Improving dialysis adherence for high risk patients using automated messaging: Proof of concept

AbstractComorbidities and socioeconomic barriers often limit patient adherence and self-management with hemodialysis. Missed sessions, often associated with communication barriers, can result in emergency dialysis and avoidable hospitalizations. This proof of concept study explored using a novel digital-messaging platform, EpxDialysis, to improve patient-to-dialysis center communication via widely available text messaging and telephone technology. A randomized controlled trial was conducted through Washington University-affiliated hemodialysis centers involving ESRD patients with poor attendance, defined as missing 2–6 sessions over the preceding 12 weeks. A cross-over study design evaluated appointment adherence between intervention and control groups. Comparing nonadherence rates eight weeks prior to enrollment, median appointment adherence after using the system increased by 75%, and median number of unintended hospitalization days fell by 31%. A conservative cost-benefit analysis of EpxDialysis demonstrates a 1:36 savings ratio from appointment adherence. EpxDialysis is a low-risk, cost-effective, intervention for increasing hemodialysis adherence in high-risk patients, especially at centers caring for vulnerable and low-income patients.</jats:p

Image processing techniques for improved porosity estimation

The work reported here is on the first phase of the development of an automated image analysis package. It is intended that the initial application should be to the problem of porosity estimation in powder metals. Although a great deal of work has been concentrated recently on using ultrasonic velocity changes and attenuation for porosity estimation, the problem can also be addressed through acoustical imaging

Element Abundances at High-redshift: Magellan MIKE Observations of sub-Damped Lyman-alpha Absorbers at 1.7 < z <2.4

We present chemical abundance measurements from high-resolution observations of 5 sub-damped Lyman-alpha absorbers at 1.7 < z < 2.4 observed with the Magellan Inamori Kyocera Echelle (MIKE) spectrograph on the 6.5-m Magellan II Clay telescope. Lines of Zn II, Mg I, Mg II, Al II, Al III, S II, Si II, Si IV, C II, C II*, C IV, Ni II, Mn II and Fe II were detected and column densities were determined. The metallicity of the absorbing gas, inferred from the nearly undepleted element Zn, is in the range of < -0.95 to +0.25 dex for the five absorbers in our sample, with three of the systems being near-solar or super-solar. We also investigate the effect of ionisation on the observed abundances using photoionisation modelling. Combining our data with other sub-DLA and DLA data from the literature, we report the most complete existing determination of the metallicity vs. redshift relation for sub-DLAs and DLAs. We confirm the suggestion from previous investigations that sub-DLAs are, on average, more metal-rich than DLAs and evolve faster. We also discuss relative abundances and abundance ratios in these absorbers. The more metal-rich systems show significant dust depletion levels, as suggested by the ratios [Zn/Cr] and [Zn/Fe]. For the majority of the systems in our sample, the [Mn/Fe] vs. [Zn/H] trend is consistent with that seen previously for lower-redshift sub-DLAs. We also measure the velocity width values for the sub-DLAs in our sample from unsaturated absorption lines of Fe II 2344, 2374, 2600 A, and examine where these systems lie in a plot of metallicity vs. velocity dispersion. Finally, we examine cooling rate vs. H I column density in these sub-DLAs, and compare this with the data from DLAs and the Milky Way ISM. We find that most of the systems in our sample show higher cooling rate values compared to those seen in the DLAs.Comment: Accepted for publication in the Monthly Notices of The Royal Astronomical Societ

Solution of fractional Drinfeld-Sokolov-Wilson equation using Homotopy perturbation transform method

In this article, the approximate solutions of the non-linear Drinfeld-Sokolov-Wilson equation with fractional time derivative have been obtained. The fractional derivative is described in the Caputo sense. He’s polynomial is used to tackle the nonlinearity which arise in our considered problems. A time fractional nonlinear partial differential equation has been computed numerically. The numerical procedures illustrate the effectiveness and reliability of the method. Effects of fractional order time derivatives on the solutions for different particular cases are presented through graphs

Hubble Space Telescope Observations of Sub-Damped Lyman-alpha Absorbers at z < 0.5, and Implications for Galaxy Chemical Evolution

We report observations of four sub-damped Lyman-alpha (sub-DLA) quasar absorbers at z<0.5 obtained with the Hubble Space Telescope Cosmic Origins Spectrograph. We measure the available neutrals or ions of C, N, O, Si, P, S, Ar, Mn, Fe, and/or Ni. Our data have doubled the sub-DLA metallicity samples at z<0.5 and improved constraints on sub-DLA chemical evolution. All four of our sub-DLAs are consistent with near-solar or super-solar metallicities and relatively modest ionization corrections; observations of more lines and detailed modeling will help to verify this. Combining our data with measurements from the literature, we confirm previous suggestions that the N(HI)-weighted mean metallicity of sub-DLAs exceeds that of DLAs at all redshifts studied, even after making ionization corrections for sub-DLAs. The absorber toward PHL 1598 shows significant dust depletion. The absorbers toward PHL 1226 and PKS 0439-433 show the S/P ratio consistent with solar, i.e., they lack a profound odd-even effect. The absorber toward Q0439-433 shows super-solar Mn/Fe. For several sub-DLAs at z<0.5, [N/S] is below the level expected for secondary N production, suggesting a delay in the release of the secondary N or a tertiary N production mechanism. We constrain the electron density using Si II* and C II* absorption. We also report different metallicity vs. Delta V_90 relations for sub-DLAs and DLAs. For two sub-DLAs with detections of emission lines from the underlying galaxies, our measurements of the absorption-line metallicities are consistent with the emission-line metallicities, suggesting that metallicity gradients are not significant in these galaxies.Comment: 77 pages, 13 figures; accepted for publication in the Astrophysical Journal. Submitted (in the original form) May 26, 2014; accepted Apr. 15, 201