Der Einfluss von Dialysemembranen mit erhöhter Permeabilität auf Inflammation und vaskuläre Verkalkung

Diese Publikationspromotion umfasst drei in internationalen Fachzeitschriften veröffentliche Artikel, die sich mit der Wirkung von Dialysemembranen mit erhöhter Permeabilität auf das Inflammationsniveau und die Gefäßmuskelverkalkung von Dialysepatienten in vitro und in vivo befassen. Der Hauptgrund für die hohe Mortalität von chronischen Dialysepatienten sind die kardiovaskulären Folge- und Begleiterkrankungen, an deren Entstehung proinflammatorische Zytokine beteiligt sind. Herkömmliche High-Flux (HF)-Filter sind nicht ausreichend in der Lage, die chronisch erhöhte Konzentration von proinflammatorischen und prokalzifierenden Zytokinen effektiv zu senken. Als mögliche Lösung für dieses Problem wurden Dialysemembranen mit höherer Permeabilität entwickelt. Diese wurden im Rahmen dieser Promotion auf ihre Fähigkeit zur Senkung von Inflammation und Kalzifizierung sowie später auch im Rahmen einer klinischen Studie, PERCI II, auf ihre Tauglichkeit in der klinischen Praxis getestet. Patientenseren aus der klinische Studie PERCI I, die den klinischen Einsatz von High Cut-Off (HCO)-Membranen untersuchte, wurden im Zellkulturmodell auf ihre kalzifizierenden Eigenschaften geprüft. Während die in vitro Ergebnisse eine reduzierte Kalzifizierung glatter Gefäßmuskelzellen unter HCO-Serum zeigten und VCAM als ein möglicher verantwortlicher Akteur identifiziert werden konnte, war ein hoher Albuminverlust für den klinischen Einsatz dieser Membran limitierend. Um diesem Problem zu begegnen, wurde eine neue Membran (Medium Cut-Off (MCO)-Membran) entworfen, deren Porengröße zwischen HF und HCO liegt. Diese wurde zuerst in einem in vitro-Dialyse-Modell im Hinblick auf ihre IL-6 Clearance und ihre Wirkung auf die Kalzifizierung mit der HCO- und der HF-Membran verglichen. Es zeigte sich, dass beide größerporigen Membranen sowohl eine bessere IL-6 Clearance aufwiesen als auch die Gefäßmuskelkalzifizierung reduzieren konnten. In einer anschließenden, zweiten klinischen Studie, PERCI II, in der die MCO-Membran mit einem HF-Filter verglichen wurde, wurden die in vitro beobachteten Befunde in vivo bestätigt. Nach zwölf Wochen Dialyse mit dem MCO-Filter ließen sich signifikant niedrigere Spiegel von IL-6- und TNFα-mRNA im Serum der Patienten messen. Auch andere wichtige proinflammatorische Zytokine konnten effektiv gesenkt werden. Zudem war der Albuminverlust zwar in den ersten vier Wochen der Studie signifikant, normalisierte sich aber, sodass am Ende der Verlängerungsphase nach zwölf Wochen kein signifikanter Albuminverlust zu verzeichnen war. Die Ergebnisse zeigen, dass Membranen mit höherer Permeabilität die Zytokinzusammensetzung in Dialyseseren verändern und sich damit auch positiv auf das Inflammationsniveau und die Verkalkungsneigung auswirken. Zudem kann die MCO Membran sicher im klinischen Alltag eingesetzt werden. Die vorliegenden Ergebnisse rechtfertigen sowohl weitere klinische Studien mit härteren Endpunkten, als auch eine intensivere Erforschung der Beeinflussung von Inflammation und vaskulärer Verkalkung.This thesis contains three peer-reviewed publications dealing with the influence of dialysis membranes with a higher permeability than conventional High-Flux (HF) filters on inflammation and calcification in dialysis patients in vitro and in vivo. The main causes for mortality in chronic dialysis patients are cardiovascular diseases which are at least partially caused by inflammatory processes. Conventional HF filters do not remove proinflammatory and procalcific cytokines effectively so that they could be responsible for this situation. To address this problem, membranes with a higher cut-off have been developed. In scope of this work, these filters were tested concerning their ability to reduce inflammation and calcification in vitro and also later on in vivo in a clinical trial, PERCI II. Serum for the in vitro experiments came from the PERCI I trial, in which a high cut-off (HCO) membrane was compared to a conventional HF membrane. This serum was examined regarding its procalcific characteristics in a cell culture model with vascular smooth muscle cells (VSMC). While the in vitro results showed a strongly reduced calcification with HCO serum and that VCAM could potentially play a role in this process, the clinical study was limited by a significant loss of albumin during haemodialysis. Therefore, a second membrane with a pore size between HF and HCO has been developed and tested in an in vitro dialysis model, the medium cut-off (MCO) membrane. In this trial, MCO- and HCO-membranes were superior to the HF membrane regarding IL-6 clearance as well as in vitro calficiation. Following these findings, a second clinical trial, PERCI II, was conducted, which proved a significantly lower level of inflammation compared to HF, manifesting in a reduced concentration of mRNA of IL-6, TNFα and other important proinflammatory cytokines. In addition, albumin levels were stable compared to the start of the study after twelve weeks of MCO-dialysis, despite of initial drops after four weeks. In conclusion, this work showed that membranes with a higher cut-off can influence the cytokine profile of dialysis serum and can also ameliorate vascular calcification in vitro. The MCO-membrane has also been evaluated in vivo over a 12-week period and can be used safely. These results encourage further research regarding the in vitro mechanism of vascular calcification as well as clinical trials with membranes with higher permeability

Descodificação através de Machine Learning

In recent years, machine learning has become one of the most rapidly expanding technologies in a variety of technological fields. In general, it allows a computer to learn from data without being expressly designed for a particular purpose. This thesis investigates the application of decoding methods inspired by machine learning to linear block codes, such as Reed-Muller (RM) codes.Recentemente, o Machine Learning tornou-se uma das tecnologias em mais rápida expansão numa variedade de campos tecnológicos. Em geral, permite que um computador aprenda com os dados sem ser expressamente concebido para um fim específico. Esta dissertação investiga a aplicação de métodos de descodificação inspirados no Machine Learning a códigos de blocos lineares, tais como os códigos de Reed-Muller

Survei Sarana Dan Prasaran Pembelajaran Pendidikan Olahraga Pada Sekolah Dasar Negeri Kaligesing Kecamatan Sadang Kabupaten Kebumen Tahun 2023

This study aims to determine the condition of sports education learning facilities and infrastructure in Kaligesing public elementary school. The research method used in this research is descriptive analysis. The results of this study indicate that the existing facilities and infrastructure are inadequate, namely soccer equipment with a percentage of 16%, basketball equipment with a percentage of 33%, gymnastic equipment with a percentage of 40%, while adequate equipment, namely volleyball equipment with a percentage of 66%, athletic equipment with a percentage of 80%

Can we constrain interior structure of rocky exoplanets from mass and radius measurements?

We present an inversion method based on Bayesian analysis to constrain the interior structure of terrestrial exoplanets, in the form of chemical composition of the mantle and core size. Specifically, we identify what parts of the interior structure of terrestrial exoplanets can be determined from observations of mass, radius, and stellar elemental abundances. We perform a full probabilistic inverse analysis to formally account for observational and model uncertainties and obtain confidence regions of interior structure models. This enables us to characterize how model variability depends on data and associated uncertainties. We test our method on terrestrial solar system planets and find that our model predictions are consistent with independent estimates. Furthermore, we apply our method to synthetic exoplanets up to 10 Earth masses and up to 1.7 Earth radii as well as to exoplanet Kepler-36b. Importantly, the inversion strategy proposed here provides a framework for understanding the level of precision required to characterize the interior of exoplanets. Our main conclusions are: (1) observations of mass and radius are sufficient to constrain core size; (2) stellar elemental abundances (Fe, Si, Mg) are key constraints to reduce degeneracy in interior structure models and to constrain mantle composition; (3) the inherent degeneracy in determining interior structure from mass and radius observations does not only depend on measurement accuracies but also on the actual size and density of the exoplanet. We argue that precise observations of stellar elemental abundances are central in order to place constraints on planetary bulk composition and to reduce model degeneracy. [...]Comment: 19 pages, 18 figures, accepted in Astronomy & Astrophysics (no changes to previous version

Flow controlled solvent vapor annealing of block copolymers for lithographic applications

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Materials Science and Engineering, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 185-192).Self-assembly of block copolymer thin-films may provide an inexpensive alternative to patterning lithographic features below the resolution limits of traditional optical methods. Block copolymers (BCPs) are polymers made of two or more distinct monomer/block units that are covalently bonded. Due to their differences in surface energy, the different blocks tend to phase segregate like oil and water; but because of the covalent linkage, this segregation is practically limited to size scales ranging from only a few nm to ~ 100 nm. A thin film of a BCP can be used in much the same way as a photoresist in the lithographic process, whereas a desired pattern morphology can be obtained by etching one block away and leaving behind a self-assembled hard mask for the underlying substrate. After a thin film of BCP is coated onto a given substrate, the BCP must be given an annealing step, where the disordered entangled polymer networks can be allowed to diffuse and equilibrate into lower free energy configurations which result in periodic patterns of micelles with different morphologies such as spheres, in/out of plane cylinders, etc. This work explored the technique of solvent vapor annealing, where organic solvents were allowed to interact with BCP thin films to facilitate annealing and act as surrogates for the different BCP polymer blocks. This allowed for a wide range of control over the BCP self-assembly (morphology, periodicity, etc.) for a given molecular weight BCP. Additionally, by adding heat at critical times during the self-assembly, time scales for solvent vapor enhanced self-assembly could be reduced from hours to seconds making the prospects for this technology to become industrially applicable more promising.by Kevin Willy Gotrik.Ph.D

INTELLIGENT SURVEY AND LIVE-SIMULATION APPARATUS (ISALSA) FOR INDUSTRIAL INTERNET OF THINGS (IIOT) NETWORKING SOLUTIONS

The global Industrial Internet of Things (IIoT) market is expected to reach $949.42 billion by 2025, and will include heavy industrial customers from different areas. For example, utilities, oil & gas, and mining sectors are among those relying on secure and reliable outdoor wireless connectivity in their harsh environments to optimize costs, improve operational efficiency, increase automation, as well as improve the safety and security of high value assets and field employees. Building such networks requires accurate and future proof designs, which are heavily dependent on the quality of results from site surveys performed in these locations. In addition, access to such rugged environments is difficult and can require a series of trainings and certifications. Presented herein are techniques that use a system/apparatus of unmanned aerial vehicles (UAVs) to perform automated site surveys that can be used to produce high level designs for IIoT networking solutions, referred to as an Intelligent Survey and Live-Simulation Apparatus (iSALSA) system. The system can also be used for pre-deployment simulation and validation of access points (APs) to be deployed throughout the intended area, which may have been developed using predictive modeling software. The end result of this solution is a drastic improvement of the safety and security of field engineers and solution architects. The proposed solution also significantly reduces the time required to develop high level designs for large scale implementations. Finally, the solution allows for longer consistent and contiguous sample periods, thus, improving the quality of the data collected

Ingeniería inversa y diseño de la automatización de un dosificador de polvos, utilizando celda de carga a través de microcontrolador atmega para la empresa Jacs

La presente tesis presenta el análisis y rediseño de una dosificadora de polvos, utilizando técnicas de ingeniería inversa y automatización. Para la comprensión de lo que conlleva realizar un proceso de ingeniería inversa se tomó en cuenta los métodos aplicados y publicados por otros ingenieros. A partir de estos se elaboró por un procedimiento para aplicar la ingeniería inversa con el objetivo de estudio una dosificadora de origen extranjero. Después de escoger un método y procedimiento para aplicar la ingeniería inversa, se realizaron los análisis de los sistemas del objetivo de la investigación, empezando por el funcionamiento, análisis físico, análisis electrónico, ventajas y desventajas de cada uno. Posteriormente, se utilizó la información recopilada por el proceso de ingeniería inversa y se comenzó el proceso de rediseño del dosificador, a partir de las sugerencias y posibles mejoras encontradas. Al diseñar se consideró cada uno de los mecanismos usados y se les realizó las mejoras y observaciones de manera individual. En cada uno se desarrolló igualmente, un rediseño mecánico, electrónico y su desarrollo de programa correspondiente. Terminado el proceso de rediseño, se ensambló un prototipo que cumpla como simulador del programa y sus componentes. Para comprobar el funcionamiento se realizaron las siguientes pruebas: 1. Una prueba del control principal del dosificador que además ayudó a asignar los valores de las variables que se usaron. 2. Una prueba para calibrar y preparar el sensor de peso anterior a la simulación. 3. Una prueba para otros componentes, que fueron un servomotor y un sensor CNY70. 4. Una prueba para revisar el orden del programa y su eficacia en la tesis 5. Una prueba general con todos los componentes trabajando simultáneamente Al haberse efectuado la simulación y realizado todas las pruebas, se consideró el rediseño con un resultado exitoso.Tesi

Antecedents of Revisit Intention to Pantjoran PIK During Covid-19 Pandemic

Revisit intention is a very important factor in the sustainability of a business. This study aims to analyze the factors that influence the revisit intention to Pantjoran PIK, North Jakarta. The exogenous variables in this study were environment, culture, and food safety & hygiene. This research is explanatory research that seeks to explain the relationship between exogenous and endogenous variables. The research instrument used was online questionnaire distributed via Google Form. The research method used is quantitative analysis with individual analysis units and the PLS-SEM approach using SMARTPLS 4 software. Sampling technique used was purposive sampling with 160 samples. The measurement model analysis meets the requirements of convergent validity, reliability and discriminant validity. However, in the structural model analysis, only Food Safety & Hygiene had significant influence on Revisit Intention. These findings are in line with similar research during the Covid-19 pandemic although different sampling technique are suggested with longitudinal data to improve accuracy. Food Court and restaurant owners are suggested to maintain the food safety and hygiene to improve revisit intention during Covid-19 pandemic

Enthusiastic Students of Poltekkes Semarang Participated in Self-Body Weight Training in the Covid-19 Era: A Survey Study

Abstract: Sports in the era of covid-19 have become a powerful weapon to maintain psychic and physical health for the public. But the question arises, what kind of exercise is good to do in the era of covid-19? Good exercise certainly exercises improves cardiorespiratory and muscle fitness. But sometimes the understanding of physical activity and exercise is still wrong. Physical activity is synonymous with daily activity while exercise is systemized and structured. In addition, regulating the exercise dose including intensity and volume is one of the problems. The purpose of this study is to provide an understanding of the preparation of exercise programs and analyze the enthusiasm of students to take part in self-body weight training. The research method is a survey, the instrument is a questionnaire, and the participants are 34 students of the Semarang Poltekkes male and female genders. The results that student enthusiasm was 60% very high, 38% high, 32% moderate, 21% low, and 1% very low. In conclusion, most students have a high enthusiasm for participating in training, then students state that they understand the content of the material and can compile an exercise program simply by paying attention to the principles of FITT (frequency, intensity, time, and type)

PERBANDINGAN FIVE YEAR SURVIVAL RATE PENDERITA KARSINOMA NASOFARING PADA MODALITAS KEMOTERAPI DAN KEMORADIASI

Latar belakang: Karsinoma nasofaring (KNF) merupakan karsinoma yang banyak diderita di wilayah Asia Timur dan Asia Tenggara. Penanggulangan KNF saat ini masih merupakan suatu problem, hal ini dikarenakan oleh gejala dini yang tidak khas, serta letak nasofaring yang tersembunyi, sehingga diagnosis sering terlambat. Adapun, angka ketahanan hidup 5 tahun penderita KNF dalam beberapa penelitian cukup bervariasi. Tujuan: Mengetahui tingkat harapan hidup 5 tahun penderita karsinoma nasofaring pada modalitas kemoterapi dan kemoradiasi. Metode: Penelitian dilakukan dengan mengambil data rekam medik 50 penderita karsinoma nasofaring yang pernah diberikan terapi di RSUP Dr. Kariadi Semarang dalam kurun waktu 2011-2014. Metode penelitian yang digunakan adalah historical cohort study untuk menilai harapan hidup 5 tahun. Data diolah dan disajikan dalam tabel distribusi frekuensi, kemudian dilakukan analisis data menggunakan uji Kaplan-Meier. Hasil: Tidak terdapat perbedaan bermakna angka harapan hidup 5 tahun antara penderita yang diberi kemoradiasi dengan penderita yang diberi kemoterapi (p=0,148). Angka ketahanan hidup 5 tahun penderita KNF yang mendapat kemoradiasi sebesar 44% sedangkan angka ketahanan hidup 5 tahun penderita KNF yang mendapat kemoterapi sebesar 28%. Stadium KNF merupakan faktor yang mempengaruhi angka harapan hidup 5 tahun penderita KNF (p=0,036). Kesimpulan: Angka harapan hidup 5 tahun penderita KNF dengan kemoradiasi lebih tinggi daripada kemoterapi. Stadium klinis KNF merupakan faktor yang berpengaruh terhadap harapan hidup 5 tahun penderita KNF. Kata kunci: karsinoma nasofaring, kemoradiasi, kemoterapi, angka harapan hidup 5 tahu