Comparison of circuit patency and exchange rates between the original and generic versions of nafamostat mesylate in critically ill adults receiving continuous renal replacement therapy

Background Nafamostat mesylate is widely used as an anticoagulant in continuous renal replacement therapy (CRRT). The generic versions of nafamostat mesylate have identical main components to the original product. However, it is questionable whether the generic versions have the same efficacy as the original. Therefore, we compared the circuit patency and exchange rates of the original nafamostat mesylate and a generic version to determine which is more efficient as an anticoagulant in CRRT. Methods This retrospective study enrolled 1,255 patients hospitalized to receive CRRT who received the original version of nafamostat mesylate or a generic version between January 2010 and July 2018. We evaluated the filter lifespan, number of filters used per day, mean blood flow, and transmembrane pressure (TMP). Results The mean filter lifespan was 36.3±15.1 hours in the original product group and 22.2±16.2 hours in the generic product group, which was not a statistically significant difference (p=0.060). The mean TMP was 62.2±47.3 mmHg in the original product group and 74.5±45.6 mmHg in the generic product group (p=0.045). Conclusions This retrospective study suggests no meaningful difference in filter lifespan between the original and generic versions of nafamostat mesylate. However, TMP was lower in the original product group than in the generic product group

Development of Machine Learning Models Predicting Estimated Blood Loss during Liver Transplant Surgery

The incidence of major hemorrhage and transfusion during liver transplantation has decreased significantly over the past decade, but major bleeding remains a common expectation. Massive intraoperative hemorrhage during liver transplantation can lead to mortality or reoperation. This study aimed to develop machine learning models for the prediction of massive hemorrhage and a scoring system which is applicable to new patients. Data were retrospectively collected from patients aged >18 years who had undergone liver transplantation. These data included emergency information, donor information, demographic data, preoperative laboratory data, the etiology of hepatic failure, the Model for End-stage Liver Disease (MELD) score, surgical history, antiplatelet therapy, continuous renal replacement therapy (CRRT), the preoperative dose of vasopressor, and the estimated blood loss (EBL) during surgery. The logistic regression model was one of the best-performing machine learning models. The most important factors for the prediction of massive hemorrhage were the disease etiology, activated partial thromboplastin time (aPTT), operation duration, body temperature, MELD score, mean arterial pressure, serum creatinine, and pulse pressure. The risk-scoring system was developed using the odds ratios of these factors from the logistic model. The risk-scoring system showed good prediction performance and calibration (AUROC: 0.775, AUPR: 0.753)

Potential and Environmental Impacts of Liquid Biofuel from Agricultural Residues in Thailand

In this study, various national strategies and programs are described by planning instruments. The TIEB (Thailand Integrated Energy Blueprint), which includes six programs (AEDP, PDP, EEDP, ODP, GDP, REDP), aims to regulate renewable energy and improve the use of biofuel. In addition, the potential of second-generation biofuels is estimated with different residue extractions of second-generation biomasses: 20% (scenario 1), 44% (scenario 2), and 66% (scenario 3). Based on the production potentials that were estimated, CO2 will decrease 1.3–3.5 megatons in the gasoline sector, and 1.4–3.8 megatons in the diesel sector under scenario 1. In scenario 2, we estimated decreases of 2.8–7.7 mega tons and 3.2–8.4 mega tons of CO2 for the gasoline and diesel sectors, respectively. Finally, scenario 3 is expected to reduce the CO2 concentration by 4.2–11.6 megatons in the gasoline sector, and by 4.7–12.6 megatons in the diesel sector. We also estimate the economic potential of a second-generation biofuel with the view of emissions trading. For bioethanol and biodiesel, respectively, 27–74 million USD and 30–81 million USD could be realized in scenario 1, 60–163 million USD and 67–178 million USD in scenario 2, and 90–244 million USD and 100–267 million USD in scenario 3. We conclude that the future potential of second-generation biofuels in Thailand is optimistic, and that they can provide both environmental and economic benefits to the country

Multi-hazard exposure mapping under climate crisis using random forest algorithm for the Kalimantan Islands, Indonesia

Abstract Numerous natural disasters that threaten people’s lives and property occur in Indonesia. Climate change-induced temperature increases are expected to affect the frequency of natural hazards in the future and pose more risks. This study examines the consequences of droughts and forest fires on the Indonesian island of Kalimantan. We first create maps showing the eleven contributing factors that have the greatest impact on forest fires and droughts related to the climate, topography, anthropogenic, and vegetation. Next, we used RF to create single and multi-risk maps for forest fires and droughts in Kalimantan Island. Finally, using the Coupled Model Intercomparison Project (CMIP6) integrated evaluation model, a future climate scenario was applied to predict multiple risk maps for RCP-SSP2-4.5 and RCP-SSP5-8.5 in 2040–2059 and 2080–2099. The probability of a 22.6% drought and a 21.7% forest fire were anticipated to have an influence on the study’s findings, and 2.6% of the sites looked at were predicted to be affected by both hazards. Both RCP-SSP2-4.5 and RCP-SSP5-8.5 have an increase in these hazards projected for them. Researchers and stakeholders may use these findings to assess risks under various mitigation strategies and estimate the spatial behavior of such forest fire and drought occurrences

Synergy of tensile strength-ductility in IN718/CoCrFeMnNi/IN718 multi-material processed by powder high-pressure torsion and annealing

© 2022 Acta Materialia Inc.Materials manufactured through conventional powder metallurgy (PM) techniques generally exhibit inferior tensile properties due to structural defects. Nevertheless, a recently proposed cold-consolidation technique using powder high-pressure torsion represents well-manufactured structures with ultra-high tensile properties in the absence of cracks or pores. This novel PM-based technique is utilized in the present investigation to fabricate a multi-material Inconel 718/CoCrFeMnNi/Inconel 718 layered structure. By a combination of uttermost high densification, ultra-fine-grained microstructure, and hetero-deformation induced strengthening effect, the present cold-consolidated multi-material exhibits tensile properties with yield strength of 1255.4 MPa, uniform elongation of 13.7%, and total elongation of 25.0%, overcoming monolithic Inconel 718 and CoCrFeMnNi systems. These findings shed light on the capability of the cold-consolidation technique to manufacture multi-layered and gradient multi-functional structures with excellent mechanical response under tensile stress.11Nsciescopu

Hierarchically heterogeneous microstructure and mechanical behavior of the multi-materials prepared by powder severe plastic deformation

A heterostructuring strategy is an effective approach for abiding problems referred to as the strength-ductility trade-off. However, tailoring the heterostructure is an arduous problem. This work synthesized hierarchically heterogeneity by combining the eutectic high-entropy alloy (EHEA) and medium-entropy alloy powders through novel powder metallurgy-based severe plastic deformation (P-SPD). EHEA forms nano-scaled heterogeneity composed of FCC and B2, and the mixture of powder types forms micro-scale heterogeneity with hard and soft domains. This hierarchically heterogeneous microstructure leads to strong hetero-deformation-induced strengthening, achieving a yield strength of ∼1.5 GPa. The present P-SPD represents the feasibility of heterostructuring, aiding the development of HEAs