Prevalence of Microalbuminuria in Children with Asymptomatic Microscopic Hematuria

Introduction: A wide range of chronic and acute diseases begin with asymptomatic microscopic hematuria. Simultaneous presence of microalbuminuria and microscopic hematuria is suggestive of an important kidney disease. The purpose of this study was to determine the prevalence of microalbuminuria in children with asymptomatic microscopic hematuria.Materials and Methods: This cross-sectional study was done on 150 children aged 2-14 years with asymptomatic microscopic hematuria at Nephrology Clinic of Children’s Hospital Medical Center in 2013-2015. All patients had clinical and laboratory tests such as BUN, creatinine, electrolytes, urine albumin/ creatinine ratio, blood pressure, etc. The obtained data were recorded and analyzed with SPSS (ver. 18). All children with anatomical anomalies, hypertension, previous urinary tract surgery, or nephrolithiasis were excluded from the study.Results: The overall prevalence of microalbuminuria was 14.5 % and there was a significant relationship between microalbuminuria and the presence of dysmorphic red blood cells on urine analysis (p-value<0.05). The incidence of RBC cast was 54% (82 patients). Two children had upper-normal levels of blood pressure for age and sex that were followed closely and received special diets and medications. Twenty-nine patients (18.6%) had a positive family history of asymptomatic microscopic hematuria and the father of one of them had IgA nephropathy with ESRD. In children with microalbuminuria that received drugs for 3-28 months (mean, 6.3 months), microalbuminuria decreased significantly.Conclusions: Isolated asymptomatic microscopic hematuria is a benign disease but its association with proteinuria may indicate a serious problem with the risk of progressive renal disease. It is recommended to determine the microalbumin/creatinine ratio in cases with asymptomatic microscopic hematuria. Keywords: Asymptomatic Microscopic Hematuria; Microalbuminuria; Prevalence; Child

On the eventual periodicity of fractional order dispersive wave equations using RBFS and transform

In this research work, let’s focus on the construction of numerical scheme based on radial basis functions finite difference (RBF-FD) method combined with the Laplace transform for the solution of fractional order dispersive wave equations. The numerical scheme is then applied to examine the eventual periodicity of the proposed model subject to the periodic boundary conditions. The implementation of proposed technique for high order fractional and integer type nonlinear partial differential equations (PDEs) is beneficial because this method is local in nature, therefore it yields and resulted in sparse differentiation matrices instead of full and dense matrices. Only small dimensions of linear systems of equations are to be solved for every center in the domain and hence this procedure is more reliable and efficient to solve large scale physical and engineering problems in complex domain. Laplace transform is utilized for obtaining the equivalent time-independent equation in Laplace space and also valuable to handle time-fractional derivatives in the Caputo sense. Application of Laplace transform avoids the time steeping procedure which commonly encounters the time instability issues. The solution to the transformed model is then obtained by computing the inversion of Laplace transform with an appropriate contour in a complex space, which is approximated by trapezoidal rule with high accuracy. Also since the Laplace transform operator is linear, it cannot be used to transform non-linear terms therefore let’s use a linearization approach and an appropriate iterative scheme. The proposed approach is tasted for some nonlinear fractional order KdV and Burgers equations. The capacity, high order accuracy and efficiency of our approach are demonstrated using examples and resultsRBFs Method

Weighted Montgomery's identities for higher order differentiable functions of two variables

We give weighted Montgomery's identities for higher order differentiable functions of two variables and by using these identities we obtain generalized Ostrowski-type and Grüss-type inequalities for double weighted integrals of higher order differentiable functions of two independent variables

Soil Moisture Measuring Techniques and Factors Affecting the Moisture Dynamics: A Comprehensive Review

The amount of surface soil moisture (SSM) is a crucial ecohydrological natural resource that regulates important land surface processes. It affects critical land–atmospheric phenomena, including the division of energy and water (infiltration, runoff, and evaporation), that impacts the effectiveness of agricultural output (sensible and latent heat fluxes and surface air temperature). Despite its significance, there are several difficulties in making precise measurements, monitoring, and interpreting SSM at high spatial and temporal resolutions. The current study critically reviews the methods and procedures for calculating SSM and the variables influencing measurement accuracy and applicability under different fields, climates, and operational conditions. For laboratory and field measurements, this study divides SSM estimate strategies into (i) direct and (ii) indirect procedures. The accuracy and applicability of a technique depends on the environment and the resources at hand. Comparative research is geographically restricted, although precise and economical—direct measuring techniques like the gravimetric method are time-consuming and destructive. In contrast, indirect methods are more expensive and do not produce measurements at the spatial scale but produce precise data on a temporal scale. While measuring SSM across more significant regions, ground-penetrating radar and remote sensing methods are susceptible to errors caused by overlapping data and atmospheric factors. On the other hand, soft computing techniques like machine/deep learning are quite handy for estimating SSM without any technical or laborious procedures. We determine that factors, e.g., topography, soil type, vegetation, climate change, groundwater level, depth of soil, etc., primarily influence the SSM measurements. Different techniques have been put into practice for various practical situations, although comparisons between them are not available frequently in publications. Each method offers a unique set of potential advantages and disadvantages. The most accurate way of identifying the best soil moisture technique is the value selection method (VSM). The neutron probe is preferable to the FDR or TDR sensor for measuring soil moisture. Remote sensing techniques have filled the need for large-scale, highly spatiotemporal soil moisture monitoring. Through self-learning capabilities in data-scarce areas, machine/deep learning approaches facilitate soil moisture measurement and prediction

Scientific Irrigation Scheduling for Sustainable Production in Olive Groves

The present study aimed at investigating scientific irrigation scheduling (SIS) for the sustainable production of olive groves. The SIS allows farmers to schedule water rotation in their fields to abate crop water stress and maximize yields, which could be achieved through the precise monitoring of soil moisture. For this purpose, the study used three kinds of soil moisture sensors, including tensiometer sensors, irrometer sensors, and gypsum blocks for precise measurement of the soil moisture. These soil moisture sensors were calibrated by performing experiments in the field and laboratory at Barani Agricultural Research Institute, Chakwal in 2018 and 2019. The calibration curves were obtained by performing gravimetric analysis at 0.3 and 0.6 m depths, thereby equations were developed using regression analysis. The coefficient of determination (R2 ) at 0.3 and 0.6 m depth for tensiometer, irrometer, and gypsum blocks was found to be equal to 0.98, 0.98; 0.75, 0.89; and 0.82, and 0.95, respectively. After that, a drip irrigation system was installed with the calibrated soil moisture sensors at 0.3 and 0.6 m depth to schedule irrigation for production of olive groves as compared to conventional farmer practice, thereby soil moisture profiles of these sensors were obtained to investigate the SIS. The results showed that the irrometer sensor performed as expected and contributed to the irrigation water savings between 17% and 25% in 2018 and 2019, respectively, by reducing the number of irrigations as compared toother soil moisture sensors and farmer practices. Additionally, olive yield efficiencies of 8% and 9%were observed by the tensiometer in 2018 and 2019, respectively. The outcome of the study suggests that an effective method in providing sustainable production of olive groves and enhancing yield efficiency

Characterization of cowpea to harvest rainwater for wheat in semiarid conditions

Aim of study: A field experiment was executed, under rainfed conditions from 2014-15 to 2017-18, to study the role of cowpea (Vigna unguiculata L.) in rainwater harvesting to enhance the wheat (Triticum aestivum L.) yield.Area of study: Rain-fed area of Pothwar region, Punjab, Pakistan.Material and methods: We designed three treatments (T1: control; T2: cowpea grown after conventional tillage and incorporated into soil to act as “green manure”; and T3: grown without any tillage practice, cut with sickle and spread as “mulch”). The effect of these treatments on soil moisture conservation was studied against conventional farmer’s practice, wherein no host crop is grown before wheat sowing.Main results: Available soil water remained highest in T2 during first three years when sufficient rainfall was received contrary to fourth year with low rainfall. The results revealed that cowpea biomass of 15.2 t/ha and 13.72 t/ha, from T2 and T3 respectively, were produced during 2015 corresponding to 213 mm rainfall. Whereas, these quantities increased to 25.69 t/ha and 24.29 t/ha during 2017 with 387 mm of rainfall. The study revealed that net income from wheat crop under T2 was Rs 13000 and Rs 9000 per hectare higher than that of control during the first two years respectively. Contrarily, net income from T2 was found negative and benefit-cost ratio reduced to 0.79 when very low rainfall was received during the last year.Research highlights: Use of cowpea as green manure gave maximum net return if sufficient rainfall is received during decomposition of cowpea and hence recommended for in-situ rainwater harvesting

Papillary Renal Cell Carcinoma: Demographics, Survival Analysis, Racial Disparities, and Genomic Landscape

Papillary renal cell carcinoma (PRCC) is the second most common histological subtype of renal cell cancer. This research aims to present a large database study highlighting the demographic, clinical, and pathological factors, racial disparities, prognosis, and survival of PRCC. The clinical and demographic data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and molecular data was cured from the Catalogue Of Somatic Mutations in Cancer (COSMIC) database. PRCC had a median age of diagnosis at 64 years, with a higher incidence in men (77%), and Whites (68%). 70.3% of cases were Grades I–IV (13, 53, 31, and 3%, respectively). In patients with known data, 85% were localized to the kidney, and 84% of cases were 7 cm in size. No metastasis occurred in 97% of the known data. The most common treatment offered was surgical resection (9%). The 5-year overall survival was 79%, with patients undergoing surgery having a 90.6% 5-year survival. Multivariable analysis revealed age > 60 years, Black race, poor histologic differentiation, distant metastases, and tumor size > 10 cm as independent risk factors for mortality. The most common mutations identified from the COSMIC database were MET, KMT2D, KMT2C, ARID1A, and SPEN. PRCC affects male individuals in the sixth decade of life. Increased age, Black race, distant metastases, and tumors > 10 cm are associated with a worse prognosis. Surgical resection offers a favorable survival outcome. Next-generation sequencing (NGS) could identify potentially targetable alterations and future personalized therapeutic approaches

Experimental investigation on compression ignition engine powered with pentanol and thevetia peruviana methyl ester under reactivity controlled compression ignition mode of operation

In the current study, an effort is carried out to study the influence of pentanol as low reactive fuel (LRF) along with diesel and Thevetia peruviana methyl ester (TPME) as high reactive fuels (HRF) in reactivity controlled compression ignition (RCCI) engine. The experiments are conducted on dual fuel engine at 50% load for RCCI mode of operation by varying pentanol percentage in injected fuels. The results revealed that RCCI mode of operation at 10% of pentanol in injected fuels exhibited higher brake thermal efficiency (BTE) of 22.15% for diesel and pentanol fuel combination, which is about 9.1% and 27.3% higher than other B20 and pentanol, B100 and pentanol fuel combinations respectively. As the percentage of pentanol increased in injected fuels, hydrocarbon (HC) and carbon monoxide (CO) emissions are increased while nitrogen oxide (NOx) and smoke emissions are decreased. Among various fuel combinations tested diesel and pentanol fuel combination gives lower HC, CO and smoke emissions and higher NOx emissions. At 10% pentanol in injected fuels, the highest heat release rate (HRR) and in-cylinder pressure are found for diesel and pentanol fuel combinations compared with other fuels

Changes in disclosure, adherence and healthcare interactions after the introduction of immediate ART initiation: an analysis of patient experiences in Swaziland.

INTRODUCTION: There are concerns that immediate ART initiation (regardless of CD4 count) negatively affects HIV status disclosure, ART adherence and healthcare interactions. We assessed changes in these factors after the 'Early access to ART for all' intervention, a universal test-and-treat study in Swaziland. METHODS: We recruited two samples of participants between 2014 and 2017. The first group was interviewed before the intervention (control); the second group at the implementation and 6 months thereafter (intervention). RESULTS: High levels of disclosure to partners (controls and intervention: 94%) and family members (controls: 78%, intervention: 79%) were reported, and high levels of adherence (85% did not miss a dose among the controls, 84% in the intervention group). There were no changes in patients reporting feeling pressured to initiate ART (controls: 10%, intervention: 11%). The quality of interaction with healthcare workers improved after the intervention; healthcare workers explained more often the choice of ART initiation (controls: 88%, intervention: 93%) and the meaning of both CD4 and viral load test results (controls: 15%, intervention: 47%). More patients in the intervention group reported receiving test results (controls: 13%, intervention: 46%). We observed no changes in disclosure, adherence or patient experiences 6 months into the intervention compared to its start. CONCLUSION: Our results suggest that both reported adherence and disclosure levels remain high after the introduction of immediate ART in Swaziland. We observed an improvement in the healthcare interactions, possibly due to training at participating facilities, which will be an important element for a successful roll-out of immediate ART

Excess of health care use in general practice and of comorbid chronic conditions in cancer patients compared to controls

<p>Abstract</p> <p>Background</p> <p>The number of cancer patients and the number of patients surviving initial treatments is expected to rise. Traditionally, follow-up monitoring takes place in secondary care. The contribution of general practice is less visible and not clearly defined.</p> <p>This study aimed to compare healthcare use in general practice of patients with cancer during the follow-up phase compared with patients without cancer. We also examined the influence of comorbid conditions on healthcare utilisation by these patients in general practice.</p> <p>Methods</p> <p>We compared health care use of N=8,703 cancer patients with an age and gender-matched control group of patients without cancer from the same practice. Data originate from the Netherlands Information Network of General Practice (LINH), a representative network consisting of 92 general practices with 350,000 enlisted patients. Health care utilisation was assessed using data on contacts with general practice, prescription and referral rates recorded between 1/1/2001 and 31/12/2007. The existence of additional comorbid chronic conditions (ICPC coded) was taken into account.</p> <p>Results</p> <p>Compared to matched controls, cancer patients had more contacts with their GP-practice (19.5 vs. 11.9, p<.01), more consultations with the GP (3.5 vs. 2.7, p<.01), more home visits (1.6 vs. 0.4, p<.01) and they got more medicines prescribed (18.7 vs. 11.6, p<.01) during the follow-up phase. Cancer patients more often had a chronic condition than their matched controls (52% vs. 44%, p<.01). Having a chronic condition increased health care use for both patients with and without cancer. Cancer patients with a comorbid condition had the highest health care use.</p> <p>Conclusion</p> <p>We found that cancer patients in the follow-up phase consulted general practice more often and suffered more often from comorbid chronic conditions, compared to patients without cancer. It is expected that the number of cancer patients will rise in the years to come and that primary health care professionals will be more involved in follow-up care. Care for comorbid chronic conditions, communication between specialists and GPs, and coordination of tasks then need special attention.</p