ESA, iron therapy and new drugs: Are there new perspectives in the treatment of anaemia?

Anemia is a well-known consequence of chronic kidney disease (CKD); it is mainly due to a relative insufficiency of erythropoietin synthesis by the failing kidneys. Over the years, the combination of erythropoiesis stimulating agents (ESA) and iron has become the standard of care of anemia. All ESAs effectively increase hemoglobin (Hb) levels in a substantial percentage of patients. However, in the last decade, their use has been surrounded by safety issues in increased cardiovascular risk, especially when used at high doses in inflamed and hyporesponsive patients. This has led to the definition of a more cautious Hb target. Iron deficiency is very frequent in CKD patients, with a higher frequency in non-dialysis patients. Traditionally, iron supplementation is mostly used as supportive therapy for anemia control. However, the concept is growing that intravenous iron therapy per se could be beneficial in the presence of heart failure. A new class of drugs, prolyl hydroxylase domain (PHD) inhibitors (PHD inhibitors) is becoming available for the treatment of anemia in CKD patients. Theoretically, these agents have a number of advantages, the main ones being that of stimulating the synthesis of endogenous erythropoietin and increasing iron avail-ability. The impact of their future use in clinical practice is still to be defined. Another possible strategy could be targeting serum hepcidin and its related pathways. This possibility is fascinating from the scientific point of view, but at present its development phase is still far from clinical application

Thermal Kinetic Inductance Detectors for Millimeter-Wave Astrophysics

Thermal Kinetic Inductance Detectors (TKIDs) combine the excellent noise performance of traditional bolometers with a radio frequency (RF) multiplexing architecture that enables the large detector counts needed for the next generation of millimeter-wave instruments. Here we present dark prototype TKID pixels that demonstrate a noise equivalent power NEP = 2×10⁻¹⁷√W/Hz with a 1/f knee at 0.1 Hz, suitable for background-limited noise performance at 150 GHz from a ground-based site. We discuss the optimizations in the device design and fabrication techniques to realize optimal electrical performance and high quality factors at a bath temperature of 250 mK

Functionally graded plate fracture analysis using the field boundary element method

This paper describes the Field Boundary Element Method (FBEM) applied to the fracture analysis of a 2D rectangular plate made of Functionally Graded Material (FGM) to calculate Mode I Stress Intensity Factor (SIF). The case study of this Field Boundary Element Method is the transversely isotropic plane plate. Its material presents an exponential variation of the elasticity tensor depending on a scalar function of position, i.e., the elastic tensor results from multiplying a scalar function by a constant taken as a reference. Several examples using a parametric representation of the structural response show the suitability of the method that constitutes a Stress Intensity Factor evaluation of Functionally Graded Materials plane plates even in the case of more complex geometries

Influence of Eta-Phase on Wear Behavior of WC-Co Carbides

Cemented carbides, also known as Widia, are hard metals produced by sintering process and widely used in mechanical machining. They show high cutting capacity and good wear resistance; consequently, they result to be excellent materials for manufacturing cutting tools and sandblast nozzles. In this work, the wear resistance of WC-Co carbides containing Eta-phase, a secondary phase present in the hard metals when a carbon content deficiency occurs, is analyzed. Different mixtures of carbide are prepared and sintered, with different weight percentages of carbon, in order to form Eta-phase and then analyze how the carbon content influences the wear resistance of the material. This characterization is carried out by abrasive wear tests. The test parameters are chosen considering the working conditions of sandblast nozzles. Additional information is gathered through microscopic observations and the evaluation of hardness and microhardness of the different mixtures. The analyses highlight that there is a limit of carbon content below which bad sintering occurs. Considering the mixtures without these sintering problems, they show a wear resistance depending on the size and distribution of the Eta-phase; moreover, the one with high carbon content deficiency shows the best performance

Stacking sequences in composite laminates through design optimization

AbstractComposites are experiencing a new era. The spatial resolution at which is to date possible to build up complex architectured microstructures through additive manufacturing-based and sintering of powder metals 3D printing techniques, as well as the recent improvements in both filament winding and automated fiber deposition processes, are opening new unforeseeable scenarios for applying optimization strategies to the design of high-performance structures and metamaterials that could previously be only theoretically conceived. Motivated by these new possibilities, the present work, by combining computational methods, analytical approaches and experimental analysis, shows how finite element Design Optimization algorithms can be ad hoc rewritten by identifying as design variables the orientation of the reinforcing fibers in each ply of a layered structure for redesigning fiber-reinforced composites exhibiting at the same time high stiffness and toughening, two features generally in competition each other. To highlight the flexibility and the effectiveness of the proposed strategy, after a brief recalling of the essential theoretical remarks and the implemented procedure, selected example applications are finally illustrated on laminated plates under different boundary conditions, cylindrical layered shells with varying curvature subjected to point loads and composite tubes made of carbon fiber-reinforced polymers, recently employed as structural components in advanced aerospace engineering applications

I am Robot, Your Health Adviser for Older Adults: Do You Trust My Advice?

Artificial intelligence and robotic solutions are seeing rapid development for use across multiple occupations and sectors, including health and social care. As robots grow more prominent in our work and home environments, whether people would favour them in receiving useful advice becomes a pressing question. In the context of human–robot interaction (HRI), little is known about people’s advice-taking behaviour and trust in the advice of robots. To this aim, we conducted an experimental study with older adults to measure their trust and compliance with robot-based advice in health-related situations. In our experiment, older adults were instructed by a fictional human dispenser to ask a humanoid robot for advice on certain vitamins and over-the-counter supplements supplied by the dispenser. In the first experimented condition, the robot would give only information-type advice, i.e., neutral informative advice on the supplements given by the human. In the second condition, the robot would give recommendation-type advice, i.e., advice in favour of more supplements than those suggested initially by the human. We measured the trust of the participants in the type of robot-based advice, anticipating that they would be more trusting of information-type advice. Moreover, we measured the compliance with the advice, for participants who received robot-based recommendations, and a closer proxy of the actual use of robot health advisers in home environments or facilities in the foreseeable future. Our findings indicated that older adults continued to trust the robot regardless of the type of advice received, highlighting a type of protective role of robot-based recommendations on their trust. We also found that higher trust in the robot resulted in higher compliance with its advice. The results underpinned the likeliness of older adults welcoming a robot at their homes or health facilities

Symmetry breaking and effects of nutrient walkway in time-dependent bone remodeling incorporating poroelasticity

© 2022. The Author(s).Bone is an extraordinary biological material that continuously adapts its hierarchical microstructure to respond to static and dynamic loads for offering optimal mechanical features, in terms of stiffness and toughness, across different scales, from the sub-microscopic constituents within osteons-where the cyclic activity of osteoblasts, osteoclasts, and osteocytes redesigns shape and percentage of mineral crystals and collagen fibers-up to the macroscopic level, with growth and remodeling processes that modify the architecture of both compact and porous bone districts. Despite the intrinsic complexity of the bone mechanobiology, involving coupling phenomena of micro-damage, nutrients supply driven by fluid flowing throughout hierarchical networks, and cells turnover, successful models and numerical algorithms have been presented in the literature to predict, at the macroscale, how bone remodels under mechanical stimuli, a fundamental issue in many medical applications such as optimization of femur prostheses and diagnosis of the risk fracture. Within this framework, one of the most classical strategies employed in the studies is the so-called Stanford's law, which allows uploading the effect of the time-dependent load-induced stress stimulus into a biomechanical model to guess the bone structure evolution. In the present work, we generalize this approach by introducing the bone poroelasticity, thus incorporating in the model the role of the fluid content that, by driving nutrients and contributing to the removal of wastes of bone tissue cells, synergistically interacts with the classical stress fields to change homeostasis states, local saturation conditions, and reorients the bone density rate, in this way affecting growth and remodeling. Through two paradigmatic example applications, i.e. a cylindrical slice with internal prescribed displacements idealizing a tract of femoral diaphysis pushed out by the pressure exerted by a femur prosthesis and a bone element in a form of a bent beam, it is highlighted that the present model is capable to catch more realistically both the transition between spongy and cortical regions and the expected non-symmetrical evolution of bone tissue density in the medium-long term, unpredictable with the standard approach. A real study case of a femur is also considered at the end in order to show the effectiveness of the proposed remodeling algorithm.Peer reviewe