 cm long, 1.9 cm diameter fuel strand under 160 kg/m 2s of oxygen at up to 1.4 MPa. The experimental results indicate that the addition of 5 wt.% 30 mum or 80 nm aluminum to paraffin increases the regression rate by approximately 15% compared to neat paraffin grains. At higher aluminum concentrations and nano-scale particles sizes, the increased melt layer viscosity causes slower regression. Alane and Al/PTFE at 12.5 wt.% increase the regression of paraffin by 21% and 32% respectively. Finally, an aging study indicates that paraffin can protect air and moisture sensitive particles from oxidation. The opposed burner and aluminum/paraffin hybrid rocket experiments show that additives can alter bulk fuel properties, such as viscosity, that regulate entrainment. The general effect of melt layer properties on the entrainment and regression rate of paraffin is not well understood. Improved understanding of how solid additives affect the properties and regression of paraffin is essential to maximize performance. In this document I investigate the effect of melt layer properties on paraffin regression using inert additives. Tests are performed in the optical cylindrical combustor at ˜1 MPa under a gaseous oxygen mass flux of ˜160 kg/m2s. The experiments indicate that the regression rate is proportional to mu0.08rho 0.38kappa0.82. In addition, I explore how to predict fuel viscosity, thermal conductivity, and density prior to testing

  8. Emerging technologies for high performance infrared detectors

    Science.gov (United States)

    Tan, Chee Leong; Mohseni, Hooman

    2018-01-01

    Infrared photodetectors (IRPDs) have become important devices in various applications such as night vision, military missile tracking, medical imaging, industry defect imaging, environmental sensing, and exoplanet exploration. Mature semiconductor technologies such as mercury cadmium telluride and III-V material-based photodetectors have been dominating the industry. However, in the last few decades, significant funding and research has been focused to improve the performance of IRPDs such as lowering the fabrication cost, simplifying the fabrication processes, increasing the production yield, and increasing the operating temperature by making use of advances in nanofabrication and nanotechnology. We will first review the nanomaterial with suitable electronic and mechanical properties, such as two-dimensional material, graphene, transition metal dichalcogenides, and metal oxides. We compare these with more traditional low-dimensional material such as quantum well, quantum dot, quantum dot in well, semiconductor superlattice, nanowires, nanotube, and colloid quantum dot. We will also review the nanostructures used for enhanced light-matter interaction to boost the IRPD sensitivity. These include nanostructured antireflection coatings, optical antennas, plasmonic, and metamaterials.

  9. Emerging technologies for high performance infrared detectors

    Directory of Open Access Journals (Sweden)

    Tan Chee Leong

    2018-01-01

    Full Text Available Infrared photodetectors (IRPDs have become important devices in various applications such as night vision, military missile tracking, medical imaging, industry defect imaging, environmental sensing, and exoplanet exploration. Mature semiconductor technologies such as mercury cadmium telluride and III–V material-based photodetectors have been dominating the industry. However, in the last few decades, significant funding and research has been focused to improve the performance of IRPDs such as lowering the fabrication cost, simplifying the fabrication processes, increasing the production yield, and increasing the operating temperature by making use of advances in nanofabrication and nanotechnology. We will first review the nanomaterial with suitable electronic and mechanical properties, such as two-dimensional material, graphene, transition metal dichalcogenides, and metal oxides. We compare these with more traditional low-dimensional material such as quantum well, quantum dot, quantum dot in well, semiconductor superlattice, nanowires, nanotube, and colloid quantum dot. We will also review the nanostructures used for enhanced light-matter interaction to boost the IRPD sensitivity. These include nanostructured antireflection coatings, optical antennas, plasmonic, and metamaterials.

  10. Video performance for high security applications

    International Nuclear Information System (INIS)

    Connell, Jack C.; Norman, Bradley C.

    2010-01-01

    The complexity of physical protection systems has increased to address modern threats to national security and emerging commercial technologies. A key element of modern physical protection systems is the data presented to the human operator used for rapid determination of the cause of an alarm, whether false (e.g., caused by an animal, debris, etc.) or real (e.g., a human adversary). Alarm assessment, the human validation of a sensor alarm, primarily relies on imaging technologies and video systems. Developing measures of effectiveness (MOE) that drive the design or evaluation of a video system or technology becomes a challenge, given the subjectivity of the application (e.g., alarm assessment). Sandia National Laboratories has conducted empirical analysis using field test data and mathematical models such as binomial distribution and Johnson target transfer functions to develop MOEs for video system technologies. Depending on the technology, the task of the security operator and the distance to the target, the Probability of Assessment (PAs) can be determined as a function of a variety of conditions or assumptions. PAs used as an MOE allows the systems engineer to conduct trade studies, make informed design decisions, or evaluate new higher-risk technologies. This paper outlines general video system design trade-offs, discusses ways video can be used to increase system performance and lists MOEs for video systems used in subjective applications such as alarm assessment.

  11. High performance magnet power supply optimization

    International Nuclear Information System (INIS)

    Jackson, L.T.

    1988-01-01

    The power supply system for the joint LBL--SLAC proposed accelerator PEP provides the opportunity to take a fresh look at the current techniques employed for controlling large amounts of dc power and the possibility of using a new one. A basic requirement of +- 100 ppM regulation is placed on the guide field of the bending magnets and quadrupoles placed around the 2200 meter circumference of the accelerator. The optimization questions to be answered by this paper are threefold: Can a firing circuit be designed to reduce the combined effects of the harmonics and line voltage combined effects of the harmonics and line voltage unbalance to less than 100 ppM in the magnet field. Given the ambiguity of the previous statement, is the addition of a transistor bank to a nominal SCR controlled system the way to go or should one opt for an SCR chopper system running at 1 KHz where multiple supplies are fed from one large dc bus and the cost--performance evaluation of the three possible systems

  12. High Dynamic Performance Nonlinear Source Emulator

    DEFF Research Database (Denmark)

    Nguyen-Duy, Khiem; Knott, Arnold; Andersen, Michael A. E.

    2016-01-01

    As research and development of renewable and clean energy based systems is advancing rapidly, the nonlinear source emulator (NSE) is becoming very essential for testing of maximum power point trackers or downstream converters. Renewable and clean energy sources play important roles in both...... terrestrial and nonterrestrial applications. However, most existing NSEs have only been concerned with simulating energy sources in terrestrial applications, which may not be fast enough for testing of nonterrestrial applications. In this paper, a high-bandwidth NSE is developed that is able to simulate...... change in the input source but also to a load step between nominal and open circuit. Moreover, all of these operation modes have a very fast settling time of only 10 μs, which is hundreds of times faster than that of existing works. This attribute allows for higher speed and a more efficient maximum...

  13. High-Performance Energy Applications and Systems

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Barton [Univ. of Wisconsin, Madison, WI (United States)

    2014-01-01

    The Paradyn project has a history of developing algorithms, techniques, and software that push the cutting edge of tool technology for high-end computing systems. Under this funding, we are working on a three-year agenda to make substantial new advances in support of new and emerging Petascale systems. The overall goal for this work is to address the steady increase in complexity of these petascale systems. Our work covers two key areas: (1) The analysis, instrumentation and control of binary programs. Work in this area falls under the general framework of the Dyninst API tool kits. (2) Infrastructure for building tools and applications at extreme scale. Work in this area falls under the general framework of the MRNet scalability framework. Note that work done under this funding is closely related to work done under a contemporaneous grant, “Foundational Tools for Petascale Computing”, SC0003922/FG02-10ER25940, UW PRJ27NU.

  14. Periodic Peritoneal Dialysis in End Stage Renal Disease: Is it Still ...

    African Journals Online (AJOL)

    ... replacement therapy out of reach of many patients with end stage renal disease (ESRD). Repeated puncture PD although inferior to HD biochemically, is easily and freely available across Rajasthan, India, and is simple to perform, and does not require sophisticated machines, thus making it an attractive option for dialysis ...

  15. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks.

    NARCIS (Netherlands)

    Raaijmakers, R.; Gajjar, P.; Schroder, C.; Nourse, P.

    2010-01-01

    Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and

  16. High performance multiple stream data transfer

    International Nuclear Information System (INIS)

    Rademakers, F.; Saiz, P.

    2001-01-01

    The ALICE detector at LHC (CERN), will record raw data at a rate of 1.2 Gigabytes per second. Trying to analyse all this data at CERN will not be feasible. As originally proposed by the MONARC project, data collected at CERN will be transferred to remote centres to use their computing infrastructure. The remote centres will reconstruct and analyse the events, and make available the results. Therefore high-rate data transfer between computing centres (Tiers) will become of paramount importance. The authors will present several tests that have been made between CERN and remote centres in Padova (Italy), Torino (Italy), Catania (Italy), Lyon (France), Ohio (United States), Warsaw (Poland) and Calcutta (India). These tests consisted, in a first stage, of sending raw data from CERN to the remote centres and back, using a ftp method that allows connections of several streams at the same time. Thanks to these multiple streams, it is possible to increase the rate at which the data is transferred. While several 'multiple stream ftp solutions' already exist, the authors' method is based on a parallel socket implementation which allows, besides files, also objects (or any large message) to be send in parallel. A prototype will be presented able to manage different transfers. This is the first step of a system to be implemented that will be able to take care of the connections with the remote centres to exchange data and monitor the status of the transfer

  17. High performance parallel backprojection on FPGA

    Energy Technology Data Exchange (ETDEWEB)

    Pfanner, Florian; Knaup, Michael; Kachelriess, Marc [Erlangen-Nuernberg Univ., Erlangen (Germany). Inst. of Medical Physics (IMP)

    2011-07-01

    Reconstruction of tomographic images, i.e., images from a Computed Tomography scanner, is a very time consuming issue. The most calculation power is needed for the backprojection step. A closer inspection shows that the algorithm for backprojection is easy to parallelize. FPGAs are able to execute many operations in the same time, so a highly parallel algorithm is a requirement for a powerful acceleration. For data flow rate maximization, we realized the backprojection in a pipelined structure with data throughput of one clock cycle. Due the hardware limitations of the FPGA, it is not possible to reconstruct the image as a whole. So it is necessary to split up the image and reconstruct these parts separately. Despite that, a reconstruction of 512 projections into a 5122 image is calculated within 13 ms on a Virtex 5 FPGA. To save hardware resources we use fixed point arithmetic with an accuracy of 23 bit for calculation. A comparison of the result image and an image, calculated with floating point arithmetic on CPU, shows that there are no differences between these images. (orig.)

  18. Technologies of high-performance thermography systems

    Science.gov (United States)

    Breiter, R.; Cabanski, Wolfgang A.; Mauk, K. H.; Kock, R.; Rode, W.

    1997-08-01

    A family of 2 dimensional detection modules based on 256 by 256 and 486 by 640 platinum silicide (PtSi) focal planes, or 128 by 128 and 256 by 256 mercury cadmium telluride (MCT) focal planes for applications in either the 3 - 5 micrometer (MWIR) or 8 - 10 micrometer (LWIR) range was recently developed by AIM. A wide variety of applications is covered by the specific features unique for these two material systems. The PtSi units provide state of the art correctability with long term stable gain and offset coefficients. The MCT units provide extremely fast frame rates like 400 Hz with snapshot integration times as short as 250 microseconds and with a thermal resolution NETD less than 20 mK for e.g. the 128 by 128 LWIR module. The unique design idea general for all of these modules is the exclusively digital interface, using 14 bit analog to digital conversion to provide state of the art correctability, access to highly dynamic scenes without any loss of information and simplified exchangeability of the units. Device specific features like bias voltages etc. are identified during the final test and stored in a memory on the driving electronics. This concept allows an easy exchange of IDCAs of the same type without any need for tuning or e.g. the possibility to upgrade a PtSi based unit to an MCT module by just loading the suitable software. Miniaturized digital signal processor (DSP) based image correction units were developed for testing and operating the units with output data rates of up to 16 Mpixels/s. These boards provide the ability for freely programmable realtime functions like two point correction and various data manipulations in thermography applications.

  19. High energy permanent magnets - Solutions to high performance devices

    International Nuclear Information System (INIS)

    Ma, B.M.; Willman, C.J.

    1986-01-01

    Neodymium iron boron magnets are a special class of magnets providing the highest level of performance with the least amount of material. Crucible Research Center produced the highest energy product magnet of 45 MGOe - a world record. Commercialization of this development has already taken place. Crucible Magnetics Division, located in Elizabethtown, Kentucky, is currently manufacturing and marketing six different grades of NdFeB magnets. Permanent magnets find application in motors, speakers, electron beam focusing devices for military and Star Wars. The new NdFeB magnets are of considerable interest for a wide range of applications

  20. Cardiovascular risk factors in hemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Helal Imed

    2010-01-01

    Full Text Available Cardiovascular diseases are a major cause of morbidity and mortality in patients with end-stage renal disease (ESRD. The aim of our investigation was the evaluation of an extensive cardiovascular profile in hemodialysis (HD and peritoneal dialysis (PD patients. We studied 74 patients with ESRD (38 males, 36 females, maintained either on chronic HD (n= 50 or chronic PD (n= 24 and age and sex matched 20 healthy subjects as controls. The lipid profile, homo-cysteine (Hcy and C reactive protein (CRP were measured. When compared to a healthy popu-lation, HD patients displayed a marked atherogenic profile, as attested by increased levels of total cholesterol (TC, triglycerides (TG, low-density lipoprotein-cholesterol (LDL-C, apolipoprotein A (Apo A, CRP, Hcy and lower concentrations of high-density lipoprotein-cholesterol (HDL-C, Apo B, albumin (ALB. A significant difference was noted concerning the rates of Apo B, HDL-C, TC, ALB and Hcy. Same biological disorders that those found at HD patients were noted in these PD patients. One also noted lower concentration in Apo A. there were a significant diffe-rence with the reference group concerning the rates of albumin, Apo A, HDL-Cl and Hcy. When compared to PD patients, HD patients had significantly decreased concentration of LDL-C. The peculiar metabolic changes observed in the present study confirm the marked tendency of patients with impaired renal function for developing cardiovascular diseases, irrespectively of the type of dialysis. We suggest including uremia-related risk factors in the panel for evaluation of cardio-vascular risk in dialysis patients.