Early peri-operative hyperglycaemia and renal allograft rejection in patients without diabetes

BACKGROUND: Patients with diabetes have an increased risk for allograft rejection, possibly related to peri-operative hyperglycaemia. Hyperglycaemia is also common following transplantation in patients without diabetes. We hypothesise that exposure of allograft tissue to hyperglycaemia could influence the risk for rejection in any patient with high sugars. To investigate the relationship of peri-operative glucose control to acute rejection in renal transplant patients without diabetes, all patients receiving their first cadaveric graft in a single center were surveyed and patients without diabetes receiving cyclosporin-based immunosuppression were reviewed (n = 230). Records of the plasma blood glucose concentration following surgery and transplant variables pertaining to allograft rejection were obtained. All variables suggestive of association were entered into multivariate logistic regression analysis, their significance analysed and modeled. RESULTS: Hyperglycaemia (>8.0 mmol/L) occurs in over 73% of non-diabetic patients following surgery. Glycaemic control immediately following renal transplantation independently predicted acute rejection (Odds ratio=1.08). 42% of patients with a glucose < 8.0 mmol/L following surgery developed rejection compared to 71% of patients who had a serum glucose above this level. Hyperglycaemia was not associated with any delay of graft function. CONCLUSION: Hyperglycaemia is associated with an increased risk for allograft rejection. This is consistent with similar findings in patients with diabetes. We hypothesise a causal link concordant with epidemiological and in vitro evidence and propose further clinical research

Usual Primary Care Provider Characteristics of a Patient-Centered Medical Home and Mental Health Service Use

BACKGROUND: The benefits of the patient-centered medical home (PCMH) over and above that of a usual source of medical care have yet to be determined, particularly for adults with mental health disorders. OBJECTIVE: To examine qualities of a usual provider that align with PCMH goals of access, comprehensiveness, and patient-centered care, and to determine whether PCMH qualities in a usual provider are associated with the use of mental health services (MHS). DESIGN: Using national data from the Medical Expenditure Panel Survey, we conducted a lagged cross-sectional study of MHS use subsequent to participant reports of psychological distress and usual provider and practice characteristics. PARTICIPANTS: A total of 2,358 adults, aged 18–64 years, met the criteria for serious psychological distress and reported on their usual provider and practice characteristics. MAIN MEASURES: We defined “usual provider” as a primary care provider/practice, and “PCMH provider” as a usual provider that delivered accessible, comprehensive, patient-centered care as determined by patient self-reporting. The dependent variable, MHS, included self-reported mental health visits to a primary care provider or mental health specialist, counseling, and psychiatric medication treatment over a period of 1 year. RESULTS: Participants with a usual provider were significantly more likely than those with no usual provider to have experienced a primary care mental health visit (marginal effect [ME] = 8.5, 95 % CI = 3.2–13.8) and to have received psychiatric medication (ME = 15.5, 95 % CI = 9.4–21.5). Participants with a PCMH were additionally more likely than those with no usual provider to visit a mental health specialist (ME = 7.6, 95 % CI = 0.7–14.4) and receive mental health counseling (ME = 8.5, 95 % CI = 1.5–15.6). Among those who reported having had any type of mental health visit, participants with a PCMH were more likely to have received mental health counseling than those with only a usual provider (ME = 10.0, 95 % CI = 1.0–19.0). CONCLUSIONS: Access to a usual provider is associated with increased receipt of needed MHS. Patients who have a usual provider with PCMH qualities are more likely to receive mental health counseling

In-process monitoring for Electron Beam Additive Manufacturing using an infrared camera system

Additive Manufacturing (AM) is being embraced at a rapid rate, mainly due to its advantages over conventional machining. These include the possibility to create parts with complex geometries, while minimizing waste. The exponential growth of the technology has brought about challenges in quality assurance, which has proved a key barrier to large scale adoption. Developing in-process monitoring techniques for AM is an ongoing challenge, and is still a long way off from the more established techniques developed for conventional machining. Previous research has brought about instances, where the technology has been implemented, with the focus on titanium alloys. This study aims to contribute to the research being carried out within in-process monitoring, and focusses on the Electron Beam Melting (EBM) process. The material being monitored is Inconel 625, to increase the scope of research to higher temperature ranges. The most suitable monitoring technology and vendor for the equipment, is narrowed down through a review of previous literature and market research. Experimental trials to analyze the performance of the monitoring technique with Inconel 625 are carried out. The extracted data is then analyzed using image processing, which gives interesting results with regards to temperature fluctuations over successive layers of the build. The events within the build process for a layer, show interesting deviations in temperature, which are mapped and presented as graphs. The after-rake event, shows a particularly large deviation, which is then attributed to differential heating of the metal powder during the rake phase. This observation is supported by noticing ‘cold-spots’ in extracted images of the build. The results are discussed, and future scope for the study is conveyed. The intention of this study is to provide a base for further research into in-process monitoring for higher temperature ranges and contribute to the development of real-time process monitoring for AM.“Additive manufacturing” (AM) eller “friformsframställning” har snabbt ökat i omfattning, främst tack vare dess fördelar jämfört med konventionell bearbetning. Fördelarna inkluderar möjligheten att tillverka delar med komplexa geometrier medan slöseri minimeras. Den exponentiella tillväxten av tekniken har medfört utmaningar inom kvalitetssäkring, vilket har visat sig vara ett hinder för storskalig anpassning.  Utveckling av processövervakningstekniker för AM är en pågående utmaning, och ligger efter i utveckling jämfört med de mer etablerade teknikerna som utvecklats för konventionell bearbetning. Tidigare forskning har visat fall där tekniken har implementerats med fokus på titanlegeringar. Denna studie syftar till att bidra till den forskning som genomförs inom processövervakning och fokuserar på EBM-processen (Electronic Beam Melting). Materialet som övervakas är Inconel 625, för att expandera forskningsområdet till högre temperaturområden. Den mest lämpliga övervakningstekniken och leverantör av utrustning väljs ut genom en gransking av tidigare litteratur och en marknadsundersökning. Experimentella försök för att analysera övervakningsteknikens prestanda med Inconel 625 utförs.  De extraherade data analyseras sedan med bildbehandling, vilket ger intressanta resultat med avseende på temperaturfluktuationer över successiva lager av byggobjektet. Händelserna inom byggprocessen för ett lager visar intressanta avvikelser i temperatur, vilka kartläggs och presenteras som grafer. Tillståndet efter räfsning visar en särskilt stor avvikelse, som sedan tillskrivs differentialvärme av metallpulvret under räfsningsfasen. Denna observation stöds genom att notera "cold-spots" i extraherade bilder av byggobjektet. Resultaten diskuteras och vidare omfång för studien framförs. Avsikten med denna studie är att ta fram en grund för vidare forskning i processövervakning för högre temperaturområden och bidra till utvecklingen av realtidsprocessövervakning för AM

DEGRADATION OF AROMATIC PETROLEUM HYDROCARBONS (BTEX) BY A SOLVENT TOLERANT BACTERIAL CONSORTIUM

Petroleum aromatic hydrocarbons like benzene, toluene, ethyl benzene and xylene, together known as BTEX, has almost the same chemical structure. These aromatic hydrocarbons are released as pollutants in the environment. This work was taken up to develop a solvent tolerant bacterial consortium that could degrade BTEX compounds as they all share a common chemical structure. We have isolated almost 60 different types of bacterial strains from different petroleum contaminated sites. Of these 60 bacterial strains almost 20 microorganisms were screened on the basis of capability to tolerate high concentration of BTEX. Ten different consortia were prepared and the compatibility of the bacterial strains within the consortia was checked by gram staining and BTEX tolerance level. Four successful microbial consortia were selected in which all the bacterial strains concomitantly grew in presence of high concentration of BTEX (10% of toluene, 10% of benzene 5% ethyl benzene and 1 % xylene). Consortium no 2 showed the highest growth rate in presence of BTEX. Degradation of BTEX by consortium no 2 was monitored for 5 days by gradual decrease in the volume of the solvents. The maximum reduction observed was 85% in 5 days. Gas chromatography results also reveal that could completely degrade benzene and ethyl benzene within 48 hours. Almost 90% degradation of toluene and xylene in 48 hours was exhibited by consortium no 2. It could also tolerate and degrade many industrial solvents such as chloroform, DMSO, acetonitrile having a wide range of log P values (0.03 - 3.1). Degradation of aromatic hydrocarbon like BTEX by a solvent tolerant bacterial consortium is greatly significant as it could degrade high concentration of pollutants compared to a bacterium and also reduces the time span of degradation.</jats:p

In-process monitoring for Electron Beam Additive Manufacturing using an infrared camera system

Additive Manufacturing (AM) is being embraced at a rapid rate, mainly due to its advantages over conventional machining. These include the possibility to create parts with complex geometries, while minimizing waste. The exponential growth of the technology has brought about challenges in quality assurance, which has proved a key barrier to large scale adoption. Developing in-process monitoring techniques for AM is an ongoing challenge, and is still a long way off from the more established techniques developed for conventional machining. Previous research has brought about instances, where the technology has been implemented, with the focus on titanium alloys. This study aims to contribute to the research being carried out within in-process monitoring, and focusses on the Electron Beam Melting (EBM) process. The material being monitored is Inconel 625, to increase the scope of research to higher temperature ranges. The most suitable monitoring technology and vendor for the equipment, is narrowed down through a review of previous literature and market research. Experimental trials to analyze the performance of the monitoring technique with Inconel 625 are carried out. The extracted data is then analyzed using image processing, which gives interesting results with regards to temperature fluctuations over successive layers of the build. The events within the build process for a layer, show interesting deviations in temperature, which are mapped and presented as graphs. The after-rake event, shows a particularly large deviation, which is then attributed to differential heating of the metal powder during the rake phase. This observation is supported by noticing ‘cold-spots’ in extracted images of the build. The results are discussed, and future scope for the study is conveyed. The intention of this study is to provide a base for further research into in-process monitoring for higher temperature ranges and contribute to the development of real-time process monitoring for AM.“Additive manufacturing” (AM) eller “friformsframställning” har snabbt ökat i omfattning, främst tack vare dess fördelar jämfört med konventionell bearbetning. Fördelarna inkluderar möjligheten att tillverka delar med komplexa geometrier medan slöseri minimeras. Den exponentiella tillväxten av tekniken har medfört utmaningar inom kvalitetssäkring, vilket har visat sig vara ett hinder för storskalig anpassning.  Utveckling av processövervakningstekniker för AM är en pågående utmaning, och ligger efter i utveckling jämfört med de mer etablerade teknikerna som utvecklats för konventionell bearbetning. Tidigare forskning har visat fall där tekniken har implementerats med fokus på titanlegeringar. Denna studie syftar till att bidra till den forskning som genomförs inom processövervakning och fokuserar på EBM-processen (Electronic Beam Melting). Materialet som övervakas är Inconel 625, för att expandera forskningsområdet till högre temperaturområden. Den mest lämpliga övervakningstekniken och leverantör av utrustning väljs ut genom en gransking av tidigare litteratur och en marknadsundersökning. Experimentella försök för att analysera övervakningsteknikens prestanda med Inconel 625 utförs.  De extraherade data analyseras sedan med bildbehandling, vilket ger intressanta resultat med avseende på temperaturfluktuationer över successiva lager av byggobjektet. Händelserna inom byggprocessen för ett lager visar intressanta avvikelser i temperatur, vilka kartläggs och presenteras som grafer. Tillståndet efter räfsning visar en särskilt stor avvikelse, som sedan tillskrivs differentialvärme av metallpulvret under räfsningsfasen. Denna observation stöds genom att notera "cold-spots" i extraherade bilder av byggobjektet. Resultaten diskuteras och vidare omfång för studien framförs. Avsikten med denna studie är att ta fram en grund för vidare forskning i processövervakning för högre temperaturområden och bidra till utvecklingen av realtidsprocessövervakning för AM

In-process monitoring for Electron Beam Additive Manufacturing using an infrared camera system

Additive Manufacturing (AM) is being embraced at a rapid rate, mainly due to its advantages over conventional machining. These include the possibility to create parts with complex geometries, while minimizing waste. The exponential growth of the technology has brought about challenges in quality assurance, which has proved a key barrier to large scale adoption. Developing in-process monitoring techniques for AM is an ongoing challenge, and is still a long way off from the more established techniques developed for conventional machining. Previous research has brought about instances, where the technology has been implemented, with the focus on titanium alloys. This study aims to contribute to the research being carried out within in-process monitoring, and focusses on the Electron Beam Melting (EBM) process. The material being monitored is Inconel 625, to increase the scope of research to higher temperature ranges. The most suitable monitoring technology and vendor for the equipment, is narrowed down through a review of previous literature and market research. Experimental trials to analyze the performance of the monitoring technique with Inconel 625 are carried out. The extracted data is then analyzed using image processing, which gives interesting results with regards to temperature fluctuations over successive layers of the build. The events within the build process for a layer, show interesting deviations in temperature, which are mapped and presented as graphs. The after-rake event, shows a particularly large deviation, which is then attributed to differential heating of the metal powder during the rake phase. This observation is supported by noticing ‘cold-spots’ in extracted images of the build. The results are discussed, and future scope for the study is conveyed. The intention of this study is to provide a base for further research into in-process monitoring for higher temperature ranges and contribute to the development of real-time process monitoring for AM.“Additive manufacturing” (AM) eller “friformsframställning” har snabbt ökat i omfattning, främst tack vare dess fördelar jämfört med konventionell bearbetning. Fördelarna inkluderar möjligheten att tillverka delar med komplexa geometrier medan slöseri minimeras. Den exponentiella tillväxten av tekniken har medfört utmaningar inom kvalitetssäkring, vilket har visat sig vara ett hinder för storskalig anpassning.  Utveckling av processövervakningstekniker för AM är en pågående utmaning, och ligger efter i utveckling jämfört med de mer etablerade teknikerna som utvecklats för konventionell bearbetning. Tidigare forskning har visat fall där tekniken har implementerats med fokus på titanlegeringar. Denna studie syftar till att bidra till den forskning som genomförs inom processövervakning och fokuserar på EBM-processen (Electronic Beam Melting). Materialet som övervakas är Inconel 625, för att expandera forskningsområdet till högre temperaturområden. Den mest lämpliga övervakningstekniken och leverantör av utrustning väljs ut genom en gransking av tidigare litteratur och en marknadsundersökning. Experimentella försök för att analysera övervakningsteknikens prestanda med Inconel 625 utförs.  De extraherade data analyseras sedan med bildbehandling, vilket ger intressanta resultat med avseende på temperaturfluktuationer över successiva lager av byggobjektet. Händelserna inom byggprocessen för ett lager visar intressanta avvikelser i temperatur, vilka kartläggs och presenteras som grafer. Tillståndet efter räfsning visar en särskilt stor avvikelse, som sedan tillskrivs differentialvärme av metallpulvret under räfsningsfasen. Denna observation stöds genom att notera "cold-spots" i extraherade bilder av byggobjektet. Resultaten diskuteras och vidare omfång för studien framförs. Avsikten med denna studie är att ta fram en grund för vidare forskning i processövervakning för högre temperaturområden och bidra till utvecklingen av realtidsprocessövervakning för AM

DEGRADATION OF AROMATIC PETROLEUM HYDROCARBONS (BTEX) BY A SOLVENT TOLERANT BACTERIAL CONSORTIUM

Petroleum aromatic hydrocarbons like benzene, toluene, ethyl benzene and xylene, together known as BTEX, has almost the same chemical structure. These aromatic hydrocarbons are released as pollutants in the environment. This work was taken up to develop a solvent tolerant bacterial consortium that could degrade BTEX compounds as they all share a common chemical structure. We have isolated almost 60 different types of bacterial strains from different petroleum contaminated sites. Of these 60 bacterial strains almost 20 microorganisms were screened on the basis of capability to tolerate high concentration of BTEX. Ten different consortia were prepared and the compatibility of the bacterial strains within the consortia was checked by gram staining and BTEX tolerance level. Four successful microbial consortia were selected in which all the bacterial strains concomitantly grew in presence of high concentration of BTEX (10% of toluene, 10% of benzene 5% ethyl benzene and 1 % xylene). Consortium no 2 showed the highest growth rate in presence of BTEX. Degradation of BTEX by consortium no 2 was monitored for 5 days by gradual decrease in the volume of the solvents. The maximum reduction observed was 85% in 5 days. Gas chromatography results also reveal that could completely degrade benzene and ethyl benzene within 48 hours. Almost 90% degradation of toluene and xylene in 48 hours was exhibited by consortium no 2. It could also tolerate and degrade many industrial solvents such as chloroform, DMSO, acetonitrile having a wide range of log P values (0.03 - 3.1). Degradation of aromatic hydrocarbon like BTEX by a solvent tolerant bacterial consortium is greatly significant as it could degrade high concentration of pollutants compared to a bacterium and also reduces the time span of degradation.</jats:p

DEGRADATION OF AROMATIC PETROLEUM HYDROCARBONS (BTEX) BY A SOLVENT TOLERANT BACTERIAL CONSORTIUM

Petroleum aromatic hydrocarbons like benzen e, toluene, ethyl benzene and xylene, together known as BTEX, has almost the same chemical structure. These aromatic hydrocarbons are released as pollutants in th e environment. This work was taken up to develop a solvent tolerant bacterial cons ortium that could degrade BTEX compounds as they all share a common chemical structure. We have isolated almost 60 different types of bacterial strains from different petroleum contaminated sites. Of these 60 bacterial strains almost 20 microorganisms were screene d on the basis of capability to tolerate high concentration of BTEX. Ten differe nt consortia were prepared and the compatibility of the bacterial strains within the consortia was checked by gram staining and BTEX tolerance level. Four successful mi crobial consortia were selected in which all the bacterial strains concomitantly grew in presence of high concentration of BTEX (10% of toluene, 10% of benzene 5% ethyl benzene and 1% xylene). Consortium #2 showed the highest growth rate in pr esence of BTEX. Degradation of BTEX by consortium #2 was monitored for 5 days by gradual decrease in the volume of the solvents. The maximum reduction observed wa s 85% in 5 days. Gas chromatography results also reveal that could completely degrade benzene and ethyl benzene within 48 hours. Almost 90% degradation of toluene and xylene in 48 hours was exhibited by consortium #2. It could also tolerate and degrade many industrial solvents such as chloroform, DMSO, acetonitrile having a wide range of log P values (0.03–3.1). Degradation of aromatic hydrocarbon like BTEX by a solvent tolerant bacterial consortium is greatly significant as it could degrade high concentration of pollutants compared to a bacterium and also reduces the time span of degradation