Silent lupus nephritis: a case report

Systemic lupus erythematosus (SLE) is a multiorgan acquired autoimmune disease. The clinical picture can vary greatly. Lupus nephritis (LN), which affects about 50% of SLE patients, is associated with high morbidity and death. While renal histologic alterations are evident in almost all patients with SLE, clinical renal involvement only affects 40% to 75% of those individuals. Because of this, some patients who have nephritis on their renal biopsy may not actually have clinical kidney disease (silent nephritis). In this article, we discuss a case of silent lupus nephritis (SLN) with respect to clinical presentation, laboratory findings, diagnosis and outcome

NEEM BIODIESEL: AN ALTERNATIVE FUEL

Objective: Fossil fuels are a major source of energy in today’s world but due to the limited availability of fossil fuels and its harmful emissions, it is now very important to shift our focus toward other sources of energy. Biofuels can help us meet this energy requirement. This study is aimed at producing neem biodiesel from neem oil by “transesterification process” using sodium hydroxide (NaOH) and studying its various fuel properties. Methods: First, extraction was done to produce neem oil from its seeds. Free fatty acid content was reduced and transesterification reaction was carried out at temperature of around 55–65°C in the presence of alkali catalyst, NaOH to produce neem biodiesel. Properties of biodiesel produced such as viscosity and flash point were then determined using redwood viscometer, Abel-Pensky apparatus, and their respective methods for other properties. Results: Produced neem biodiesel showed higher pour point than that of conventional diesel. Viscosity of neem oil was much higher than standards and was greatly reduced when converted to biodiesel using transesterification and biodiesel showed kinematic viscosity of 5.2 cSt at 35°C. Conclusion: Neem biodiesel produced has many fuel properties close to that of conventional diesel. Furthermore, the biodegradable, non-toxic nature of biodiesel is another reason for considering it as an alternative fuel. As we cannot directly use neem oil in diesel engine due to its high viscosity, so it is needed to convert it into biodiesel so that its properties become comparable to the conventional diesel

Microgravity induces overconfidence in perceptual decision-making

Does gravity affect decision-making? This question comes into sharp focus as plans for interplanetary human space missions solidify. In the framework of Bayesian brain theories, gravity encapsulates a strong prior, anchoring agents to a reference frame via the vestibular system, informing their decisions and possibly their integration of uncertainty. What happens when such a strong prior is altered? We address this question using a self-motion estimation task in a space analog environment under conditions of altered gravity. Two participants were cast as remote drone operators orbiting Mars in a virtual reality environment on board a parabolic flight, where both hyper- and microgravity conditions were induced. From a first-person perspective, participants viewed a drone exiting a cave and had to first predict a collision and then provide a confidence estimate of their response. We evoked uncertainty in the task by manipulating the motion's trajectory angle. Post-decision subjective confidence reports were negatively predicted by stimulus uncertainty, as expected. Uncertainty alone did not impact overt behavioral responses (performance, choice) differentially across gravity conditions. However microgravity predicted higher subjective confidence, especially in interaction with stimulus uncertainty. These results suggest that variables relating to uncertainty affect decision-making distinctly in microgravity, highlighting the possible need for automatized, compensatory mechanisms when considering human factors in space research.Comment: 12 pages, 10 figure

Assessing the Burden of Unnecessary Central Venous Catheters in Patients on Medical-Surgical Floors

Project goals: Our project goals are to: a) assess the burden of unnecessary PICCs and other non-tunneled central lines on med-surg units at TJUH and b) understand the underlying reasons behind the problem. In the first phase of our project we conducted an audit of med-surg unit PICCs and other non-tunneled central lines with the goal of obtaining a rough estimate of the number of line days that are unnecessary. SMART AIM By December 31, 2017, the TJUH medical-surgical floors will reduce the number of unnecessary PICC lines by 30%.https://jdc.jefferson.edu/patientsafetyposters/1024/thumbnail.jp

Distributed State Estimation For Smarter Electric Power Grids

The focus of this thesis is to design and implement distributed and decentralized state estimation (SE) algorithms for smart Electric Power Grids (EPGs). These algorithms are applied to two different types of EPGs: 1) modern, deregulated transmission networks that include advanced wide-area monitoring systems, and; 2) smart distribution networks with high penetration of distributed and renewable generation (DG) configured of microgrids. Microgrids are capable of cutting off from the main grid and operating autonomously in the islanded mode of operation in case of emergency situations. SE in such systems is complex because of highly non-linear system dynamics, slow and corrupted measurement updates, as well as the sheer computational complexity of the estimation algorithms. The contribution of this thesis is to explore the design and implementation of a reduced-order, distributed particle filter for state estimation in EPGs. Knowledge of the EPG state is necessary for EPG control, optimization, and emergency troubleshooting

Distributed Communication and Control Frameworks for Smart Grids using the Internet of Things and Blockchain Technology

Smart distribution grids (SDGs) are power systems that harness distributed energy resources (DERs) to increase their operational efficiency and sustainability. However, the uncontrolled operation of DERs lead to operational challenges, resulting in transformer overload and voltage violations. Distribution system operators (DSOs) are responsible for preventing such issues, however, DERs are typically owned by agents such as homeowners and private enterprises, whose motivations revolve around financial incentives and maximizing operational convenience, which do not always align with the DSO's objectives. Thus, new communication and control frameworks are required to coordinate the actions of agents and DSOs to deliver mutually beneficial results. The architectures of these frameworks should be distributed to avoid unilateral authority, and auditable to alleviate any trust issues between participants. Thus, this thesis develops distributed communication and control frameworks for SDGs that are built upon modern communication technologies such as the Internet of Things (IoT), and blockchains, both of which provide architectures that are distributed. The proposed control strategies of this thesis are inspired from principles related to transactive energy systems (TES), where distributed control techniques are combined with economically oriented decision making to improve overall energy efficiency. Accordingly, this thesis proposes three new frameworks, and validates their efficacy using both simulated and real-world experiments at a microgrid in Vaughan, Ontario. First, a fully distributed communication framework (DCF) is proposed for agent messaging, which is built upon the IoT-based framework known as Data Distribution Service (DDS). The DCF provides 1000 messages/second at 36 millisecond latency, and also enhances the efficacy of agents in resolving voltage violations in real-time at the microgrid. Second, a blockchain-based TES is proposed to enable agents to bid for voltage regulation services, where smart contracts enable multiple violations to be resolved in parallel, leading to less bidding cycles. Third, a blockchain-based residential energy trading system (RETS) is proposed , which enables residential communities and DSOs to participate in peer to peer energy trading and demand response. The RETS reduces the peak demand of the community by 48 kW (62%), which leads to an average savings of $1.02 M for the DSO by avoiding transformer upgrades

Successful Percutaneous Left Atrial Appendage Closure in the Presence of a Nonobstructive Appendage Membrane.

• LAA membranes are rare and usually diagnosed incidentally on TEE. • A thorough TEE assessment is needed to distinguish LAA membranes from other entities. • The clinical significance of LAA membranes and association with stroke are unclear. • The presence of an LAA membrane may affect placement of an LAA occlusion device