A cohort study on the rate of progression of diabetic chronic kidney disease in different ethnic groups.

OBJECTIVE: To compare the rate of progression of diabetic chronic kidney disease in different ethnic groups. DESIGN: Prospective longitudinal observational study. PARTICIPANTS: All new patients attending a tertiary renal unit in east London with diabetic chronic kidney disease between 2000 and 2007 and followed up till 2009 were included. Patients presenting with acute end-stage kidney failure were excluded. MAIN OUTCOME MEASURES: The primary outcome was annual decline in the estimated glomerular filtration rate (eGFR) in different ethnic groups. Secondary end points were the number of patients developing end-stage kidney failure and total mortality during the study period. RESULTS: 329 patients (age 60±11.9 years, 208 men) were studied comprising 149 south Asian, 105 White and 75 Black patients. Mean follow-up was 6.0±2.3, 5.0±2.7 and 5.6±2.4 years for White, Black and south Asian patients, respectively. South Asian patients were younger and had a higher baseline eGFR, but both systolic and diastolic blood pressures were higher in Black patients (p<0.05). Baseline proteinuria was highest for the south Asian group followed by the White and Black groups. Adjusted linear regression analysis showed that an annual decline in eGFR was not significantly different between the three groups. The numbers of patients developing end-stage kidney failure and total mortality were also not significantly different between the three groups. ACE or angiotensin receptor blockers use, and glycated haemoglobin were similar at baseline and throughout the study period. CONCLUSIONS: We conclude that ethnicity is not an independent factor in the rate of progression renal failure in patients with diabetic chronic kidney disease

Comparison of ultrasonographically measured fetal interventricular septal thickness between diabetic and healthy mother

Background: During pregnancy, metabolic changes occur in response to increased nutrient needs of the fetus and mother, including progressive insulin resistance that can lead to gestational diabetes mellitus (GDM). GDM can result in fetal complications. This study aimed to compare fetal interventricular septal thickness, measured by ultrasound, between diabetic and healthy mothers. Methods: This cross-sectional study was conducted at the department of radiology and imaging, BIRDEM, Dhaka, Bangladesh. A total of 334 subjects were enrolled in this study as per inclusion criteria. The study duration was 2 years; from July 2012 to June 2014. All study subjects were divided into 3 groups named group A, group B, and group C. 167 non-diabetic, 84 controlled diabetics, and 83 uncontrolled diabetic mothers were considered as group A, group B, and group C respectively. Data were analyzed by SPSS computed program. Results: In this study, 47.9% of subjects in group A were ≤25 years old, while 52.4% of group B and 53.0% of group C were in the 26-30 age range. The mean age was 25.9±3 years in group A, 25.5±2.9 years in group B, and 25.2+3.3 years in group C, with no statistically significant difference between the three groups (p&gt;0.05). The mean gestational age was similar across the three groups, with no statistically significant difference (p&gt;0.05). However, the mean fetal interventricular septal thickness was significantly different between the groups, with group A and B having similar thicknesses, while group C had a significantly larger thickness (p&lt;0.05). The difference in fetal interventricular septal thickness was also statistically significant between the three groups at 32 weeks of gestational age (p&lt;0.05). Conclusions: In this study, the fetal interventricular septal thickness was significantly higher in uncontrolled diabetic mothers followed by controlled diabetic and non-diabetic and almost alike between non-diabetic and controlled diabetic mothers. The study also revealed that M-mode ultra-sonogram measurement of interventricular septal thickness can be included in routine scanning during the third trimester

A blockchain-based authentication protocol for cooperative vehicular ad hoc network

The efficiency of cooperative communication protocols to increase the reliability and range of transmission for Vehicular Ad hoc Network (VANET) is proven, but identity verification and communication security are required to be ensured. Though it is difficult to maintain strong network connections between vehicles because of there high mobility, with the help of cooperative communication, it is possible to increase the communication efficiency, minimise delay, packet loss, and Packet Dropping Rate (PDR). However, cooperating with unknown or unauthorized vehicles could result in information theft, privacy leakage, vulnerable to different security attacks, etc. In this paper, a blockchain based secure and privacy preserving authentication protocol is proposed for the Internet of Vehicles (IoV). Blockchain is utilized to store and manage the authentication information in a distributed and decentralized environment and developed on the Ethereum platform that uses a digital signature algorithm to ensure confidentiality, non-repudiation, integrity, and preserving the privacy of the IoVs. For optimized communication, transmitted services are categorized into emergency and optional services. Similarly, to optimize the performance of the authentication process, IoVs are categorized as emergency and general IoVs. The proposed cooperative protocol is validated by numerical analyses which show that the protocol successfully increases the system throughput and decreases PDR and delay. On the other hand, the authentication protocol requires minimum storage as well as generates low computational overhead that is suitable for the IoVs with limited computer resources

Synthetic matrix enhances transplanted satellite cell engraftment in dystrophic and aged skeletal muscle with comorbid trauma

Muscle satellite cells (MuSCs) play a central role in muscle regeneration, but their quantity and function decline with comorbidity of trauma, aging, and muscle diseases. Although transplantation of MuSCs in traumatically injured muscle in the comorbid context of aging or pathology is a strategy to boost muscle regeneration, an effective cell delivery strategy in these contexts has not been developed. We engineered a synthetic hydrogel-based matrix with optimal mechanical, cell-adhesive, and protease-degradable properties that promotes MuSC survival, proliferation, and differentiation. Furthermore, we establish a biomaterial-mediated cell delivery strategy for treating muscle trauma, where intramuscular injections may not be applicable. Delivery of MuSCs in the engineered matrix significantly improved in vivo cell survival, proliferation, and engraftment in nonirradiated and immunocompetent muscles of aged and dystrophic mice compared to collagen gels and cell-only controls. This platform may be suitable for treating craniofacial and limb muscle trauma, as well as postoperative wounds of elderly and dystrophic patients.Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH under award numbers R21AR072287 (to Y.C.J.) and R01AR062368 (to A.J.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was also funded by the Parker H. Petit Institute for Bioengineering and Bioscience Seed Grant Program (to A.J.G. and Y.C.J.)

Synthetic matrix enhances transplanted satellite cell engraftment in dystrophic and aged skeletal muscle with comorbid trauma

Muscle satellite cells (MuSCs) play a central role in muscle regeneration, but their quantity and function decline with comorbidity of trauma, aging, and muscle diseases. Although transplantation of MuSCs in traumatically injured muscle in the comorbid context of aging or pathology is a strategy to boost muscle regeneration, an effective cell delivery strategy in these contexts has not been developed. We engineered a synthetic hydrogel-based matrix with optimal mechanical, cell-adhesive, and protease-degradable properties that promotes MuSC survival, proliferation, and differentiation. Furthermore, we establish a biomaterial-mediated cell delivery strategy for treating muscle trauma, where intramuscular injections may not be applicable. Delivery of MuSCs in the engineered matrix significantly improved in vivo cell survival, proliferation, and engraftment in nonirradiated and immunocompetent muscles of aged and dystrophic mice compared to collagen gels and cell-only controls. This platform may be suitable for treating craniofacial and limb muscle trauma, as well as postoperative wounds of elderly and dystrophic patients.Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH under award numbers R21AR072287 (to Y.C.J.) and R01AR062368 (to A.J.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This work was also funded by the Parker H. Petit Institute for Bioengineering and Bioscience Seed Grant Program (to A.J.G. and Y.C.J.)

Using Computer Simulation for Reducing the Appointment Lead-Time in a Public Pediatric Outpatient Department

Pediatric outpatient departments aim to provide a pleasant, effective and continuing care to children. However, a problem in these units is the long waiting time for children to receive an appointment. Prolonged appointment lead-time remains a global challenge since it results in delayed diagnosis and treatment causing increased morbidity and dissatisfaction. Additionally, it leads to an increased number of hospitalization and emergency department visits which augments the financial burden faced by healthcare systems. Despite these considerations, the studies directly concentrating on the reduction of appointment lead-time in these departments are largely limited. Therefore, this paper proposes the application of Discrete-event Simulation (DES) approach to evaluate potential improvement strategies aiming at reducing average appointment lead-time. Initially, the outpatient department is characterized to effectively identify the main activities, process variables, interactions, and system constraints. After data collection, input analysis is conducted through intra-variable independence, homogeneity and goodness-of-fit tests followed by the creation of a simulation model representing the real pediatric outpatient department. Then, Mann-Whitney tests are used to prove whether the model was statistically comparable with the real-world system. After this, the outpatient department performance is assessed in terms of average appointment lead-time and resource utilization. Finally, three improvement scenarios are assessed technically and financially, to determine if they are viable for implementation. A case study of a mixed-patient type environment in a public pediatric outpatient department has been explored to validate the proposed methodology. Statistical tests demonstrate that appointment lead-time in pediatric outpatient departments may be meaningfully minimized using this approach. © 2019, Springer Nature Switzerland AG

Local structure study of In_xGa_(1-x)As semiconductor alloys using High Energy Synchrotron X-ray Diffraction

Nearest and higher neighbor distances as well as bond length distributions (static and thermal) of the In_xGa_(1-x)As (0<x<1) semiconductor alloys have been obtained from high real-space resolution atomic pair distribution functions (PDFs). Using this structural information, we modeled the local atomic displacements in In_xGa_(1-x)As alloys. From a supercell model based on the Kirkwood potential, we obtained 3-D As and (In,Ga) ensemble averaged probability distributions. This clearly shows that As atom displacements are highly directional and can be represented as a combination of and displacements. Examination of the Kirkwood model indicates that the standard deviation (sigma) of the static disorder on the (In,Ga) sublattice is around 60% of the value on the As sublattice and the (In,Ga) atomic displacements are much more isotropic than those on the As sublattice. The single crystal diffuse scattering calculated from the Kirkwood model shows that atomic displacements are most strongly correlated along directions.Comment: 10 pages, 12 figure

Negative Thermal Expansion Coefficient of Graphene Measured by Raman Spectroscopy

The thermal expansion coefficient (TEC) of single-layer graphene is estimated with temperature-dependent Raman spectroscopy in the temperature range between 200 and 400 K. It is found to be strongly dependent on temperature but remains negative in the whole temperature range, with a room temperature value of -8.0x10^{-6} K^{-1}. The strain caused by the TEC mismatch between graphene and the substrate plays a crucial role in determining the physical properties of graphene, and hence its effect must be accounted for in the interpretation of experimental data taken at cryogenic or elevated temperatures.Comment: 17 pagese, 3 figures, and supporting information (4 pages, 3 figures); Nano Letters, 201

Micro-Electro-Mechanical-Systems (MEMS) and Fluid Flows

The micromachining technology that emerged in the late 1980s can provide micron-sized sensors and actuators. These micro transducers are able to be integrated with signal conditioning and processing circuitry to form micro-electro-mechanical-systems (MEMS) that can perform real-time distributed control. This capability opens up a new territory for flow control research. On the other hand, surface effects dominate the fluid flowing through these miniature mechanical devices because of the large surface-to-volume ratio in micron-scale configurations. We need to reexamine the surface forces in the momentum equation. Owing to their smallness, gas flows experience large Knudsen numbers, and therefore boundary conditions need to be modified. Besides being an enabling technology, MEMS also provide many challenges for fundamental flow-science research