13 research outputs found

    Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

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    Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis

    On the mechanical behaviour of AA 7075-T6 during cyclic loading

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    The mechanical behavior of an aluminum alloy during uniaxial cyclic loading is examined using finite element simulations of aggregates with individually resolved crystals. The aggregates consist of face centered cubic (FCC) crystals with initial orientations assigned by sampling the orientation distribution function (ODF) determined from the measured crystallographic texture. The simulations show that the (elastic) lattice strains within the crystals evolve as the number of cycles increases. This evolution is attributed to the interactions between grains driven by the local plasticity. Under constant amplitude strain cycles, the average (macroscopic) stress decays with increasing number of cycles in concert with the evolution of the lattice strains. Further, the average number of active slip systems also decreases with increasing cycles, eventually reaching zero as the material response becomes totally elastic at the grain level. During much of the cyclic history only a single slip system is activated in most grains. The simulation results are compared to experimental data for the macroscopic stress and for lattice strains in the unloaded state after 1, 30 and 1000 cycles. © 2003 Elsevier Science Ltd. All rights reserved

    Influence of modelling variables on the distribution of lattice strains in a deformed polycrystal, with reference to neutron diffraction experiments

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    The distribution of (elastic) lattice strains following plastic deformation of an aluminium alloy is examined using finite element simulations of aggregates with individually resolved crystals. The aggregates consist of face centred cubic crystals with initial orientations assigned by sampling the measured crystallographic texture. The simulations show that the lattice strains within the crystals are influenced by various microstructural features, material parameters and modelling assumptions. A hierarchy among these various effects is established, based on applications where low probability events are crucial, such as in fatigue or fracture problems. The simulation results are discussed in detail and compared with experimental data for the macroscopic stress, the lattice strains in the unloaded state and the associated uncertainties

    Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

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    In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (p = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (p = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk
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