Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers

Rational & Objective A key aspect of smooth transition to dialysis is the timely creation of a permanent access. Despite early referral to kidney care, initiation onto dialysis is still suboptimal for many patients, which has clinical and cost implications. This study aimed to explore perspectives of various stakeholders on barriers to timely access creation. Study Design Qualitative study. Setting & Participants Semi-structured interviews with 96 participants (response rate, 67%), including patients with stage 4 chronic kidney disease (n = 30), new hemodialysis patients with (n = 18) and without (n = 20) permanent access (arteriovenous fistula), family members (n = 19), and kidney health care providers (n = 9). Analytical Approach Thematic analysis. Results Patients reported differential levels of behavioral activation toward access creation: avoidance/denial, wait and see, or active intention. 6 core themes were identified: (1) lack of symptoms, (2) dialysis fear and practical concerns (exaggerated fear, pain, cost, lifestyle disruptions, work-related concerns, burdening their families), (3) evaluating value against costs/risks of access creation (benefits, threat of operation, viability, prompt for early initiation), (4) preference for alternatives, (5) social influences (hearsay, family involvement, experiences of others), and (6) health care provider interactions (mistrust, interpersonal tension, lack of clarity on information). Themes were common to all groups, whereas nuanced perspectives of family members and health care providers were noted in some subthemes. Limitations Response bias. Conclusions Individual, interpersonal, and psychosocial factors compromise dialysis preparation and contribute to suboptimal dialysis initiation. Our findings support the need for interventions to improve patient and family engagement and address emotional concerns and misperceptions about preparing for dialysis

Development of PAN (personal area network) for Mobile Robot Using Bluetooth Transceiver

In recent years, wireless applications using radio frequency (RF) have been rapidly evolving in personal computing and communications devices. Bluetooth technology was created to replace the cables used on mobile devices. Bluetooth is an open specification and encompasses a simple low-cost, low power solution for integration into devices. This research work aim was to provide a PAN (personal area network) for computer based mobile robot that supports real-time control of four mobile robots from a host mobile robot. With ad hoc topology, mobile robots may request and establish a connection when it is within the range or terminated the connection when it leaves the area. A system that contains both hardware and software is designed to enable the robots to participate in multi-agent robotics system (MARS). Computer based mobile robot provide operating system that enabled development of wireless connection via IP address

Chemical Raman Enhancement of Organic Adsorbates on Metal Surfaces

Using a combination of first-principles theory and experiments, we provide a quantitative explanation for chemical contributions to surface-enhanced Raman spectroscopy for a well-studied organic molecule, benzene thiol, chemisorbed on planar Au(111) surfaces. With density functional theory calculations of the static Raman tensor, we demonstrate and quantify a strong mode-dependent modification of benzene thiol Raman spectra by Au substrates. Raman active modes with the largest enhancements result from stronger contributions from Au to their electron-vibron coupling, as quantified through a deformation potential, a well-defined property of each vibrational mode. A straightforward and general analysis is introduced that allows extraction of chemical enhancement from experiments for specific vibrational modes; measured values are in excellent agreement with our calculations.Comment: 5 pages, 4 figures and Supplementary material included as ancillary fil

Dynamics of axial separation in long rotating drums

We propose a continuum description for the axial separation of granular materials in a long rotating drum. The model, operating with two local variables, concentration difference and the dynamic angle of repose, describes both initial transient traveling wave dynamics and long-term segregation of the binary mixture. Segregation proceeds through ultra-slow logarithmic coarsening.Comment: 4 pages, 3 Postscript figures; submitted to PR

Exact Inference on Gaussian Graphical Models of Arbitrary Topology using Path-Sums

We present the path-sum formulation for exact statistical inference of marginals on Gaussian graphical models of arbitrary topology. The path-sum formulation gives the covariance between each pair of variables as a branched continued fraction of finite depth and breadth. Our method originates from the closed-form resummation of infinite families of terms of the walk-sum representation of the covariance matrix. We prove that the path-sum formulation always exists for models whose covariance matrix is positive definite: i.e.~it is valid for both walk-summable and non-walk-summable graphical models of arbitrary topology. We show that for graphical models on trees the path-sum formulation is equivalent to Gaussian belief propagation. We also recover, as a corollary, an existing result that uses determinants to calculate the covariance matrix. We show that the path-sum formulation formulation is valid for arbitrary partitions of the inverse covariance matrix. We give detailed examples demonstrating our results

Odorant Inhibition in Mosquito Olfaction.

How chemical signals are integrated at the peripheral sensory system of insects is still an enigma. Here we show that when coexpressed with Orco in Xenopus oocytes, an odorant receptor from the southern house mosquito, CquiOR32, generated inward (regular) currents when challenged with cyclohexanone and methyl salicylate, whereas eucalyptol and fenchone elicited inhibitory (upward) currents. Responses of CquiOR32-CquiOrco-expressing oocytes to odorants were reduced in a dose-dependent fashion by coapplication of inhibitors. This intrareceptor inhibition was also manifested in vivo in fruit flies expressing the mosquito receptor CquiOR32, as well in neurons on the antennae of the southern house mosquito. Likewise, an orthologue from the yellow fever mosquito, AaegOR71, showed intrareceptor inhibition in the Xenopus oocyte recording system and corresponding inhibition in antennal neurons. Inhibition was also manifested in mosquito behavior. Blood-seeking females were repelled by methyl salicylate, but repellence was significantly reduced when methyl salicylate was coapplied with eucalyptol

Laser-based three-dimensional manufacturing technologies for rechargeable batteries.

Laser three-dimensional (3D) manufacturing technologies have gained substantial attention to fabricate 3D structured electrochemical rechargeable batteries. Laser 3D manufacturing techniques offer excellent 3D microstructure controllability, good design flexibility, process simplicity, and high energy and cost efficiencies, which are beneficial for rechargeable battery cell manufacturing. In this review, notable progress in development of the rechargeable battery cells via laser 3D manufacturing techniques is introduced and discussed. The basic concepts and remarkable achievements of four representative laser 3D manufacturing techniques such as selective laser sintering (or melting) techniques, direct laser writing for graphene-based electrodes, laser-induced forward transfer technique and laser ablation subtractive manufacturing are highlighted. Finally, major challenges and prospects of the laser 3D manufacturing technologies for battery cell manufacturing will be provided

On-Demand Power Source for Medical Electronic Implants: Acousto-Mechanical Vibrations from Human Vocal Folds

For use in vibration-driven power generation, we have quantitatively characterized the acousto-mechanical vibrations that propagate from the human vocal folds through the neck and head along the skeletal frames. We have used five MEMS accelerometers to characterize the acousto-mechanical vibrations present in various situations. The acousto-mechanical vibrations excite vibration-driven energy harvesters at their resonance frequencies between 90-300 Hz and generate up to 0.15 mW/cm^3 on demand

Diamagnetically Levitated MEMS Accelerometers

We introduce the theory and a proof-of-concept design for MEMS-based, diamagnetically-levitated accelerometers. The theory includes an equation for determining the diamagnetic force above a checkerboard configuration of magnets. We demonstrate both electronic probing and a rapid MEMS-based interferometer technique for position sensing of the proof mass. Through a proof-of-concept design, we show electrostatic-measurement sensitivity achieving 34 μg at a 0.1 V sense signal and interferometer-measurement sensitivity achieving 6 μg for in-plane vibrations at 5 Hz. We conclude by outlining batch-fabrication steps to produce levitated accelerometers

Traveling Granular Segregation Patterns in a Long Drum Mixer

Mixtures of granular media often exhibit size segregation along the axis of a partially-filled, horizontal, rotating cylinder. Previous experiments have observed axial bands of segregation that grow from concentration fluctuations and merge in a manner analogous to spinodal decomposition. We have observed that a new dynamical state precedes this effect in certain mixtures: bi-directional traveling waves. By preparing initial conditions, we found that the wave speed decreased with wavelength. Such waves appear to be inconsistent with simple PDE models which are first order in time.Comment: 11 page